Key takeaways:
Constipation happens when you have fewer than three bowel movements per week.
Symptoms of constipation include dry, hard stools that are difficult to pass.
You can treat constipation with over-the-counter (OTC) medications and home remedies, like consuming more fiber, drinking more fluids, and doing more physical activity.
With so many myths circulating about constipation and how to treat it, it can be hard to know where to turn for help. Fortunately, avoiding constipation and treating it can be easier than you may think.
Read on to learn about why constipation happens — and what you can do to get your stools back to normal.
What does it mean to be constipated?
Constipation is a medical condition that causes changes to your stool and your ability to go to the bathroom. Everyone’s stooling patterns are a little bit different. But with constipation, you’ll notice a clear change from your usual pattern of bowel movements. That said, people’s experiences with constipation can differ.
Some people may notice that they’re stooling less often than normal. Others may notice that they can still use the bathroom regularly but that their stools look different than usual — usually harder and cracked. Most people experience a little of both, along with discomfort and straining. Some people also feel like they haven’t completely emptied their bowels, even after having a bowel movement.
What are the symptoms of constipation?
You can tell that you have constipation by noticing changes to your regular bowel movement patterns.
Common symptoms of constipation include:
Fewer bowel movements per week than normal
Pooping fewer than three times per week
Harder or drier stools than normal
Pain or straining while stooling
Feeling like you aren’t able to pass stool or get all your stool out
There’s a wide range of “normal” when it comes to how often you should poop and what your stools look like. On average, most people poop from three times a week up to three times a day. The Bristol Stool Chart can help you understand different types of stool.
What causes constipation?
Constipation can be caused by anything that makes your intestines move more slowly or causes stool to stay in your colon longer than usual. There are a surprising number of things that can cause constipation, including everyday habits, medications, and medical conditions.
1. Diet and exercise habits
What you eat and drink can increase your risk of getting constipated. So can your activity level.
Here are some everyday habits that can lead to constipation:
A lack of physical activity: The muscles around your colon are more active when you get more activity throughout the day. These muscles help you pass stool. If they’re not moving, your stool sticks around in your colon, getting harder and drier and, therefore, more difficult to pass.
Not drinking enough fluids: If you don’t drink enough fluids, your body will try to make up for it by sucking out as much water from your stool as possible, so you can hold on to every drop. But this makes stool hard, dry, and more difficult to pass.
Not eating enough fiber: Fiber from fruits and vegetables makes stools bulkier and easier to pass. Not getting enough fiber can make your stools harder and drier.
Holding it in: Overriding the urge to go to the bathroom is sometimes necessary, but holding it in often can lead to constipation.
2. Medications
Some medications are notorious for causing constipation, like:
Prescription pain medications: Opioid medications slow the intestines down. If you’re taking these, talk to a healthcare professional about also starting treatment to prevent constipation.
Certain antihistamine medications: Older allergy medications, like diphenhydramine (Benadryl), can cause constipation by slowing the gut. Newer ones, like cetirizine (Zyrtec) and fexofenadine (Allegra), are much less likely to do so.
Tricyclic antidepressants: Older antidepressants, like amitriptyline, can slow the gut, the same way that some antihistamines do.
Incontinence medications: Medications, like oxybutynin, treat urinary incontinence (leaking urine) by relaxing the bladder muscles. But these medications also relax the colon and can cause constipation.
Iron supplements: Ferrous sulfate and other iron supplements are a common cause of constipation. While taking them, you might also have harder and black-colored stools.
3. Medical conditions
Some medical issues can cause constipation. If you have one of these medical conditions, talk with a healthcare professional about starting treatment to keep your bowel movements regular:
Blockages of the colon or intestines: Bowel tumors and narrowing of the intestines can cause stool to back up. This can be caused by medical conditions, like Crohn’s disease.
Certain nerve conditions: Some medical conditions — like multiple sclerosis, Parkinson’s disease, spinal cord injuries, and stroke — can affect the nerves around your intestines. This can make it harder for your intestines to move stool out of your body.
Pelvic muscle problems: The muscles in the pelvis help the intestines move. If these muscles and the intestines aren’t working together properly, you can get constipated.
Certain hormone conditions: Hypothyroidism and Type 1 and Type 2 diabetes can cause constipation.
Pregnancy: Constipation is pretty common during pregnancy. Hormones that get released when you’re pregnant slow down the normal movement of your digestive system.
How is constipation treated?
Many treatments for constipation are available over the counter (OTC). You could consider taking these in addition to adding fiber, water, and exercise to your daily routine.
Oral medications to treat constipation include:
Stool softeners, like docusate sodium (Colace)
Fiber supplements, like psyllium (Metamucil)
Stimulant laxatives, like sennosides (Senna, Ex-lax) and bisacodyl (Dulcolax)
Osmotic laxatives, like lactulose or polyethylene glycol (Miralax, Glycolax)
Suppositories and at-home enemas
You could also consider using a toilet stool (like a Squatty Potty), since raising your feet and putting yourself in a squatting position may make having a bowel movement easier.
How can you prevent constipation?
There are many steps you can take to prevent constipation. You could:
When should I see a healthcare professional about constipation?
If you’ve adjusted your fiber and water intake, changed how you sit on the toilet, and started exercise and still haven’t found relief, talk to a healthcare professional about other options, like suppositories, enemas, and OTC medications. These options are meant to be used for short periods of time. So, if you find yourself using them too often, talk with a healthcare professional about more long-term options. For chronic constipation, they may recommend certain medications, like Linzess (linaclotide).
Sometimes constipation can be a sign of a medical emergency. Get immediate medical attention if you have:
Severe abdominal or rectal pain
Vomiting
Signs of an infection (like fever, rapid breathing, or fast heart rate)
An inability to pass stool and feeling like it’s stuck
What can happen if constipation is not treated?
Constipation can disrupt everyday activities and make you feel bloated and uncomfortable. Constipation that goes on for a long time can cause other problems, too, like:
Hemorrhoids: Hemorrhoids are swollen veins around the anus that can be painful, itchy, and bloody.
Anal fissures: These are tiny tears around your anus that are painful.
Rectal prolapse: Rectal prolapse is when the last part of the intestine, called the rectum, actually protrudes out of the anus.
Fecal impaction: This is when stools become so hard that they literally get stuck in your intestines. A healthcare professional has to remove the stool manually, a procedure known as manual disimpaction.
Frequently asked questions
Yes, constipation may cause mild back pain if stool collects in your colon and puts pressure on your lower back. Treating your constipation should relieve this mild discomfort. But if the pain is intense or you have other symptoms, like fever or vomiting, get medical attention right away.
Miralax (polyethylene glycol) is an over-the-counter medication that can help treat constipation. The standard dose for adults is 17 g (1 capful or packet). Mix this into 4 oz to 8 oz of liquid. Miralax takes 1 to 3 days to start working for constipation. If your constipation doesn’t improve after taking Miralax for 7 days or if you have severe constipation, connect with a healthcare professional. They may recommend a different treatment.
If you think your baby is constipated, your pediatrician may first recommend trying natural remedies to relieve it. With your baby on their back, gently move their legs so it looks like they're pedaling a bike. This can help get their bowels moving. If your baby is already eating solid foods, try giving them high-fiber foods, like prunes, apricots, and apples.
Keep in mind that sometimes babies will go as long as 5 to 7 days without pooping. This can be OK so long as they’ve already established a pattern of pooping, and they’re growing and eating well. Contact your baby’s pediatrician if it looks like your baby is in pain when pooping or has blood in their stool.
Yes, constipation may cause mild back pain if stool collects in your colon and puts pressure on your lower back. Treating your constipation should relieve this mild discomfort. But if the pain is intense or you have other symptoms, like fever or vomiting, get medical attention right away.
Miralax (polyethylene glycol) is an over-the-counter medication that can help treat constipation. The standard dose for adults is 17 g (1 capful or packet). Mix this into 4 oz to 8 oz of liquid. Miralax takes 1 to 3 days to start working for constipation. If your constipation doesn’t improve after taking Miralax for 7 days or if you have severe constipation, connect with a healthcare professional. They may recommend a different treatment.
If you think your baby is constipated, your pediatrician may first recommend trying natural remedies to relieve it. With your baby on their back, gently move their legs so it looks like they're pedaling a bike. This can help get their bowels moving. If your baby is already eating solid foods, try giving them high-fiber foods, like prunes, apricots, and apples.
Keep in mind that sometimes babies will go as long as 5 to 7 days without pooping. This can be OK so long as they’ve already established a pattern of pooping, and they’re growing and eating well. Contact your baby’s pediatrician if it looks like your baby is in pain when pooping or has blood in their stool.
The bottom line
Constipation is a common concern and can be caused by medications, medical conditions, or not getting enough fiber, water, and exercise. There are medications, suppositories, and enemas that can help to alleviate constipation. But these options work best when paired with changes in diet and increased exercise, as well as addressing any other issues that could be causing constipation.
Why trust our experts?
References
Better Health Channel. (2024). Constipation. Victoria State Government Department of Health.
HealthyChildren.org. (2024). Pooping by the numbers: What's normal for infants?
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms and causes of constipation.
Setya, A., et al. (2023). Fecal impaction. StatPearls.
University of Rochester Medical Center. (2023). Constipation.
