What is constipation?
Constipation means fewer than 3 bowel movements per week, hard stools, straining, or feeling of incomplete evacuation. It's extremely common and affects 16% of US adults.
Most cases improve with lifestyle changes and OTC options. Some need prescription medication. Chronic or worsening constipation, especially over age 50, can occasionally signal something more serious and warrants in-person evaluation.
Do I have constipation? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Low fiber, low fluid intake, sedentary lifestyle, ignoring the urge to go, certain medications (opioids, iron, calcium channel blockers, antidepressants), pregnancy, IBS, hypothyroidism, diabetes, anatomical issues, and aging.
Is it contagious?
No.
The order that works: fluids → fiber → exercise → laxative. Each step matters before the next.
Can it be treated online?
Routine constipation is well-suited to telehealth. Red flags requiring in-person workup: blood in stool, unintentional weight loss, family history of colon cancer, onset over 50 with new symptoms, severe abdominal pain, or vomiting.
How constipation is treated
Start with lifestyle: water, fiber (psyllium/Metamucil 1–2 tsp daily, working up), exercise. OTC options: polyethylene glycol (MiraLax) is first-line and very safe. Bisacodyl or senna are stimulant laxatives — use occasionally, not daily. For chronic refractory: linaclotide, lubiprostone, or plecanatide (Rx). Opioid-induced constipation has specific Rx options.
Self-care while you wait
- Drink 6–8 glasses of water daily
- Aim for 25–35g fiber per day from food
- Daily physical activity
- Don't ignore the urge to go
- Schedule time after meals — the gastrocolic reflex helps
- Limit cheese, processed foods if they slow you
- Squat position (or feet on a small stool) helps mechanics
How long does it last?
Acute constipation usually resolves in days with appropriate treatment. Chronic constipation can be lifelong but well-managed.
Frequently asked questions
Is daily Miralax safe long-term?
Yes — it's not absorbed and not habit-forming. Many people use it long-term safely.
Will fiber alone fix it?
For mild cases, yes. But too much fiber too fast can worsen bloating. Increase gradually and pair with fluids.
What about probiotics?
Mixed evidence. Some specific strains help mild constipation. Worth trying for 4 weeks.
Am I really constipated if I'm not going every day?
Bowel habits vary normally — every other day can be fine if there's no straining and stools are soft.
Is straining dangerous?
Chronic straining contributes to hemorrhoids and pelvic floor problems. Fix the constipation rather than push through.
