Constipation: what actually fixes it, which laxative is which, and when to see a GP

Constipation is one of those problems people put up with for months before mentioning to anyone, which is a shame, because it is common, usually simple to fix, and occasionally a sign of something that should not wait. If you are going less often than usual, straining, or never feeling quite finished, you are in very large company: it is one of the most frequent digestive complaints GPs hear. At The Online GP by The Wellness, our doctors talk through bowel problems with patients every day, without embarrassment on either side, and most people tell us they wish they had asked sooner.

Key points

• Constipation usually means going less than three times a week, straining, hard or lumpy stools, or feeling incompletely emptied.

• The common causes are everyday ones: too little fibre, too little fluid, too little movement, ignoring the urge, travel, stress and some medicines.

• Most cases respond to simple measures within days to a couple of weeks.

• Pharmacy laxatives are fine for short-term relief; the type matters, and a GP can help you choose well.

• Blood in your stool, unintentional weight loss, persistent change after 50, or severe pain means book a doctor promptly.

• A same-day phone consultation at The Online GP costs from £59.

What counts as constipation

There is no single normal: some people go twice a day, others every other day. Constipation is about change and discomfort, not a number. Doctors look for fewer than three bowel movements a week, hard or lumpy stools, straining, a feeling of blockage, or a sense of not finishing. If your pattern has changed and it bothers you, that is reason enough to act.

Why it happens

The usual suspects are unglamorous: not enough fibre (most UK adults fall well short of the recommended 30g a day), not enough fluid, long periods sitting, routinely ignoring the urge to go, travel and time-zone shifts, stress, and medicines including iron tablets, some painkillers (especially codeine), some antidepressants and some blood pressure treatments. Pregnancy commonly slows the bowel too. Occasionally, constipation is a symptom of an underactive thyroid, high calcium, diabetes, or more rarely a bowel condition, which is why persistent change deserves a proper conversation.

What genuinely helps at home

• Fibre, increased gradually. Oats, wholemeal bread, fruit (kiwis and prunes have genuinely good evidence), vegetables, beans and lentils. Add fibre slowly over a week or two; a sudden jump causes bloating.

• Fluid. Fibre without fluid makes things worse. Aim for pale-straw urine as your guide.

• Movement. Even a daily 20-minute walk measurably helps the bowel keep time.

• Toilet habit. Give yourself unhurried time after breakfast (the bowel's most active window), never ignore the urge, and try a small footstool to raise your knees above your hips.

When a pharmacy is enough, and when you need a GP

Your pharmacist can supply laxatives without a prescription, and for short-term constipation they work well. The choice matters: bulk-forming laxatives suit mild, long-term sluggishness; osmotic laxatives such as macrogols are the usual first choice for most adults; stimulant laxatives are best kept for occasional short use. Getting this wrong (the wrong type, or stimulants for months) is one of the commonest self-treatment mistakes we see.

Book a same-day GP consultation if:

• constipation lasts more than two to three weeks despite doing the right things;

• you need laxatives regularly to go at all;

• you have abdominal pain, bloating or vomiting alongside it;

• you suspect a medicine is the cause - never stop a prescribed medicine, but do ask;

• it is your child who is constipated (children's constipation needs its own approach, and early treatment prevents a miserable cycle);

• you are pregnant and simple measures have not worked.

A doctor can check for the medical causes, review your medicines, choose the right laxative properly, and refer for tests when the pattern warrants them. Phone consultations cost £59 for 15 minutes and video consultations £150.

When to seek help promptly

Do not sit on these: blood in your stool or on the paper that keeps happening, unintentional weight loss, a persistent change in bowel habit if you are over 50, severe or worsening abdominal pain, vomiting with an inability to pass stool or wind, fever with abdominal pain, or constipation alternating with diarrhoea. These patterns need assessment promptly, and most turn out to have straightforward explanations, but they are not watch-and-wait territory.

What it costs

A walk-in clinic visit in central London typically costs £100 to £250 before any prescription. A phone consultation at The Online GP costs £59 for 15 minutes, and most constipation questions are settled in one call with a clear plan: what to change, which laxative if any, how long to give it, and exactly what would make us want to see you again. The NHS remains the right route for many people, and your own GP can always help; our role is to be there when you want an unhurried answer today, without the wait.

Why people choose The Online GP by The Wellness

Because bowel problems are the ones people most often delay over, and the delay is usually worse than the problem. Our GMC-registered doctors discuss this every day, plainly and without fuss, and you leave the call with a plan rather than another month of putting up with it. Most patients tell us they wish they had booked weeks earlier.

Book a same-day phone consultation from £59, or message us on WhatsApp at +44 7961 280835 and we will find you the next available doctor. You can also call 020 3951 3429.

Frequently asked questions

How long is too long to be constipated?

If simple measures (fibre, fluid, movement, toilet routine) have not fixed things within two to three weeks, speak to a GP. Sooner if there is blood, weight loss, severe pain, or you are over 50 with a new persistent change.

Which laxative is best?

For most adults, an osmotic laxative such as a macrogol is the evidence-based first choice: effective, gentle and safe for longer use when needed. Bulk-forming types suit mild cases with plenty of fluid. Stimulant laxatives work fast but are best kept occasional. A short consultation matches the type to your situation properly.

Can constipation be a sign of something serious?

Usually not, but persistent change can occasionally signal thyroid problems, high calcium, diabetes or bowel conditions, and new persistent change after 50 always deserves a conversation. The pattern matters more than the symptom alone, which is exactly what a doctor assesses.

Do prunes and kiwis actually work?

Yes, the evidence is genuinely good. Studies show kiwis (two a day) and prunes (around 50g a day) improve stool frequency and consistency as effectively as some fibre supplements, with fewer side effects. They are a sensible first move alongside more fluid.

Is it safe to take laxatives every day?

Osmotic laxatives are safe for daily use over weeks to months when needed, under guidance. Stimulant laxatives are the ones to avoid using daily long-term. If you need any laxative most days to go at all, that is a reason to speak to a doctor, not just to keep buying them.

How much does a consultation cost at The Online GP?

Phone consultations are £59 for 15 minutes, video consultations £150, and in-person appointments £220 at our clinic at Unit 4, 10 Portman Square, London W1H 6AZ. Most constipation questions are fully resolved in one phone call.

References

• NHS: Constipation, reviewed 2024.

• NICE Clinical Knowledge Summary: Constipation, 2024.

• British Dietetic Association: fibre and bowel health, 2024.

• Chey WD et al, American Journal of Gastroenterology: evidence for kiwifruit and prunes in chronic constipation, 2021.

Written by The Wellness Team and medically reviewed by The Wellness Clinical Team. This article is general information and is not a substitute for a personal consultation.