--- title: "Constipation: NHS self-help and red flags | HealthAnswers" description: "Most constipation improves with fibre, fluids and activity. A pharmacist can suggest short-term laxatives. Blood, weight loss or a lasting change in…" url: https://healthanswers.co.uk/conditions/constipation/ robots: noindex --- # Constipation: NHS self-help and red flags | HealthAnswers Health A–Z Most constipation improves with fibre, fluids and activity. A pharmacist can suggest short-term laxatives. Blood, weight loss or a lasting change in bowel habit needs a GP. Written by HealthAnswers editorial team Medically reviewed by [Dr Neil Singh MBChB - nMRCGP](https://healthanswers.co.uk/our-doctors/neil-singh/) · GMC 7039648 Reviewed 13 August 2026 ## Quick answer What helps constipation and when is it serious? Constipation means stools that are hard, infrequent or difficult to pass. NHS first steps are more fibre, more fluid and more movement. A pharmacist can suggest a short course of laxatives if that is not enough. See a GP for blood in the stool, unexplained weight loss, or a persistent change in bowel habit. Call 999 for sudden severe tummy pain with vomiting and no stool or wind. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Constipation, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 7 sections ## Key facts about constipation - Constipation means pooing less often than is normal for you, or passing hard, painful stools. - Fibre, fluids and activity are the NHS first steps, before laxatives. - A pharmacist can suggest short-term laxatives; follow the pack, not a forum dose. - Blood in the stool, unexplained weight loss, or a lasting change in bowel habit needs a GP. - A negative bowel cancer screening kit does not explain away new bowel symptoms. ## Should I use this page, or skip it? Use this page if stools are hard, infrequent or difficult to pass and you want NHS first steps. Skip it and call 999 for sudden severe tummy pain, vomiting, and no stool or wind. See a GP promptly for blood in the stool, unexplained weight loss, or a lasting change in bowel habit. This is a self-help and door-chooser page for adults, not a diagnosis. It will not tell you which branded laxative to buy. It will tell you what to try first, when a pharmacist is enough, and when laxatives are the wrong response to a red flag. If pain eases after you poo and this has gone on for months, also read [irritable bowel syndrome](https://healthanswers.co.uk/conditions/irritable-bowel-syndrome/). If you are straining and noticing bright red blood on the paper, see [haemorrhoids](https://healthanswers.co.uk/conditions/haemorrhoids/) — and still get persistent bleeding checked. ## What counts as constipation? Constipation means a change in how you poo: less often than is normal for you, or stools that are dry, hard, lumpy, or painful to pass. NHS guidance also includes straining and feeling you have not fully emptied. Bloating or tummy ache often sit alongside. It is common and usually improves with diet and lifestyle. NHS also flags “not had a poo at least three times in the last week” as a useful prompt, but your own baseline matters more. Someone who usually goes twice a day and then stops for several days is constipated even if a chart says otherwise. In older people, or people with dementia or a learning disability, constipation is easy to miss. New restlessness or confusion can be pain. Carers should look at the bowel chart, not only at whether someone “seems themselves”. Pregnancy and the weeks after birth commonly slow the bowel. So do long car journeys, a new diet, a hospital stay, and sitting for hours. Those stories usually still start with fibre, fluids and activity unless red flags are present. ## What should I try first — fibre, fluids and activity? Start with fibre, fluids and activity before a laxative. Increase fibre gradually with fruit, vegetables, wholegrains and pulses, and drink more water as you do. NHS advice includes fruits that contain sorbitol, such as apples, grapes and berries. Go when you get the urge. A daily walk helps many people. Jumping fibre overnight is a common way to feel bloated and then abandon the plan. Add a little, drink more, wait. Wheat bran, oats or linseed are NHS examples, not magic. Alcohol does not count as useful fluid. Toilet routine helps. Keep a regular time, give yourself long enough, and do not ignore the urge. Some people find it easier with feet on a low stool so the knees sit above the hips. That is a position change, not a gadget you must buy. NHS says you may notice a difference within a few days, and that it can take a few weeks. If you have blood, weight loss, or a sudden lasting change in habit, do not spend those weeks experimenting. See a GP. ## When can a pharmacist laxative help? If diet and lifestyle are not enough, a pharmacist can suggest a short course of laxatives. NHS advice is that most laxatives work within a few days and should only be used for a short time. Follow the pack and the pharmacist, not a dose from a forum. Ask a GP if you need laxatives regularly. Different laxatives work in different ways: some add bulk, some draw water in, some stimulate the bowel. The right type depends on whether stools are hard, whether you are in pain, and what else you take. That is why the pharmacist conversation is worth more than grabbing the brightest box. See the [laxatives](https://healthanswers.co.uk/treatments/laxatives/) page for the types. Do not stack several products because the first has not worked in an hour. Most need time. Stimulant laxatives in particular are a short-term tool, not a daily habit without advice. If you take opioid painkillers such as [codeine](https://healthanswers.co.uk/treatments/codeine/), constipation is expected. Do not stop a prescribed painkiller on your own. Ask the pharmacist or GP how to manage the bowel while you still need the pain medicine. Long-term constipation can lead to faecal impaction, where stool packs the rectum and liquid stool leaks around it. That can look like diarrhoea. It needs a clinician, not another stimulant from the cupboard. ## When do blood, weight loss or a change in bowel habit need a GP? See a GP if constipation is not getting better, keeps returning, or you are regularly bloated. Get checked promptly for blood in your poo, weight loss without trying, a sudden lasting change in bowel habit, ongoing tummy pain, or feeling tired all the time. These do not prove cancer, but they should not be managed with laxatives alone. NICE suspected-cancer guidance is why GPs take a lasting change in bowel habit, [blood in poo](https://healthanswers.co.uk/symptoms/blood-in-poo/), and [unexplained weight loss](https://healthanswers.co.uk/symptoms/unexplained-weight-loss/) seriously. Most people with those symptoms do not have [bowel cancer](https://healthanswers.co.uk/conditions/bowel-cancer/). The cost of checking is a conversation and, sometimes, tests. The cost of waiting is a delayed diagnosis. | What you notice | More likely first step | Do not do this | | --- | --- | --- | | Hard stools after a week of travel, a new diet, or less fluid | Fibre, fluids, activity; pharmacist if needed | Ignore blood or weight loss because “it is only constipation” | | Bright red blood on the paper after straining | GP to check; haemorrhoids are common but not a free pass | Assume it is piles without anyone looking | | Lasting change in bowel habit, unexplained weight loss, persistent blood | GP promptly | Treat with endless laxatives | | Sudden severe tummy pain, vomiting, no stool or wind | 999 | Wait to see if a laxative works | [Bowel cancer screening](https://healthanswers.co.uk/tests/bowel-cancer-screening/) is a separate NHS programme using a home kit. A negative kit does not cancel symptoms. Complete the kit when it arrives, and still see a GP about new bleeding, weight loss, or a persistent change in how you poo. Speak to a GP before you stop any prescribed medicine that might be causing constipation. ## Could it be IBS, haemorrhoids or something else? Constipation can sit inside irritable bowel syndrome, especially if pain eases after you poo and symptoms have lasted months. Straining can also cause haemorrhoids, which may bleed bright red on the paper. Neither label rules out the need to check red flags. A negative bowel screening kit does not explain away new symptoms. IBS is a pattern: tummy pain related to poo, bloating, and a change towards constipation, diarrhoea, or both. It is diagnosed after other causes have been considered, not by buying a probiotic. If that pattern fits, read [IBS](https://healthanswers.co.uk/conditions/irritable-bowel-syndrome/) and still use the red-flag list on this page. Haemorrhoids are common with constipation. They can itch, swell, and bleed. Treat the constipation as well as the pile. Persistent or unexplained [blood in poo](https://healthanswers.co.uk/symptoms/blood-in-poo/) still belongs with a GP, including if you already “know you have piles”. Diverticular disease and, rarely, bowel cancer can also constipate. You cannot tell from home. Age, a sudden change, and red flags are why the GP exists. ## Who is this page not for? This page is about constipation in adults. It is not a guide to constipation in babies or children — use NHS pages for those ages. It cannot tell you which branded laxative to buy. It is not a bowel cancer diagnosis. If your only issue is bright red blood with a known pile, still get persistent bleeding checked. Skip this page if you cannot pass stool or wind and have severe pain and vomiting — that is urgent care, not fibre advice. Skip it if you need a personal medicine review; bring the packet to a pharmacist or GP instead. If the real question is which NHS service to use, see [pharmacy, GP, 111 or A&E](https://healthanswers.co.uk/guides/pharmacy-gp-111-or-ae/). ## ! When to see a GP about constipation See a GP if constipation is not getting better with treatment, keeps returning, or you are regularly bloated. See a GP promptly if you have blood in your poo, have lost weight without trying, notice a sudden lasting change in bowel habit, have ongoing tummy pain, or feel tired all the time. Call **999** if you have sudden severe tummy pain, vomiting, and cannot pass stool or wind. ## Common questions about constipation What counts as constipation? NHS guidance treats it as a change in how you poo: less often than usual, or stools that are dry, hard, lumpy, or painful to pass. Straining and feeling you have not fully emptied also count. Some people go daily; others every few days. The useful comparison is your own normal, not a neighbour’s. What should I try before a laxative? Increase fibre gradually with fruit, vegetables, wholegrains and pulses, and drink more fluid as you do. NHS advice includes fruits that contain sorbitol, such as apples, grapes and berries. Go when you get the urge. A daily walk helps many people. Give changes a few days, sometimes a few weeks, unless red flags are present. Can I get laxatives from a pharmacist? Yes. If diet and lifestyle are not enough, a pharmacist can suggest a short course. NHS advice is that most laxatives work within a few days and should only be used for a short time. Follow the pack and the pharmacist. See a GP if you need stimulant laxatives regularly, or if constipation keeps returning. When is constipation a sign of something serious? Most constipation is not cancer. See a GP promptly for blood in the stool, unexplained weight loss, a persistent change in bowel habit, ongoing tummy pain, or constipation with constant tiredness. Those symptoms need checking rather than another packet of laxatives. A negative screening kit does not replace that assessment. Could it be IBS or haemorrhoids instead? Yes. Constipation can be part of irritable bowel syndrome, especially with tummy pain that eases after you poo. Straining can cause haemorrhoids, which may bleed bright red on the paper. Neither label cancels red flags. New, persistent, or unexplained bleeding still needs a GP. Can medicines cause constipation? Yes. Some painkillers, including codeine-type medicines, iron, and some antidepressants and blood-pressure tablets, can slow the bowel. Do not stop a prescribed medicine on your own. Ask a pharmacist or GP whether constipation is a known effect and what to do instead. Does a negative bowel screening kit mean I can ignore constipation? No. Bowel cancer screening looks for hidden blood in poo. It is not a constipation test and it does not catch every problem. NHS advice is to see a GP about bowel symptoms even after a recent negative kit. Screening and symptoms are two different doors. ## Sources - [NHS — Constipation](https://www.nhs.uk/conditions/constipation/) - [NHS — Laxatives](https://www.nhs.uk/medicines/laxatives/) - [NHS — Bowel cancer screening](https://www.nhs.uk/conditions/bowel-cancer-screening/) - [NICE CKS — Constipation](https://cks.nice.org.uk/topics/constipation/) - [NICE — Suspected cancer: recognition and referral (NG12)](https://www.nice.org.uk/guidance/ng12)