Constipation: causes, management and when to seek help

Constipation is a common problem and usually means passing stools less often than usual, having hard or difficult-to-pass stools, or feeling that the bowels have not fully emptied. It can affect people of all ages and is often related to diet, lifestyle or changes in routine.

This page explains how GPs assess constipation, common causes, what usually helps, and when further investigation is needed.

These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.

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What counts as constipation

Constipation can mean different things to different people. It may include:

Passing stools less than three times a week
Hard, dry or lumpy stools
Straining or pain when opening the bowels
A feeling of incomplete emptying
Bloating or abdominal discomfort

Normal bowel habit varies widely, so change from your usual pattern is often more important than frequency alone.

Seek urgent medical advice if you have:

Severe or persistent abdominal pain
Vomiting with constipation
Unintentional weight loss
Blood in the stool
New constipation starting after the age of 50

Common causes of constipation

Diet and fluid intake

Constipation is commonly linked to:

Low fibre intake
Not drinking enough fluids
Sudden changes in diet

Lifestyle factors

These include:

Reduced physical activity
Ignoring the urge to open the bowels
Changes in routine, such as travel or illness

Medications

Some medicines can cause constipation, including:

Opioid painkillers
Certain antidepressants
Iron supplements
Some blood pressure medicines

Medical and hormonal factors

Constipation may also be associated with:

Pregnancy
Hypothyroidism
Neurological conditions
Pelvic floor dysfunction

In many cases, more than one factor is involved.

How GPs assess constipation

Assessment usually includes:

Duration and pattern of symptoms
Stool consistency and ease of passage
Diet, fluid intake and activity level
Medication review
Associated symptoms such as pain, bleeding or weight loss

Examination or tests are guided by symptoms and risk factors.

When tests may be considered

Most people with uncomplicated constipation do not need investigations.

A GP may consider tests if:

Constipation is persistent or worsening
There are red flag symptoms
Symptoms started later in life
There is a family history of bowel disease

Investigations may include blood tests or referral for further assessment where appropriate.

Self-care and lifestyle measures

Simple steps often improve symptoms:

Increasing fibre gradually through diet
Drinking enough fluids
Staying physically active
Establishing a regular toilet routine
Allowing time and privacy to open the bowels

Sudden large increases in fibre can worsen bloating, so gradual changes are best.

Laxatives and medical treatment

If lifestyle measures are not enough, laxatives may be used:

Osmotic laxatives to soften stools
Bulk-forming laxatives where fibre intake is low
Stimulant laxatives for short-term use when needed

Treatment choice depends on symptoms and response, and may be adjusted over time.

Constipation and long-term management

Some people experience chronic constipation. Management focuses on:

Identifying contributing factors
Using the lowest effective treatment
Reviewing medication regularly
Avoiding unnecessary long-term use of stimulant laxatives

A GP can help tailor a plan if symptoms persist.

AccessGP work with blood tests to help you

When to seek GP review

Consider GP review if:

Constipation lasts more than a few weeks
Symptoms affect quality of life
Over-the-counter treatments are not helping
You are unsure which treatment is appropriate
There are changes in your usual bowel pattern