Are you experiencing bowel movements that are hard and dry, less frequent than usual, and difficult or painful to pass? If you answered "yes" to any of these, you may be experiencing constipation.

Occasional constipation affects almost everyone, especially adults, and females in particular. About 25% of men and 35% of women over the age of 65 experience constipation. Pregnancy, childbirth, and surgery can also contribute to constipation.

On the other hand, not everything that seems like constipation is. You may think you're constipated if you don't have a bowel movement every day, or if your stool is firm. But these by themselves don't necessarily equal constipation. "Normal," in terms of bowel movement frequency, depends on your age, physiology, diet, social and cultural influences, and other individual factors. There is no right or wrong number of bowel movements that you should have per day or per week. For example, while the normal frequency of bowel movements in Western society may range from 1 to 3 per day to 1 to 3 per week, in countries where a high-fibre diet predominates, normal bowel movements may occur as often as several times a day.

How does constipation happen? Water is absorbed from the food you eat as it moves through the colon (large intestine). What's left is a waste product, which doctors refer to as stool. As the muscles in the colon contract, the stool is pushed down towards the rectum. But when the muscles of the colon are sluggish, the colon absorbs too much water, and the stool becomes hard and dry, which makes it difficult to pass. This results in painful and difficult bowel movements.

What commonly causes constipation? Constipation can be caused by:

  • a low-fibre diet
  • not drinking enough fluids
  • lack of exercise
  • ignoring the urge to have a bowel movement
  • a change in routine, such as travel
  • a life change, such as pregnancy
  • older age
  • chronic illness
  • recovering from surgery
  • taking certain medications.

There are several kinds of medications that can cause constipation. For example, 95% of people who take medications such as pain medications (narcotics or opioids) to control pain, either after surgery or for other reasons, experience constipation. Other constipation-causing medications include:

  • antacids that contain aluminum
  • anticholinergic drugs
  • anticonvulsants for epilepsy
  • antidepressant drugs
  • antiparkinsonism drugs
  • antipsychotic drugs
  • antispasmodic drugs
  • calcium channel blockers
  • diuretic drugs
  • iron supplements
  • tranquilizers

However, if you have tried different treatments and lifestyle modifications unsuccessfully, the constipation has not gone away, you may be suffering from chronic constipation. Also known as idiopathic, or "of unknown origin," chronic constipation may be associated with inadequate fluid and fibre intake, rectal disease such as hemorrhoids or fissures, irritable bowel disease, intestinal problems such as problems with nerves and muscles in the colon, or hormonal control. Seniors are particularly prone to chronic constipation because of age-related decreases in bowel function, diets low in fibre, lack of physical activity, and use of medications that promote constipation.