Constipation: causes, symptoms and how to improve bowel function

Constipation is a common digestive problem that can manifest as infrequent bowel movements, hard stools, bloating, or a feeling of incomplete evacuation. According to data from a large systemic review and meta-analysis, functional constipation can affect approximately 10-15% of adults, depending on the diagnostic criteria used, and longer-lasting symptoms are often associated with a poorer quality of life.

While often thought to be primarily caused by insufficient fiber in the diet, other contributing factors can include a lack of fluids, low physical activity, stress, certain medications, specific health conditions, or changes in gut microbiota. Therefore, it is important not only to seek quick relief but also to understand the potential causes of the problem.

According to the Rome IV criteria used by gastroenterologists, constipation may be characterized by the following symptoms:

• Less frequent bowel movements than usual

• Hard or lumpy stools

• Straining during defecation

• A feeling of incomplete evacuation

• Bloating or a feeling of heaviness

The causes of constipation can be diverse. Most often, the problem is not due to a single circumstance but a combination of several interconnected factors.

Fiber helps increase stool volume and maintain regular bowel movements. If there is a lack of fiber in the diet, stools can become harder, making defecation more difficult. Adequate fluid intake is equally important. When the body lacks fluids, stools can become drier and harder to pass.

Physical activity is important not only for overall health but also for normal bowel function. Prolonged sitting and limited movement can slow down intestinal motility, leading to less frequent or more difficult bowel movements for some people.

The digestive system is closely linked to daily habits. Travel, changes in daily routine, lack of sleep, or increased stress can affect bowel function. For this reason, some people notice that constipation is more common during holidays, business trips, or more intense periods of life.

Constipation can also be associated with the use of certain medications. Among the most commonly mentioned are some pain relievers, iron supplements, antidepressants, or medications for treating blood pressure. If symptoms appeared after starting a new medication, it is worth consulting a doctor or pharmacist.

Gut microbiota is the totality of microorganisms living in the digestive tract. More and more research shows that the composition of the gut microbiota in people suffering from constipation may differ from that of individuals who have regular bowel movements.

It is believed that the microbiota can influence gut motility and defecation frequency, so its changes may, in some cases, be associated with altered bowel function. Although microbiota is not the sole cause of constipation, it is considered one of the factors that can contribute to this problem.

For this reason, scientists are interested in various ways to help maintain microbiota balance, including the use of prebiotic fibers and probiotics. Some studies have evaluated the effect of probiotics on people suffering from constipation. While results depended on specific bacterial strains, certain probiotics were associated with more favorable bowel movement indicators.

If you are interested in products for gut microbiota and digestive comfort, you can find more of them in the gut health supplements category. 

When experiencing constipation, you usually want a quick solution. While dietary and lifestyle changes are important in the long term, some measures can help relieve symptoms faster. 

Adequate fluid intake is important for normal bowel function. If the body lacks fluids, stools can become harder and more difficult to pass. Sufficient fluid intake is especially important when increasing fibre in the diet. As a guide, about 30-35 ml of fluid per kilogram of body weight per day is often cited in practice, but individual needs may vary depending on physical activity, ambient temperature and other factors. 

Physical activity can help maintain normal bowel function and is one of the first remedies to try when constipated. In addition to walking, light exercises that help move the abdominal and pelvic areas can be performed. For some people, squats, torso twists, bringing the knees to the chest while lying down, or simply more active walking are suitable. Even a short period of physical activity is often more beneficial than prolonged sitting. 

Constantly postponing defecation can make it harder to maintain a regular bowel rhythm. When you feel the urge to defecate, it is recommended not to ignore it.

Some foods and herbs are more frequently mentioned when discussing faster relief from constipation. 

Dried plums are one of the most frequently mentioned natural remedies for constipation. They contain fibre and other compounds that can help maintain regular bowel movements. Scientific studies have linked the consumption of dried plums to more favourable defecation rates in people suffering from constipation. 

Kiwis have also attracted attention in recent years. According to some research data, their consumption may be associated with more frequent defecation and softer stool consistency. As with other foods, the effect may vary depending on the individual situation. 

Senna, cascara, buckthorn and rhubarb have long been used for less frequent bowel movements. They contain compounds associated with promoting intestinal motility. They are most often mentioned for the following properties:

• can stimulate intestinal motility;

• traditionally used for short-term relief of constipation;

• more often used episodically, not daily.

Although these plants have been used for a long time, it is not recommended to use them for extended periods without the advice of a specialist.

Diet is one of the most important factors influencing bowel function. Healthy eating recommendations emphasize that adequate fibre intake is an important part of a balanced diet, so it is useful to assess whether you are getting enough in your daily diet. 

According to research, a higher fibre intake can be beneficial for people suffering from constipation, especially concerning defecation frequency. However, fibre intake should be increased gradually, along with sufficient fluid intake. It is important to know that fibre does not help everyone equally, so the effect may vary depending on the individual situation.

Among the various types of fibre, prebiotic fibres are distinguished. One of the best known are FOS (fructooligosaccharides), which are not digested in the small intestine and reach the large intestine, where they become food for beneficial bacteria. FOS differ from many other fibres in that they:

• act as food for gut bacteria;

• can promote the growth of beneficial bacteria;

• contribute to microbiota diversity;

• can help maintain regular bowel movements 

Scientific studies evaluate FOS not only for their effect on the microbiota, but also for their potential effect on defecation frequency and stool consistency.

In your diet, it is worth paying attention to several food groups that can help "collect" more fibre and thus maintain normal bowel function.

Vegetables, fruits and berries are among the main sources of fibre. In addition, many of them naturally contain water, which, together with fibre, can help maintain normal bowel function. Including more various plant-based products daily usually increases the total fibre content in the diet.

Beans, lentils, chickpeas, and other legumes are among the richest sources of fibre. They can increase the total fibre content in the diet, but their amount should also be increased gradually.

Whole grain products naturally contain soluble and insoluble fibres. Oats, whole grain bread, buckwheat or brown rice can be a beneficial part of a varied diet to get more fibre.

Fermented products, such as kefir, natural yoghurt or fermented vegetables, can supplement a microbiota-friendly diet. Although their effect on constipation varies, they are often included in general recommendations for maintaining gut health.

Flax seeds can be beneficial for constipation due to their soluble and insoluble fibres. They can help increase stool volume and maintain regular bowel movements. Chia seeds are often mentioned in a similar context, as they are also a source of fibre. Flax seeds and chia seeds can be mixed into yoghurt, kefir, porridge or other foods.

Some plants are more commonly associated with overall digestive well-being rather than just bowel motility. Among the most frequently mentioned are:

• Fennel;

• Peppermint;

• Lemon Balm;

• Cinnamon;

• Mallow;

• Dandelion.

These plants are traditionally used to support digestive comfort and are more often mentioned in the context of reducing bloating, feelings of heaviness after meals, or general digestive discomfort.

The most scientific data among these plants has been gathered on the effects of peppermint on certain digestive symptoms, particularly in irritable bowel syndrome.

Complex formulas are also available on the market, combining prebiotic fibers and traditionally used plants for digestive comfort. Such formulas often contain FOS and various plant-based ingredients, such as fennel, peppermint, lemon balm, or cinnamon. One such product is the gut harmony food supplement Le Dieci Erbe Flor.

If constipation is a frequent problem, it's worth paying attention not only to what you eat, but also to what might be in excess in your diet. Highly processed foods, low-fiber snacks, large amounts of sweets, and a diet lacking fruits, vegetables, and whole-grain products can make it difficult to get enough fiber.

If constipation persists despite quick remedies, dietary and lifestyle changes, or if the problem recurs frequently, it is advisable to consult a doctor.

Also, do not delay seeking medical attention if accompanied by:

• blood in stool;

• unexplained weight loss;

• severe or recurrent abdominal pain;

• anemia;

• sudden changes in bowel habits.

Important to know: If constipation does not resolve within a few weeks or if warning symptoms appear, it is important to consult a doctor to identify the possible causes of the problem.

Constipation usually results from a combination of factors: diet, lack of fluids, low physical activity, stress, or changes in gut microbiota. Short-term relief can be provided by certain foods, natural remedies, or lifestyle changes. In the long run, the most important thing is to ensure adequate fiber intake, a varied diet, fluid consumption, physical activity, and habits that promote a healthy gut microbiota. If symptoms recur frequently or persist for a long time, it is advisable to consult a doctor.