Regular bowel movements, often referred to informally as “doing a poo”, are a normal bodily function. Yet for some individuals, passing stool can become difficult when they experience constipation. Constipation occurs when stools are hard or dry and are passed infrequently (for example, fewer than three times per week). It is one of the most widespread digestive complaints, affecting roughly one in five Australians, and can cause significant discomfort. Knowing its typical causes, warning signs, prevention strategies, and when to seek professional help is essential.
Symptoms of constipation
Everyone’s definition of a “normal” bowel movement varies, some people go multiple times a day, others less often. If you’re constipated, you might notice:
- Hard, dry stools that are difficult to expel
- Straining or pain during bowel movements
- Visiting the toilet less than three times per week
- A feeling of incomplete evacuation
- Bloating and excess gas
- Abdominal cramps or nausea
- A sense of blockage when stool becomes lodged
- Needing to remain seated longer than usual
If constipation persists or is accompanied by worrying signs, such as blood in your stool, severe abdominal pain, or unintended weight loss, it’s important to consult your GP, as these could indicate an underlying condition.
What causes constipation?
Multiple lifestyle and medical factors often combine to slow bowel transit: Lifestyle factors:
- Low-fibre diet: Fibre adds bulk and softness to stool; without enough, faeces can harden and become tough to pass.
- Inadequate hydration: Not drinking enough water dries out stool, making it painful to pass.
- Physical inactivity: A sedentary lifestyle can slow gut motility.
- Medications: Certain drugs, such as strong painkillers, antacids, anti-nausea agents, antidepressants, supplements, and chemotherapy, can cause constipation.
- Suppressing the urge: Ignoring the need to defecate allows stool to remain in the colon longer, where more water is reabsorbed, compacting it further.
- Routine changes: Travel or schedule disruptions can disturb normal bowel habits.
- Pregnancy: Progesterone can relax intestinal muscles in early pregnancy.
Medical factors:
- Anal fissure: Small tears in the anus can make passing stool painful, leading to avoidance.
- Physical obstructions: Conditions like haemorrhoids or rectal prolapse can block stool passage.
- Recent surgery: Recovery, especially after abdominal or gynaecological surgery, often affects diet, activity, and medication use.
- Irritable Bowel Syndrome: IBS can alternate between constipation and diarrhoea alongside abdominal pain and bloating.
- Endocrine issues: Hypothyroidism or diabetes can impair normal bowel function.
Who is at risk of constipation?
Diet and exercise habits play a major role, but certain groups are more vulnerable:
- Older adults (65+): Age-related lifestyle changes, comorbidities, and less fibre or fluid intake.
- Women and children: Women report constipation more often than men, and children may struggle with toilet training.
- Pregnant women: Hormonal shifts and pressure on intestines.
- Bed-ridden individuals: Illness or post-surgical recovery often involves immobility, pain management, and routine changes.
Constipation in Children
Constipation is common in infants and children, though “normal” patterns vary. Signs include hard stools, infrequent toilet visits, or signs of discomfort:
- Pain or distress when passing stool
- Irritability, tantrums, or refusal to use the toilet
- Abdominal pain or gas
- Fidgeting or “holding on” to avoid defecation
- Decreased appetite
- Accidental soiling (overflow diarrhoea around a blockage)
Establishing healthy habits is key. Our pharmacists recommend:
- Encouraging a toilet routine after meals.
- Praising any successful toilet visits and addressing anxieties.
- Providing a small footstool so their knees are higher than their hips.
- Ensuring adequate water intake at each meal.
- Offering a fibre-rich diet and encouraging thorough chewing.
- Limiting fatty, salty, or sugary snacks and fizzy drinks.
- Promoting at least an hour of daily physical activity.
- Staying calm about accidents and encouraging open discussion.
How to treat and prevent constipation
Often, simple lifestyle adjustments can restore regularity:
- Hydration: Aim for about 1.5 L (6–8 cups) of water per day.
- Exercise: Target at least 30 minutes of activity on most days.
- Fibre: Eat plenty of fruits, vegetables, whole grains, prunes, or bran; consider supplements if needed.
- Limit low-fibre foods: Cut back on meat, dairy, and processed items.
- Reduce alcohol and caffeine.
- Use laxatives sparingly: Stimulant laxatives may help short-term but can lead to dependency if used over two weeks. Bulk-forming agents and osmotic laxatives are alternatives.
- Probiotics: May be beneficial for chronic or recurrent constipation.
- Respond promptly: Heed the urge rather than delaying.
When to seek help
If constipation becomes chronic or is accompanied by additional bowel symptoms, it’s vital to discuss this with your GP to rule out more serious issues.