It’s possible that you can be constipated yet still have bowel movements. This can occur due to diet or health conditions including irritable bowel syndrome.

Constipation is typically defined as having fewer than three bowel movements a week. However, constipation has a few other potential symptoms, including:

  • having a hard time passing stools
  • passing stools that are hard and dry
  • feeling like you’re not passing all the stool (incomplete evacuation)

Keep reading for more info on why constipation (and incomplete evacuation) occurs, and how to treat and prevent it.

In a perfect world, you’d have bowel movements that are formed, yet soft and easy to pass (no straining or struggling for long time periods).

While there’s no perfect number of bowel movements you should be having every week, most people aim to have a bowel movement every one to two days.

When you’re constipated, things go a little differently. You may sit on the toilet for long times, trying to poop. You may also feel like you need to poop, but only get out a small amount of hard, dry stool, and you still feel like you could poop more.

This is known as incomplete evacuation, and is a hallmark constipation symptom.

The causes list for incomplete evacuation is very long. From diet to medicines to lifestyle, there are many factors.

Common causes

  • Diet. Not drinking enough water or eating enough fiber are common constipation contributors. Replacing these foods with dairy products and sugary foods can further the problem. Switching to a diet higher in fiber and fluids can help reduce constipation symptoms in many people.
  • Ignoring the urge to go. If you resist the urge to go too often, it messes with your nerves that sense when it’s time to poop. Over time, this can lead to constipation.
  • Irritable bowel syndrome (IBS). This condition can cause chronic constipation as well as stomach pain and bloating.
  • Medications. Many medications can slow down intestinal movement or affect how the nerves and muscles in the digestive tract work. While you shouldn’t stop taking any medicines without your doctor’s approval, medications that treat conditions like depression, diabetes, high blood pressure, and Parkinson’s disease can cause constipation.
  • Sedentary lifestyle. Movement and exercise can help stimulate the bowels to move stool forward. People who are confined to bed or get very little physical activity are more prone to incomplete evacuation.
  • Dyssynergic defecation. This condition occurs when the nerves and muscles responsible for promoting defecation don’t work together as they should. Examples include if the anal muscles don’t relax enough for stool to leave the body, or if the rectal muscles tighten instead of relaxing.

Less common causes

  • Anal fissure. An anal fissure occurs when there’s a tear near the end of the anus. This causes often-extreme pain when trying to pass stool.
  • Cancer. Cancers of the bowel and anus can cause constipation. Other symptoms may include rectal bleeding, chronic stomach discomfort, and unexplained fatigue.
  • Hypothyroidism. A low-performing thyroid affects the hormones that promote digestion, which can result in constipation.
  • Neurological disorders. Disorders such as Parkinson’s disease or a history of brain injuries can lead to nervous system dysfunction that causes constipation.
  • Stricture. A stricture occurs when a part of the intestines becomes narrower. Stool is harder to pass through this narrow place.
  • Anxiety and depression. A strong connection exists between the body and mind. Those who are anxious or depressed are more likely to experience incomplete evacuation. Taking medicines for anxiety and depression, unfortunately, can also contribute to constipation.

A healthcare provider can help you determine if a current condition, or a medication you’re taking is causing your constipation.

Constipation can be problematic for several reasons. One, it’s uncomfortable. Two, it increases your risk for problems such as fecal impaction and bowel obstruction, where your stool can’t leave your body.

Constipation that is ongoing can lead to hemorrhoids, anal fissures, diverticular disease, rectal bleeding, and rectal prolapse.

While practically everyone gets constipated periodically, there are some times when you should call a doctor. These include:

  • abdominal pain or stomach distention (bloating), and you haven’t gone to the bathroom in a few days
  • going longer than five days to a week without having a bowel movement
  • having to use laxatives more than two to three times per week
  • rectal bleeding

Consider your symptoms as a whole when trying to decide if it’s time to call a doctor. If constipation and discomfort are becoming the rule, not the exception, it’s best to talk to your healthcare provider.

Healthcare providers can immediately treat constipation with medications that make stool softer and easier to pass. Examples include over-the-counter medicines, such as laxatives or stool softeners.

In rare instances, a doctor will need to remove may need have a fecal impaction (hard, built-up stool in the rectum that won’t pass) removed.

If there are problems such as strictures, an anal fissure, or other physical problems with the intestines, a doctor may recommend surgery to correct the problem.

There are a number of lifestyle changes that can help prevent constipation from occurring. These preventive tips can also help treat constipation.

To prevent or treat constipation, try:

  • drinking plenty of water each day such that your urine is pale yellow in color
  • engaging in regular physical activity, such as walking or swimming, to promote intestinal movement
  • going to the bathroom when you feel like you need to; some people will even try to go to the bathroom the same time every day to “train” their bowels
  • incorporating more fiber in your diet, such as fruits, vegetables, and whole grains; aiming for about 25 to 30 grams of fiber a day is a good goal

You can also talk to your healthcare provider about preventive tips. They can take into account your overall health and dietary needs, and come up with a good plan for you.

You can still poop and be constipated if the poop you pass doesn’t give you the satisfaction of a good evacuation.

Don’t be embarrassed or worried about approaching the constipation topic with your healthcare provider. Pretty much everyone has been constipated at least once in their lives, so there’s nothing to be embarrassed about.

Because there are lots of lifestyle and medication methods you can use to relieve constipation, it’s best to talk to your healthcare provider about potential treatments, especially if your constipation is chronic.