Bad constipation: what to know

Constipation may cause hard or lumpy stools, straining, a feeling of incomplete emptying, bloating, or fewer bowel movements than usual. Dehydration, a low-fibre diet, reduced movement, travel, and some medicines can slow the bowel. Irritable bowel syndrome can combine constipation with abdominal pain and changing bowel habits. An underactive thyroid can also present with constipation, tiredness, dry skin, or feeling unusually cold.

Diverticular disease concerns the bowel wall and may coexist with altered bowel habits, but constipation alone does not establish that diagnosis. A sudden change deserves attention when it persists or comes with weight loss, bleeding, or marked fatigue.

Drink regularly unless a clinician has told you to restrict fluids. Increase fibre gradually through vegetables, fruit, beans, and whole grains, and keep moving with gentle walking. Sit on the toilet when you feel the urge, allow time, and place your feet on a low support if that makes passing stool easier. A pharmacist can advise on a suitable laxative; do not keep using one without review if the problem continues. Nutrition counselling may help build a realistic eating routine.

Seek urgent help for severe or worsening abdominal pain, repeated vomiting, a swollen abdomen, inability to pass stool or gas, fainting, or black or bloody stool. Arrange a medical review for constipation that keeps returning, a persistent change in bowel habit, unexplained weight loss, rectal bleeding, fever, or significant tiredness. Children, older adults, and people taking medicines that slow the bowel may need earlier advice.

Could a medicine, dehydration, thyroid problem, or bowel condition be contributing? Is a laxative appropriate for me, and how should it be used? Which symptoms mean I should seek urgent help?