Physiological constipation

by Dr Harold Gunatillake

Moments of irregular constipation causing blockage are common among healthy people at one time or another and is not considered serious. When constipation becomes regular, more persistent and progressive, then one has to take serious note of and get investigated. Endoscopy and barium studies including blood tests are done preliminarily to find out whether some pathological event is happening within the gut.

Sometimes, you may visit the toilet and have a very hard motion like little hard balls and needs to strain a lot to evacuate. This situation by definition is also considered as constipation, requiring attention.

Constipation in most situations is a symptom of another problem in your gut.

Chronic constipation is common when taking antacid medicine for stomach ulcers, hyper-acidity and GERD (Gastro-oesophageal reflux disease), in irritable bowel syndrome and many others. In early cancer of the large bowel change of bowel habits could be an early symptom which you should be aware of, if you are over 60.

Let’s talk about the physiological events that occur in most of us when over 60 years, old. Change or adding certain foods into your daily meal is the commonest cause of constipation in daily life and needs to be aware of such foods. Most people don’t realise that cheese and milk can cause hardening of stools, and you may have to eat less amounts more infrequently. Yogurt as a probiotic with live bacteria relieves constipation caused by dairy.

Fast foods

Those who eat fast foods can cause constipation as they are low in fibre. Fibre is essential for the activation of smooth muscles in your gut to get moving and we call that movement-peristalsis. Doctors listen to your tummy with the stethoscope to check for bowel sounds caused by peristalsis.

Fried foods

Fried foods are full of fat and difficult to digest. More water is absorbed from the slow movement of such food in the large gut and the stools become very hard. Drink plenty of water after eating fried foods to prevent constipation.


Did you know that such nourishing eggs are constipating? Eggs have high protein and have no fibre. You need to add high fibre foods when cooking eggs.

Tender meat

Meat has no fibre and you need to add vegetables like cabbage and broccoli when cooking meat.

Refined sugar

Pastries, desserts, cookies, cakes and other sugary treats can cause constipation, unlessyou have had high fibre food before. People who live alone tend to lose interest in cooking and may eat prepared tinned foods. These foods are low in fibre and may lead to constipation.

White bread

All processed foods lack fibre. White bread having low fibre can cause constipation. Always go for whole-grain bread.

Not eating high fibre food

People may become constipated if they do not eat enough high-fibre foods like vegies, fruits and whole grains due to change of lifestyles or lack of opportunities as on holidays.


A cup of Joe generally makes you run to the toilet to pass water as we call it a diaphoretic, like alcohol, but for some individuals drinking more than a cup or two may get constipated. In such an event stick to the first cup and have the second after a few hours.


For most alcohol will cause loose motions from the inflammatory action within the gut and also make you pass urine. For others, especially after brandy may have constipation the next day. Drink plenty of water to avoid constipation


For non-specific physiological situation one has to change the lifestyle through diet. Constipation that is chronic, or having an underlying cause such as medication or disease, may require further investigations and treatment by a specialist.

In non-specific situation drink plenty of water, eat high fibre diets, exercise daily, and eat plenty of fruits like pawpaw and mangoes.

If that is not sufficient you may try a daily stool softener a very effective reliever of constipation. Coloxyl contains the active ingredients docusate sodium which is a stool softener that works gently to soften the stool making them easier to pass.

Medications- check on the labels of every medicine you take and some of them may cause constipation. You don’t have to change the medication, but supplementing with more fruits and stool softener like Coloxyl is all that is required.

Even with a stool softener and high fibre diet the problem persists you may need to see your family doctor.

(Some reference to WebMD)


  1. I am 83 years of age. I bowel moment is very difficult.
    I pass marble size stools at intervals. I have restricted
    Taking hard food. Can I have any suggested remedy


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