Surprising symptoms of constipation 

Constipation happens to almost everyone at some point, and for some people it’s a more regular struggle. It’s often defined as having fewer than three bowel movements a week, but it can also feel like going less often than what’s normal for you or having a hard time when you do go.

When you’re constipated, you might feel bloated, uncomfortable or like your body didn’t quite finish what it needed to. Those feelings are common, but constipation doesn’t always show up in obvious ways — it can affect your body in ways you might not expect.

"Occasional constipation is common,” says Rani Berry, M.D., a gastroenterologist with Sutter. “But symptoms that persist for weeks, require frequent laxative use or occur with bleeding, weight loss or severe pain deserve a medical evaluation rather than ongoing self-treatment." 

Unexpected constipation symptoms

One surprising symptom of constipation is diarrhea. This can happen when hard stool becomes stuck in the colon and liquid stool leaks around the blockage.

Can constipation cause back pain? Yes. A buildup of stool or trapped gas can create pressure in the abdomen that sometimes causes discomfort in the lower back. Constipation can also put pressure on the bladder, which may lead to urinary urgency, frequent urination or occasional leakage.

Nausea is another possible symptom. When stool moves more slowly through the digestive tract, it can contribute to feelings of fullness, discomfort and queasiness.

Some people may also notice bad breath when constipation is severe or prolonged, although this symptom is less common than bloating, abdominal discomfort or nausea. 

What causes constipation?

Occasional constipation often occurs when you aren't getting enough fiber or fluids. Changes in routine, such as travel, can also affect bowel habits. Ignoring the urge to have a bowel movement may make constipation worse over time.

Physical activity also plays a role. Regular movement helps stimulate the digestive system, while a sedentary lifestyle may contribute to slower bowel function.

For some people, constipation becomes a chronic issue. This may be related to conditions that affect communication between the digestive system and the brain, often called the gut-brain axis. Stress, anxiety and conditions such as irritable bowel syndrome (IBS) can all influence how the digestive tract functions.

Certain medications can also contribute to constipation. If you think a medication may be affecting your bowel habits, talk with your healthcare provider. They may be able to adjust your treatment plan or recommend strategies to help manage the side effect. 

Constipation relief

The best approach to constipation relief depends on the cause and how often symptoms occur.

For occasional constipation, increasing your fiber intake, drinking more water and staying physically active may help improve bowel regularity. Some people also find relief with over-the-counter laxatives.

There are two common types of laxatives:

• Stimulant laxatives, which encourage the bowel to contract and may provide faster relief.
• Osmotic laxatives, which draw water into the bowel to soften stool and make it easier to pass.

Because laxatives are not appropriate for every situation, talk with your provider if you find yourself needing them regularly. 

When to talk with your provider

Occasional constipation is common, but ongoing symptoms shouldn’t be ignored.

Talk with your healthcare provider if constipation:

• Lasts more than a few weeks
• Happens frequently
• Causes severe pain
• Is accompanied by blood in the stool
• Occurs alongside unexplained weight loss

A provider can help identify potential causes and recommend treatments that address the underlying issue. 

Getting back to feeling better

Constipation can cause more than infrequent bowel movements. It may lead to bloating, nausea, back pain and other uncomfortable symptoms that affect your daily life.

"For many people, small habits make a big difference,” says Berry. “Drinking enough fluids, getting regular physical activity and gradually increasing dietary fiber can often improve bowel regularity without the need for medication."

The good news is that many causes of constipation can be addressed through lifestyle changes, medication adjustments or medical treatment. If symptoms persist, your doctor can help you find the right solution.