Constipation

What is it?

Constipation is one of the most prevalent GI complaints globally, affecting roughly 16% of adults and up to 33% of those over 60. It is defined functionally by stool frequency (fewer than 3 per week), consistency (hard/lumpy), straining, sensation of blockage, or incomplete evacuation. The cause is multifactorial: low fiber intake, inadequate hydration, physical inactivity, medications, and psychological factors all contribute. Most cases respond to lifestyle modification and first-line osmotic laxatives. Alarm symptoms (blood in stool, unexplained weight loss) require colonoscopy to rule out structural causes.

Common causes

When to see a doctor

• 1Blood in stool or black tarry stools
• 2Constipation with unexplained weight loss or night sweats
• 3New onset constipation over age 50 without clear explanation
• 4Severe abdominal pain or abdominal distension
• 5No bowel movement for more than a week despite laxative use
• 6Alternating constipation and diarrhea

What you can do

• ✓Increase dietary fiber to 25–38 g/day: fruits, vegetables, whole grains, legumes
• ✓Drink at least 8 cups (2 L) of water daily — fiber without fluid can worsen constipation
• ✓Exercise daily — physical activity stimulates intestinal motility
• ✓Do not ignore the urge to defecate; use the toilet within 30 min of waking when the gastrocolic reflex is strongest
• ✓Try elevating your feet on a small stool while sitting on the toilet (squatting position)
• ✓Warm liquids (coffee, warm water with lemon) in the morning stimulate bowel movement

Conditions that cause this symptom

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Frequently asked questions