Constipation: Causes, Treatment and Warning Signs

Introduction

Constipation is common and often lasts only a short time[2]. It may improve with changes in food, fluid intake, activity, and bathroom habits[2,3,4].

However, some symptoms need medical care[1]. Ongoing constipation may also need a check for another health problem[6,7].

This guide covers constipation causes, treatment, prevention, and when to see a doctor. It also explains safe constipation relief and key warning signs.

Overview: What Constipation Is and How to Recognize It

Constipation is not based only on how often you have a bowel movement. Stool form, pain, straining, and a sense of incomplete emptying also matter[1,7,9].

Common signs and symptoms

Constipation is commonly defined in several ways. It may mean fewer than three bowel movements per week[1,2]. It may also involve hard or dry stools[1,2].

Other common constipation symptoms include:

• Fewer than three bowel movements in one week[1,2].
• Hard, dry, or lumpy stools[1].
• Straining while trying to pass stool[3,9].
• Difficult or painful stool passage[1,2].
• A feeling that some stool remains in the bowel[1,9].
• Bloating or belly pain[3].

A person can be constipated despite having more than three bowel movements each week[7,9]. Hard stools or frequent straining may still point to constipation[7,9]. Trouble passing stool can also be a sign[7,9].

How bowel habits can differ

Bowel habits differ from one person to another[3]. Knowing your usual pattern can help you notice a change[3].

One person may usually pass stool each day. A change to twice a week may be important. Another person may pass stool often but have hard and painful stools.

Changes in stool form or ease of passage may matter as much as frequency[7,9]. New or lasting changes deserve attention[3,9].

Occasional versus chronic constipation

Almost everyone gets constipated at some point[2]. Most cases are brief and not serious[2].

Changes in diet or daily routine can cause short-term symptoms[8]. Travel and reduced activity may also play a role[8].

Long-term constipation is called chronic constipation[7]. Symptoms that last or keep returning may need medical review[6,7]. A clinician may check for a health condition, medicine effect, or bowel problem[6,7,8].

Symptoms and Changes to Monitor

Tracking constipation symptoms can help you judge whether self-care is working. It can also give your clinician useful details during an exam[6].

Write down:

• How often you have a bowel movement.
• Whether the stool is hard, dry, or lumpy.
• How often you need to strain.
• Whether passing stool causes pain.
• Whether you feel empty afterward.
• When your symptoms began.
• Whether the symptoms followed a change in diet.
• Whether you recently changed a medicine or supplement.
• Whether travel or a new routine came before the symptoms.

Hard or difficult stools may be constipation even when bowel movements occur often[7,9]. Knowing your normal pattern can help you spot problems early[3].

Also watch for bleeding, constant pain, vomiting, or fever[1]. An inability to pass gas is another key warning sign[1]. Lower back pain and weight loss without trying also need prompt care[1].

Causes and Risk Factors

Constipation can have more than one cause. Daily habits, medicines, supplements, and health problems may all play a part[3,7,8].

Diet, hydration, activity, and daily habits

A low-fiber diet can contribute to constipation[3,7,8]. High-fiber foods may make stools softer and easier to pass[4].

Not drinking enough water may also contribute to symptoms[3,8]. Fluid is important when you increase fiber or take a fiber supplement[4].

Other common factors include:

• Too little physical activity[3,7,8].
• Changes in eating or sleep patterns[8].
• Travel and other routine changes[8].
• Delaying a trip to the bathroom[3,8].
• Ignoring the urge to pass stool[3,8].
• Eating too few high-fiber foods[3,7,8].

Stress may also affect bowel habits[8]. More than one factor may be present at the same time[8].

Medicines and supplements that may contribute

Some medicines can cause constipation[3,7,8]. Vitamins and other supplements may also contribute[3].

Symptoms may start after you begin a new product. They may also start after a change in how much you take.

Make a list of all products you use, including:

• Prescription medicines.
• Medicines bought without a prescription.
• Vitamins.
• Minerals.
• Herbal products.
• Dietary supplements.

Show this list to a clinician or pharmacist. Ask whether a product could be affecting your bowel habits[8].

Do not stop a prescribed medicine on your own. Some cases require a medicine change planned by a healthcare professional[7].

Medical conditions and bowel function problems

Constipation can result from another health condition[7,8]. Possible causes include an underactive thyroid and diabetes[8]. High calcium levels and some kidney-related problems may also play a role[8].

Some endocrine disorders can cause constipation[8]. An endocrine disorder affects glands that make hormones.

Diseases of the brain, spinal cord, or nerves may also affect bowel function[8]. These are called neurologic conditions.

In some people, stool moves too slowly through the colon[5,10]. The colon is the main part of the large bowel.

Other people have trouble using the muscles needed to pass stool[10]. Pelvic floor dysfunction is one example[10]. It means the muscles at the base of the pelvis do not work well together.

Structural problems in the colon or rectum may also cause constipation[8]. Since the causes differ, the same treatment will not work for everyone.

Treatment and Safe Constipation Relief

Constipation treatment depends on the cause and how long symptoms have lasted[6,7]. Many mild cases improve with home care[2,4]. Chronic constipation may need medical treatment[7].

First steps for relief at home

Start with small changes that are easy to maintain. Useful steps may include:

• Add more high-fiber foods to your meals[2,4].
• Drink enough water and other fluids when adding fiber[4].
• Get regular physical activity[2,3,4].
• Use the bathroom when you feel the urge[2,3].
• Set aside a regular time for a bowel movement[4].

Depending on age and sex, adults should generally consume 22 to 34 grams of fiber per day[4]. Fiber can come from fruits, vegetables, and grains[2].

Drink enough fluid when you add fiber or use a fiber supplement[4]. This may help make stool easier to pass[4].

Regular physical activity may help relieve constipation[4]. MedlinePlus suggests walking, swimming, or another activity three or four times each week[3]. Choose an activity that fits your needs and ability.

Bowel training may also help improve regularity[4]. This means trying to have a bowel movement at the same time each day[4]. A clinician may suggest a schedule based on your routine[4].

Over-the-counter treatment options

Nonprescription medicines may help when basic changes are not enough[7]. However, constipation products work in different ways.

Fiber supplements increase your fiber intake[4]. You should drink enough water and other liquids when using them[4].

Laxatives are medicines that help you pass stool. Osmotic laxatives keep more water in the bowel[10]. Examples include polyethylene glycol and magnesium salts[10].

Guidelines favor osmotic laxatives over stimulant laxatives when medicine is needed for chronic constipation[10]. A clinician or pharmacist can help you review your choices.

Ask for professional advice if you:

• Have a long-term health problem.
• Take prescription medicines.
• Have severe or unexplained symptoms.
• Need to use laxatives often.
• Think another medicine is causing constipation.

A medicine change may be needed when a drug causes or worsens constipation[7,8]. A healthcare professional should guide that change[7].

Do not rely only on home remedies for severe pain or vomiting[1]. The same warning applies if you cannot pass gas[1]. These symptoms need prompt medical care[1].

Medical evaluation and prescription treatment

Contact a healthcare professional if self-care does not work[1]. Long-term symptoms may require treatment for another condition[7].

A clinician may suggest prescription medicine or a change in current medicine[7]. Other forms of care may target the cause of the constipation[7].

Pelvic floor biofeedback may help constipation linked to pelvic floor dysfunction[10]. Biofeedback uses sensors and guided practice. It helps a person learn to use the pelvic muscles in a better way[10].

Some people need tests to find the cause of lasting symptoms[6]. The results can help guide the treatment plan[6].

How to Prevent Constipation

Several daily habits may help treat or prevent constipation. These include more fiber, enough fluid, regular activity, and prompt bathroom use[2,3,4]. Bowel training may also support a more regular pattern[4].

Build a fiber-rich eating pattern

Fruits, vegetables, and grains provide dietary fiber[2]. Eating more of these foods may help prevent constipation[2].

Adults generally need 22 to 34 grams of fiber each day[4]. The exact amount depends on age and sex[4].

Build a high-fiber pattern one step at a time. You might add fruit at breakfast. You could add vegetables to lunch or dinner.

Drink enough water and other liquids as you add fiber[4]. Fluid is also important when taking a fiber supplement[4].

Support regular bowel habits

Regular physical activity may help prevent and ease constipation[2,3,4]. Walking and swimming are two options listed in self-care guidance[3].

Respond when you feel the urge to pass stool[2,3]. Repeated delays can contribute to constipation[3,8].

Give yourself enough time in the bathroom. Try not to rush. A regular bathroom schedule may support better bowel habits[4].

Some people sit on the toilet at about the same time each day[4]. This approach is a form of bowel training[4].

Create a practical prevention plan

A simple record may help you find patterns. Keep the log easy to use.

You may record:

• Bowel movement dates.
• Stool form.
• Straining or pain.
• Foods eaten each day.
• Fiber-rich foods.
• Water and other drinks.
• Physical activity.
• Travel or routine changes.
• Medicines and supplements.

Knowing your normal bowel pattern can help you notice changes[3]. It may also help you act before symptoms become worse[3].

Bring your notes to a medical visit. A clinician may ask about diet, exercise, medicines, and stools[6].

When to See a Doctor for Constipation

Some constipation warning signs need prompt care[1]. Other symptoms mean you should make an appointment instead of continuing self-care.

Emergency and urgent warning signs

Constipation with certain symptoms requires prompt medical evaluation[1]. Seek care right away for:

• Bleeding from the rectum[1].
• Blood in the stool[1].
• Constant abdominal pain[1].
• An inability to pass gas[1].
• Vomiting[1].
• Fever[1].
• Lower back pain[1].
• Weight loss without trying[1].

Do not manage constant abdominal pain only with home remedies[1]. Vomiting or an inability to pass gas also needs prompt care[1].

Severe pain and major belly swelling should not be treated only at home. Seek prompt care if these occur with vomiting or an inability to pass stool or gas[1].

When ongoing symptoms need an appointment

Make an appointment if constipation does not improve with self-care[1]. You should also seek advice if symptoms keep returning.

Tell your clinician about a family history of colon or rectal cancer[1]. Constipation that does not improve needs medical review in this setting[1].

Cleveland Clinic advises calling a healthcare provider when constipation lasts longer than three weeks[8]. It also advises seeking care for severe pain or blood in the stool[8].

Do not wait for a routine appointment if urgent warning signs appear[1]. Seek prompt care instead[1].

What to expect during a medical evaluation

A healthcare professional will ask about your bowel habits and stool[6]. You may also discuss your diet, exercise, medicines, and health history[6].

Be ready to explain when the symptoms began. Tell the clinician what you have tried. Bring your medicine and supplement list.

The clinician may gently press on your abdomen[6]. This exam checks for pain, sore areas, or unusual lumps[6].

The clinician may inspect the anus and nearby skin[6]. A rectal exam may also be needed[6]. During this exam, a gloved finger checks the rectum and anal muscles[6].

Some people do not need more tests after the first visit[6]. Others may need blood tests or selected procedures[6]. These tests can help find conditions linked to constipation[6].

Conclusion

Understanding constipation causes, treatment, prevention, and when to see a doctor can guide safer choices. Mild cases often improve with fiber, enough fluid, activity, and regular bathroom habits[2,3,4].

Increasing fiber and fluids when appropriate may help treat or prevent constipation[2,4]. Regular activity, prompt bathroom use, and bowel training may also help[2,3,4].

Seek medical advice when symptoms continue or keep returning[1,7]. Prompt care is needed for bleeding, constant abdominal pain, or an inability to pass gas[1]. Vomiting, fever, lower back pain, and unexplained weight loss are also warning signs[1].