Constipated? Emergency doctor unpacks myths, risks and what actually helps

Constipation is something most people would rather not talk about, yet almost everyone experiences it at some point. According to emergency and sports physician Dr Darren Green, silence often fuels myths, poor habits and unnecessary suffering.

Speaking on CapeTalk, Green said constipation is far more common and more misunderstood than many realise.

What constipation actually is

Many people assume missing a day or two means something is wrong.

Medically, that’s not the case.

“People feel if I haven’t gone for two days, I’m constipated,” Green explained. “But medically, it’s defined as going less than three times a week, and it’s not only about frequency, it’s about consistency.”

He said bowel movements offer important clues about what’s happening in the gut, from diet and hydration to muscle movement and nerve function.

Why gut health matters

Green stressed that chronic constipation shouldn’t be ignored, as it can signal deeper problems in the gut environment.

“Our bowel habits and stools tell a story about what’s going on in that environment,” he said, pointing to the gut microbiome, the complex ecosystem of bacteria that affects digestion, immunity and even mood.

“About 95% of serotonin, the neurotransmitter linked to mood, is present in the gut,” he said. “So, when things are out of balance, people often feel drained, low in energy or depressed.”

Diet, fibre and hydration

A colourful, varied diet is key, but fibre alone isn’t a magic fix.

“Fibre in the presence of sufficient hydration becomes a bulking agent that moves through the gut,” Green said. “Without enough water, a high-fibre diet can actually make constipation worse.”

Regular physical activity also plays a role, stimulating the gut’s natural rhythmic contractions that move waste along.

Toilet habits can make it worse

Spending too long on the toilet, especially while scrolling on a phone, can cause problems.

“You shouldn’t be on the loo for longer than five to 10 minutes,” Green warned. Prolonged sitting increases pressure on blood vessels and raises the risk of haemorrhoids.

Simple changes like better posture and foot positioning can help. Green noted that raising the feet slightly can improve the body’s natural alignment during bowel movements.

Laxatives and home remedies

Occasional use of laxatives like senna or even castor oil can help, but Green cautioned against relying on them long-term.

“Use them acutely, not chronically,” he said. “If constipation is ongoing, you need to get to the root cause.”

Natural options such as pears, prunes, prune juice and fermented foods can support gut health, particularly in children and older adults. Probiotics, hydration and balanced meals remain essential.

Special cases: after birth, menopause and children

Constipation after childbirth is common, often linked to pain medication, dehydration and physical stress. Menopause can also affect bowel habits due to hormonal changes.

In children, fear, distraction or reluctance to use the toilet can lead to painful constipation. Green said foods like pears and prune juice often help, but severe cases may need medical advice.

The bottom line

Constipation may be common, but it’s not trivial. As Green put it, bowel habits reflect overall health, and paying attention early can prevent long-term problems.

“Rather fix the environment than chase quick solutions,” he said.

For more details, listen to Green using the audio player below: