Why Am I Constipated So Often?

Day four. You’ve started planning your week around it. The meeting is fine, the dinner is fine, but you’re aware of every hour between you and a bathroom that cooperates.

What counts, and how common it is

NIDDK¹ adds one more sign to the definition: a feeling that not all the stool has passed. The NHS² lists the same markers and adds stomach ache, bloating and nausea.

Notice what isn’t on either list. You don’t have to go every day. The NHS² counts you as constipated if you haven’t pooped at least 3 times in the last week.

It’s common. NIDDK¹ says about 16 out of 100 adults have constipation, and the number climbs to 33 out of 100 for adults 60 and older. Women are among the groups at higher risk, especially during pregnancy and after giving birth.

The everyday causes

NIDDK’s³ list starts with the unglamorous ones. Not enough fiber. Not enough fluids. Not enough movement. Ignoring the urge to go.

That last one deserves its own line. If you hold it at work, on a trip, at a friend’s house, your body takes the hint. The NHS² says not to delay when you feel the urge.

Life changes show up on the list too, including pregnancy, travel and aging.

Medicines and medical causes

If the basics are covered and nothing moves, look at the second tier. NIDDK³ says several classes of medicine can cause or worsen constipation, including narcotic pain relievers, certain antidepressants and diuretics.

Medical causes include irritable bowel syndrome, diabetes, an underactive thyroid (hypothyroidism), Parkinson’s disease, prior colon surgery, and inflammation or blockages in the gut.

One of them is worth a closer look for women. NIDDK³ flags pelvic floor dysfunction as especially affecting women. The muscles that hold up your bladder also have to relax on cue for a bowel movement. When they don’t, the result can be straining and a feeling that you haven’t finished. Our bladder articles cover the same muscles from the other direction.

What helps

Fiber comes first. NIDDK⁴ says adults should get 22 to 34 grams a day, depending on age and sex. It names oatmeal and bran flake cereals, lentils, beans and chickpeas, berries, apples with the skin on, oranges, pears, carrots, broccoli, green peas, collard greens, and nuts such as almonds and pecans.

Add it a little at a time, NIDDK⁴ says, so your body gets used to the change. Drink water and other liquids with it to help the fiber work better.

The NHS² adds a daily walk or run, and a practical tip that sounds silly and works for plenty of people: rest your feet on a low stool while you’re on the toilet, with your knees above your hips when possible.

Then there’s timing. NIDDK⁵ describes bowel training: try to have a bowel movement at the same time every day, such as 15 to 45 minutes after breakfast, because eating naturally stimulates the colon.

The play

Try this: the after-breakfast sit

Eat breakfast, then give yourself 15 to 45 minutes before heading out the door.

Sit on the toilet with your feet on a low stool and your knees above your hips, and let it come on its own schedule.

Do it daily, whether or not you feel the urge, and keep it unhurried.

When food and habits aren’t enough

NIDDK⁵ lists over-the-counter options in several categories: fiber supplements, osmotic agents, stool softeners, lubricants and stimulant laxatives. It adds a clear caution about the last group: use stimulants only if constipation is severe or other treatments haven’t worked. The NHS² says to speak to a pharmacist, that most laxatives work within 3 days, and that they’re for short-term use.

Long-term laxative dependence is a conversation for your clinician, NIDDK⁵ says, because stopping safely takes guidance.

For constipation that persists, NIDDK⁵ says doctors may prescribe medicines that increase fluid in the gut or help the colon muscles work. Biofeedback therapy retrains the pelvic floor muscles.

When to get checked

Don’t wait if

1. Urgent

   Go to urgent care or the ER right away if constipation comes with constant belly pain and vomiting, a fever, or you can’t pass gas. NIDDK³ lists these alongside constipation as red flags.

The NHS² says to see a GP if constipation continues despite treatment, if you’re regularly constipated, if you notice blood in your stool, if you lose weight without trying, or if there’s a sudden change in how you poop.

NIDDK’s³ list of symptoms that need medical attention adds bleeding from the rectum, constant pain in the abdomen, being unable to pass gas, vomiting, fever and lower back pain.

Book an appointment if any of these fit:

• Constipation keeps returning, or hasn’t improved after changing food, fluids and routine
• You see blood on the paper or in the toilet
• You’ve lost weight without trying
• Your bowel habits changed suddenly
• You’ve been leaning on laxatives for a long time

Day one of the after-breakfast sit is tomorrow. Put the footstool where you can see it.