Constipation: A Practical Checklist
Constipation: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
Infrequent, difficult or incomplete emptying of the bowel. It is extremely common, usually manageable without prescription, and occasionally a sign of something that needs investigating.
Key takeaways
- UK fibre recommendation: 30g a day
- Fluid: 6-8 drinks a day
- Most useful single change: Increase fibre gradually and increase fluid alongside it.
- Commonest mistake: Long-term stimulant laxatives without medical advice.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Increase fibre gradually and increase fluid alongside it
- Do not ignore the urge to go; delay hardens stool
- Use a footstool to raise the knees above the hips
- Review medicines with a pharmacist if constipation started with a new one
Do not
- Long-term stimulant laxatives without medical advice
- Increasing fibre sharply without more fluid
- Regular heavy straining, which contributes to haemorrhoids and prolapse
The numbers behind the list
Those two lists follow from the published figures here.
| Measure | Figure |
|---|---|
| UK fibre recommendation | 30g a day |
| Fluid | 6-8 drinks a day |
| First-line laxative | a bulk-forming laxative such as ispaghula |
| If stools remain hard | an osmotic laxative such as macrogol is added |
| Common drug causes | opioids, iron, some antidepressants and antacids |
If you change one thing
Increase fibre gradually and increase fluid alongside it. It heads the list. If you take nothing else from this page, take that.
Where to go next
- Constipation in Five Minutes
- What the Guidance Really Says About Constipation
- Constipation — the reference entry
- What the Guidance Really Says About Acid Reflux
- Coeliac Disease: What Published Guidance Supports
When to speak to a doctor
See a GP for a persistent change in bowel habit lasting three weeks or more, blood in your stool, unexplained weight loss, persistent abdominal pain, or constipation that is new and unexplained over 50. Seek urgent help for severe abdominal pain with vomiting and inability to pass wind, which can indicate obstruction.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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