Home Your medical guide Pull up that stool. Let’s have #ConstipationConversations

Pull up that stool. Let’s have #ConstipationConversations

written by Vidya Sury May 10, 2017
Constipation Conversations

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My husband is the sort of person who is absolutely organized. However, one of his secret fears when he travels is constipation. It is a source of major worry, stressing over whether his bowel movements will be comfortable. Of course, he makes sure he is prepared to overcome it by drinking plenty of water and sticking to a fiber-rich diet. Nevertheless, the tension is always there, haunting.

I’ve always been regular in my bowel movements and would marvel at how my best friend only “went” once in three or four days. I used to think that must be a problem, but later learned that frequency of bowel movements is unique to each individual. The important thing is to stay healthy with a diet rich in fiber. Oh, these days we always secretly worry about whether our son, who’s away at college, is “regular” in his “habits”.

Going, or not going, and constipation are sensitive or taboo topics for people. They are embarrassed to talk about it. I remember how, when my son went to school, while talking to other parents, if one mentioned that her child poops only once in two days, there would be total silence, as if she uttered a profanity. I mean, we are happy to discuss all sorts of things, but not this.

But why is constipation a sensitive topic for people?

Constipation is a topic that can be difficult to discuss, but it is very common. People tend to whisper the word, as though they are ashamed of it. Those experiencing it feel physically terrible—often bloated, gassy. Moreover, it is considered bad etiquette to talk about bowel movements in a social setting, making  people are reluctant to talk about it even with their doctors. They think it is gross to discuss something that happens behind closed doors and feel uncomfortable about describing it. The truth is, bowel movements are a natural part of our life and crucial for our health. There is nothing inappropriate about discussing constipation. A healthy functioning bowel is a basic part of good health and it is important to talk about it.

Constipation  – the hard facts

A normal bowel routine can range anywhere from 3 bowel movements a day, to three a week. Normal bowel function indicates a soft, well-formed stool, usually passed once a day.

There are seven types of stools (faeces) according to the Bristol Stool Chart. which shows seven categories of stool. While different people have different bowel habits, the important thing is that your stools are soft and easy to pass – like types 3 and 4 below.

constipation conversations

Type 1–2 indicate constipation

Type 3–4 are ideal stools as they are easier to pass, and

Type 5–7 may indicate diarrhoea and urgency.

What is constipation, then? It is a fairly common condition that affects 1 in every 7 Indians.  Constipation is when there are fewer than 3 bowel movements a week.  It happens when too much water is absorbed from the lower bowel, when food moves too slowly via the digestive system. This causes the bowel motions to become too dry and hard, difficult to pass, strain to pass it, and ending up with a sense of incomplete bowel movement.

While constipation needn’t always be a serious condition, if the symptoms you just read continue over weeks or months, it is time to see your doctor.  

It is important to know that bowel movements can vary from day to day based on various things such as the amount and type of fiber you consume, how much fluid you consume, your general health status and any underlying medical conditions.

What causes constipation?

The most common risk factors that can cause or worsen constipation are:

  1. Poor lifestyle and diet
  2. Not eating enough fibre. We need at least 25-35 grams of fiber daily.
  3. Not drinking enough water. This leads to hard, dry stools. Water intake should ideally be 2-3 liters a day and this includes other beverages. Liquids like fizzy drinks can make constipation worse as they lead to dehydration.
  4. Not enough exercise. Physical activity promotes normal muscle contractions in the system. Not being active can lead to weight gain and obesity and a higher risk for constipation.
  5. Not going when there is the urge to go, probably because of no access to a toilet.
  6. Stressing over hygiene and refusing to use public restrooms.
  7. Stress, anxiety, grief, depression
  8. Medications and long term laxative use.
  9. Pregnancy
  10. Obesity
  11. Gut bacteria imbalance
  12. Restricted mobility
  13. Irritable bowel syndrome

In older people, severe constipation causes fecal incontinence or bowel leakage and this can be mistaken for diarrhea.

Can you prevent constipation?

Yes you can.  Here’s your ABC of constipation prevention.

  • Aware and alert: Be aware of your regular bowel routine, be alert to any significant change
  • Bowel routine: Empty your bowels at a fixed time every day
  • Constipasana (the correct posture to sit on the western commode toilet) to sit right: Remember to use a footrest and to lean forward if you sit
  • Drink sufficient fluids: Include 2- 3L of fluid in your daily diet.
  • Exercise regularly: physical activity helps the bowel muscles to contract during a bowel movement
  • Fiber: High-fibre foods including whole wheat grains, nuts, seeds, help to keep your bowel movements regular
  • Go when you need to: Do not ignore the urge to empty your bowels

Consider adopting a healthy and balanced diet that includes fresh fruits and vegetables. Get regular exercise, and look for ways to eliminate stress.

If you’ve  never had issues with bowel movements, constipation seems like a non-issue.  But for those who suffer from the condition, anxiety, physical discomfort, poor appetite, depression, low libido, stress and a lowering of self-confidence are all part of the package, leading to a poor quality life.

Luckily, you don’t need to go through all that. Lifestyle changes alone can go a long way in helping overcome constipation. And there’s no shame talking to your doc to get help!


I attended a panel discussion on constipation awareness facilitated by Abbott India Limited. Any opinion expressed in this blog is my personal opinion and not the opinion of Abbott India Limited. Abbott India Limited does not assume any liability for the content of the blog. The blog post is not meant to be a replacement for a doctor consultation, nor is it a medical recommendation or prescription of treatment for people having constipation problems. Any reader of this blog suffering from constipation problems should specifically consult his/her doctor for treatment  and follow the suggested course of treatment.


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