Constipation is a common issue that can be frustrating and uncomfortable [1]. When it becomes long-term or doesn’t get better with simple changes, doctors might call it ‘refractory’ or ‘chronic’ constipation. This usually means having fewer than three bowel movements a week, along with other symptoms like straining, having hard or lumpy stools, or feeling like you haven’t fully emptied your bowels [2]. It’s important to know that this condition can be managed effectively with the right approach. Your doctor will ask specific questions about your symptoms to understand what type of constipation you have and rule out other causes.
What Can I Do to Help Myself?
- Food and Water Making changes to your diet is a great first step [3].
- Increase Your Fibre Slowly: Fibre helps to soften your stool and make it easier to pass. Aim for about 25–30 grams of fibre each day [4]. It’s important to increase your fibre intake gradually to let your body adjust and to avoid feeling bloated or gassy [4]. Good sources of fibre include [2]:
- Whole grains: Wholemeal bread, porridge, and wholegrain breakfast cereals.
- Fruits and Vegetables: Fruits with the skin on, berries, apples, pears, and vegetables like carrots and broccoli.
- Legumes, Nuts, and Seeds: Lentils, beans, chickpeas, nuts, and seeds.
- Soluble Fibre Supplements: Products containing psyllium husk can be very effective. This type of fibre absorbs water to form a gel, which helps with both constipation and diarrhoea [5]. You can mix this powder with water or another liquid.
- Drink Plenty of Fluids: Fibre needs water to work properly. Aim to drink 1.5 to 2 litres of fluids a day, such as water, diluted fruit juice, or clear soups, to help soften your stool [6].
- Increase Your Fibre Slowly: Fibre helps to soften your stool and make it easier to pass. Aim for about 25–30 grams of fibre each day [4]. It’s important to increase your fibre intake gradually to let your body adjust and to avoid feeling bloated or gassy [4]. Good sources of fibre include [2]:
- Lifestyle Changes
- Get Regular Physical Activity: Being active helps move food through your system more quickly. Aim for regular exercise, such as a daily walk, run, or bike ride, to help stimulate your bowel muscles [7,8].
- Establish a Toilet Routine: Try to set aside a regular time each day to use the toilet without rushing. A good time is often within 30 minutes after breakfast, as eating helps stimulate your bowel to move [8,9]. Putting your feet on a small stool can also help you get into a better position [9].
- Understanding Laxatives: If diet and lifestyle changes are not enough, your doctor or pharmacist may recommend a laxative. There are a few different types, and they work in different ways [10].
- Bulking Laxatives (Fibre Supplements): These are often the first choice. They work by absorbing water to make your stool bulkier and softer, which helps trigger a bowel movement. Psyllium husk is a common example [7].
- Osmotic Laxatives: These work by drawing more water into your bowel, which softens the stool.
- Stimulant Laxatives: These work by stimulating the muscles in your bowel to contract and move stool along. Examples include senna and bisacodyl. They are usually recommended for short-term relief [10].
- Prescription Medications: If over-the-counter laxatives don’t work, your doctor may prescribe stronger medications that work in different ways to increase fluid in your bowel or stimulate movement.
Always speak with your doctor or pharmacist before starting a new laxative to make sure it is the right and safest choice for you. With a combination of these strategies, most people can find significant relief from long-term constipation.
Further Support If you would like further information on dietary support, our dietitian, Parisa is available.
For further support from one of our gastroenterologists, please contact our reception team.
Important If constipation starts suddenly or your bowel habits change, please see your doctor for a specialist referral, as this can sometimes be a sign of a more serious condition.
Disclaimer: This information is for educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor and never disregard professional medical advice or delay in seeking it because of something you have read in this document.
References:
- NICE British National Formulary. Constipation: Description of condition. Updated April 15, 2024. Accessed October 23, 2025. https://bnf.nice.org.uk/
treatment-summaries/ constipation/ - Hull University Teaching Hospitals NHS Trust. Relieving Constipation and Promoting Healthy Bowels. Patient Information Leaflet. Accessed October 23, 2025. https://www.hey.nhs.uk/
patient-leaflet/relieving- constipation-and-promoting- healthy-bowels-improving-you- bowel-health/ - World Gastroenterology Organisation. WGO Practice Guideline: Constipation. Published 2010. Accessed October 23, 2025. https://www.
worldgastroenterology.org/ guidelines/constipation/ constipation-english - Health Service Executive. Managing Constipation: Dietary Advice for a Healthy Bowel. Patient Information Leaflet. Published 2018. Accessed October 23, 2025. https://www.hse.ie/eng/
services/list/2/primarycare/ community-funded-schemes/ continence/public/managing- constipation-dietary-advice- for-a-healthy-bowel-final.pdf - Royal Berkshire NHS Foundation Trust. Modifying fibre in your diet. Patient Information Leaflet. Published June 2024. Accessed October 23, 2025. https://www.royalberkshire.
nhs.uk/media/rr3oxyok/ modifying-fibre-in-the-diet_ jun24.pdf - Imperial College Healthcare NHS Trust. Constipation and Defecatory Dysfunction. Patient Information Leaflet. Published April 2022. Accessed October 23, 2025. https://www.imperial.nhs.uk/-/
media/website/patient- information-leaflets/ physiotherapy/constipation- and-defecatory-dysfunction.pdf - Gastrointestinal Society. Constipation. Badgut.org. Updated June 21, 2023. Accessed October 23, 2025. https://badgut.org/
information-centre/a-z- digestive-topics/constipation/ - NICE British National Formulary. Constipation: Overview. Updated April 15, 2024. Accessed October 23, 2025. https://bnf.nice.org.uk/
treatment-summaries/ constipation/ - Health Service Executive. Managing Constipation: Sit properly on the toilet. Patient Information Leaflet. Published 2018. Accessed October 23, 2025. https://www.hse.ie/eng/
services/list/2/primarycare/ community-funded-schemes/ continence/public/managing- constipation-dietary-advice- for-a-healthy-bowel-final.pdf - World Gastroenterology Organisation. WGO Practice Guideline: Constipation – Graded approach to treatment. Published 2010. Accessed October 23, 2025. https://www.
worldgastroenterology.org/ guidelines/constipation/ constipation-english