How to Relieve Constipation: What Works, What to Watch For, and When to See a Clinician

Why does constipation happen?

Your colon absorbs water as food moves through it. When movement slows — from too little fluid, insufficient fiber, inactivity, stress, certain medications, or an underlying condition — stool dries out and becomes harder to pass. Most constipation in otherwise healthy adults is functional, meaning there is no structural problem, but the body is signaling that something in the system needs adjusting.

Common contributing factors include low-fiber diets, inadequate hydration, sedentary routines, travel and schedule disruption, and medications such as opioids, iron supplements, certain antidepressants, and calcium channel blockers. Less commonly, constipation reflects an underlying condition like hypothyroidism, diabetes, or a structural change in the colon [1, 2].

What can you try at home first?

Hydration is the foundation. Aim for enough water that urine runs pale yellow throughout the day.

Fiber — both soluble (oats, beans, fruit with the skin, psyllium husk) and insoluble (whole grains, vegetables) — softens stool and adds bulk. Add either type gradually; too much at once can worsen bloating. A joint AGA–ACG clinical practice guideline supports fiber and osmotic laxatives as first-line approaches for chronic idiopathic constipation 1Ref 1Chang L, Chey WD, Imdad A, et al. (2023).American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation.First-line recommendations for fiber and osmotic agents in chronic idiopathic constipation; classification of laxative types.

Physical movement stimulates gut muscle contractions. Even a 20-minute walk can help — and guidelines from the WHO support regular physical activity as broadly beneficial to health 3Ref 3Bull FC, Al-Ansari SS, Biddle S, et al. (2020).World Health Organization 2020 guidelines on physical activity and sedentary behaviour.Physical activity as broadly beneficial to health; supports walking and movement as part of constipation management.

Timing and position matter. Sitting upright and not rushing when the urge arises makes passing easier. Many people find warm liquids — particularly coffee — reliably move things along. Prunes and prune juice contain sorbitol, a compound that gently draws water into the bowel; this is one of the better-studied home remedies.

Avoid straining, which can cause hemorrhoids.

What over-the-counter options are available, and how do they differ?

Several product categories are sold without a prescription 1Ref 1Chang L, Chey WD, Imdad A, et al. (2023).American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation.First-line recommendations for fiber and osmotic agents in chronic idiopathic constipation; classification of laxative types:

• Bulk-forming agents (psyllium, methylcellulose) mimic dietary fiber and are generally the gentlest option for ongoing use.
• Osmotic agents (polyethylene glycol, magnesium citrate) draw water into the bowel to soften stool. Polyethylene glycol has a strong evidence base for chronic constipation.
• Stool softeners (docusate) add moisture to stool; evidence for significant clinical benefit is mixed.
• Stimulant laxatives (bisacodyl, senna) prompt the bowel wall to contract and work faster, but are generally intended for short-term use. Relying on them regularly without clinician guidance can create dependence.
• Suppositories and enemas act locally and can be effective when oral measures have not worked.

A pharmacist is a useful first stop for guidance on which option suits your situation.

What else could be causing constipation?

Medication side effects are among the most overlooked causes. Opioids, iron supplements, certain antidepressants, antacids containing calcium or aluminum, and blood pressure medications (particularly calcium channel blockers) are common contributors.

Irritable bowel syndrome (constipation type) often presents with recurring cramps linked to bowel changes, bloating, and a sense of incomplete emptying, and has typically been present for months.

Hypothyroidism can slow gut motility significantly. It is worth considering — particularly in middle-aged women — if constipation comes with fatigue, weight gain, feeling cold, dry skin, or hair loss 4Ref 4Jonklaas J, Bianco AC, Bauer AJ, et al. (2014).Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement.Hypothyroidism as a systemic cause of constipation, relevant to evaluation when lifestyle measures fail.

Pelvic floor dysfunction is underdiagnosed, especially in women who have given birth or had pelvic surgery. The hallmark is a sensation of incomplete emptying, or the need to press around the vagina or rectum to pass stool.

Structural causes — including colon polyps, narrowing, or, less commonly, colorectal cancer — are less common overall but become more important to consider in people over 45, especially with new-onset constipation, blood in stool, unintentional weight loss, or pencil-thin stools. The US Preventive Services Task Force recommends colorectal cancer screening beginning at age 45 for adults at average risk 5Ref 5Davidson KW, Barry MJ, Mangione CM, et al. (US Preventive Services Task Force) (2021).Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.Colorectal cancer screening starting at age 45 for average-risk adults; supports investigation of new-onset constipation in older adults with red-flag symptoms.

When should you see a clinician?

See a clinician if:

• You have tried the basics for a week without improvement.
• Constipation keeps coming back or significantly affects your quality of life.
• You take opioids or other medications known to cause constipation — proactive management is better than waiting for it to become severe.
• You are pregnant — extra care is needed when choosing any laxative; ask your OB or midwife before using any product.
• You have diabetes — autonomic neuropathy can slow gut motility and your constipation may be part of a larger picture.
• Any of the red flags listed below are present.

A clinician can identify whether medications are driving the problem, order thyroid or metabolic blood work, and — for people over 45 who are not up to date on colorectal cancer screening — ensure appropriate workup is in place 5Ref 5Davidson KW, Barry MJ, Mangione CM, et al. (US Preventive Services Task Force) (2021).Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.Colorectal cancer screening starting at age 45 for average-risk adults; supports investigation of new-onset constipation in older adults with red-flag symptoms.