Constipation

Constipation is infrequent, difficult, or incomplete passage of stool. It is very common, affecting people of all ages, and while usually not serious, it can significantly affect comfort and quality of life if persistent.

• Fewer than three bowel movements a week
• Hard, dry, or lumpy stools that are difficult or painful to pass
• A feeling of incomplete emptying after a bowel movement
• Straining during bowel movements
• Bloating or abdominal discomfort

• Most commonly related to inadequate dietary fibre intake, insufficient fluid intake, and low physical activity.
• Can be worsened by ignoring the urge to have a bowel movement, certain medicines (such as some pain medicines and iron supplements), and, in older adults, reduced mobility.
• Less commonly, an underlying medical condition (such as an underactive thyroid or a bowel condition) can contribute, particularly with new or worsening constipation in adulthood.

• Usually diagnosed through a description of bowel habit, stool consistency, and associated symptoms, without needing specific testing in most cases.
• Alarm features — such as rectal bleeding, unintentional weight loss, new symptoms in someone over 50, or a family history of bowel cancer — prompt further evaluation to exclude an underlying cause.

Increasing dietary fibre gradually, along with adequate fluid intake, is the first step in managing most cases of constipation.

Regular physical activity supports healthy bowel movement.

Responding promptly to the urge to have a bowel movement, rather than delaying, helps prevent worsening constipation.

A laxative may be used for short-term relief if dietary and lifestyle measures are not sufficient, with the type chosen based on the individual situation and used as directed rather than long-term without medical guidance.

Persistent constipation not responding to simple measures, or constipation with alarm features, should be assessed further to identify and address any underlying cause.

• Eat a diet rich in fibre, including fruits, vegetables, and whole grains.
• Drink adequate fluids throughout the day.
• Engage in regular physical activity.
• Respond promptly to the urge to have a bowel movement rather than delaying it.
• Establish a regular time for bowel movements, such as after a meal, to help train regular bowel habits.