Constipation affects all of us at some point, but consistent, or even daily constipation may have a significant impact on one's life. Causes ranges from common conditions such as dehydration or having a fiber-poor diet, to more serious causes, such as colon cancer or bowel obstruction. Read more below to learn about constipation symptoms, causes, and treatment.

Hallmarks of Constipation Symptoms

It has been four days since you've gone to the bathroom. You feel bloated, gassy, stopped up, and your stomach hurts. You wish you'd taken your grandmother's advice and had a glass of prune juice every day of your life. You're constipated and need relief.

Constipation is a common disorder that affects all of us at one time or another. But if you're experiencing constipation symptoms often, or even daily (as some people might on certain medications), this can greatly impact your quality of life.

Constipation symptoms can either be an acute issue, brought on by a sudden change in eating habits, such as eating too little fiber, fruits, and vegetables; too little fluid consumption; or changes in lifestyle, such as travelling or eating out too often. Constipation can also be chronic, resulting in having no bowel movements, no matter how much you try. This is common when taking certain medications, such as opioid pain medications, diuretics, and some other.

Everyone needs to "go." So, let's talk about what might be keeping you from having a good bowel movement, the symptoms of constipation, and common treatments to bring you relief.

Common characteristics of constipation

If you're experiencing constipation, it can likely be described by the following:

  • Having a bowel movement three times or less a week: Daily is ideal, even twice daily
  • Overly hard, compacted stools that are very difficult to void
  • Feeling of blocked bowels
  • Pellet-like stool: Once you do "go," your stool is hard and pellet-like, and there's not enough of it.
  • Straining: Needing to push and strain very hard to complete a bowel movement
  • Needing assistance: Having to help yourself have a bowel movement through pushing on your abdomen, using enemas or fingers, or using laxatives
  • Feeling as if you are not completely voiding all stool [1]

More serious symptoms of constipation

Serious constipation may also be associated with:

Symptoms of constipation that require a doctor's attention

Constipation symptoms that indicate you should see a doctor include:

  • Black, tarry stool: This can indicate liver problems or early colon/rectal cancer.
  • Not having bowel movements at all
  • Constipation accompanied by abdominal pain and fever

About colon and rectal cancer

*Note: Colon and rectal cancer is on the rise today, and those diagnosed with colon/rectal cancer are getting younger and younger. Colon cancer can cause changes in bowel movements, and one of its primary symptoms is constipation, diarrhea, and a narrowing of stools.

Individuals at risk for colon cancer today are anyone over the age of 30, especially those with a family history of rectal or colon cancer. Today, doctors are recommended everyone start getting colonoscopies much earlier, any time after age 30 (American Cancer Society suggests 45).

9 Constipation Causes

Constipation is due to slow or irregular movement of stool through the lower gastrointestinal tract and can be short-term or chronic. There are many causes to constipation, including changes in diet, such as reduced fiber or liquids, decreased exercise or activities, medications, pregnancy, aging, disorders of the gastrointestinal tract, and several systemic diseases. More serious causes include a blockage in the colon from a polyp or tumor. Constipation can also be a result of endocrine or neurologic disorders, or diseases of the bowel and gut like Crohn's, IBS, or celiac disease.

Common causes of constipation

The most common causes of constipation include the following.

  • Dehydration
  • Being bed-ridden or sedentary: Exercise helps get the bowels moving
  • A diet low in fiber
  • Frequent flying and traveling: Traveling involves lots of sitting and eating convenience foods that are typically low in fiber and fresh fruits and vegetables.
  • Taking certain types of medications

Serious causes of constipation symptoms

Serious causes of constipation include the following.

  • Colon cancer: A tumor can block the colon and make passing stool difficult.
  • Small or large bowel obstruction: Usually bloating, pain and vomiting accompany this. This needs immediate medical attention.
  • Hemorrhoids or anal fissures: Any disorder of the anus can make it hard to have a bowel movement, often because it is painful to try and void.

Gastrointestinal disorders

Gastrointestinal disorders that may result in constipation include the following.

  • Irritable bowel syndrome (IBS): This is a common condition, often characterized by alternating periods of diarrhea and constipation.
  • Inflammatory bowel disease: Inflammatory bowel diseases, like Crohn's and Ulcerative Colitis, can lead to changes in bowel habits. These diseases typically cause diarrhea or blood in the stool, constipation, and other symptoms.
  • Celiac Disease: Often this causes diarrhea and can also cause constipation.

Systemic causes

Systemic causes of constipation may include the following.

  • Neurologic: There are many conditions of the nervous system that cause constipation.
  • Depression: Changes in mood and depression, especially, can slow many body processes, including the bowels. The body gets depressed with the psyche.
  • Diabetes: This disease can lead to damage to the nerves that help move the bowels.

Constipation from not eating enough fiber

Constipation is defined as having stools which are large, hard, and difficult to pass. This leaves the person feeling bloated and uncomfortable. Many things can cause constipation, and a common one is lack of fiber in the diet.

To determine whether lack of fiber is causing the constipation, all other causes are first ruled out:

  • Not drinking enough water, sometimes to the point of dehydration.
  • Lack of exercise, which helps increase blood circulation and therefore motility (contraction and movement) of the bowel.
  • A very low or no-fat diet.
  • A need for probiotics, which replenish the "good" bacteria in the gut.
  • Medications, or certain illnesses, which have a constipating effect.
  • Constantly ignoring the feeling of needing to move the bowels, and delaying going to the toilet.

If fiber is needed, the best sources are fresh vegetables; fresh or dried fruits; and whole wheat and brown rice, because those include the fiber-rich bran. Over-the-counter fiber tablets can be tried, though laxatives should only be used if recommended by a medical provider.

Rarity: Common

Top Symptoms: constipation, constipation, pain in the lower left abdomen, pain when passing stools, feeling of needing to constantly pass stool

Symptoms that always occur with constipation from not eating enough fiber: constipation, constipation

Symptoms that never occur with constipation from not eating enough fiber: vomiting

Urgency: Self-treatment

Constipation resulting from dehydration

Constipation means difficulty in passing bowel movements. A common cause of constipation is dehydration, or insufficient water in the body. If the contents of the bowel are not kept full and lubricated by plenty of fluid, the waste can become dry and packed and very hard to pass.

Most susceptible are pregnant women, especially those with a condition called hyperemesis gravidarum. This syndrome causes severe nausea and vomiting throughout most of the pregnancy and can easily lead to dehydration.

Anyone with an illness that causes prolonged vomiting and diarrhea will soon become dehydrated. A number of prescription medications can act as diuretics, meaning they cause the body to lose extra fluid through the urine.

The use of alcohol, or illegal drugs such as cocaine, also has a very dehydrating effect. The ill effects called a "hangover" that often happen after a night of drinking are actually due to the dehydration caused by the alcohol.

Treatment involves rehydrating, either with plain water by mouth or, in severe cases, hospitalization for IV fluid rehydration.

Rarity: Common

Top Symptoms: constipation, constipation, general abdominal pain, pain in the lower left abdomen, pain when passing stools

Symptoms that always occur with constipation resulting from dehydration: constipation

Symptoms that never occur with constipation resulting from dehydration: vomiting

Urgency: Self-treatment

Opioid-related constipation

Opioids (oxycodone, morphine, percocet, fentanyl) are powerful pain relievers that act on different chemical receptors throughout the body. In the intestines, opioids signal the gut to slow down movement, leading to constipation.

Rarity: Rare

Top Symptoms: constipation, feeling of needing to constantly pass stool, straining while passing stool, hard stools, pain in the lower left abdomen

Symptoms that always occur with opioid-related constipation: constipation

Urgency: Primary care doctor


Hypothyroidism, or "underactive thyroid," means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body's metabolism.

The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.

Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.

Diagnosis is made through a simple blood test.

Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It's important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches

Urgency: Primary care doctor


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When to see a doctor for constipation

Any lasting change in the way you move your bowels or any blood in the stool needs to be evaluated and colon and rectal cancer ruled out, especially now that everyone is more at risk.

Again, if you have nausea, vomiting, severe abdominal pain or a fever accompanied by constipation, you should see a doctor, who can test for blockage of the bowel or other serious disorders that can be causing your discomfort.

At home constipation treatments

Treatments for both acute and chronic constipation symptoms include:

  • Increasing your fluid intake.
  • Eating lots of fresh fruit, vegetables, and whole grains.
  • Using an over-the-counter fiber supplement: Such as Metamucil, glucomannan, or psyllium fiber
  • Over-the-counter stool softeners: Such as Colace or Surfak
  • Laxatives: Such as Milk of Magnesia or Lactulose
  • Enemas: These are more potent than anything you take by mouth to relieve constipation.

Constipation FAQs

Can constipation cause pain?

Constipation can be associated with pain either associated with straining or passing hard stool during bowel movements, abdominal distension, or, most worrisome, when the intestines are completely blocked.

How often should I poop?

There is a wide range in the normal frequency of bowel movements. Depending on age, activity, diet, and individual variability, onethree bowel movements a day to as few as three per week can be normal. Constipation is fewer than three bowel movements per week.

What can constipation cause?

Constipation can result in a variety of other problems. Severe straining of hard stools can result in a tear to the anus or hemorrhoids. Severe constipation can cause impacted or retained hard stool, rectal prolapse where the rectum slips out of the anus and rarely poor blood flow to the or bowel perforation.

Questions Your Doctor May Ask About Constipation

  • Have you experienced any nausea?
  • After passing stool, do you feel like you still have to go?
  • Have you had any changes in your weight?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?

Self-diagnose with our free if you answer yes on any of these questions.

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