Constipation is a common digestive problem that affects millions of people worldwide. Research shows that about 16% of people globally experience this condition (1), with North America having particularly high rates (2).

What Is Constipation?

Constipation occurs when stool moves too slowly through the digestive tract, becoming hard, dry, and difficult to pass. The colon (large intestine) normally absorbs water from digested food and forms stool, using muscles to pushing waste toward the rectum for elimination. When this process slows down, excess water gets absorbed, resulting in harder stools that are challenging to pass.

Several factors can disrupt this normal process, including dietary choices, insufficient fluid intake, certain medications, or health conditions that affect intestinal muscle blood flow and function.

Note
Constipation means different things to different people. While doctors often define it as fewer than three bowel movements per week, you might consider yourself constipated if your stools are hard, difficult to pass, or if you feel you haven’t completely emptied your bowels.

Common Symptoms of Constipation

While bowel habits vary from person to person, you may be constipated if you experience:

  • Fewer than three bowel movements per week
  • Hard, dry, or lumpy stools that are difficult to pass
  • Straining during bowel movements
  • A sensation of incomplete evacuation after having a bowel movement
  • A feeling of blockage in your rectum

Research shows that the most common symptoms include straining during bowel movements (82.8%), hard or lumpy stools (74.2%), and feeling like you haven’t completely emptied your bowels (68.1%) (3).

What Causes Constipation?

Constipation can result from various factors, ranging from everyday habits to medical conditions and medications.

Lifestyle and Diet

Your daily habits can significantly impact your risk of constipation:

Physical Activity: Being physically active helps reduce your risk of constipation. Research shows that people who exercise regularly have a 31% lower chance of developing constipation compared to those who are inactive (4).

Fluid Intake: Not drinking enough fluids can lead to constipation. Research has found that when healthy people reduce their fluid intake to less than 500ml per day, they have fewer bowel movements (from 6.9 to 4.9 per week) and smaller stools (5).

Fiber Intake: What you eat plays a major role in preventing constipation. Studies show that not eating enough fiber is strongly linked to constipation problems (6).

Tip
Simple lifestyle changes can significantly reduce your risk of constipation. Aim for at least 30 minutes of physical activity most days, drink 6-8 glasses of water daily, and gradually increase your fiber intake from fruits, vegetables, and whole grains.

Demographic Factors

Gender: Women tend to experience constipation more frequently than men. Research shows women are more likely to report constipation symptoms (7).

Age: Constipation becomes more common as people age. Studies show that older adults worldwide experience constipation at higher rates (18.9%) than the general population (8).

Medical Conditions

Several medical conditions can cause or contribute to constipation:

Neurological Disorders: People with Parkinson’s disease often experience constipation, which can appear years before other symptoms of the disease develop. Research has found that people with constipation have a 2.36 times higher risk of developing Parkinson’s disease (9). This may be due to impairments in the nervous system that disrupt the normal digestive process.

Diabetes: People with diabetes who also have constipation often experience different bowel function issues. Studies show they’re more likely to have problems with how food moves through their digestive system (10).

Autism Spectrum Disorder: Children with autism spectrum disorder experience constipation much more frequently than other children. Research has found that these children have almost four times the risk of constipation (11).

Medications That Can Cause Constipation

Many medications can cause or worsen constipation:

Opioid Pain Medications: Constipation is an extremely common side effect of opioid medications. Studies show that up to 87% of people who are terminally ill and taking opioids experience constipation (12). Constipation can occur with short-term use of opioids as well, such as after surgery (39).

Iron Supplements: People taking iron supplements often report more digestive problems, and constipation is one of them. (13).

Antipsychotics: Some antipsychotic medications are particularly associated with constipation. For example, people taking clozapine are three times more likely to experience constipation (31.2%) than those taking other types of antipsychotics (14).

Warning
If you’re taking medications and experiencing constipation, don’t stop taking your prescribed drugs without consulting your healthcare provider. They can help adjust your dosage, switch medications, or suggest ways to manage constipation while continuing necessary treatment.

How Constipation Affects Quality of Life

Constipation is more than just a physical discomfort. It can significantly impact your daily life and overall well-being.

Studies focused on children with functional constipation have found that they experience considerably lower health-related quality of life compared to children without it (15).

For older adults, constipation can cast a shadow over everyday life. Research examining older people’s experiences shows that constipation negatively affects physical comfort, mental wellbeing, and even social activities (16).

Treatment Options for Constipation

Let’s explore several effective strategies for managing constipation.

Dietary Changes

Making adjustments to what you eat is often the first and most effective step in relieving constipation.

Increase Your Fiber Intake

Health experts recommend consuming 25-30 grams of fiber daily, with a mix of both soluble and insoluble types (17). The recommended daily intake of fiber for managing constipation is 25–30 grams (17).

Various fiber sources have proven to be effective for relieving constipation. Wheat bran supplements can increase bowel movement frequency by up to 55% and decrease intestinal transit time by 50% (18). Psyllium, a plant-based fiber, improves stool frequency, weight, and consistency in patients with constipation (19).

Even simple dietary swaps (like replacing white bread with whole wheat or multigrain bread) can effectively relieve mild constipation without causing gastrointestinal side effects that sometimes occur with laxatives (20).

Consume Certain Fruits and Vegetables

Kiwifruit: Eating kiwifruit regularly can help improve bowel function if you have constipation. Research shows that eating just two green kiwifruits daily helps increase bowel movements and reduces discomfort (21).

Prunes: Prunes (dried plums) are a natural remedy that can help relieve constipation effectively. Studies show that prunes work even better than some fiber supplements for improving bowel movements and should be considered as a first option for mild to moderate constipation (22).

Stay Hydrated

Water Intake with Fiber: Drinking enough water makes fiber work better for constipation relief. Research shows that people who drink 2 liters of water daily (along with eating a high-fiber diet) have more frequent bowel movements than those who just increase fiber alone (23).

Fact
Even mild dehydration can contribute to constipation. When you don’t drink enough fluids, your body pulls water from your intestines to maintain hydration elsewhere, leaving stools harder and more difficult to pass.

Probiotics and Prebiotics

Probiotics can significantly improve constipation by enhancing digestive function. Research shows that in adults with functional constipation, certain probiotic supplements reduce gut transit time by 12.4 hours and increase bowel movements by 1.3 per week (24).

Not all probiotics work equally well, however. Studies have identified specific beneficial strains for constipation, particularly Bifidobacterium and Lactobacillus species, which have shown significant improvements in bowel movement frequency compared to placebo in clinical trials (25).

Tip
When choosing a probiotic for constipation, look for products containing multiple strains, particularly Bifidobacterium and Lactobacillus species. Check the label for at least 1 billion colony-forming units (CFUs), as this is the dosage range that has shown effectiveness in studies.

Lifestyle Changes

Several daily habits can significantly improve bowel function and prevent constipation.

Exercise and Physical Activity

Regular physical activity is one of the most effective ways to prevent and manage constipation. Research shows that exercise, particularly aerobic exercise like walking, significantly improves constipation symptoms (26).

Establish a Regular Bathroom Routine

Training your body to have bowel movements at consistent times can significantly help with constipation. Research shows that establishing a regular bathroom schedule helps increase the frequency of bowel movements (27).

Try to set aside time for a bowel movement about 15-45 minutes after breakfast each day. This timing takes advantage of the natural increase in colonic activity that occurs after meals (known as the gastrocolic reflex).

Non-Invasive Physical Therapies

Several gentle physical techniques can help stimulate bowel function without medication or invasive procedures.

Abdominal Massage

Abdominal massage is a simple technique that can help relieve constipation. Research shows that regular abdominal massage helps increase bowel movements and improves constipation symptoms in various groups of people (28).

Biofeedback

Biofeedback therapy can help people who have a specific type of constipation called pelvic floor dyssynergia (where the pelvic floor muscles don’t relax properly during bowel movements). Research shows that biofeedback training works better than medications or a placebo for this type of constipation (29).

Medications for Constipation

When lifestyle changes don’t provide enough relief, medications can help manage constipation.

Over-the-Counter Options

  • Fiber Supplements: Products containing psyllium, methylcellulose, or polycarbophil add bulk to stool and help it retain water. You must be drinking enough water for these to work, however.
  • Osmotic Laxatives: These draw water into the intestines to soften stool and increase bowel movements.
    • Polyethylene Glycol (PEG): PEG helps increase water in the intestines, which softens stool and makes it easier to pass. Multiple studies have confirmed that PEG is effective and well-tolerated for treating constipation (30).
    • Magnesium Supplements: Magnesium supplements can help relieve constipation by drawing water into the intestines and relaxing the bowel muscles. Research shows that magnesium supplements may increase stool frequency by 3.72 bowel movements per week and improve stool consistency in adults with chronic constipation (31).
  • Stimulant Laxatives: These cause the intestines to contract, moving stool along.
    • Bisacodyl: Bisacodyl helps stimulate the intestines to move stool through more quickly. Research shows that taking 10 mg of bisacodyl once daily for 4 weeks helps increase complete spontaneous bowel movements from 1.1 to 5.2 per week in people with chronic constipation (32).
Warning
Use laxatives sparingly and as directed. Overuse can lead to dependency, where your bowels no longer function properly without them. Never use stimulant laxatives for more than two weeks without consulting a healthcare professional.

Constipation in Children

Pediatric constipation is common, affecting many children worldwide. Research shows that childhood constipation affects between 0.7% and 29.6% of children, with most studies finding rates around 8.9% (33).

Children with constipation often have behavioral issues as well. Studies have found that children with functional constipation have a much higher rate of behavior problems (36.8%) compared to children without constipation (9%) (34).

Note
For children with constipation, a combination approach is often most effective, including dietary changes, proper toilet habits, and sometimes medications. It’s important to create a positive, non-stressful toilet routine and avoid punishments for accidents.

Constipation in Elderly Individuals

Constipation is particularly common in older adults and requires special attention. It negatively impacts physical and mental well-being, as well as social life (16).

Adding a high-fiber porridge to the diet can significantly help older adults with constipation. Research found that elderly patients who ate a fruit and fiber-rich porridge had daily defecation without laxatives 76% of the time, as compared with just 23% in those without the porridge (35).

Constipation During Pregnancy

Many women experience constipation during pregnancy. Research shows that constipation affects about one-third (32.4%) of pregnant women worldwide, with the highest rates occurring during the second trimester (34%) (36).

Increasing fiber intake during pregnancy can help manage constipation. Studies show that pregnant women who take fiber supplements have more frequent bowel movements and improved stool consistency (37).

When to See a Doctor

While most cases of constipation can be managed with lifestyle changes and over-the-counter remedies, certain situations warrant medical attention.

Warning Signs That Require Medical Attention

See your doctor if you experience:

  • Constipation that doesn’t respond to self-care measures
  • Severe abdominal pain
  • Blood in your stool
  • Rectal bleeding
  • Unexplained weight loss
  • Persistent change in bowel habits

If you notice blood in your stool, it’s important to consult a healthcare provider promptly. While rectal bleeding can sometimes occur due to hemorrhoids or anal fissures caused by constipation, it can also be a sign of more serious conditions. Research shows that about 15% of people report rectal bleeding, but only about 14% of those with bleeding seek medical attention (38).

Warning
Seek immediate medical attention if your constipation is accompanied by severe abdominal pain, persistent vomiting, blood in your stool, unexplained weight loss, or extreme bloating. These could be signs of a serious condition requiring prompt evaluation.

Conclusion

Constipation is a common condition that affects millions of people worldwide, with significant impacts on quality of life. The good news is that most cases can be effectively managed with evidence-based approaches.

For most people, a combination of lifestyle changes is the best starting point. When lifestyle changes aren’t enough, over-the-counter remedies can provide relief. Probiotics and prebiotics offer a more natural approach that may also benefit your overall gut health.

Remember that constipation, while common, should not be ignored, especially if it’s new, persistent, or accompanied by concerning symptoms. With the right approach, most people can find effective relief and maintain healthy bowel function.

Was this article helpful?