How to Stay Regular

Chances are you’ve experienced constipation at some point in your life. It’s one of the most common gastrointestinal complaints, affecting people of all ages, genders, and backgrounds. Constipation is typically defined as having fewer than three bowel movements per week, along with stools that are hard, dry, difficult to pass, or accompanied by straining and a sense of incomplete evacuation. While it’s usually temporary, constipation can significantly affect quality of life and, if left unmanaged, may lead to complications such as hemorrhoids or fissures.

It’s important to remember that “normal” bowel habits vary widely. Some people pass stool several times a day, while others go only a few times a week. What matters most is your personal pattern. If your usual rhythm changes and bowel movements become less frequent or more difficult, you may be experiencing constipation.

Why Constipation Happens

Constipation occurs when stool moves too slowly through the digestive tract. As it lingers, the colon absorbs more water, making the stool firmer and more compact, which can make bowel movements more challenging. Many everyday factors can contribute, including:

• a low-fiber dietary pattern,
• inadequate fluid intake,
• a sedentary lifestyle,
• changes in routine, such as travel, diet, or altered sleep or eating schedules,
• high intake of cheese and milk (excess calcium can be binding for some people), fried foods (which can slow down the digestive tract), or refined grains (which usually means low-fiber intake)
• medications, including some pain relievers, antacids, iron supplements, and antidepressants
• certain medical conditions, such as thyroid disorders, neurologic diseases, or diabetes,
• stress and anxiety, which can disrupt normal bowel patterns.

Constipation becomes more common with age; an estimated 30 to 40 percent of adults over 65 report issues. Women are also more likely than men to experience chronic constipation.

Dietary Pattern and Lifestyle

Harmony Allison, an assistant professor at Tufts University School of Medicine and associate chief of gastroenterology at Tufts Medical Center, emphasizes that digestive health reflects overall health. “A healthy body equals a healthy digestive pattern,” she says.

Several everyday habits can help support regular bowel movements:

• Increase fiber intake. Fiber adds bulk to stool and helps it move through the intestines more easily. Aim for three to five servings of vegetables and fruits per day and include other high-fiber foods like beans, whole grains, bran cereals, and nuts. Increase fiber gradually to minimize bloating or gas.
   
• Stay hydrated. Adequate fluid intake helps keep stool soft. Aim to drink several glasses of water daily.
   
•  Move your body. Physical activity stimulates the muscles of the digestive tract. Even a daily walk can help promote regular bowel movements.
   
• Establish a routine. Eating at consistent times can help regulate bowel function. Many people also find it helpful to try using the bathroom at the same time each day—often 20 to 30 minutes after breakfast, when the colon is naturally more active, but don’t force it.
   
• Adjust your position. Placing your feet on a small stool while seated on the toilet helps straighten the rectum and can make bowel movements easier.

Short-Term Relief at Home

If constipation persists despite dietary pattern and lifestyle adjustments, over-the-counter products may help. Options include fiber supplements (such as psyllium or methylcellulose), osmotic laxatives like polyethylene glycol (MiraLAX), stool softeners, and, in some cases, stimulant laxatives. Allison favors fiber supplements that are mixed with water, noting that supplements alone—without enough fluid—can actually worsen constipation.

Start with the gentlest option, and use stimulant laxatives sparingly. Avoid using laxatives for more than two weeks without speaking to a healthcare provider, as overuse can worsen symptoms.

When to Seek Medical Care

If constipation is a new problem for you or lasts more than three weeks, see your healthcare provider. “Constipation accompanied by significant pain—not related to gas—may warrant urgent medical evaluation,” Allison cautions. Other reasons to seek care include seeing blood in your stool, losing weight without trying, having pain during bowel movements, or experiencing symptoms suggesting pelvic floor dysfunction, such as feeling unable to relax the muscles during a bowel movement. 

Paying attention to what your body needs—more fiber, more fluids, more movement—can go a long way toward preventing constipation and supporting overall digestive health. And if symptoms don’t improve, your healthcare provider can guide you toward the right treatment.

This article originally appeared in the Tufts Health & Nutrition Letter, published each month by the Friedman School of Nutrition Science and Policy.