10 Essential Facts about Constipation

10 Essential Facts about Constipation

Constipation is a common issue that affects people of all ages. While often dismissed as a minor inconvenience, it can be physically painful and, in some cases, a symptom of an underlying health problem. In the UK, it is one of the leading reasons for over-the-counter medicine purchases, yet many people are unsure of how to manage it effectively.

1. It is defined by more than just frequency

There is a common myth that you must “go” every day. In reality, “normal” ranges from three times a day to three times a week. Constipation is usually defined as passing stools fewer than three times a week, having to strain, or passing stools that are unusually hard, dry, or lumpy.

Bristol stool form scale infographic with faeces type flat vector illustration.

2. Lack of fibre is the most common cause

Most people in the UK do not eat enough fibre. Fibre adds bulk to the stool and retains water, making it softer and easier to pass. There are two types—soluble (found in oats and fruit) and insoluble (found in whole grains and vegetables)—and a balance of both is essential for keeping the “transit time” of your gut healthy.

3. Hydration is the engine of the gut

Fibre cannot do its job without water. If you increase your fibre intake but don’t drink enough fluids, the fibre can actually sit in your gut like a dry brick, making constipation worse. The bowel’s main job is to reabsorb water; if you are dehydrated, the body will pull even more water out of your waste, leaving the stool hard and difficult to move.

4. Movement outside helps movement inside

Physical activity is a natural stimulant for the muscles in your intestines. A sedentary lifestyle can lead to “sluggish” bowels. Even a 20-minute daily walk can help reduce the time it takes for food to move through the large intestine, limiting the amount of water the body absorbs back from the stool.

5. Ignoring the “urge” creates a cycle

The “gastrocolic reflex” is strongest in the morning or after a meal. If you repeatedly ignore the urge to go—perhaps due to a busy schedule or lack of privacy—the rectum eventually stops sending the signal. The longer the stool sits in the colon, the drier and harder it becomes, making the next attempt much more difficult.

6. Medications can be a hidden trigger

Many common medications have constipation as a side effect. These include:

• Opioid painkillers (like codeine or morphine).

• Iron supplements.

• Antidepressants.

• Blood pressure medications (calcium channel blockers). If you noticed a change after starting a new prescription, it’s worth discussing with your GP.

7. Not all laxatives work the same way

If lifestyle changes aren’t enough, laxatives can help, but they work in different ways:

• Bulk-forming: (e.g., Fybogel) work like fibre.

• Osmotic: (e.g., Laxido or Movicol) draw water into the bowel to soften the stool.

• Stimulant: (e.g., Senna) irritate the gut lining to force a contraction. These should generally only be used for short-term relief.

8. Pelvic floor health matters

Sometimes, the issue isn’t the stool itself but the “exit strategy.” Dyssynergic defecation occurs when the muscles of the pelvic floor and the anal sphincter don’t coordinate properly. Instead of relaxing to let the stool out, the muscles contract. This often feels like “pushing against a closed door.”

9. Pregnancy and hormones play a role

Progesterone, a hormone that rises during pregnancy and during certain points of the menstrual cycle, acts as a natural muscle relaxant. While this is important for the womb, it also relaxes the muscles of the digestive tract, slowing down transit and making constipation a very common complaint for women.

10. Persistent change can be a “Red Flag”

While most constipation is down to diet or lifestyle, a prolonged change in bowel habit—especially if you are suddenly going less often or your stools have become thinner—can be a sign of colorectal (colon) cancer. A tumour can physically narrow the passage in the bowel, making it harder for waste to pass through.

MyHSN Top Tip: If you have been constipated for three weeks or more, or if you notice blood in your stool or unexplained weight loss, see your GP. While it is often caused by simple factors, a persistent change in bowel habit is one of the key warning signs of colon cancer and should always be checked out.