Constipation is one of the most common digestive problems in the United States. Around 16 out of 100 U.S. adults have constipation. This figure doubles for adults over age 60.

It’s defined as having hard, dry bowel movements or passing stool fewer than three times a week.

Each person’s bowel habits are different. Some people go three times a day, while others go three times a week.

However, you may be constipated if you experience the following symptoms:

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends seeking medical advice if symptoms don’t go away or if you notice the following:

  • bleeding from the rectum
  • blood in your stool
  • persistent abdominal pain
  • pain in the lower back
  • a feeling that gas is trapped
  • vomiting
  • fever
  • unexplained weight loss
  • a sudden change in bowel movements

A healthcare professional may carry out tests to rule out a more serious condition, such as colorectal cancer or irritable bowel syndrome (IBS).

Your colon’s main job is to absorb water from residual food as it’s passing through your digestive system. It then creates stool (waste).

The colon’s muscles eventually propel the waste out through the rectum to be eliminated. If stool remains in the colon too long, it can become hard and difficult to pass.

Poor diet frequently causes constipation. Dietary fiber and adequate water intake are necessary to help keep stools soft.

Fiber-rich foods are usually plant-based. Fiber comes in soluble and insoluble forms. Soluble fiber can dissolve in water and creates a soft, gel-like material as it passes through the digestive system.

Insoluble fiber retains most of its structure as it goes through the digestive system. Both forms of fiber join with stool, increasing its weight and size while also softening it. This makes it easier to pass through the rectum.

Stress, changes in routine, and conditions that slow muscle contractions of the colon or delay your urge to go may also lead to constipation.

Common causes of constipation include:

  • low fiber diet, particularly diets high in meat, milk, or cheese
  • dehydration
  • low exercise levels
  • delaying the impulse to have a bowel movement
  • travel or other changes in routine
  • medications, including certain antacids, pain medications, diuretics, and some treatments for Parkinson’s disease
  • pregnancy
  • older age (constipation affects around one-third of people ages 60 and over)

Underlying health issues

The following underlying health conditions can bring on constipation:

Changing your diet and increasing your physical activity level are the easiest and fastest ways to treat and prevent constipation.

You can try the following techniques as well:

  • Every day, drink 1.5 to 2 quarts of unsweetened fluids, like water, to hydrate the body.
  • Limit consumption of alcohol and caffeinated drinks, which cause dehydration.
  • Add fiber-rich foods to your diet, such as raw fruits and vegetables, whole grains, beans, prunes, or bran cereal. Your daily intake of fiber should be between 20 and 35 grams.
  • Cut down on low fiber foods, such as meat, milk, cheese, and processed foods.
  • Aim for about 150 minutes of moderate exercise every week, with a goal of 30 minutes per day at least five times per week. Try walking, swimming, or biking.
  • If you feel the urge to have a bowel movement, don’t delay. The longer you wait, the harder your stool can become.
  • Ask your doctor about bowel training to get your body used to passing stool 15 to 45 minutes after breakfast each day.
  • Raise your knees by putting your feet on a footstool when having a bowel movement.
  • When using the bathroom, allow yourself plenty of time, and try to relax your muscles.
  • Use laxatives sparingly. A healthcare professional may prescribe laxatives or enemas for a short period of time to help soften your stools. Never use laxatives for more than 2 weeks without talking with a healthcare professional. Your body can develop a dependence on them.
  • Ask a healthcare professional if any of your medications might be causing constipation.

Over-the-counter medications

If home remedies do not work, a healthcare professional may recommend an over-the-counter laxative, such as:

  • fiber supplements
  • osmotic agents, such as Milk of Magnesia
  • stool softeners
  • lubricants, such as mineral oil
  • stimulants

Prescription drugs

If you still have trouble with constipation, a healthcare professional may prescribe medications to help, such as:

  • lubiprostone, which increases fluid levels in the intestine
  • linaclotide or plecanatide, which can help make bowel movements more regular for people with long-term constipation or IBS
  • prucalopride, which can help the colon move the stool along

A healthcare professional may also advise that you stop taking certain medications that may cause constipation.

Other options

Other strategies that may help are:

  • biofeedback therapy, which can help a person retrain their muscles
  • an enema
  • a procedure to manually remove feces to provide relief
  • surgery to remove a blockage
  • long-term treatment for a chronic condition, such as IBS

Tips for preventing constipation are similar to those for relieving it.

Try the following:

  • Eat plenty of fruits, vegetables, and whole grains.
  • Eat high fiber foods and ask a healthcare professional about using fiber supplements.
  • Include prunes or bran cereal in your diet.
  • Drink plenty of water.
  • Avoid alcohol and caffeine, as they can lead to dehydration.
  • Get regular exercise.
  • Consider adding probiotics to your diet, like those found in yogurt and kefir with live active cultures.
  • Train your muscles to have a bowel movement at the same time each day.

Some studies have shown that adding probiotics can be helpful for people with chronic constipation. If you add fiber supplements, remember to drink plenty of fluids. Fluids help fiber work more efficiently.

If constipation persists, or if you have concerns about your symptoms, it may be time to see a healthcare professional.

A healthcare professional:

  • will ask questions about your symptoms, medical history, and any medications or underlying conditions
  • may carry out a physical examination, including a rectal exam
  • may do some blood tests to check your blood count, electrolytes, and thyroid function

They may recommend additional tests to identify the cause of your symptoms. Tests may include the following:

Marker study

A marker study, also called a colorectal transit study, is used to test how food is moving through your colon. For this test, you’ll swallow a pill that contains tiny markers that will show up on an X-ray.

Numerous abdominal X-rays will be taken over the next few days so the healthcare professional can visualize how the food is moving through your colon and how well your intestinal muscles are working.

You may also be asked to eat a diet high in fiber during the test.

Anorectal manometry

An anorectal manometry is a test used to evaluate anal sphincter muscle function. For this test, a healthcare professional will insert a thin tube with a balloon tip into your anus.

When the tube is inside, they will inflate the balloon and slowly pull it out. This test allows them to measure your anal sphincter’s muscle strength and see whether your muscles are contracting properly.

Barium enema X-ray

A barium enema X-ray is a type of test used to examine the colon. For this test, you’ll drink a special liquid the night before the test to clean out the bowel.

The actual test involves the insertion of a dye called barium into your rectum, using a lubricated tube. The barium highlights the rectum and colon area. This allows the healthcare professional to better view these areas on an X-ray.

Colonoscopy

A colonoscopy is another type of test healthcare professionals use to examine the colon. In this test, a healthcare professional will examine your colon using a colonoscope. This is a tube fitted with a camera and light source.

A sedative and pain medication is often given, so you’ll likely not even remember the examination and should feel no pain.

To prepare for this test, you’ll be on a liquid-only diet for 1 to 3 days. You may have to take a laxative or enema the night before the test to clean out the bowel.

Constipation is a common problem that affects people as they get older, when they use certain medications, or if they don’t have much fiber in their diet.

Most cases of constipation are mild and easily treated with changes in diet and exercise.

If you’re experiencing chronic constipation or constipation along with other bowel changes, it’s important that you talk with a healthcare professional.