Constipation is one of the common gastrointestinal problems and is defined as a bowel movement that occurs less than three times a week; these bowel movements may be painful, hard, dry, and difficult to pass. Although occasional constipation is normal, persistent cases can have a more considerable influence on the quality of life of an individual. 

According to National Library of Medicine, approximately 12% of the global population experiences constipation. And according to the Lancet Gastroenterology and Hepatology, Constipation affects between one in six and one in ten people globally at any point in time. 

Influence of Age, Gender, and Lifestyle: 
Constipation does not discriminate according to age and gender; however, some people are more susceptible than others. Some of the most affected include women, particularly when pregnant or post-partum due to hormonal fluctuations. Older people are also at risk due to slow digestion and other factors of old age. Lifestyle influences, such as a lack of physical activities, inadequate hydration, and poor dieting habits, also contribute to constipation. People who are accustomed to jobs that have extended periods of sitting on a daily basis contribute to constipation. 

What are the constipation causes?  
Constipation occurs because the colon absorbs too much water, or the large intestine makes the poop turn hard in consistency, making it difficult to be pushed out. Typically, as the food travels up the digestive tract, your intestines absorb the nutrients, and the digested food (waste) that goes from your small intestine to your large intestine is the stuff that becomes your poop. This waste contains water that your colon absorbs so as to make it more solid. In the case of constipation, food moves slowly through your digestive tract. This occurs because the colon has too much time–more than enough time–to absorb water from the waste, thereby leaving the stool dry and hard, and unable to pass without much resistance. 

Lifestyle causes: 

Slow movement of stool may result when a patient does not: 

• Drink sufficient fluids. 

• Consume enough dietary fibre. 

• Exercise regularly. 

• Use the toilet when the urge to pass stool arises. 

Medications: 
Constipation may be a side effect of some medications, such as pain relievers. Some medicines used to treat the following conditions may also be constipation causes: 

• High blood pressure 

• Convulsions 

• Depression 

• Diseases of the nervous system 

• Allergies 

Diseases of the pelvic floor musculature: 
The pelvic floor muscles add support for the walls of the torso. The elimination process for stool from the rectum requires relaxation and straining of these muscles. Chronic constipation may be caused by weaknesses or coordination issues with these muscles. 

Obstruction of the colon or rectum: 
Damage or alteration of the tissues in the colon or rectum can block the flow of stool. It can also be caused by tumours in the colon, rectum or other tissues nearby. 

Different aspects: 
Several diseases may affect the muscles, nerves, or hormones that regulate the passage of stool, thus causing chronic constipation. The following could be responsible: 

• Irritable Bowel Syndrome. 

• Diabetes 

• Multiple sclerosis 

• Nerve dysfunction or damage 

• Overactive thyroids, also known as hyperthyroidism 

• Parkinson’s disease 

• Pregnancy 

In some situations, the constipation causes are unknown. 

The symptoms of constipation include: 

• Having fewer than three bowel movements a week. 

• Having had dry, lumpy or hard stools. 

• Stools being either painful or difficult to pass. 

• Getting cramps or stomach-ache 

• Feeling bloated and nauseated. 

• Feeling that you did not entirely empty your bowels after that movement. 

What are the risk factors for constipation? 
Constipation can happen to anyone at any age. But there are some risk factors, wherein certain characteristics increase a person’s chances of becoming chronically constipated (chronic constipation) 

Dietary and behavioural risk factors: 
Some dietary and behavioural habits pose the risk for chronic constipation: 

Low fibre intake: Fibre helps add bulk to stools and promotes regular bowel movements. 
Poor fluid intake: Fluids soften the stool so that passing it becomes easier. 
Inactivity: Exercise causes stimulation of intestinal muscles and aids in the smooth running of the digestive system. 
Overlooking the urge to go: Very often, overlooking the urge to use the bathroom can cause an imbalance of bowel function, leading to constipation in time. Often, by upgrading diet and lifestyle, most people prevent and control constipation from occurring well. 

What are the complications?  
Chronic constipation complications can be: 

– Swollen tissues around the anus, known as haemorrhoids. 
– Ripped tissues of the anus, also known as anal fissures. 
– Hard stools that build up in the large intestine, called faecal impaction. 
– Exposed tissues of the rectum that have slipped out of the anal opening, popularly known as rectal prolapse. 

Effective treatments and lifestyle changes: 
Treatment depends on the intensity as well as the causes. These are regular treatments that include: 

Dietary supplements and changes: Taking more fibre through fruits, vegetables, and whole grains helps soften the stool and regulate bowel movement. 
Laxatives: Over-the-counter drugs should not be used for long-term purposes, but sometimes they are effective over the short term.  
Hydration: Drink a lot of water, which prevents constipation.  
Exercise: It stimulates bowel movement and overall gut health.  
Prescription drugs: The doctor can prescribe certain prescription medicines that stimulate the bowel or increase the fluid content of stool in some urgent cases.  

In many patients, nonpharmacologic interventions such as improving diet, hydration, and managing stress significantly reduce symptoms. For selected others, the doctors might recommend even more invasive treatments if conservative treatments fail.