Constipation: Causes, Treatments, and How to Find Relief

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Constipation affects millions of people worldwide and is one of the most common digestive complaints. Whether it happens occasionally or becomes a chronic problem, constipation can cause considerable discomfort, bloating, abdominal pain, and frustration. Fortunately, most cases can be improved with changes to diet, daily habits, and, when necessary, appropriate medications.

However, constipation isn’t always as simple as needing more fiber or drinking more water. It can be related to medications, hormonal problems, underlying digestive conditions, or even difficulties with the muscles responsible for emptying the bowels. Understanding what’s causing the problem is important because different types of constipation may respond to different treatments.

In this comprehensive guide, we’ll explore the symptoms and causes of constipation, practical ways to improve bowel regularity, the most effective over-the-counter remedies, prescription treatment options, and when it’s important to seek medical attention.

Note: This guide primarily discusses constipation in adults. Children and teenagers can develop constipation too, but their evaluation and treatment may differ. They should receive age-appropriate guidance from a healthcare professional rather than automatically following adult laxative recommendations.

What Is Constipation?

Constipation is a digestive problem characterized by infrequent bowel movements, difficult passage of stools, or a feeling that the bowels haven’t completely emptied. It generally occurs when stool moves too slowly through the large intestine (colon), allowing more water to be absorbed and making the stool harder and drier.

Constipation is commonly defined as having fewer than three bowel movements per week. However, frequency alone doesn’t determine whether someone is constipated. A person who has a bowel movement every day can still experience constipation if they regularly strain, pass hard stools, or struggle to empty their bowels.

Likewise, not everyone needs to have a bowel movement every day. Normal bowel habits vary considerably between individuals, and some healthy people naturally have bowel movements several times a day while others go every two or three days. What’s more important is whether bowel movements are comfortable, reasonably predictable, and complete.

Acute vs. Chronic Constipation

Constipation can be classified according to how long it lasts:

Acute Constipation: This develops suddenly and is usually temporary. It can occur after traveling, changing diets, becoming dehydrated, starting a new medication, or changing daily routines. It often improves once the underlying cause is addressed.
Chronic Constipation: This involves persistent or recurring difficulty with bowel movements over an extended period. It may result from dietary habits, medications, digestive disorders, hormonal conditions, or problems with intestinal or pelvic floor function.

Occasional constipation is generally not a major concern. However, constipation that persists, repeatedly returns, or interferes with daily life deserves further attention because it may indicate an underlying problem requiring more targeted treatment.

Symptoms of Constipation

Constipation can present differently from one person to another. Some people primarily experience infrequent bowel movements, while others have difficulty passing stool even when they go to the bathroom regularly.

Common symptoms include:

Infrequent Bowel Movements: Having fewer than three bowel movements per week is a common indicator, although frequency alone isn’t enough to establish a diagnosis.
Hard, Dry, or Lumpy Stools: Stools may become small, hard, and difficult to pass because too much water has been absorbed in the colon.
Straining: Excessive effort or pushing may be needed to pass stool, sometimes even when the stool isn’t particularly hard.
Incomplete Evacuation: Feeling as though stool remains in the rectum after finishing a bowel movement.
Abdominal Discomfort: Constipation can cause abdominal pain, cramping, pressure, or a sensation of fullness.
Bloating and Excessive Gas: Stool accumulation and changes in intestinal movement can contribute to abdominal bloating and gas.
Difficulty Emptying the Rectum: Some people experience a sensation of blockage or need to change their position or use other maneuvers to help pass stool.
Feeling Uncomfortably Full: Prolonged constipation can produce a persistent feeling of fullness or pressure in the abdomen.
Occasional Overflow Diarrhea: In some cases, particularly when severe stool accumulation or fecal impaction develops, softer stool can pass around the retained stool. This can look like diarrhea even though the underlying problem is constipation.

The Bristol Stool Chart

One useful way to understand constipation is through the Bristol Stool Form Scale, which categorizes stools according to their shape and consistency. It is commonly used by healthcare professionals to assess bowel habits.

The scale identifies seven stool types:

Type 1: Separate, hard lumps that are difficult to pass.
Type 2: Sausage-shaped stools that are lumpy and firm.
Type 3: Sausage-shaped stools with cracks on the surface.
Type 4: Smooth, soft, sausage-shaped or snake-like stools.
Type 5: Soft blobs with clearly defined edges.
Type 6: Mushy stools with ragged edges.
Type 7: Entirely liquid stools without solid pieces.

Types 1 and 2 are commonly associated with constipation, while types 3 and 4 are generally considered desirable stool consistencies. Types 6 and 7 are more commonly associated with diarrhea.

The Bristol Stool Chart can be particularly helpful when evaluating treatment effectiveness. For example, someone may still have infrequent bowel movements despite improvements in stool softness, suggesting that factors other than stool consistency may be contributing to their constipation.

When Should You Worry About Constipation?

Most occasional constipation can be managed with relatively simple measures. However, there are situations where constipation may be a sign of something more serious.

Seek prompt medical assessment if constipation is accompanied by any of the following:

Blood in the Stool: Rectal bleeding or blood mixed with stool should be evaluated, even though relatively minor conditions such as hemorrhoids can sometimes explain it.
Unexplained Weight Loss: Unexpected weight loss alongside a change in bowel habits warrants investigation.
Persistent Abdominal Pain: Ongoing or worsening abdominal pain should not automatically be attributed to constipation.
Fever: Fever accompanying constipation, particularly with abdominal pain, can indicate inflammation or infection.
Unexplained Anemia: Iron-deficiency anemia can sometimes be associated with gastrointestinal blood loss and requires investigation.
New and Persistent Changes in Bowel Habits: A significant change in bowel habits, particularly later in adulthood, should be evaluated.
Family History of Colorectal Cancer or Inflammatory Bowel Disease: This may increase the importance of investigating persistent or unexplained digestive symptoms.

When is constipation an emergency? Severe or constant abdominal pain, vomiting, marked abdominal swelling, and an inability to pass gas or stool can indicate a bowel obstruction or another serious condition. These symptoms require immediate medical assessment, particularly when they occur together. Do not attempt to manage suspected obstruction with additional fiber or laxatives at home.

It’s also worth remembering that constipation doesn’t automatically mean something serious is happening. Nevertheless, persistent symptoms, warning signs, and significant changes from your normal bowel habits should never be dismissed.

Causes of Constipation

Constipation can stem from numerous factors, and sometimes several causes contribute simultaneously. Some involve dietary and lifestyle habits, while others are related to medications, hormonal changes, digestive conditions, or problems with the muscles and nerves responsible for bowel movements.

Dietary and Lifestyle Factors

Inadequate Fiber Intake: Not eating enough dietary fiber is one of the most common contributors to constipation. Fiber helps retain water in stool and increases stool bulk, making bowel movements easier. Fruits, vegetables, whole grains, nuts, seeds, and legumes are particularly useful sources.
Inadequate Fluid Intake: Dehydration can result in harder, drier stools. Adequate hydration helps maintain stool moisture, especially when increasing dietary fiber. However, drinking excessive amounts of water does not necessarily resolve constipation in someone who is already adequately hydrated.
Sedentary Lifestyle: Low levels of physical activity may contribute to constipation. Regular movement can support normal intestinal function, although exercise alone is not necessarily enough to resolve chronic constipation.
Changes in Routine or Diet: Traveling, changing meal schedules, switching diets, and disruptions to normal bathroom routines can interfere with bowel regularity.
Ignoring the Urge to Defecate: Repeatedly ignoring the natural urge to have a bowel movement can allow stool to remain in the colon longer, leading to increased water absorption and harder stools.
Aging: Constipation becomes more common with age. Contributing factors include reduced physical activity, changes in dietary habits, underlying medical conditions, and increased use of medications that affect bowel function.
Pregnancy: Hormonal changes, particularly increased progesterone, can slow intestinal movement. Iron supplements and pressure from the growing uterus can also contribute to constipation.
Inadequate Food Intake: Eating very little food can reduce the amount of material moving through the digestive tract. This may result in smaller and less frequent bowel movements. Inadequate nutrition can also contribute to changes in normal digestive function.
Stress and Disrupted Sleep: Stress can influence communication between the brain and digestive system, potentially affecting bowel habits. Poor sleep and irregular daily routines may also contribute to digestive disturbances.

Diets

Several dietary patterns can influence constipation, particularly when they reduce fiber intake, food volume, or fluid consumption. However, no single diet causes constipation in everyone.

High-Protein Diet: High-protein diets can contribute to constipation when they replace fiber-rich foods with meat, eggs, protein powders, and other foods containing little to no fiber. Protein itself doesn’t necessarily cause constipation. The bigger issue is often what gets removed from the diet when protein intake increases. Low-fiber low-carb diets can be particularly problematic when fruits, vegetables, legumes, and whole grains are restricted.
Keto Diet: The ketogenic diet substantially reduces carbohydrate intake, which can unintentionally reduce fiber consumption. Although vegetables, nuts, seeds, and avocados can provide fiber on keto, a diet dominated by meat, cheese, butter, and processed foods may leave people short of their daily requirements.
Fasting: Fasting may reduce the amount of food entering the digestive tract, resulting in smaller or less frequent bowel movements. Some fasting routines may also reduce fluid intake, potentially contributing to dehydration. However, fasting does not automatically cause constipation, and the effect depends on the overall eating and drinking pattern.
Dairy-Rich Diet: Dairy foods contain relatively little fiber, so consuming large amounts of cheese and other dairy products may displace fruits, vegetables, and whole grains. Some individuals also report constipation after consuming particular dairy products. However, lactose intolerance typically causes bloating, gas, and diarrhea rather than constipation.
Gluten-Containing Diet: Individuals with celiac disease can experience constipation as one of their digestive symptoms after consuming gluten. However, gluten itself is not a common cause of constipation in the general population. There is little reason to eliminate gluten unless celiac disease or another relevant condition has been identified. Importantly, testing for celiac disease should generally occur before starting a gluten-free diet.
Highly Processed, Low-Fiber Diets: Diets containing large amounts of refined grains, fast food, processed snacks, and other low-fiber foods may contribute to constipation, particularly when they replace fiber-rich plant foods.

One important consideration is that simply eating more fiber isn’t always the answer. Some individuals with severe constipation, significant bloating, or pelvic floor dysfunction may become more uncomfortable when they substantially increase fiber without addressing the underlying problem.

Medical Conditions

Various medical conditions can interfere with intestinal movement, stool consistency, or the ability to empty the bowels. Examples include:

Irritable Bowel Syndrome (IBS): IBS is a disorder of gut-brain interaction that affects bowel habits and causes recurrent abdominal pain. IBS with constipation (IBS-C) is one of its recognized subtypes. People with IBS-C may experience abdominal discomfort, bloating, hard stools, and difficulty passing stool. Unlike ordinary functional constipation, recurrent abdominal pain is an important feature of IBS.
Hypothyroidism: An underactive thyroid produces insufficient thyroid hormones, which can slow various bodily processes, including gastrointestinal movement. Constipation is a recognized symptom of hypothyroidism.
Diabetes: Diabetes can damage nerves involved in controlling the digestive tract, a complication sometimes called diabetic autonomic neuropathy. This can interfere with normal intestinal movement and contribute to constipation. Poorly controlled blood glucose levels can also affect digestive function.
Diverticular Disease: Diverticulosis involves small pouches that develop in the wall of the colon. Most people with uncomplicated diverticulosis have no symptoms, and the condition does not ordinarily obstruct the passage of stool or directly cause constipation. Diverticulitis, which occurs when these pouches become inflamed or infected, can cause abdominal pain, fever, and changes in bowel habits.
Neurological Disorders: Conditions affecting the nervous system, including Parkinson’s disease, multiple sclerosis, spinal cord injuries, and certain neurological disorders, can interfere with the nerve signals that regulate intestinal contractions and bowel emptying.
Pelvic Floor Dysfunction: The pelvic floor muscles need to relax in a coordinated manner when passing stool. In some people, these muscles fail to relax properly or contract when they should relax. This is sometimes called dyssynergic defecation and can make bowel movements difficult even when stools are relatively soft.
Celiac Disease: An autoimmune condition triggered by gluten that damages the small intestine. Although diarrhea is a common presentation, some individuals experience constipation instead.
Pregnancy-Related Hormonal Changes: Increased progesterone during pregnancy can slow intestinal contractions. Iron supplements and mechanical pressure from the growing uterus can further contribute to constipation.
Metabolic and Hormonal Conditions: Conditions involving elevated calcium levels, electrolyte disturbances, and other hormonal or metabolic abnormalities can interfere with intestinal muscle function.
Structural Abnormalities: Narrowing of the intestine, strictures, intestinal obstructions, and certain tumors can physically interfere with stool passage. These causes are less common but need to be considered when constipation develops alongside warning signs or significant changes in bowel habits.
Fecal Impaction: This occurs when a large amount of hardened stool becomes stuck in the rectum or lower colon. It can cause significant discomfort, difficulty passing stool, abdominal bloating, and sometimes liquid stool leaking around the impacted material. It often requires medical treatment rather than simply increasing dietary fiber.

Drugs

Certain medications and supplements can interfere with normal intestinal contractions, alter fluid balance, or make stools harder. Medication-related constipation is particularly common among older adults and individuals taking several medications.

Common medications associated with constipation include:

Opioids: Pain medications such as codeine, morphine, oxycodone, and hydromorphone can significantly slow intestinal movement. Opioids directly activate receptors in the digestive tract, reducing intestinal contractions and increasing water absorption. Opioid-induced constipation can be persistent and often requires specific treatment.
Antacids with Aluminum or Calcium: Certain antacids containing aluminum hydroxide or calcium carbonate can make stools harder and contribute to constipation.
Antidepressants: Some antidepressants, particularly tricyclic antidepressants, have anticholinergic properties that can reduce intestinal movement. Other antidepressants may also cause constipation in some individuals.
Anticholinergic Medications: Drugs that block acetylcholine activity can decrease smooth muscle contractions in the intestines. Examples include certain antihistamines, medications for overactive bladder, and some medications used for neurological or psychiatric conditions.
Calcium Channel Blockers: Certain blood pressure medications, particularly verapamil, can relax intestinal smooth muscle and slow bowel movements.
Iron Supplements: Iron supplements, especially certain higher-dose preparations, can contribute to constipation, nausea, and abdominal discomfort. They can also darken stool, although black, tarry stools should not automatically be attributed to iron supplementation.
Calcium Supplements: Calcium supplements can contribute to constipation in some people, particularly at higher supplemental intakes.
Diuretics: Medications that increase urine production can contribute to dehydration when fluid losses are not adequately replaced. Dehydration may then worsen constipation.
Anticonvulsants: Some medications used to control seizures may cause constipation as a side effect.
Antispasmodics: Certain medications used to reduce intestinal cramping can also slow gastrointestinal movement, potentially worsening constipation.
Antipsychotic Medications: Some antipsychotics have significant anticholinergic effects and can cause substantial constipation. Clozapine is particularly important because severe gastrointestinal hypomotility can occur and may become dangerous without appropriate monitoring.

If constipation develops after starting a medication or changing its dosage, discuss the issue with your prescriber or pharmacist. Sometimes an alternative medication, a dosage adjustment, or an appropriate constipation treatment can help. However, never stop a prescribed medication without discussing it with your healthcare professional first.

How Is Constipation Diagnosed?

Most uncomplicated cases of constipation can be identified through a discussion of symptoms and medical history. However, persistent or difficult-to-treat constipation may require additional investigation to determine the underlying cause.

Medical History and Physical Examination

A healthcare professional will typically ask about bowel movement frequency, stool consistency, straining, abdominal symptoms, diet, physical activity, and the duration of constipation. They may also review medications and supplements, previous digestive problems, and family history.

A physical examination may include checking the abdomen for tenderness or abnormal fullness. Depending on the symptoms, a rectal examination may also be recommended to assess retained stool, muscle coordination, and other abnormalities.

Laboratory Testing

Blood testing is not automatically necessary for everyone with constipation. However, depending on the medical history and symptoms, a healthcare professional may consider tests for conditions such as hypothyroidism, diabetes, elevated calcium levels, anemia, or other metabolic abnormalities.

For example, thyroid-stimulating hormone testing may be appropriate when symptoms suggest an underactive thyroid. Blood glucose testing may be considered when diabetes is suspected. The choice of tests should be guided by individual clinical findings rather than ordering every possible test for every case of constipation.

Colonoscopy and Imaging

A colonoscopy allows a healthcare professional to examine the inside of the colon for abnormalities such as inflammation, polyps, tumors, and other structural problems.

However, colonoscopy is not routinely required simply because someone has constipation. It may be recommended when there are warning signs, concerning changes in bowel habits, relevant family history, or a need for age-appropriate colorectal cancer screening.

Imaging studies, such as abdominal X-rays or CT scans, may be considered when a bowel obstruction, structural abnormality, or another abdominal condition is suspected.

Specialized Tests for Chronic Constipation

When conventional treatments fail to provide adequate relief, additional testing may help identify the specific mechanism behind constipation.

Anorectal Manometry: This test evaluates pressure and muscle coordination in the rectum and anal sphincter. It can help identify pelvic floor dysfunction or difficulties coordinating the muscles involved in passing stool.
Balloon Expulsion Test: A small balloon is placed in the rectum and filled with water or air. The test measures whether the individual can appropriately expel it, providing information about how effectively the pelvic floor muscles coordinate during bowel movements.
Colonic Transit Study: This evaluates how quickly material travels through the colon. It can help identify slow-transit constipation, where intestinal movement is unusually slow.
Defecography: This imaging examination evaluates the mechanics of bowel emptying and can identify structural or functional problems affecting the rectum and pelvic floor.

These tests are particularly useful when constipation persists despite appropriate treatment. Identifying whether the problem involves slow intestinal movement or difficulty relaxing the pelvic floor can significantly change the treatment approach.

Treatments for Constipation

Treatment depends on the underlying cause, severity, and duration of constipation. For occasional constipation, dietary and lifestyle changes may be sufficient. Chronic constipation may require over-the-counter laxatives, prescription medications, or specialized therapies.

Importantly, there is no single treatment that works for everyone. Someone with low dietary fiber intake may benefit from additional fiber, while someone with slow intestinal movement may respond better to an osmotic laxative. Individuals with pelvic floor dysfunction may need specialized muscle retraining rather than simply taking more laxatives.

Over-the-Counter Remedies

Several types of laxatives and bowel-regulating products are available without a prescription. They work through different mechanisms, and understanding these differences can help people choose an appropriate treatment with guidance from a pharmacist or healthcare professional.

Fiber Supplements: Fiber supplements can help increase stool bulk and improve bowel regularity. Common options include psyllium husk, methylcellulose, and calcium polycarbophil. Psyllium is particularly well studied and has evidence supporting its use in chronic constipation. Fiber supplements are especially useful for people who aren’t getting enough fiber through their regular diet. However, they should be introduced gradually because increasing fiber too quickly can cause gas, bloating, and abdominal discomfort. Adequate fluid intake is also important. Fiber supplements may not be appropriate when bowel obstruction or severe fecal impaction is suspected.
Osmotic Laxatives: Osmotic laxatives draw water into the intestines, helping soften stool and making bowel movements easier. Common examples include polyethylene glycol (PEG), magnesium hydroxide, and lactulose. Polyethylene glycol is particularly well supported by clinical evidence and is a commonly recommended first-line medication for chronic idiopathic constipation. Magnesium-containing laxatives can also be effective, but they require caution in individuals with impaired kidney function because magnesium can accumulate in the body. Lactulose is another option, although it may cause bloating and gas. Osmotic laxatives are generally more effective than simply relying on stool softeners when persistent constipation is the problem.
Stimulant Laxatives: Medications such as bisacodyl, sodium picosulfate, and senna stimulate intestinal activity, helping move stool through the colon. They can be effective for occasional constipation, as rescue treatments, or when other approaches aren’t sufficient. However, they may cause abdominal cramping, urgency, and diarrhea. Guidelines support bisacodyl and sodium picosulfate primarily for short-term or rescue treatment, while longer-term use should be discussed with a healthcare professional. The idea that all stimulant laxatives inevitably cause a permanently lazy bowel is an oversimplification, but frequent unsupervised use or escalating doses is not advisable.
Stool Softeners: Docusate sodium and docusate calcium are examples of stool softeners intended to increase the water content of stool. Although commonly marketed for constipation, their clinical evidence is relatively limited, and they may not provide meaningful relief for many people with established chronic constipation. They are often less effective than better-supported treatments such as polyethylene glycol. They should not automatically be considered the best option simply because they are labelled as stool softeners.
Lubricant Laxatives: Mineral oil is a lubricant that coats stool and makes it easier to pass. However, it is not usually a preferred treatment because of potential problems with aspiration into the lungs, particularly in people with swallowing difficulties or certain neurological conditions. Prolonged use may also interfere with the absorption of fat-soluble vitamins. Mineral oil should not be used routinely without professional guidance.
Suppositories and Enemas: Glycerin or bisacodyl suppositories can sometimes help stimulate a bowel movement or soften stool in the rectum. Enemas may be used in selected cases when stool is difficult to pass, but they should not become a routine solution without medical guidance. Certain enemas, especially sodium phosphate products, can cause serious electrolyte disturbances or kidney complications when used improperly or in susceptible individuals.
Probiotics: Probiotics are live microorganisms intended to influence the gut microbiome. Some clinical studies suggest that certain probiotic preparations may modestly improve stool frequency in people with constipation. However, the results are inconsistent, and the benefits appear to depend on the specific bacterial strain and formulation. A 2025 British Dietetic Association guideline found that the overall evidence was relatively limited and did not establish one universally effective probiotic strain for chronic constipation. Probiotics should therefore be considered an optional adjunct rather than a replacement for better-established treatments.
Herbal Remedies: Certain herbal products contain naturally occurring stimulant laxatives. Senna, for example, is used in standardized medicinal preparations to stimulate bowel movements. However, herbal laxative teas and supplements may contain variable amounts of active ingredients. Products containing cascara sagrada or other stimulant compounds can cause abdominal cramping, diarrhea, dehydration, and electrolyte disturbances. They are not necessarily safer simply because they are marketed as natural. Ginger may help with some digestive symptoms, but it is not an established treatment for constipation.

Which over-the-counter laxative is most effective? For adults with chronic idiopathic constipation, polyethylene glycol (PEG) has particularly strong support in clinical guidelines. Fiber supplements, especially psyllium, can also be useful when fiber intake is inadequate. Stimulant laxatives are effective options for short-term or rescue treatment. Docusate and generic probiotic products have less convincing evidence as primary treatments.

One final point: laxatives aren’t inherently harmful or addictive when used appropriately. Some individuals with chronic constipation need ongoing treatment to maintain comfortable bowel movements. The important consideration is choosing the right treatment and periodically reviewing persistent symptoms with a healthcare professional rather than continuously increasing doses or combining multiple laxatives without guidance.

Lifestyle Changes

Lifestyle changes are an important part of preventing and managing constipation. Although they may not resolve every case, they can improve bowel regularity and reduce the need for medication in some individuals.

Increase Fiber Intake: Incorporate more fiber-rich foods such as fruits, vegetables, legumes, nuts, seeds, and whole grains. Adults generally need approximately 22–34 grams of fiber daily, depending on age and sex. Increase intake gradually over several weeks to allow the digestive system to adjust. Foods such as pears, kiwi, prunes, beans, oats, and lentils can be particularly useful. For individuals who have difficulty meeting their fiber requirements through food, a fiber supplement may be helpful.
Stay Adequately Hydrated: Drink enough water and other fluids to prevent dehydration and support normal stool consistency. Fluid requirements vary depending on body size, activity level, climate, and medical conditions. There is no universal requirement that everyone must drink exactly eight cups of water daily. Increasing fluids is particularly important when increasing fiber intake, but drinking excessive amounts of water is unlikely to correct constipation in someone who is already adequately hydrated.
Regular Physical Activity: Engage in regular movement throughout the day. Walking, cycling, swimming, and other forms of moderate physical activity may help support normal bowel function. Even relatively modest increases in daily movement can be helpful for people who spend much of their time sitting.
Establish a Regular Bathroom Routine: Try to allow time for a bowel movement at a consistent time each day. Many people find that attempting to use the bathroom after breakfast is helpful because eating stimulates intestinal activity through a natural response called the gastrocolic reflex. This reflex increases movement in the colon after a meal.
Don’t Ignore the Urge: Respond to the natural urge to have a bowel movement rather than repeatedly postponing it. Regularly ignoring these signals may contribute to difficulty maintaining a normal bowel routine.
Improve Bathroom Posture: Sitting on the toilet with the feet supported on a small footstool, allowing the knees to sit slightly higher than the hips, may make bowel movements more comfortable. Leaning forward slightly and relaxing the abdominal and pelvic floor muscles can also help. Avoid excessive straining or spending unnecessarily long periods sitting on the toilet.
Allow Enough Time and Privacy: Rushing through bathroom visits or regularly postponing bowel movements can interfere with normal bowel habits. Establishing a comfortable, consistent routine may be particularly beneficial for individuals whose schedules make regular bathroom visits difficult.
Manage Stress: Stress can influence communication between the brain and digestive system. Techniques such as relaxation exercises, meditation, breathing exercises, and other enjoyable activities may help some people manage stress-related digestive symptoms.
Maintain Regular Eating Habits: Skipping meals or significantly changing eating schedules may alter the normal stimulation of intestinal movement. Eating regular, balanced meals that contain fiber-rich foods can help support more predictable bowel habits.

Remember, lifestyle changes may take time to show results. Increasing fiber intake, improving hydration, and establishing regular bathroom habits can be beneficial, but they aren’t guaranteed to resolve constipation caused by underlying medical conditions or abnormal intestinal movement.

For persistent or chronic constipation, consult with a healthcare professional rather than relying indefinitely on lifestyle changes alone. The goal is to identify the underlying cause and find an effective, sustainable treatment approach.

Prescription Medications

When lifestyle modifications and over-the-counter treatments do not provide sufficient relief, prescription medications may be considered. These medications generally work by increasing intestinal fluid secretion, improving intestinal movement, or counteracting the effects of particular medications that cause constipation.

They are typically reserved for persistent or chronic constipation, particularly when ordinary treatments have been ineffective or poorly tolerated. Their availability and approved indications can vary between countries.

Lubiprostone (Amitiza): Lubiprostone activates chloride channels in the intestinal lining, increasing fluid secretion into the intestines. This softens stool and helps facilitate bowel movements. It is used for certain forms of chronic idiopathic constipation and constipation-predominant irritable bowel syndrome, depending on the country’s approved indications. Nausea, diarrhea, and abdominal discomfort are possible side effects.
Linaclotide (Linzess/Constella): Linaclotide activates guanylate cyclase-C receptors in the intestinal lining, increasing chloride and bicarbonate secretion into the intestines. This increases intestinal fluid and helps accelerate stool movement. It is used for chronic idiopathic constipation and IBS-C. Diarrhea is one of its most common adverse effects and can occasionally be severe.
Prucalopride (Resotran/Resolor): Prucalopride is a selective serotonin 5-HT4 receptor agonist that stimulates intestinal contractions and helps move stool through the colon. It is generally considered when conventional laxatives have not provided adequate relief. The approved indication varies by country. For example, Health Canada’s Resotran product monograph specifies its use for adult female patients with chronic idiopathic constipation when laxatives have failed to provide adequate relief. Common side effects include headache, nausea, abdominal discomfort, and diarrhea.
Plecanatide (Trulance): Plecanatide works similarly to linaclotide by activating guanylate cyclase-C receptors in the intestinal lining. This increases fluid secretion, softens stool, and promotes bowel movements. It is approved for chronic idiopathic constipation and IBS-C in the United States. Availability and approved indications differ between countries. Diarrhea is the most common side effect.
Naloxegol (Movantik): Naloxegol is a peripherally acting mu-opioid receptor antagonist (PAMORA) specifically used for opioid-induced constipation. It blocks opioid effects in the digestive tract while generally preserving their pain-relieving effects in the central nervous system. It is particularly useful when ordinary laxatives do not adequately address constipation caused by opioid pain medications.
Naldemedine (Symproic): Naldemedine is another peripherally acting opioid receptor antagonist used to treat opioid-induced constipation in adults. It works by counteracting the effects of opioids on intestinal movement without generally interfering with their pain-relieving effects.
Methylnaltrexone (Relistor): Methylnaltrexone is another medication that blocks peripheral opioid receptors in the digestive tract. It is used for certain cases of opioid-induced constipation when conventional laxatives are insufficient. Its approved uses depend on the formulation and country.

These prescription medications differ substantially in their mechanisms, effectiveness, side effects, and approved uses. They aren’t interchangeable, and some are designed specifically for opioid-related constipation rather than ordinary chronic constipation.

For example, linaclotide and plecanatide increase intestinal fluid secretion, while prucalopride directly stimulates intestinal motility. Naloxegol, naldemedine, and methylnaltrexone are more specialized treatments that target opioid-related effects in the digestive tract.

Pelvic Floor Physical Therapy and Biofeedback

Not all constipation is caused by hard stool or slow intestinal movement. Some individuals have difficulty coordinating the muscles involved in bowel movements. This is particularly relevant in a condition called dyssynergic defecation.

Normally, the pelvic floor muscles and anal sphincter relax while the rectum and abdominal muscles help move stool out of the body. With pelvic floor dysfunction, these muscles may fail to relax appropriately or may contract at the wrong time. As a result, passing stool can become difficult despite adequate intestinal movement and relatively soft stool.

Pelvic floor physical therapy and biofeedback are specialized treatments that help individuals learn to coordinate these muscles more effectively. During biofeedback sessions, sensors provide information about muscle activity so patients can practice relaxing and contracting the appropriate muscles during simulated bowel movements.

For people with confirmed pelvic floor dysfunction, biofeedback can be more effective than simply increasing fiber intake or repeatedly adding laxatives. It addresses the underlying problem with bowel emptying rather than just changing stool consistency.

Treating Fecal Impaction

Severe constipation can sometimes lead to fecal impaction, where hardened stool becomes lodged in the rectum or lower colon. This can cause significant discomfort, difficulty passing stool, and sometimes liquid stool leaking around the retained material.

Fecal impaction generally requires medical assessment because simply increasing fiber or taking additional over-the-counter laxatives may not be sufficient. Depending on the situation, treatment may involve specific laxative regimens, suppositories, enemas, or supervised removal of impacted stool by a healthcare professional.

After the impaction has been resolved, an ongoing treatment plan is important to prevent recurrence. This may include dietary adjustments, appropriate laxatives, medication review, and investigation of any underlying digestive or pelvic floor problems.

When Is Surgery Considered?

Surgery is rarely necessary for constipation and is generally reserved for carefully selected individuals with severe, treatment-resistant disease.

In certain cases of confirmed slow-transit constipation, where the colon moves stool abnormally slowly despite extensive medical treatment, specialists may consider surgery involving removal of part or most of the colon. This is a major intervention and can lead to complications or persistent digestive symptoms if the underlying problem has not been correctly identified.

Importantly, surgery should not be considered simply because someone has tried several laxatives without success. Specialized testing is needed to confirm slow intestinal transit and exclude pelvic floor dysfunction or other disorders that could explain the symptoms. The American Gastroenterological Association’s 2026 clinical practice update emphasizes careful evaluation and appropriate non-surgical treatment before considering surgery for refractory constipation.

Special Considerations: Constipation During Pregnancy and in Children

Although many constipation treatments are widely used in adults, certain populations require additional consideration because the causes and appropriate treatment approaches can differ.

Constipation During Pregnancy

Constipation is common during pregnancy. Hormonal changes can slow gastrointestinal movement, while iron supplements, changes in physical activity, dietary changes, and pressure from the growing uterus can contribute.

Increasing dietary fiber, drinking adequate fluids, and remaining physically active when medically appropriate are reasonable starting points. However, pregnant individuals should consult their healthcare professional or pharmacist before starting laxatives, herbal remedies, or other constipation treatments. The appropriate choice depends on the individual’s pregnancy and medical circumstances.

Constipation in Children and Teenagers

Constipation is also common in children and teenagers. It can be associated with changes in diet, insufficient fluid intake, withholding bowel movements, toilet-training difficulties, and disruptions to school or bathroom routines.

Unlike adults, children may not always recognize or communicate constipation symptoms clearly. Some may avoid using the bathroom because of previous painful bowel movements, which can create a cycle of stool retention and increasingly difficult bowel movements.

Management may involve dietary changes, establishing regular bathroom routines, and age-appropriate medications when recommended by a healthcare professional. Persistent constipation in children should be evaluated rather than managed indefinitely through home remedies alone.

How Long Does It Take to Relieve Constipation?

The time needed to improve constipation depends on its underlying cause and the treatment being used. Some people notice improvements relatively quickly, while those with chronic constipation may require several weeks of adjustments and a more structured treatment plan.

Different treatments have different time frames. Fiber supplementation generally requires consistent use over time, while polyethylene glycol often takes a few days to produce a noticeable bowel movement. Stimulant laxatives may work more quickly, although their suitability depends on the circumstances.

More importantly, having one bowel movement does not necessarily mean the underlying problem has been resolved. People with chronic constipation may need ongoing adjustments to their diet, medications, physical activity, or bathroom routines to maintain regular bowel movements.

If constipation does not improve despite reasonable self-care and appropriate treatment, or if symptoms repeatedly return, a healthcare professional should reassess the situation. Continuing to add more fiber or take increasingly large amounts of laxatives may not address the actual cause.

Preventing Constipation

Although not every case of constipation can be prevented, maintaining healthy digestive habits can reduce the likelihood of developing problems with bowel regularity.

Eat a Fiber-Rich Diet: Regularly include fruits, vegetables, legumes, nuts, seeds, and whole grains. A variety of fiber sources helps maintain stool bulk and supports normal bowel function.
Maintain Adequate Hydration: Drink enough fluids throughout the day to prevent dehydration. Fluid needs vary, so focus on maintaining adequate hydration rather than following an arbitrary water target.
Stay Physically Active: Regular movement can support digestive health and help maintain normal intestinal activity.
Maintain Consistent Eating Habits: Regular meals help stimulate normal intestinal activity and provide opportunities to consume adequate fiber and fluids.
Respond to Natural Bowel Signals: Avoid repeatedly postponing bathroom visits when you feel the urge to have a bowel movement.
Review Medications: If you regularly experience constipation, discuss your medications and supplements with a healthcare professional to determine whether any could be contributing.
Establish a Consistent Bathroom Routine: Allow time for bowel movements, particularly after meals, and avoid excessive straining.

Final Thoughts on Managing Constipation

Constipation is a common digestive problem with many possible causes, ranging from inadequate fiber intake and dehydration to medications, hormonal changes, and underlying gastrointestinal disorders.

For occasional constipation, simple measures such as increasing dietary fiber, maintaining adequate hydration, exercising regularly, and establishing consistent bathroom habits may be enough. When additional treatment is necessary, over-the-counter options such as psyllium and polyethylene glycol have good supporting evidence, while stimulant laxatives can provide effective short-term or rescue relief.

For persistent constipation, prescription medications such as linaclotide and prucalopride may be appropriate, depending on the underlying problem. Individuals with opioid-induced constipation may benefit from medications that specifically counteract the effects of opioids in the digestive tract. Those with pelvic floor dysfunction may benefit more from specialized biofeedback therapy than from simply taking additional laxatives.

Ultimately, the best approach is to identify what’s causing constipation rather than simply treating the symptom. Most cases can be managed without invasive procedures, but persistent symptoms, concerning changes in bowel habits, or warning signs should always be evaluated by a healthcare professional.