Constipation: Causes & Treatment

We all have our own digestive rhythm, and healthy bowel movements range quite widely from three a day to three a week. Going to the toilet less than usual is known as constipation, a widespread symptom in women and the elderly that may have a lot to do with our daily habits.

However, you cannot always treat constipation at home. In some cases, this symptom can be related to major illnesses, which is why it is essential to acknowledge the warning signs and see a doctor to assess them.

Key Facts

  • Having fewer than three bowel movements a week is called constipation. It becomes chronic constipation if this symptom lasts for more than three months.
  • Constipation is a symptom, not a disease. This means that it can occur for a number of different reasons, each requiring a different type of treatment. 
  •  Over-the-counter drugs that help alleviate constipation, such as laxatives, do not usually address the cause of the problem. As such, we strongly encourage you to consult your doctor if your constipation continues for an extended period of time.

Constipation: What You Need to Know

To begin to understand what constipation is and how to deal with it, it is essential that you learn to identify it correctly. In the following section, we will explain everything you need to know about it!

What is constipation?

Many of us have a sense of what constipation is, but we often mistake a day without going to the toilet for this symptom. In fact, people are not aware that they suffer from constipation when they haven’t used the toilet for over a week.

We talk about constipation when you have fewer than three bowel movements a week (this means you only go to the bathroom twice or less). In addition, this symptom is often accompanied by very hard stools that are difficult to pass (1, 2). You may sit on the toilet for a long time and feel like “pooing” without being able to.

It is also necessary to distinguish between acute and chronic constipation. Health professionals have different opinions about when the latter starts, saying it becomes chronic after 3 or 6 months (3, 4, 5).

girl with stomachache
Having less than three bowel movements a week is known as constipation. (Source: Ragiboglu: 83038260/ 123rf.com)

Constipation at different stages of life: recognising and treating it

Constipation can happen to anyone. However, certain individuals are much more likely to become constipated. In some cases, it is also much more difficult for them to recognise this symptom. Let’s see how we can identify constipation at different ages and under different conditions:

Pregnant women

Women who are not even pregnant are much more prone to constipation than men of the same age. In fact, they are twice as likely to experience it (5, 6)!

Now imagine that a pregnant woman undergoes both hormonal changes (due to an increase in progesterone) and anatomical changes due to the presence of a new being in her womb. She will almost certainly have this symptom! So, what can they do to manage it? Here are some tips for you (7, 8):

  1. Drink more water: Water doesn’t simply hydrate your cells; it can also hydrate your stool to make it easier to pass. We recommend that you drink 6 to 8 glasses of water a day. You can also have plum juice (9).  
  2. Add some fibre to your meals: Start by gradually increasing your consumption of vegetables, fruit, pulses, and cereals. If you dramatically raise your intake overnight, you may feel discomfort and even get diarrhoea. Keep in mind that the recommended amount of fibre per day is 25-30 grams (10).  
  3. Move your body: Exercising is one of the best ways to get your bowels moving. During pregnancy, we suggest low-impact activities such as walking on flat ground, aquatic fitness, or yoga.
  4. If all else fails, try medications prescribed by your physician: Various constipation drugs can be used during pregnancy. The most common are laxatives (stool softeners) and fibre supplements such as Metamucil (11). Be sure to follow your doctor’s advice, especially if you’re taking laxatives (12).

Iron supplements may be contributing to your constipation. We do not recommend that you stop taking them, but you may want to discuss this with your doctor and consider changing the supplement or dose (11).

pregnant girl holding her belly
During pregnancy, we suggest low-impact activities such as walking on flat ground, aquatic fitness, or yoga. (Source: Białasiewicz: 31487666/ 123rf.com)

Babies

Constipation in babies and adults are very different. Babies rarely suffer from this symptom, but we can be concerned if they don’t fill their nappy for a couple of days. The consistency of bowel movements will be different depending on your baby’s age. We’ve designed a handy chart to help you recognise what’s normal and what’s not (13):

AgeNormal bowel movementsWarning signs: call your paediatrician!
First days of lifeThe baby will pass meconium in the first 24-36 hours. These stools are green and yellow. The baby has not passed any stools after the first 36 hours.
First week of lifeAbout 4-8 bowel movements per dayThe stools are infrequent, hard, and require a lot of effort from the baby to be passed (they turn red from the effort or tighten their abdomen).
From 28 days of life to 3 monthsThe frequency of bowel movements decreases. Several days may go by without a bowel movement, but the stool should be soft and easily passed.The stools are infrequent, hard, and require a lot of effort from the baby to be passed.
After starting to eat solid food (six months onwards)The baby will typically have a bowel movement after meals or at least 1-2 times a day.The stools are infrequent, hard, and require a lot of effort from the baby to be passed.

If your baby shows any warning signs, don’t try to solve it at home. It’s time to see your paediatrician!

The elderly

People over the age of 65 are three times more likely to be constipated (1). As our body ages, our bowel movements also become a little slower. In addition, certain diseases and the use of medication may contribute to this symptom (14, 15):

  • Malnutrition and weakness
  • Bowel obstruction 
  • Alterations in nervous regulation 
  • Use of powerful analgesics such as opioids
  • Medicines such as antacids, iron supplements, antidepressants, and heart medication

Try to make small adjustments to your diet by increasing your fibre intake gradually, drinking more water, and avoiding very fatty foods. If your constipation doesn’t improve in the next three months, you are advised to consult your physician to determine if there is a major underlying cause.

Additionally, you should see your doctor immediately if your constipation is accompanied by other symptoms such as bleeding during a bowel movement or between bowel movements, weight loss, severe abdominal bloating, vomiting, or any other symptoms that prevent you from leading a normal life.

taking care of old man
The elderly are more likely to suffer from constipation. (Source: Lightfieldstudios: 117464613/ 123rf.com)

How Can You Treat Constipation?

From lifestyle changes to drug treatments, there’s a lot you can do to help relieve constipation!

Home remedies

You can do plenty from home to relieve your constipation, from drinking a little more water to exercising and slowly adding fibre-rich foods to your diet.

In addition to this, you can try to implement these three simple changes in your daily life: 

  1. Colon massages: According to many studies, colonic massage can improve intestinal transit (16). To do it yourself, sit on the toilet and raise your knees to make your abdomen soft. Try massaging in the normal direction of your colon (from the top of your right hip, below your ribs, to the top of your left hip). 
  2. Use a stool in the bathroom: Improving your posture in the bathroom can greatly help your intestines. Try raising your knees up to your chest using a stool to make your bowel movements easier. It’s quick and simple! 
  3. Eat plums: This delicious fruit contains sorbitol, which works as a natural laxative and also contains plenty of fibre if eaten whole. Other useful foods include apples, pears, and cherries (17)
plums in bowl
Plums are a natural laxative. (Source: Igorr: 127890770/ 123rf.com)

Probiotics for constipation

Probiotic supplements contain living microorganisms normally found in a healthy intestine. This means that they can help repopulate your colon with bacteria and fungi that are essential for restoring it to a normal state.

It has been shown that the alteration of the intestinal flora is related to the worsening of constipation; the use of probiotics could improve this condition (18).

Choose probiotics that contain 100 million to 1 billion colony-forming units (CFUs) and are protected by an enteric coating. This will help them reach your gut without being blocked by your stomach acids (19).

a happy woman taking a sun bath
Working out is one of the best ways to get your bowels moving. (Source: Atamanenko: 45241193/ 123rf.com)

Drug treatments for constipation

If you cannot improve your constipation with the strategies we discussed above, you may need certain medications to give a little boost to your digestive system.

Laxatives are the most widely used drugs to relieve constipation and can typically be found as (20)

  1. Osmotic laxatives: They are the cheapest and fastest-acting. The elderly should refrain from using them as they can cause dehydration.
  2. Stimulant laxatives: They act a little more slowly, but are useful for treating constipation caused by medicines such as opioids.  
  3. Emollient laxatives: They are the slowest to act, but can be used by people with heart and blood pressure conditions.

Please bear in mind that laxatives cannot cure the cause of constipation; they can only alleviate the symptom. See your physician to identify the cause of your chronic constipation.


Our Conclusions

Constipation is simply a symptom that can be related to an unhealthy lifestyle, changes in our bodies such as pregnancy or old age, or gastrointestinal diseases that require medical attention. 

The first steps to counteract this can be taken from home by improving our habits and using certain supplements or over-the-counter medication. However, it is imperative that you seek medical advice if this symptom persists or worsens rapidly.

Don’t forget to check out our other articles for more information, and feel free to share it to spread the word! Leave us a comment in the section below if you have any questions for us. 

(Source of featured image: Twinsterphoto: 50498522/ 123rf.com)

References(20)

  1. Fundación Española del Aparato Digestivo. Guía para prevenir y tratar el estreñimiento. SaludigestivoEs n.d.
  2. García García JI, Ventura Pérez M, Peña Forcada E, Domingo Regany E. Dolor abdominal urgente: diagnóstico diferencial del estreñimiento. Semergen 2014;40:e51-6.
  3. Wald A. Chronic constipation: advances in management. Neurogastroenterol Motil 2007;19:4–10.
  4. Johanson JF. Constipation. GI Epidemiology, Oxford, UK: Blackwell Publishing Ltd; 2008, p. 184–90.
  5. Gotfield J.Estreñimiento en adultos. Manuales MSD. 2020
  6. McCrea GL, Miaskowski C, Stotts NA, Macera L, Paul SM, Varma MG. Gender differences in self-reported constipation characteristics, symptoms, and bowel and dietary habits among patients attending a specialty clinic for constipation. Gend Med 2009;6:259–71.
  7. Jewell DJ, Young G. Interventions for treating constipation in pregnancy. Cochrane Database Syst Rev 2001:CD001142.
  8. Derbyshire E, Davies J, Costarelli V, Dettmar P. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy. Matern Child Nutr 2006;2:127–34.
  9. FESNAD y AECOSAN. Hábitos para toda la vida. Hidratación también es salud. [Internet]. 2016
  10. Fibra dietética: esencial para una dieta saludable. MayoclinicOrg 2019.
  11. Personal de Mayoclinic. Estreñimiento en el embarazo: ¿son seguros los ablandadores de heces? MayoclinicOrg 2020.
  12. Societat Catalana de Digestología. Información para pacientes: Estreñimiento. [Internet] scdigestologia.org
  13. Personal de AMIR. Manual de Pediatría. 2019.
  14. Carlos B. y Cols. Guía de buena práctica clínica en geriatría. Estreñimiento en el anciano. Sociedad Española de Geriatría y Gerontología. 2014
  15. Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM, Stoa JM. Chronic constipation in the elderly. Am J Gastroenterol 2012;107:18–25; quiz 26
  16. Sinclair M. The use of abdominal massage to treat chronic constipation. J Bodyw Mov Ther 2011;15:436–45.
  17. attaluri A, Donahoe R, Valestin J, Brown K, Rao SSC. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation: Randomised clinical trial: dried plums in constipation. Aliment Pharmacol Ther 2011;33:822–8.
  18. Dimidi E, Christodoulides S, Fragkos KC, Scott SM, Whelan K. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2014;100:1075–84
  19. Antonieta G., Ramon B. Probióticos. Farmacia Profesional. 2017.
  20. Personal de Mayo Clinic. Laxantes de venta libre para tratar el estreñimiento: Úsalos con precaución. [Internet]. Mayoclinic.org. 2018.
Previous Diet and Diarrhoea: What Should We Eat After? Next Collagen for Skincare: How Can Collagen Help Me?
Scientific Article
Fundación Española del Aparato Digestivo. Guía para prevenir y tratar el estreñimiento. SaludigestivoEs n.d.
Go to source
Scientific Article
García García JI, Ventura Pérez M, Peña Forcada E, Domingo Regany E. Dolor abdominal urgente: diagnóstico diferencial del estreñimiento. Semergen 2014;40:e51-6.
Go to source
Scientific Article
Wald A. Chronic constipation: advances in management. Neurogastroenterol Motil 2007;19:4–10.
Go to source
Scientific Article
Johanson JF. Constipation. GI Epidemiology, Oxford, UK: Blackwell Publishing Ltd; 2008, p. 184–90.
Go to source
Official website
Gotfield J.Estreñimiento en adultos. Manuales MSD. 2020
Go to source
Human Clinical Trials
McCrea GL, Miaskowski C, Stotts NA, Macera L, Paul SM, Varma MG. Gender differences in self-reported constipation characteristics, symptoms, and bowel and dietary habits among patients attending a specialty clinic for constipation. Gend Med 2009;6:259–71.
Go to source
Scientific Article
Jewell DJ, Young G. Interventions for treating constipation in pregnancy. Cochrane Database Syst Rev 2001:CD001142.
Go to source
Human Clinical Trials
Derbyshire E, Davies J, Costarelli V, Dettmar P. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy. Matern Child Nutr 2006;2:127–34.
Go to source
Official website
FESNAD y AECOSAN. Hábitos para toda la vida. Hidratación también es salud. [Internet]. 2016
Go to source
Official website
Fibra dietética: esencial para una dieta saludable. MayoclinicOrg 2019.
Go to source
Official website
Personal de Mayoclinic. Estreñimiento en el embarazo: ¿son seguros los ablandadores de heces? MayoclinicOrg 2020.
Go to source
Official website
Societat Catalana de Digestología. Información para pacientes: Estreñimiento. [Internet] scdigestologia.org
Go to source
Medical textbook
Personal de AMIR. Manual de Pediatría. 2019.
Scientific Article
Carlos B. y Cols. Guía de buena práctica clínica en geriatría. Estreñimiento en el anciano. Sociedad Española de Geriatría y Gerontología. 2014
Go to source
Scientific Article
Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM, Stoa JM. Chronic constipation in the elderly. Am J Gastroenterol 2012;107:18–25; quiz 26
Go to source
Scientific Article
Sinclair M. The use of abdominal massage to treat chronic constipation. J Bodyw Mov Ther 2011;15:436–45.
Go to source
Human Clinical Trials
attaluri A, Donahoe R, Valestin J, Brown K, Rao SSC. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation: Randomised clinical trial: dried plums in constipation. Aliment Pharmacol Ther 2011;33:822–8.
Go to source
Literature review
Dimidi E, Christodoulides S, Fragkos KC, Scott SM, Whelan K. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2014;100:1075–84
Go to source
Scientific Article
Antonieta G., Ramon B. Probióticos. Farmacia Profesional. 2017.
Go to source
Official website
Personal de Mayo Clinic. Laxantes de venta libre para tratar el estreñimiento: Úsalos con precaución. [Internet]. Mayoclinic.org. 2018.
Go to source