Being constipated means your bowel movements are tough or happen less often than normal. You might be constipated if you have less than three bowel movements per week.
Constipation is very common. Around 2.5 million people visit their doctor each year in the U.S. because they are constipated.
It's usually not serious, and home remedies can get you back on track.
How often should you poop?
The normal length of time between bowel movements varies from person to person. Some people have them three times a day. Others have them just a few times a week.
But going longer than 3 days without one is usually too long. After 3 days, your stool gets harder and more difficult to pass.
You may have:
- Few or no bowel movements
- Trouble having a bowel movement (straining to go)
- Hard or small stools
- A feeling that everything didn’t come out
- Belly bloating
- A feeling like your rectum is blocked
- A stomachache or cramps
You also may feel like you need help to empty your bowels, such as pressing on your belly or using a finger to remove stool from your bottom.
What Causes Constipation
Some causes of constipation include:
- Changes to what you eat or your activities
- Changes to your daily routine, such as traveling
- Not drinking enough water
- Not eating enough fiber
- Eating a lot of dairy products
- Not being active
- Ignoring the urge to poop
- Older age
- Intestinal obstruction
- Using a lot of laxatives
- Some medications, such as prescription pain medicines, antidepressants, antihistamines, some blood pressure medications, some anti-seizure medications, and iron pills
- Antacid medicines that have calcium or aluminum
- Eating disorders
- Irritable bowel syndrome
- Problems with the nerves and muscles in your digestive system
- Colon cancer
- Neurological conditions such as Parkinson's disease or multiple sclerosis
- An underactive thyroid (called hypothyroidism)
- Excess calcium in your blood (hypercalcemia) because of overactive parathyroid glands, medications, cancer (lung, breast, multiple myeloma), or other causes
Constipation Risk Factors
Some things that can increase your risk of constipation are:
Being older: After age 65, your metabolism slows down, the muscles lining your digestive tract that help move stool (poop) along get weaker, and you might be less active.
Being assigned female at birth: Changes in hormones can affect your digestive system, especially during pregnancy and after giving birth. Your unborn baby may press against your intestine and make it harder for you to pass stool.
Getting little to no activity: Moving your body helps your digestive system work normally.
Having a mental health condition such as depression or an eating disorder: Not getting enough exercise, not eating a healthy diet, and taking antidepressants or other medications can cause constipation.
Not eating enough high-fiber foods: Fiber is the part of plant foods that your body can't digest. It bulks up your stool and helps it move through your intestines.
Certain medications: Pain medications, antidepressants, antacids, iron pills, allergy medicines, anti-seizure medicines, anti-nausea medicines, blood pressure medicines, and more can cause constipation.
Certain neurological diseases (of the brain and spinal cord) and some digestive diseases: Parkinson's disease, stroke, spinal cord injury, multiple sclerosis, irritable bowel syndrome (IBS), colorectal cancer, and diverticulitis affect your digestive system and cause constipation.
Constipation can usually be fixed with diet and lifestyle changes, such as:
- Drink an extra two to four glasses of water a day, unless your doctor tells you to limit fluids for another reason.
- Try warm liquids, especially in the morning.
- Add fruits and vegetables to your diet.
- Eat prunes and bran cereal.
- Exercise most days of the week. When you move your body, the muscles in your intestines are more active, too.
- Don’t ignore the urge to poop. Listen to your body when it's telling you it's time to go.
- Eat foods with probiotics such as yogurt and kefir.
- Skip processed meats, fried foods, and refined carbs such as white bread, pasta, and potatoes. You can eat lean meats such as poultry and low-fat dairy products.
- Keep a food diary and make a note of any foods that constipate you.
- Adjust how you sit on the toilet. Raising your feet, leaning back, or squatting may make it easier to poop.
- Take an over-the-counter fiber supplement (Metamucil®, MiraLAX®, Citrucel® or Benefiber®). Start with a small amount at first.
- Avoid reading or using your phone or other devices while you're trying to move your bowels.
- Drink less alcohol and caffeinated drinks, which can make you dehydrated.
- Talk to your doctor about bowel training. It can help train your body to pass stool shortly after breakfast every morning.
- Don't rush when going to the bathroom. Give yourself time to relax, which can help your digestive muscles relax.
- Talk to your doctor about any medications that could be causing your constipation.
You can try taking a laxative, too. There are several types of laxatives:
- Fiber supplements, osmotic agents (such as milk of magnesia), and stool softeners help bring water into your intestine to soften your poop and make it easier to pass.
- Lubricant laxatives (such as mineral oil) can help stool slide more easily through your bowel.
- Stimulant laxatives help your bowels contract to move stool along.
You can buy many laxatives over the counter. Ask your doctor or pharmacist which kind might work for you and how long you should take it.
If other methods don't work for you, your doctor may suggest an enema or suppository medication. An enema is an injection of a lubricant, such as water, soapy water, or mineral oil, that helps flush out the rectum and soften stool. Suppositories are capsules inserted into the rectum. They contain medication, such as osmotic or stimulant laxatives.
How Long Does Constipation Last?
When constipation lingers for 3 weeks or more, get a checkup just to make sure a medical condition isn't causing the problem. Also, see your doctor if:
- You've never been constipated before
- You have stomach pain
- You notice blood in your stools
- You're losing weight without trying
Don’t let constipation go unchecked for too long. When untreated, constipation can lead to unpleasant complications such as hemorrhoids and rectal prolapse, a condition that causes part of the intestine to push out through the anus from too much straining.
Constipation Danger Signs
Call your doctor right away if you have sudden constipation with belly pain or cramping and you aren’t able to poop or pass gas at all.
Also, make the call if:
- Constipation is a new problem for you and lifestyle changes haven’t helped
- You have blood in your stool
- You’re losing weight even though you’re not trying to
- You have severe pain with bowel movements
- Your constipation has lasted more than 2 weeks
- The size, shape, and consistency of your stool have changed dramatically
Your doctor will start by asking you questions about your medical history, lifestyle and habits, and your bowel movements. They'll also do a physical exam, and they may do a rectal exam. This is a quick exam in which your doctor inserts a finger into your rectum to check for any problems, such as a lump.
Your doctor may recommend some other tests to find the cause of your constipation:
Blood, stool, and urine tests: These look for any problems with your hormones, or conditions such as diabetes, anemia, and cancer. They also show if there is an infection or inflammation.
Colonoscopy or sigmoidoscopy: Your doctor inserts a tiny camera into your rectum and colon to look for any issues.
Imaging tests: X-ray, CT scan, or MRI scan are other ways your doctor can look for anything unusual in your digestive system.
Bowel function tests: Defecography, anorectal manometry, balloon expulsion, radiopaque marker, and scintigraphy are all tests that see how your colon is working and how poop moves through and out of your colon.
If your constipation doesn't get better with lifestyle changes and over-the-counter medicines, your doctor may prescribe a stronger medication, such as:
- Lubiprostone (Amitiza)
- Linaclotide (Linzess)
- Lactulose (Cephulac®, Kristalose®)
- Plecanatide (Trulance)
- Prucalopride (Motegrity)
If your constipation is caused by opioid pain medications, your doctor might prescribe:
- Methylnaltrexone (Relistor)
- Naldemedine (Symproic)
- Naloxegol (Movantik)
These medications help block the effect opioids have on the movement of stool through your colon.
Surgery for constipation
You most likely will not need surgery for constipation. But if there's a problem with the structure of your colon, surgery can fix it and prevent constipation. Some reasons why you might need surgery are:
- Anal tear
- Colon blockage
- Narrowing of your intestine
- Your rectum collapsing into your vagina
Once your constipation is gone, you can prevent it from happening by:
- Eating more high-fiber foods such as fruits, vegetables, and whole grains
- Eating fewer low-fiber foods such as processed foods and meat
- Eating foods with probiotics such as yogurt and kefir
- Exercising or being active for at least 30 minutes a day
- Drinking at least eight 8-ounce glasses of water a day
- Avoiding alcohol and caffeine, which can dehydrate you
- Creating a schedule for having a bowel movement, such as after breakfast in the morning
- Going the bathroom when you get the urge instead of waiting
- Taking a fiber supplement
- Taking a magnesium supplement
- Keeping a food diary and avoiding any foods that make you feel backed up