Medically reviewed by Dr Usman Naeem, 24 Oct 2026.
Key points
- Constipation means hard stools, straining, a feeling of incomplete emptying, or fewer than three bowel movements a week.
- Bloating (a feeling of fullness) and visible abdominal distension are related but not identical.
- Fibre, fluids, activity and a toilet routine help most people; laxatives work best when used correctly and for a defined time.
- Blood in the stool, weight loss, anaemia, or new constipation in older age need further tests.
Overview
Constipation can be due to slow movement through the bowel, difficulty coordinating the muscles used to pass stool (dyssynergic defecation), medicines, low fibre or low activity, or conditions such as an under-active thyroid or diabetes. Many people have more than one factor.
Bloating has many causes including constipation, IBS, swallowed air, food intolerance (for example lactose), coeliac disease and, uncommonly, other conditions. If the abdomen swells persistently, particularly in women over 50, or with weight loss or pain, medical review is advised.
Causes and risk factors
- Low fibre intake, low fluid intake, low activity, ignoring the urge to pass stool
- Medicines: iron tablets, some painkillers, anticholinergics, some antidepressants, some blood pressure medicines
- Under-active thyroid, diabetes, high calcium, pregnancy
- Pelvic floor dysfunction; IBS with constipation; less often, bowel narrowing or tumour
Symptoms
- Hard or lumpy stools, straining, a sense of blockage
- Fewer than three bowel movements a week
- Bloating or lower abdominal discomfort
When to seek urgent medical care
- Blood in the stool, unintended weight loss or anaemia
- New constipation in an older adult, or a family history of bowel cancer
- Severe pain, repeated vomiting or inability to pass wind or stool (possible blockage): urgent care
- Persistent abdominal swelling, especially in women over 50
In an emergency go to the nearest emergency department or call Rescue 1122.
How it is assessed
- Review of diet, fluids and medicines
- Blood tests (for example thyroid, calcium, blood count, coeliac test) when relevant
- Colonoscopy when warning features are present, and specialised bowel function tests (anorectal manometry) in selected patients
Treatment
Steps that help most people
- Increase fibre gradually (fruit, vegetables, pulses, whole grains, ispaghula husk) and drink enough fluids
- Use a regular toilet routine, ideally after a meal, with feet on a small stool to raise the knees; do not ignore the urge
- Stay active; a daily walk helps
Laxatives
- Osmotic laxatives (such as polyethylene glycol or lactulose) are usually tried first. Stimulant laxatives can be used for short periods. Use under guidance, and review if you need them for long
- Treatment for pelvic floor problems may involve biofeedback therapy
What you can do
- Gradual fibre increase prevents gas and bloating
- Review your medicines with your doctor if you suspect they are causing constipation
- Keep a record of stool pattern and food for a couple of weeks if bloating is the main problem
Common questions
Can drinking more water cure constipation?
Water helps when you are dehydrated, but extra water alone rarely fixes constipation. Fibre, activity, routine and sometimes laxatives work together.
Is a daily bowel movement necessary?
No. Normal frequency ranges from three times a day to three times a week. What matters is whether stools are easy to pass and you feel empty afterwards.
When is bloating serious?
Bloating with weight loss, vomiting, blood in the stool, persistent pain or anaemia, or persistent abdominal swelling in a woman over 50, needs medical review.
اردو خلاصہ
اگر ہفتے میں تین بار سے کم پاخانہ آئے، پاخانہ سخت ہو یا زور لگانا پڑے تو اسے قبض کہتے ہیں۔ ریشے دار غذا آہستہ آہستہ بڑھائیں، پانی کافی پئیں، روزانہ چہل قدمی کریں اور روز ایک مقررہ وقت پر بیت الخلا جائیں۔ جلاب والی دوائیں بغیر مشورہ مسلسل استعمال نہ کریں۔
پاخانے میں خون، وزن میں کمی، خون کی کمی، چند ہفتوں میں عادت میں نئی تبدیلی یا پیٹ کا مسلسل پھولنا ہو تو ڈاکٹر کو دکھائیں۔
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This page gives general information prepared for Dr Usman Naeem and is not personal medical advice. See the medical disclaimer.