Constipation: Causes and Why It Happens

Constipation is a change in the pattern of bowel movements: less often than usual, with hard or dry stool, straining, or a feeling of incomplete emptying. Constipation can be suspected if stool occurs less than three times a week or less often than usual. In adults there are many causes, and it is not always possible to find an obvious one.

What counts as constipation

The reference point is not daily stool, but one's own habits and signs. Constipation is likely if stool occurs less than three times a week, the stool is unusually large or small, dry, hard, or lumpy, there is straining or pain during defecation, or a feeling of incomplete emptying remains. Abdominal pain, bloating, and nausea are possible. In older people, in dementia, or in developmental disorders, constipation is easy to miss: a sign may be a change in behavior, such as confusion. Constipation is common and almost everyone experiences it at least once; in most cases it lasts a short time and is not dangerous. It is not necessary for stool to occur every day, but if bowel habits change, this should be discussed with a doctor.

Why constipation happens: main causes

The most common causes are related to lifestyle: insufficient fiber (dietary fiber from fruits, vegetables, grains), too little fluid, insufficient movement and prolonged sitting or lying down, ignoring the urge to go to the toilet, a change in diet or daily routine, stress, anxiety, or depression. Constipation is more common after age 65, during pregnancy, and after childbirth. Sometimes there is no obvious cause.

Constipation due to bowel and other organ diseases

Constipation can be caused by a disease, such as diverticular disease or bowel cancer, but this is a rare cause. With prolonged constipation, fecal impaction (accumulation of stool in the rectum) is possible, the main sign of which is diarrhea leaking through hard stool. If bowel habits change or there is persistent bloating, a doctor's evaluation is needed.

Why constipation occurs in women

Constipation often occurs during pregnancy and after childbirth. If constipation occurs at this time and symptoms persist, a doctor's consultation is needed. Constipation is also more common in people over 65, and causes such as stress or a change in routine do not depend on sex.

Constipation as a side effect of medications

Constipation can be a side effect of medications, such as opioid painkillers. Before changing a prescribed regimen, the issue should be discussed with a doctor: stopping the medication on one's own is undesirable. If constipation is related to a medication being taken, this is a separate reason for consultation. If constipation is suspected to be related to a medication, this should be discussed with a doctor.

When constipation requires evaluation and a doctor's visit

A doctor is needed if constipation does not improve with treatment, occurs regularly, is accompanied by persistent bloating, blood in the stool, unintentional weight loss, constant fatigue, abdominal pain, or a sudden change in bowel habits. The doctor may order tests, such as colonoscopy or a barium X-ray.

• stool less than three times a week or less often than usual;
• dry, hard, lumpy stool;
• straining or pain during defecation;
• a feeling of incomplete emptying;
• bloating, abdominal pain, nausea.

Constipation by itself is not a reason to call an ambulance; 103 or 112 — for a life-threatening condition.

This material is for reference: it describes possible causes but does not replace a doctor's consultation, which will assess the situation individually.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer