Chronic Constipation
الإمساك المزمن
Infrequent or difficult bowel movements persisting over weeks or longer, most often related to diet, fluid intake, physical activity, or certain medications, though it can also signal an underlying digestive or metabolic condition. Usually manageable with fiber, hydration, and lifestyle changes; persistent cases warrant medical evaluation.
This information is for general awareness only and does not replace professional medical advice. Consult a doctor for diagnosis and treatment.
Quick answer
Constipation means passing stools less often than usual, or with difficulty — hard, dry or lumpy stools, straining, or feeling you haven't emptied fully. It is chronic when it persists for weeks or longer.
It is very common and most often related to low fibre or fluids, low activity, ignoring the urge to go, certain medicines, or changes in routine.
Fibre, fluids, activity and a regular toilet routine help most people. See a doctor if it is persistent, new in later life, or comes with blood, weight loss, severe pain or a change in bowel habit that lasts.
Symptoms
Fewer than three bowel movements a week
Hard, dry or lumpy stools
Straining or pain when passing stools
A feeling of incomplete emptying
Bloating and abdominal discomfort
Feeling of blockage in the rectum
Reduced appetite
Symptom guides
Causes and risk factors
Causes
- Low fibre or low fluid intake
- Low physical activity
- Ignoring the urge to go or changes in routine
- Medicines — Certain painkillers, iron supplements, some antidepressants and others.
- Medical conditions — Underactive thyroid, diabetes, IBS, pelvic-floor problems, neurological conditions.
- Pregnancy and older age
- Structural problems — Such as narrowing or, rarely, a tumour of the bowel.
Risk factors
- Older age
- Being female
- Low-fibre diet and inactivity
- Pregnancy
- Taking constipating medicines
- Underlying medical or neurological conditions
- Anxiety, depression or eating disorders
How is it diagnosed?
Doctors usually diagnose constipation from your history and examination, and use tests when there are warning signs or it doesn't respond to treatment.
History and examination
Stool pattern, diet, medicines and warning signs; abdominal and rectal examination.
Blood tests
For example thyroid function, blood count and calcium, if a medical cause is suspected.
Colonoscopy or imaging
For warning signs such as bleeding, anaemia, weight loss or new symptoms in older adults.
Specialist bowel function tests
For persistent, difficult-to-treat cases.
Treatment
Most constipation improves with lifestyle changes; laxatives are used if needed. The choice depends on the cause and the person and should be guided by a doctor or pharmacist.
More fibre and fluids
Gradually increase fruit, vegetables, whole grains and pulses, with enough water.
Regular activity
A regular toilet routine
Try to go after meals and don't ignore the urge; a footstool can help position.
Laxatives
Different types work in different ways; use as advised and avoid long-term use without medical guidance.
Treating a cause
Reviewing medicines or treating a related condition.
Increase fibre gradually — too much too fast can cause bloating and gas.
When should you see a doctor?
Arrange a medical assessment if
- Constipation lasting more than a few weeks despite changes
- New constipation in an older adult
- Alternating constipation and diarrhoea that persists
- Constipation in a young child
- You depend on laxatives
Seek urgent care if
- Blood in the stool or black stools
- Unintentional weight loss
- Severe abdominal pain, vomiting, and inability to pass stool or wind (possible obstruction)
- Severe abdominal swelling
Prevention
Eat enough fibre
Vegetables, fruit, whole grains and pulses.
Drink enough fluids
Be active most days
Go when you feel the urge
Review medicines that may cause constipation with your doctor
Frequently asked questions
What is constipation?
Infrequent or difficult passing of stools — often hard, dry or lumpy — with or without straining.
How many bowel movements a week is normal?
It varies. Many people go between three times a day and three times a week; what matters is a change from your own normal.
What foods relieve constipation?
High-fibre foods such as vegetables, fruit, whole grains and legumes, along with enough fluids.
Are laxatives safe?
Short-term use as advised is generally safe, but long-term reliance should be discussed with a doctor.
Can constipation cause haemorrhoids?
Straining can contribute to haemorrhoids and anal fissures.
When is constipation a sign of something serious?
When it comes with blood, weight loss, severe pain, vomiting, or is a new persistent change in an older adult.
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Medical sources
This page summarizes general information from the sources below.