Constipation — Causes and When It Needs Investigation
Also described as difficulty passing stool, hard stools, infrequent motion.
Constipation is usually managed with fibre, fluids, activity and a regular toilet routine. What matters clinically is change: a new and persistent alteration in bowel habit after 45, with blood, weight loss or anaemia, needs a colonoscopy to exclude a bowel cause.
🚨 Get emergency care if you have
- •New persistent change in bowel habit lasting over three weeks
- •Blood in the stool, or anaemia
- •Unexplained weight loss
- •Constipation with vomiting and a distended abdomen — possible obstruction
- •A family history of bowel cancer
What causes constipation?
Low fibre, low fluid and inactivity
The commonest cause, and the most responsive to change.
Medication
Iron, opioid painkillers, some antacids and antidepressants all slow the bowel.
Hypothyroidism
Constipation with fatigue, weight gain and cold intolerance.
Irritable bowel syndrome
Constipation alternating with looser stools, with bloating and cramping relieved by defaecation.
Colorectal cancer
A persistent change in habit, sometimes with blood or anaemia. Highly treatable when found early.
How it is investigated
- ✓Haemoglobin and thyroid function
- ✓Colonoscopy where alarm features are present or age is over 45
- ✓Abdominal X-ray if obstruction is suspected
- ✓Medication review
Not every patient needs every test. The consultation decides which of these apply to you.
Frequently asked questions
How often should I pass stool?▼
Anything from three times a day to three times a week can be normal. Frequency matters less than change: a shift from your own long-standing pattern, especially with straining, blood or incomplete emptying, is what warrants attention.
Are laxatives harmful long term?▼
Bulk-forming and osmotic laxatives are generally safe for extended use under guidance. Stimulant laxatives taken daily for long periods are less ideal and often signal an underlying cause that should be investigated instead of managed indefinitely.
This page is general health information, not a diagnosis or a substitute for a consultation. Symptoms overlap between harmless and serious conditions, and only an examination can tell them apart. If you are worried, see a doctor.
Plan your first visit
Not sure which specialist to see? Tell our care team the reason for your visit and we will help you choose.
- Bring previous prescriptions, relevant test reports or scan images, a medication list and photo ID.
- If you plan to use insurance, bring your policy details. OPD, tests and admission benefits depend on your individual plan and approval.
- Your first consultation determines which tests or treatments are needed; not everyone needs every test listed on this page.
Appointments are requests until confirmed. In a medical emergency, call 044 2025 2025 or go to the nearest emergency department.