Constipation is one of the digestive problems people most often normalize. People live with it for years, manage it with over-the-counter laxatives, and never consult anyone because they assume that “it’s always been this way.”
The point is that chronic constipation measurably affects quality of life and, in certain cases, is a sign of something that should be evaluated.
What is considered constipation
It is not defined only by frequency. Constipation is considered present when, persistently, there are two or more of these situations:
- Fewer than three bowel movements per week
- Hard stools or small pieces
- Excessive straining to pass stool
- A feeling of incomplete evacuation
- A feeling of blockage
- Need for manual maneuvers to achieve it
Constipation is considered chronic when this persists for at least three months.
It is worth clarifying something: it is not mandatory to have a bowel movement every day. The normal range is broad, from three times a day to three times a week. What matters is not the number, but the change from your own pattern and the associated difficulty.
Common causes
- Insufficient fiber. The most common cause and the easiest to correct.
- Low fluid intake. Especially relevant in Panama’s climate.
- Sedentary lifestyle. Movement stimulates intestinal motility.
- Ignoring the urge to have a bowel movement. Repeatedly postponing it gradually dulls it.
- Medications. Opioid pain relievers, some antidepressants, iron supplements, antacids with aluminum, and certain antihypertensives.
- Hypothyroidism and other metabolic conditions.
- Pregnancy.
- Routine changes such as travel or work shifts.
When to stop managing it on your own
Consult a gastroenterologist if:
- You have been like this for more than three months
- It started recently and without a clear cause, especially after age 45
- You alternate constipation with diarrhea, a pattern typical of irritable bowel syndrome
- You rely on laxatives to have a bowel movement
- There is significant abdominal pain
- Dietary measures did not work
Warning signs
Require evaluation without delay:
- Blood in the stool
- Unexplained weight loss
- Stools that are persistently thinner than usual
- Anemia
- Severe abdominal pain
- Vomiting
- Family history of colon cancer
A change in bowel habits in an adult who used to be regular is a valid reason—especially if there is a risk of colon cancer—to indicate a colonoscopy. It is not alarmism: it is ruling things out.
About laxatives
Laxatives have their place, but not all are the same, and not all are suitable for long-term use.
Stimulants, which act the fastest and are the most commonly purchased without a prescription, are not intended for indefinite daily use. Over time, the bowel can become dependent and respond less and less.
If you have been needing them for months to have a bowel movement, that in itself is already a reason to consult.
Measures that work
- Increase fiber gradually. Increasing it suddenly causes gas and bloating, and many people quit because of that.
- Drink enough water. Fiber without liquid makes the problem worse.
- Move daily, even if it is just walking.
- Set a schedule. Try at the same time every day, without rushing. The bowel responds to routine.
- Do not postpone the urge when it appears.
- Elevate your feet with a small stool when sitting: it improves the angle and reduces straining.
Evaluation at CEGAS
At CEGAS, we evaluate chronic constipation with a gastroenterology-focused approach and support in nutrition, looking for the cause instead of chaining laxatives.
If you have been normalizing it for years, schedule your appointment.
Related reading
- Irritable bowel syndrome: symptoms and management
- Colon cancer: at what age should you get your first colonoscopy?
- Digestive health guide for Panamanians
This content is for informational purposes and does not replace a medical consultation or treatment recommendations from a professional.
