Constipation refers to a disorder of bowel movements in which defecation is difficult or occurs less frequently than usual. Constipation is often present when bowel movements occur less than three times a week or require straining to pass. The bowel moves more slowly in this condition, which can lead to hard stools, a feeling of fullness, and abdominal pain. A distinction is made between acute constipation and chronic constipation, with chronic constipation defined as lasting for at least three months.
Chronic constipation is a common symptom in gastroenterology and can significantly impair quality of life. Causes of constipation range from a diet low in fiber and lack of exercise to medications or organic diseases such as intestinal obstruction or a tumor in the colon. A thorough medical history, physical examination, and, if necessary, further diagnostic tests help distinguish between functional and secondary constipation.
What are some possible causes of constipation?
- A diet low in fiber
- Insufficient fluid intake
- insufficient exercise
- Emotional stress, a hectic lifestyle, and stress
- A change in diet during or after a trip
- Abuse of laxatives
- Side effects of medications
- Pregnancy (hormonal changes)
- Certain medical conditions, e.g., diabetes mellitus
Causes of acute (sudden) constipation can also include
- bowel tumors,
- disturbances in bowel motility (peristalsis) following surgery, and
- suppression of bowel movements due to pain associated with conditions of the anal region
.
What to Do About Constipation?
If you have chronic constipation, you should review your lifestyle habits and make changes if necessary. Essentially, this involves
- eating more fiber,
- drinking more fluids, and
- being more active.
Switch to a high-fiber diet with at least 30 g of fiber per day. To allow your intestines to adjust to the change, make the switch gradually over several days or weeks. Any bloating or discomfort that may occur at first usually goes away after about one to two weeks.
Replace white flour with whole-grain flour, e.g.,
- whole-grain bread,
- brown rice,
- whole-grain pasta.
It’s also a good idea to incorporate more fruits, vegetables, and legumes into your diet. As a snack, you can eat soaked dried fruit. You can also enrich your meals with wheat bran, oat bran, and ground flaxseed.
Dietary fiber can only function properly if there is sufficient fluid available. Therefore, you should drink at least 1.5 liters of fluid at the same time.
You should only use a laxative if these measures do not work. However, long-term use of laxatives can cause serious health problems. Bowel function may decrease even further, potentially leading to chronic bowel disorders. Relying on laxatives again creates a vicious cycle. You may also become dependent on them.
Therefore, always discuss the use of laxatives with your doctor.
If, in addition to constipation,
- other symptoms occur,
- severe pain, or
- blood in the stool
, you should also see a doctor.
Additional measures that may help with chronic constipation
- Daily consumption of foods with a laxative effect, such as fermented milk products (yogurt, quark, thick milk) and sauerkraut
- Limit your intake of low-fiber foods such as refined flour baked goods and pasta, sugar, chocolate, etc.
- A substantial breakfast or a glass of cold fruit juice
- Regular physical activity such as cycling or walking. Physical activity stimulates the passage of food through the intestines and thus also promotes bowel movements.
- Yoga and other relaxation techniques such as autogenic training
- Gradually warming and alternating-temperature foot baths, as well as cold water stimulation to stimulate bowel activity
- A week of fasting. Fasting boosts metabolism and often regulates bowel function in the long term
FAQ
What are the most common causes of constipation?
Common causes of constipation include a diet low in fiber, insufficient fluid intake, and a lack of exercise. Certain medications, such as opioids, antidepressants, or other drugs, can also cause constipation. Organic causes such as tumors, intestinal obstruction, or other diseases of the large intestine must be ruled out by a doctor.
When is constipation considered chronic?
Chronic constipation is defined as symptoms that have persisted for at least three months and involve a persistent disturbance in bowel movements. Chronic constipation is described in the S2k guideline on chronic constipation issued by the German Society for Neurogastroenterology and Motility. The guideline distinguishes between various forms and causes, including functional constipation and secondary constipation.
What diagnostic tests are recommended for constipation?
Diagnosis includes a medical history, physical examination, and, if necessary, further procedures such as anorectal manometry to assess motility and function in the rectum. If warning signs such as blood in the stool or acute constipation are present, further evaluation should be conducted. Diagnosis and treatment are guided by the recommendations of the Society for Gastroenterology and the German Society for Neurogastroenterology and Motility.
How can constipation be relieved?
To relieve constipation, a high-fiber diet that includes prebiotic fibers and at least two liters of fluid daily is recommended as a first step. Regular exercise supports digestion and improves bowel transit. If necessary, laxatives such as lactulose, bisacodyl, or sodium picosulfate can be used, but only for a short period if possible.
Who is particularly affected?
Women and older adults are particularly prone to chronic constipation. People with irritable bowel syndrome or neurological disorders are also more likely to experience constipation. Suppressing the urge to have a bowel movement, as well as side effects from medications for epilepsy or other conditions, can further exacerbate constipation.
Share this article
About the medical author
Sabine Schneider
Editor-in-Chief
Sabine Schneider – medical author: Explore expert articles and medical expertise in the Leading Medicine Guide.
View full expert profile →
