PROBIO Journal · Gut & microbiome
Constipation: what helps quickly? Causes, home remedies and a 72-hour plan
No bowel movement for days, a feeling of pressure in your abdomen, and on the toilet it only works with straining? Constipation is unpleasant, but usually easy to get under control.
About one in seven adults in Germany has to deal with constipation at least from time to time, women and people over 60 more often. In this guide you will learn when it counts as constipation, what causes are behind it, what helps quickly, which home remedies and foods make sense and when you should see a doctor. It also includes a 72-hour plan and a guide to preventing constipation in the long term.
When is it called constipation?
How often a bowel movement is normal varies greatly from person to person: anything between three times a day and three times a week is considered normal. It is called constipation when at least two of these points apply:
- fewer than three bowel movements a week
- hard, lumpy stools
- heavy straining on the toilet
- the feeling of not having emptied your bowel completely
- the feeling of a blockage in the rectum
If constipation lasts only a few days, for example when travelling, it is called acute constipation. If the symptoms last longer than three months, doctors call it chronic constipation.
Bristol Stool Scale: what does your stool look like?
| Type | Appearance | Assessment |
|---|---|---|
| Type 1 | separate hard lumps | marked constipation |
| Type 2 | sausage-shaped, lumpy | mild constipation |
| Types 3 and 4 | sausage-shaped, smooth or with cracks | ideal |
| Types 5 to 7 | soft to liquid | too soft, tending towards diarrhoea |
Constipation: the most common causes
| Cause | Explanation |
|---|---|
| Too little fibre | Most adults eat only around 20 g of fibre a day instead of the recommended 30 g. The stool becomes smaller and harder. |
| Drinking too little | The bowel then draws more water from the stool, and it becomes hard. |
| Lack of exercise | Exercise also gets your bowel moving. Sitting for long periods slows it down. |
| Suppressing the urge | If you regularly hold on, for example at the office or when out and about, you lose the natural reflex. |
| Changed routine | Travel, shift work, the clocks changing, fasting or a diet |
| Stress and little sleep | The gut and the nervous system are closely linked. Stress can slow down digestion. |
| Medication | For example, iron supplements, strong painkillers (opioids), some antidepressants or medication for high blood pressure |
| Hormones | During pregnancy, before a period and during the menopause, digestion slows down in many women. |
| Medical conditions | Such as an underactive thyroid, diabetes, irritable bowel syndrome or bowel diseases, which should be checked by a doctor |
If constipation, diarrhoea and bloating alternate, irritable bowel syndrome may be behind it. Read more in Irritable bowel syndrome: recognising triggers and bringing order to everyday life.
What helps quickly with constipation? 7 immediate tips
- A large glass of warm water in the morning: Straight after getting up, it stimulates the so-called gastrocolic reflex, i.e. the movement of the bowel after eating and drinking.
- Have breakfast: For most people, the urge to have a bowel movement is strongest after breakfast. Allow yourself 10 minutes for the toilet afterwards.
- Walk briskly: 20 to 30 minutes of walking, ideally after a meal, gets your bowel moving.
- Feet up on the toilet: Place your feet on a small stool (toilet stool) so that your knees are higher than your hips. In this squatting position the rectum straightens, and the stool passes more easily.
- Don’t strain: Breathe calmly into your belly and keep your abdomen relaxed. Heavy straining encourages haemorrhoids.
- Abdominal massage: Massage your abdomen with a flat hand for 5 minutes in a clockwise direction, i.e. following the course of the large intestine.
- Prunes or soaked linseed: They are among the most tried-and-tested home remedies for constipation, see below.
And laxatives?
Over-the-counter laxatives from the pharmacy can help in the short term with acute constipation. Ask your pharmacist for advice and do not take laxatives for longer periods without medical advice. Chronic constipation should be treated by a doctor.
Home remedies for constipation
| Home remedy | How it works |
|---|---|
| Prunes | 4 to 6 a day, ideally soaked in water overnight. They contain fibre and sorbitol, which binds water in the bowel. |
| Linseed | 1 to 2 tbsp crushed or soaked, with at least one large glass of water |
| Psyllium husks | Stir 1 tsp into 200 ml of water, drink immediately and follow with another glass. Increase slowly. |
| Warm water in the morning | On an empty stomach, stimulates bowel movement |
| Coffee | In many people, the first cup in the morning triggers the urge to have a bowel movement |
| Sauerkraut and kefir | Fermented foods with fibre or live cultures, well tolerated by many |
Important with linseed and psyllium husks: always drink plenty, otherwise they can make constipation worse. Keep a gap of 1 to 2 hours from any medication.
Foods for constipation: what to eat, what to avoid?
| More likely to help | More likely to slow things down |
|---|---|
| Wholemeal bread, oats, brown rice | White bread, toast, white pasta |
| Pulses such as lentils and chickpeas (increase slowly) | Chocolate and sweets in larger amounts |
| Vegetables, cooked or raw | Lots of cheese and meat, few vegetables |
| Fruit such as kiwi, pear, berries, figs, prunes | Bananas while they are still green |
| Nuts, seeds, linseed, chia seeds | Ready meals and fast food |
| Water and unsweetened herbal tea | Too little fluid |
How much fibre is in which foods and how to reach 30 g a day is shown in our Fibre table with daily requirement and the best foods.
Increase fibre slowly
If you suddenly eat much more fibre overnight, you often get bloating and a feeling of fullness. So increase by about 5 g per week, for example first oats at breakfast, then a week later pulses at lunch. And drink more as well.
The 72-hour plan for constipation
| Day | What you can do |
|---|---|
| Day 1 | A large glass of warm water in the morning. Drink 2 litres over the day. Walk briskly for 30 minutes. In the evening, soak 4 to 6 prunes. |
| Day 2 | The soaked prunes and their water for breakfast, with oats and 1 tbsp of crushed linseed. After breakfast, 10 minutes of toilet time with a footstool, without time pressure. |
| Day 3 | Again a fixed toilet time after breakfast. Vegetables and wholegrains at lunch, an abdominal massage in the evening. Keep drinking plenty and moving. |
If the constipation has not improved after three days, seek advice from a pharmacy or your GP practice.
Preventing constipation in the long term
- Gradually increase fibre to 30 g a day, from wholegrains, vegetables, fruit and pulses.
- Drink enough, 1.5 to 2 litres, more with lots of fibre, in hot weather or with exercise.
- Move every day, for at least 30 minutes, and break up long periods of sitting.
- Respond to the urge and take your time, even when out and about.
- Eat regularly, especially breakfast, and plan fixed toilet times.
- Look after your gut flora: A varied plant-based diet and fermented foods support a diverse microbiome. You can read how to do this in everyday life in Building up your gut flora: how to strengthen your gut microbiome in 3 phases.
- Balance stress and sleep well, for example with our 10 rules for better sleep.
Constipation: when should you see a doctor?
Occasional constipation for a few days is usually harmless. Have it checked by a doctor if it lasts longer than two to three weeks, keeps coming back, or if it is new and you are over 50. Immediate medical help is needed if:
- blood in your stool or black stools
- severe or increasing abdominal pain, a bloated, hard abdomen
- vomiting, especially if neither stool nor wind is passing (suspected bowel obstruction, an emergency)
- fever
- unintentional weight loss
- newly occurring alternation between constipation and diarrhoea
In Germany, from the age of 50, statutory health insurance covers bowel cancer screening. A sudden change in your digestion is a good reason to take up this appointment.
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Frequently asked questions about constipation
What helps quickly with constipation?
A large glass of warm water in the morning, a breakfast with oats and linseed, soaked prunes, 20 to 30 minutes of brisk walking and a fixed toilet time after breakfast with your feet on a stool.
How long is constipation normal?
A few days without a bowel movement now and then are usually harmless, for example when travelling. If constipation lasts longer than two to three weeks, have it checked by a doctor.
How often is a bowel movement normal?
Anything between three times a day and three times a week is considered normal. More important than the frequency is that you can pass stool without heavy straining.
Which home remedies help with constipation?
Tried and tested are soaked prunes, crushed linseed or psyllium husks with plenty of water, warm water in the morning, exercise and a clockwise abdominal massage.
What should you eat when constipated?
High-fibre foods such as wholegrains, oats, vegetables, pulses, kiwi, pear, berries and prunes. Drink plenty as well and increase fibre slowly.
Which foods cause constipation?
White-flour products, lots of cheese and meat with few vegetables, sweets in larger amounts, ready meals and unripe bananas. Above all, though, too little fluid.
Does linseed help with constipation?
Linseed is rich in fibre and mucilage. Take 1 to 2 tbsp crushed or soaked and drink at least one large glass of water with it.
Why does more fibre sometimes not help?
If you drink too little with it, fibre can even make the stool harder. You should also increase it slowly. If the constipation still persists, have other causes checked.
What helps with hard stools?
Drinking more, soluble fibre such as oats, linseed or psyllium husks, prunes and exercise. On the toilet, don’t strain; instead raise your feet and breathe calmly.
When do I need to see a doctor about constipation?
If constipation lasts longer than two to three weeks, if there is blood in the stool, severe abdominal pain, vomiting, fever or unintentional weight loss, or if your digestion suddenly changes after the age of 50.
Read more in the PROBIO Journal
- Fibre and prebiotics: table, daily requirement and the best foods
- Building up your gut flora: how to strengthen your gut microbiome in 3 phases
- Bloating and feeling of fullness: causes and what helps
- Quality at PROBIO: raw materials, forms and bioavailability
This article is for general information only and does not replace medical advice, diagnosis or treatment. Food supplements should not be used as a substitute for a varied and balanced diet and a healthy lifestyle.