If you’ve done fewer than three poos in the last 7 days, you’re probably constipated. Your poos may also be small, hard or dry, and difficult to pass.
Other signs of constipation include bloating and stomach pain, and feeling like you haven’t fully emptied your bowels after a poo.
While it’s uncomfortable, constipation isn’t usually a cause for concern. However, certain signs and symptoms mean that you should visit your doctor.
In this article, we’ll explain the causes of constipation, describe warning signs to look out for and suggest home care strategies to try if you’re not noticing any of the warning signs.
Causes of constipation
Most people experience constipation at least once in their life. Those most at risk include older adults, females and pregnant people.
Many factors can lead to constipation, including:
- a low-fibre diet
- not drinking enough fluids
- not exercising
- lying or sitting down for long periods
- not going for a poo when you need one
- stress
- certain medications
- some health conditions, like inflammatory bowel disease (IBD)
When to seek help
Constipation often passes on its own. But it sometimes results from an underlying health issue, like irritable bowel syndrome (IBS).
If you’re concerned and wondering whether to see a doctor, here are some questions to consider.
1. How long has it been going on?
If you’ve been constipated for 2 weeks or more, or if you haven’t done a poo in over 1 week, you should visit your doctor.
The same applies if you've tried to treat your constipation and it isn’t improving.
When you’re constipated for a long time, you can develop faecal impaction, which means that your poo becomes hard and can damage blood vessels and tissues in your gut.
Without treatment, this can lead to ulcers in your intestines or holes (perforations) in your gut lining.
Rarely, faecal impaction may cause a condition called toxic megacolon. This leads to a build-up of gas and food, and it causes toxic compounds to move into your blood.
2. Is there blood in your poo?
Whether you’re constipated or not, if you notice blood in your poo or on toilet paper after a poo, you should consult a doctor.
Blood in stool can be a sign of:
- ulcerative colitis, a form of IBD
- colon cancer, also called colorectal cancer
- a gut infection, also called gastroenteritis
- diverticulitis, when small pouches form in your intestines and can become infected
- haemorrhoids, swollen veins around your bum hole (anus) or in your rectum
- an anal fissure, a tear in the lining of your anus
3. Do you have severe gut pain?
Constipation can be uncomfortable and make you feel bloated. But if you experience sharp, ongoing pain in your abdomen, you may have a more serious health condition.
Intense pain may signal that your bowel has perforated. Other symptoms of a perforated bowel include:
- nausea, or feeling sick
- vomiting
- fever and chills
- a swollen belly
4. Can you still fart?
If you feel like you need to pass wind but can’t, it could be a sign of a bowel obstruction – a blockage. Other symptoms include:
- vomiting, or being sick
- severe tummy pain and cramping
- a feeling of fullness or bloating
- loud sounds coming from your belly
5. Do you have a fever and chills?
A fever isn’t a standard symptom of constipation. If you have a fever and chills, this could signal an infection, and you should visit your doctor.
For instance, it could be diverticulitis. This condition causes pouches to form in the wall of your intestine, and these can become infected and require treatment.
6. Are you throwing up?
Constipation doesn’t usually cause vomiting. So, if you’re constipated and being sick, there’s a strong chance that something else is going on.
7. Has the colour of your poo changed?
Your poo may change colour when you’ve eaten certain foods. For instance, it may look greener if you’ve had lots of leafy greens or foods with green dye.
Similarly, if you’ve eaten beetroot, your stool might be reddish or darker than normal. In these cases, there’s no need to worry.
However, a change in poo colour is sometimes a sign of a medical issue. Here are some stool colours and what they might mean:
- black or red poo: bleeding in your gut
- white poo: problems with your liver or gallbladder
- green or orange poo: too much bile
8. Have you lost weight without trying?
If you’re losing weight without changing your diet or exercise routine, it could point to an underlying health issue. Here are some examples:
- mental health conditions, such as anxiety or depression
- gut conditions, such as coeliac disease or IBD
- metabolic conditions, such as type 2 diabetes
- autoimmune conditions, such as lupus or an overactive thyroid
However, weight loss won’t be the only symptom of any of these conditions.
If you're not feeling yourself or you feel that something isn't quite right, see your doctor.
Treating and preventing constipation
If you aren’t experiencing any of the warning signs above, there are strategies you can try to get things moving again. Here are some of these approaches:
- Make sure you aren’t dehydrated: Drink more hydrating fluids, like water, fruit juice, tea and coffee. Coffee can be particularly helpful for constipation – but if caffeine makes you jittery or anxious, opt for another strategy or consider decaf.
- Eat more fibre: Up your intake of fruits, veg, nuts, seeds, beans and whole grains. These high-fibre recipes might offer some inspiration. And prunes are a great place to start because they also contain sorbitol, a laxative. Alternatively, you could try a fibre supplement that contains psyllium husk.
- Have fewer foods that are low in fibre or high in fat, salt or sugar: This list includes pastries, biscuits, takeaways, chocolate and sweets.
- Try a probiotic supplement: Studies show that probiotics can help relieve constipation for some people.
- Get active: Physical activity can sometimes get things moving. You don’t necessarily need to hit a gym. Low-level activity, like a walk or some yoga, may help.
Small diet and lifestyle changes can make a big difference. You can learn more ways to quickly relieve constipation at home in this article.
You could also speak with a pharmacist about laxatives. As a rule, you should only use a laxative for a short period. So, once your constipation improves, stop the treatment.
It’s not advised to get into the habit of taking a laxative every day to keep things moving, especially with osmotic, stimulant or softening laxatives.
Another type, bulk-forming laxatives, is considered the gentlest, and it’s fibre-based.
If you’re experiencing any of the warning signs described earlier, speak with your doctor before you take a laxative.
Summary
Usually, constipation isn’t a sign of anything more serious. However, it can occur with other symptoms that may point to a different health condition.
These symptoms include blood in your stool, a fever and chills, severe pain in your tummy, unexplained weight loss and being unable to pass wind. If you experience any of these, speak with your doctor.
If you aren’t experiencing them, you can try some home care approaches to easing constipation.
For instance, eating more fibre, getting more exercise, trying probiotic supplements and staying hydrated can all help.
To learn more about gut health, visit Symprove’s Gut Hub.
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Epidemiology of constipation in children and adults: A systematic review. Best Practice and Research Clinical Gastroenterology. (2011). Link.
Fecal impaction: A systematic review of its medical complications. BMC Geriatrics. (2016). Link.
Poo-torial. (n.d.). Link.
Rectal bleeding. (n.d.). Link.
Toxic megacolon. StatPearls. (2023). Link.
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Unintentional weight loss. (2022). Link.