Chronic constipation: causes, remedies that work and when fibre is not enough

In short: constipation is not one single thing. There are different types with different causes, which is why "more fibre and more water" sometimes works and sometimes only makes bloating worse. This guide explains how to recognise your type, which remedies to try first, why laxatives are not a long-term answer and when an intestinal wash at home can help. If your symptoms are new, severe or persistent, always talk to your doctor.

What is constipation?

You are constipated when you pass stools rarely, with effort, when stools are hard or when you feel you have not fully emptied your bowel. It is more common in women and older people, but it can affect anyone.

• Occasional constipation: linked to travel, changes in routine, too little water, stressful periods.
• Chronic constipation: when symptoms last for months and keep coming back.

How to tell if you are constipated: the Bristol scale

Doctors use the Bristol Stool Scale to describe stool shape. It is a simple way to keep an eye on your bowel.

Type	Appearance	What it suggests
1	Separate hard lumps	Severe constipation
2	Sausage-shaped but lumpy	Constipation
3	Sausage-shaped with cracks	Normal
4	Smooth and soft, like a sausage	Normal (ideal)
5	Soft blobs with clear edges	Tending towards diarrhoea
6	Mushy, ragged pieces	Mild diarrhoea
7	Entirely liquid	Diarrhoea

If you are often at types 1 and 2, your bowel is holding on to stools for too long.

The two main types of constipation

1. Lazy bowel (slow transit)

Stools move slowly through the colon, lose water and become hard. The urge comes rarely. Diet, movement, hydration and habits matter a lot.

2. Difficulty emptying (obstructed defecation)

The urge is there, but emptying is hard: you strain for a long time and feel "blocked" or incompletely emptied. The problem lies in the last part of the bowel and the pelvic floor muscles. Here, adding a lot of fibre can simply increase volume and bloating: a medical assessment is needed.

The two types often overlap, sometimes together with irritable bowel syndrome with constipation.

Common causes

• too little water and too few vegetables;
• a sedentary lifestyle;
• putting off the urge (work, public toilets, rushing);
• changes in routine, travel, stress;
• some medicines;
• pregnancy and hormonal changes;
• long-term laxative use;
• bowel or other conditions, to be assessed by a doctor.

Remedies to try first

1. Drink regularly throughout the day.
2. Increase fibre gradually (vegetables, fruit, pulses, whole grains): a sudden increase causes bloating.
3. Move every day, even just walking.
4. Don't put off the urge and try to go at the same time each day, for example after breakfast.
5. Use a footstool on the toilet: knees higher than hips make emptying easier.
6. Take your time, without straining hard.

See also: abdominal bloating: causes and remedies.

Why laxatives are not a long-term solution

Laxatives are medicines. Used occasionally and on medical advice they can help, but taken for months or years they risk creating a vicious circle: the bowel gets used to them, the dose goes up and the natural urge weakens. Never stop a prescribed medicine suddenly without talking to your doctor.

Intestinal washing at home: when it can help

An intestinal wash introduces lukewarm water into the last part of the bowel: it softens stools and helps you empty without chemicals. That is why people with recurring constipation use it as an alternative to constantly reaching for laxatives.

With a CE-certified medical device for home colon hydrotherapy you can do it in your own bathroom, on your own and without stress: being relaxed helps a lot when emptying is difficult. To understand how it differs from a traditional enema, read enema or colon hydrotherapy?.

Before starting, check the contraindications: washing does not replace diagnosis or prescribed treatment.

When to see a doctor

See your doctor promptly if constipation:

• has appeared recently for no obvious reason, especially after 50;
• comes with blood in the stool, unintended weight loss, fever or anaemia;
• causes severe abdominal pain or vomiting;
• does not improve despite changing your habits.

Frequently asked questions

How often should you go?

There is no single number for everyone: anything from three times a day to three times a week is considered normal. What matters most is that emptying is easy and complete.

Is fibre always good?

No. It helps a lazy bowel a lot, but in people who struggle to empty it can increase bloating. Increase it gradually and see how you react.

Does intestinal washing create dependence like laxatives?

Washing uses only water and does not act like a stimulant medicine. As with any health habit, it is best to agree how often to use it with your doctor.

Want advice on your situation?

Download the free intestinal cleansing guide or request a consultation: we will help you understand whether the home device is right for you.