Kolkata, December 20, 2025: Chronic constipation is a common gastrointestinal complaint, defined by infrequent bowel movements—usually fewer than three per week—along with symptoms such as excessive straining, hard stools, or a persistent feeling of incomplete evacuation. It affects nearly 9–20 per cent of the global population and is more common among women and older adults. Despite its prevalence, constipation is often misunderstood as a disease, whereas it is more accurately a symptom reflecting lifestyle patterns or underlying medical conditions. Dr. Udipta Ray (Director, Robotics, GI Surgery, Fortis Hospital, Anandapur, Kolkata) has provided detailed information on this topic.
Perceptions of bowel health vary widely across cultures. In India, many people feel physically and mentally unsettled if their bowels are not cleared every morning. In contrast, in colder countries, passing stools once every two or three days may be considered normal. From a medical standpoint, constipation is identified not just by frequency but also by difficulty and discomfort during defecation.
Multiple factors contribute to constipation. Genetics play an important role, with the condition often seen across generations in the same family. Modern research has shown that the intestine contains an extensive network of nerves and neurotransmitters, and even minor imbalances can affect bowel motility. Lifestyle factors are among the most common causes. Physical inactivity, prolonged sitting, and limited movement—especially among older adults—slow intestinal contractions. As clinicians often say, when the body is inactive, the gut becomes inactive too.
Dietary habits significantly influence bowel function. Increased consumption of refined and ready-to-eat foods and inadequate intake of vegetables and fruits reduce dietary fibre, which is essential for healthy colonic movement. Hydration is equally important. As a general guideline, one litre of water is required per 20 kilograms of body weight per day, with necessary adjustments for climate and existing medical conditions. Poor sleep habits, night shifts, and excessive screen time also disturb the body’s natural digestive rhythm.
Constipation is not always psychological, although stress may worsen symptoms due to the gut–brain connection. Medical conditions such as hypothyroidism, low potassium levels, inflammatory bowel disease, intestinal narrowing, or tumours of the colon or rectum may also present as constipation.
Medical advice should be sought if constipation is persistent or associated with warning signs such as rectal bleeding, abdominal pain, fever, loss of appetite, or unexplained weight loss. Self-medication with laxatives should be avoided, particularly in the presence of pain or bloating, as it may worsen undiagnosed intestinal problems. Initial treatment usually includes fibre supplements such as psyllium husk, adequate fluids, and lifestyle correction.
Surgery is rarely required and is reserved only for specific conditions such as rectal prolapse, obstructed defecation syndrome, or tumours causing obstruction. In most cases, answering three simple questions—have you eaten well, slept well, and exercised adequately—goes a long way in preventing and managing constipation effectively.
