Constipation: Common Causes and What Actually Helps

Constipation is one of the most common gut problems there is, and one of the least talked about. The good news is that it's usually caused by everyday things you can change, and the remedies that help most are simple. This guide covers what counts as constipation, the usual causes, and what to try, in roughly the order to try it.

Am I constipated?

The NHS says it's likely to be constipation if you haven't pooed at least three times in the last week or you're going less often than usual, your poo is unusually large or small and dry, hard or lumpy, you're straining or in pain when you go, or you feel you haven't fully emptied your bowels. You might also have stomach ache, bloating or feel sick.

Frequency alone isn't the whole story, though. Going every day but passing hard lumps can still be constipation, while going every other day with soft, easy stools is fine. Our guide to how often you should poo covers the normal range. On the Bristol Stool Chart, types 1 and 2 (hard lumps) suggest constipation, while types 3 and 4 are what Bladder & Bowel UK describes as ideal.

Common causes of constipation

The NHS lists these as the most common causes:

• Not eating enough fibre, found in fruit, vegetables and cereals
• Not drinking enough fluids
• Not moving enough, or spending long periods sitting or lying down
• Being less active than usual
• Often ignoring the urge to go to the toilet
• Changing your diet or daily routine
• A side effect of a medicine
• Stress, anxiety or depression

It's also more common during pregnancy and in people over 65. Constipation can be part of irritable bowel syndrome (IBS) too, in which case the advice is a little different (see below).

What helps relieve constipation

1. More fibre, added gradually

Fibre adds bulk to your poo and helps it hold water, which makes it softer and easier to pass. The NHS recommends adults aim for 30g a day, and the British Dietetic Association (BDA) says UK adults average only around 18g. For constipation specifically, the NHS suggests adding wheat bran, oats or linseed to your diet, and fruits that contain sorbitol, such as apples, apricots, grapes, raspberries and strawberries.

Go slowly. The BDA advises increasing fibre gradually to avoid bloating and wind. A sudden jump from 15g to 30g is a common reason people give up. Our guide to how much fibre you need a day has easy swaps.

2. Kiwi fruit and prunes

Two foods have more trial evidence than most. In a 2021 study of adults with chronic constipation in the US, eating two green kiwi fruits a day, a portion of prunes, or a psyllium fibre supplement all increased the number of complete bowel movements over four weeks, and the kiwi group reported the fewest side effects. It was a small exploratory trial, but kiwi and prunes are cheap, safe things to try.

3. Enough fluid

Fibre needs water to work. The BDA warns that fibre draws water into the bowel, so you may become dehydrated if you don't drink enough, and the NHS suggests drinking plenty of water and other fluids and avoiding alcohol. A simple rule from the NHS is a glass of water with every meal.

4. Move every day

The NHS suggests going for a daily walk or run. Being active helps keep things moving, and long periods sitting or lying down are one of the listed causes.

5. A toilet routine, and a better position

Keep to a regular time and place, give yourself plenty of time, and don't delay when you feel the urge. The NHS also suggests resting your feet on a low stool while you poo, so your knees are above your hips. This changes the angle and can make it easier to go.

6. Speak to a pharmacist about laxatives

If diet and lifestyle changes aren't helping, the NHS says a pharmacist can recommend a laxative. Most work within three days and are meant to be used for a short time only. Tell the pharmacist about any other medicines you take.

If you have IBS with constipation

If constipation is part of IBS, the type of fibre matters. The NHS suggests eating more soluble fibre, such as oats, pulses, carrots, peeled potatoes and linseeds, and NICE advises people with IBS to avoid insoluble fibre such as bran, which can make bloating worse. Our guide to IBS trigger foods covers this in more detail.

Track what changes

Constipation often improves with small changes, but it's easy to lose track of what you changed and when. A few weeks of noting your bowel movements (with a Bristol type), your fibre and fluid intake, and anything unusual, such as a new medicine, makes it much easier to see what works. It's also exactly what a GP will ask about.

GutBox can help with this. Log a meal from a photo, your voice or a barcode and it counts your fibre for you, and a gut check records your stool type in a tap, so you can see whether your fibre and your Bristol scores move together. It's free to download.