Constipation becomes concerning when it’s new, persistent, or severe—especially if it lasts more than a few weeks, doesn’t respond to simple changes (like more fiber or water), or comes with “red flag” symptoms like weight loss, blood in the stool, new pain, or a family history of colon cancer. Chronic constipation (trouble with bowel movements for 3 months or longer) often needs attention and workup.

Constipation can result from:

• Diet and lifestyle: Low fiber intake, dehydration, lack of exercise, ignoring the urge to go, or extreme diets.

• Medications: Painkillers (especially opioids), some antidepressants, antacids with calcium or aluminum, iron supplements, antihistamines, and more.

• Medical conditions: Hypothyroidism, diabetes, Parkinson’s disease, irritable bowel syndrome (IBS), spinal cord injury, neurologic problems, or hormonal changes.

• Structural problems: Colon polyps, tumors, strictures, anal fissures, or pelvic floor dysfunction.

• Other: Chronic idiopathic constipation or functional constipation, where no clear cause is found but bowel function is slowed.

For most people, getting to the bottom of constipation doesn’t require lots of tests. We start by really listening to your story—reviewing your symptoms, habits, and health history—then do a focused checkup (which may include a quick physical exam) and sometimes ask you to track your bowel patterns with a simple stool diary.

Routine bloodwork is often the only testing needed, just to rule out common issues like anemia, thyroid problems, diabetes, or celiac disease.

Most people don’t need any special tests beyond this! More advanced testing—like colonoscopy, special imaging, or an x-ray of your abdomen—is only recommended if your symptoms are severe, have lasted a long time, or if there are “red flags” (like blood in the stool, weight loss, or strong family history of colon cancer).

The vast majority of patients get answers and relief with just a thoughtful conversation, focused exam, and simple labs—no extensive testing required.

Both conditions cause infrequent, hard, or difficult-to-pass stools, but IBS-C (irritable bowel syndrome with constipation) also comes with consistent abdominal pain or discomfort that’s partly relieved by having a bowel movement, along with bloating or changes in stool appearance.

By contrast, chronic constipation doesn’t always involve pain or discomfort and tends to be more about stool frequency and ease of passage.

Treatments are similar in many ways, but IBS-C may call for therapies that also target gut sensitivity and pain, such as certain prescription medications, dietary changes (like low FODMAP diets), or antispasmodics.

Your gut is basically a bustling city of trillions of “good bugs” called your microbiome—and a happy city means smooth traffic! When your gut bacteria get out of balance, things can slow down, leading to frustrating “traffic jams” (aka constipation). Feeding your gut’s “residents” a fiber-packed menu (think fruits, veggies, and whole grains) keeps them happy and productive, making natural compounds that help move things along.

Want to give your gut an extra boost?

Probiotics like Lactobacillus or Bifidobacterium based supplements act like sending in friendly reinforcements, while prebiotics—special fibers in foods like onions, bananas, and leeks—are the snacks those bacteria love. Keep your gut bugs content, and your bowels just might cruise in the fast lane—though everyone’s city is a little different!

Yes! For some folks, certain foods act like uninvited party crashers in your gut—lactose (from milk) and gluten (from wheat) are common culprits that can slow things down, causing constipation, bloat, or sometimes turning things into a rollercoaster (hello, tummy troubles!). For instance, lactose intolerance can stall your gut’s engine, and undiagnosed celiac disease (gluten gone rogue) is notorious for backing up the system. If you spot a “cause-and-effect” after specific foods, don’t keep it to yourself—bring your detective work to us! We will crack the case and get your gut back on track.

First-Line Treatments for Constipation

• Increase fiber and fluids: Try for 20–35 grams of fiber every day from fruits, veggies, and whole grains, and drink plenty of water (sorry - it had to be said). Fiber gives your stool bulk, while water keeps things soft and moving.

• Regular exercise: Even a daily walk can help “wake up” your colon and keep things moving.

• Respond to the urge: Don’t ignore the need to go—holding it in can make constipation worse.

• Consider probiotics: Certain probiotic supplements (with strains like Bifidobacterium or Lactobacillus) may help improve gut motility and regularity, especially for people with slow bowel movements or after antibiotics. BioGaia probiotics (containing Lactobacillus reuteri DSM 17938) are one of the most researched probiotics for constipation and have been shown in studies to help improve stool frequency and consistency, especially for those with slow bowels or after antibiotic use.

• Over-the-counter options:

  • Bulk-forming laxatives: Psyllium (Metamucil), methylcellulose (Citrucel) add bulk and soften stool.

  • Osmotic agents: Polyethylene glycol (PEG, Miralax), milk of magnesia, or lactulose pull water into the bowel for easier passage.

  • Stool softeners: Docusate can help, but there’s less evidence for long-term benefit.

If standard steps haven’t worked, here are options backed by research:

• Prescription medications:

  • Lubiprostone, linaclotide, and plecanatide are prescription drugs that help draw water into the bowel and are effective for chronic, stubborn constipation.

  • Prucalopride is a newer medication that stimulates bowel motility (a 5-HT4 agonist); strong evidence shows it increases bowel frequency and improves symptoms in people with chronic constipation, especially when laxatives haven’t helped. 

• Stimulant laxatives: Senna or bisacodyl can be used for short-term relief or as needed, but aren’t ideal for long-term regular use.

• Pelvic floor retraining: Biofeedback therapy can be very helpful for pelvic floor dysfunction—teaching muscles to coordinate for easier bowel movements.

• Treat underlying causes: Optimizing thyroid function, improving diabetes control, or changing medications if possible.

• Low Dose Naltrexone (LDN): Some emerging evidence suggests LDN may improve gut motility and help with constipation, particularly in patients with opioid-induced constipation or certain inflammatory/immune-related gut disorders. 

• High-dose vitamin C: Taking vitamin C in higher amounts can draw water into the colon and gently stimulate a bowel movement. This is effective for some people, but too much can cause diarrhea, so increases should be gradual and guided.  

• Aloe vera: Clinical studies suggest that aloe vera juice can enhance gut motility and relieve constipation, especially in older adults. 

• Rarely, surgery: For very severe or specific anatomical problems.

If you have “refractory” (hard to treat) constipation, we will create a plan tailored to your specific situation—combining medical, lifestyle, and occasionally complementary therapies for the best results. And if constipation is persistent or comes with worrisome symptoms, always book a visit for a careful assessment and a personalized plan—there’s almost always a way to get relief!