Constipated? We've Been There—And Brought Solutions

What is Constipation?

How often is normal? Once or twice a day? Every two or three days? Doctors generally answer this question with: anywhere from three times a day to three times a week. Constipation—medically known as obstipation or constipation—is usually defined as having fewer than three bowel movements per week. This can happen occasionally; many people experience it, for example, when travelling. However, constipation becomes a problem when it is chronic or long-term.

It's not just about frequency though, discomfort also plays a part in defining constipation. Someone who habitually has bowel movements twice a week, but without difficulty and feels perfectly fine, doesn’t need to worry about their lower frequency. On the other hand, someone who has daily bowel movements but struggles with hard, painful stools may also meet the criteria for constipation.

Who is Most Likely to Experience Constipation?

Constipation is quite common: around 15% of people in Germany experience it. Women and older adults are more frequently affected by these digestive issues. Constipation is also common during pregnancy. However, this is usually temporary. Things often return to normal in the months following childbirth.

What Causes Constipation?

Temporary constipation is often linked to diet and lifestyle. Typical triggers include:

• An unhealthy, low-fibre diet
• Lack of fluids
• Lack of physical activity

So, is it all our own fault? Well, not entirely. There are indeed people who eat little fibre, drink less, and have a sedentary lifestyle—yet they still have regular bowel movements. Doctors, therefore, believe that some people may have a natural predisposition to constipation, possibly due to an unfavourable gut flora or naturally sluggish bowel movements.

Constipation can also occur in connection with certain medical conditions, where it’s classified as pathological. Conditions that increase the likelihood of constipation include:

• Irritable Bowel Syndrome (IBS)
• Chronic inflammatory bowel diseases (Crohn’s disease, ulcerative colitis)
• Hypothyroidism
• Diabetes
• Neurological conditions like Alzheimer’s or Multiple Sclerosis

Additionally, regular medication use can play a role, as constipation is a side effect of many commonly prescribed drugs.

Quick Solutions for Temporary Constipation

Remember: fruits are your friends against constipation! Prunes, kiwis, or mango—fresh or dried—are great for relieving constipation. Fibre supplements can also offer quick relief.

Try incorporating:

• Psyllium husk, wheat bran, acacia fibre, flaxseed: known as insoluble fibres
• Inulin and pectin: known as soluble fibres

Good to know: Insoluble fibres are plant-based fibres that swell up, making the stool softer and bulkier, which helps move things along in the intestines. Soluble fibres, also from plants, help maintain a healthy gut flora and, in turn, aid your digestion.

You can also boost your gut flora directly with “good” bacteria: lactobacilli have proven particularly helpful here. These beneficial microorganisms can be found in fermented foods such as natural yoghurt with live cultures, buttermilk, ayran, kefir, cheese (Cheddar, Gruyère, Bergkäse, Parmesan, Harzer), and sauerkraut.

When to Use Laxatives to Relieve Constipation

If home remedies and lifestyle changes aren’t enough to resolve constipation, it’s perfectly fine to use laxatives. Macrogol, sodium picosulfate, and bisacodyl are commonly prescribed first-line treatments that are safe and effective, even for long-term use. You may have heard warnings about becoming dependent on laxatives, where they lose their effectiveness. Don’t worry. According to current medical guidelines, dependence is rare even after many years of use.

Warning Signs: When You Should Really See a Doctor

If constipation is accompanied by severe, persistent, or recurring abdominal pain, fever, or vomiting, you should immediately see a doctor or visit the emergency department. These warning signs could indicate a serious issue, such as a bowel obstruction.

Preventing Constipation in the Long-Term

Are you drinking enough water, eating enough fibre, and staying active? These three things can help prevent constipation:

• Drink 1.5 to 2 litres of water daily.
• Eat fibre-rich foods daily: Good sources of fibre include vegetables, fruits, wholemeal bread, whole grain products, cereals, brown rice, legumes, nuts, and seeds.
• Engage in at least 30 minutes of physical activity daily. This can be walking, cycling, housework, gardening, or sports.