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Constipation

Fewer than three bowel movements a week; stools that are hard, dry or lumpy; straining, or feeling that you haven’t fully emptied. Occasional constipation is normal. When it lasts more than three months, it is considered chronic.

Common causes

  1. Diet: too little fibre and water. Fibre adds bulk, and water softens the stool.
  2. Changes in routine: travel, stress, ignoring the urge, or changes in sleep.
  3. Lack of movement: physical activity helps your gut muscles contract.
  4. Medicines: painkillers like opioids, iron supplements, some antidepressants, blood-pressure medicines, and antacids containing aluminium or calcium.
  5. Medical conditions: IBS, hypothyroidism, diabetes, Parkinson’s, pelvic floor disorders, and pregnancy.
  6. Age: the risk increases after 65, because the gut slows down and people are often less active.

When to seek medical advice

See a doctor promptly if you notice blood in the stool, unexplained weight loss, severe abdominal pain, vomiting, or constipation that starts suddenly after the age of 50. If over-the-counter remedies haven’t helped after 2–3 weeks, it is also worth getting checked. A doctor can rule out blockages, thyroid problems or other conditions, and advise on treatment.

What helps most people

  1. Fibre and water. Aim for 25–35 g of fibre a day. Think beans, lentils, whole grains, berries, pears, kiwi, prunes and vegetables. Add fibre gradually, so that gas doesn’t become a problem, and pair it with enough water — without fluid, extra fibre can make things worse.
  2. Movement. 20–30 minutes of walking on most days stimulates the intestines to contract.
  3. Bathroom habits. Don’t ignore the urge. Try going 15–45 minutes after a meal, when your colon is most active. Raise your feet on a stool so that your knees are above your hips: that straightens the rectum and reduces straining.
  4. Over-the-counter remedies:
    • Bulk-forming: psyllium (isabgol), methylcellulose. They work like dietary fibre. Gentle, but they need water.
    • Osmotic: polyethylene glycol, magnesium citrate. They draw water into the colon.
    • Stool softeners: docusate. Helpful if straining is painful, as after surgery.
    • Stimulants: senna, bisacodyl. They trigger contractions. Best for short-term use.

Check with a doctor or pharmacist before starting laxatives if you take other medicines, are pregnant, or have kidney disease, because of possible interactions.

Myths worth dropping

  • “Daily is mandatory.” Normal ranges from three times a day to three times a week.
  • “Detoxes fix it.” Your colon doesn’t need cleansing. Harsh cleanses often cause dehydration and electrolyte problems.
  • “All fibre is the same.” Soluble fibre, in oats and psyllium, softens the stool. Insoluble fibre, in wheat bran, adds bulk. You need both.

Prevention basics

Build your meals around plants, drink water when you’re thirsty, move your body, and give yourself unhurried bathroom time. Managing stress matters too: the gut and the brain talk constantly.

Constipation is common, and usually manageable with small changes in lifestyle. If it is persistent, painful, or comes with any of the warning signs above, get it evaluated, so that you treat the cause and not just the symptom.

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