A person's hand holds a pill, illustrating treatment for constipation symptoms.

Here are the top 10 most common symptoms of constipation that are often recognizable. Read on to learn more about each one:

  • Difficulty in emptying the bowels
  • Difficult bloating
  • Difficulty in evacuating gas
  • Intestinal fullness sensation
  • Abdominal distension
  • Fecal incontinence
  • Liquid fecal matter leaks
  • Mucus leaks
  • Gastroesophageal reflux
  • Nausea or vomiting.

These symptoms differ by age, diet habits, and other individual particularities.

Follow the rest of the guide to learn how to differentiate each symptom and how to deal with them.

Also, include them in your list and present them to your doctor so you can quickly identify the causes of your symptoms.


One of the most recognizable symptoms of constipation is the difficulty of emptying the bowels.

The easiest way to know if you are constipated is to pay attention to the way you feel when you go to the toilet.

Place yourself on the toilet bowl and start thinking about stool evacuation.

When this thing happens, focus your attention on your body and your lower abdomen.

If you need to strain or squeeze your lower abdomen, then it means that you must put extra effort into this process.

Stool evacuation should be natural without straining any part of your body.

When you need to put in the effort to evacuate the stool often, then it means you suffer from constipation.

Hard and dry stools are difficult to evacuate unless something breaks them into smaller pieces.

Position yourself on the toilet bowl using a footstool. Stay in a squat position on the toilet bowl.

This posture is the only way to make stool evacuation natural. If the posture does not help, then you are constipated.

According to a medical study published by the U.S. National Library of Medicine:

“In addition to infrequent bowel movements, the definition of constipation includes excessive straining, a sense of incomplete evacuation, failed or lengthy attempts to defecate, use of digital maneuvers for evacuation of stool, abdominal bloating, and hard consistency of stools.”


Bloating is one of the most common symptoms of constipation because small quantities of gas are always present inside the intestines.

The presence of gas inside the intestines is natural. Gas comes from fermentation, foods rich in CO2, and air intake.

Bloating appears when large quantities of gas or air stay trapped inside the intestines without the possibility of evacuation.

The stool blocks different quantities of air or gas inside the intestines.

This process makes the air inside move in different parts of the intestines, trying to evacuate.

The air of gas increases the volume inside the intestine. This thing makes our intestines feel full.

The feeling of having the intestines filled with matter or gas creates intestinal discomfort.

When large quantities of gas move inside the intestines without the possibility of evacuation for long intervals of time, then it means that you are constipated.

According to a medical study about bloating and intestinal gas published by The U.S. NLCBI:

“A parallel study by Gardiner et al. assessing the severity of bloating in functional gastrointestinal disorders shows that severe bloating is associated with the severity of abdominal pain, constipation, and somatization.”


Having gas or air trapped inside the intestines is normal. Gas will form inside the intestines after any meal.

Gas forms from fermentation or air intake when eating.

The evacuation of gas should be natural without complications.

If gas evacuation requires effort in normal circumstances, then it means that you are constipated.

If the rectum feels irritated when you strain or try to push the lower abdomen, then it means there is a quantity of hard and dry stool inside the large intestine.

This thing means that dry stool keeps the gas inside and prevents it from evacuation.

Forcing gas evacuation can cause leaks from the rectum.

Usually, hard and dry stool blocks gas and fecal matter to evacuate.

If this thing happens, then you are severely constipated and also dehydrated.

According to a medical study called “Responses to gastric gas in patients with functional gastrointestinal disorders”, published by The U.S. National Library of Medicine:

“Patients with functional bloating exhibited a slow transit response, with reduced rectal gas evacuation and abdominal symptoms but without compensatory belching.”


Flatulence is one of the most common symptoms of constipation because digestion produces gas.

Flatulence is the evacuation of a mix of gases (called flatus) produced by symbiotic bacteria and yeast.

Bacteria and yeast live inside the gastrointestinal tract of mammals.

Our body evacuates the gas using pressure thru the anus.

Usually, this gas has a typical smell and produces a specific evacuation sound.

Different types of foods create bacterial fermentation and even more intestinal gas.

The entire digestion produces every day a few liters of gas.

Some gases (partial quantities) are re-absorbed in the blood flow. Breathing eliminates them. The rest of the gas evacuates straight through the intestine.

Excessive flatulence occurs when we have more than fifteen gas evacuations per day.

Excessive gas is a sign that a large quantity of stool blocks the gas from evacuation.

The gas smell is similar to sulfur (the result of food that decomposes).

The sulfuric smell comes from bacteria that decompose dietary fiber.

According to a medical study called "Flatulence - causes, relation to Diet and Remedies" published by The U.S. NCBI:

“Medical experts recommend drug treatment, enzyme treatment, food processing, and plant breeding.”


Another typical example of constipation symptom is having the intestines full from bottom to top.

Food is the main element that fills the intestines in most cases.

Too much fecal matter inside the intestines can create this sensation.

Another sensation is feeling the entire body filled with matter from the rectum to the chest.

Constipation can appear whenever we eat food rich in sugar.

The same thing can happen when we eat food rich in fats.

Dry stools that absorb water inside the intestine can stay there for long intervals of time.

When dry and lumpy stools do not evacuate quickly, the new food will stack on top of them.

If we repeat this process often, then our intestines will get full.

This thing can cause other symptoms. Also, it can enlarge our abdomen.

Medical experts from the Journal of Medicine and Life (JML) evaluate the “Upper Gastrointestinal Sensitization and Symptom Generation”:

“Typically, patients who are suffering from upper gastrointestinal (GI) disorders present with various symptoms such as early satiety, postprandial fullness, bloating, nausea, vomiting, and epigastric pain.”


Abdominal distension is a symptom that appears when the volume of the abdomen increases.

Abdominal distension can have two causes: organic causes and disorders of the gut-brain nerve axis.

The disorders of the gut-brain nerve axis are:

  • irritable bowel syndrome (IBS);
  • chronic idiopathic constipation;
  • pelvic floor dysfunction;
  • functional dyspepsia;
  • functional bloating.

The organic causes are many like:

  • food intolerances (carbohydrates, lactose, fructose);
  • celiac disease (gluten intolerance);
  • pancreatic insufficiency;
  • gastroesophageal surgery (bariatric surgery);
  • obstruction of gastric emptying;
  • gastroparesis;
  • ascites (accumulation of liquid inside the peritoneal cavity);
  • malignant gastrointestinal or gynecological tumors;
  • hypothyroidism;
  • excess adipose tissue (obesity);
  • pregnancy;
  • diverticulosis of the small intestine.

Another rare cause can be chronic intestinal pseudo-obstruction.

Also, bacterial overpopulation of the small intestine (SIBO - small intestinal bacterial overgrowth) can be a crucial cause.

Having the intestines filled with fecal matter for long intervals of time can lead to severe abdominal distension.

Bloating accompanies this symptom often.

According to a medical study called “Management of Chronic Abdominal Distension and Bloating”, published by U.S. NLM:

“Abdominal bloating and distension can develop for multiple reasons, including food intolerances, a previous infection that perturbed the intestinal microbiota, disordered visceral sensation, delayed intestinal transit, or abnormal viscero-somatic reflux.”


Fecal incontinence is one of the most crucial symptoms of constipation because it affects our social life and overall health.

  • Medical experts describe fecal incontinence as one of the most devastating physical disabilities because it affects:
  • interhuman relationships;
  • developing careers;
  • self esteem.

Fecal incontinence (or rectal incontinence) represents the involuntary evacuation of fecal matter and gas.

Constipation, radiation therapy, birth (women), and other surgical interventions can lead to fecal incontinence.

For example, constipation or chronic diarrhea can modify the functional properties of the rectum.

Also, surgery can damage the pelvic floor muscles or the pudendal nerves.

The good news is that many long-term treatments for fecal incontinence have results.

In most cases, the first treatment options include non-surgical options.

These non-surgical options include diarrhea control, constipation control, special physical exercises for the pelvic floor muscles, and biofeedback exercises.

Surgical treatment includes sphincteroplasty.

This procedure is necessary if anal surgery, trauma, or natural birth creates damage to the anal sphincter.

Other surgical procedures include colostomy, pelvic floor surgery, and graciloplasty.

According to a medical study called “Evaluation of Psychosocial Profiles in Patients With Fecal Incontinence, Constipation, and Mixed Symptoms; A Controlled Study”:

“We found significant and severe impairment of psychosocial profiles in fecal incontinence, chronic constipation, and those with mixed symptoms. Somatization, OCD, depression, and anxiety were the predominant features.”
“Subjects with Mixed disorder had considerable psychological dysfunction, as revealed by GSI, than those with constipation or incontinence alone.”


The liquid fecal matter leak is another crucial constipation symptom.

Dry stool inside the large intestine and rectum only allows liquid fecal matter to pass.

This thing happens without the need to defecate.

Also, there is no need to squeeze the rectum or the abdomen.

This process takes place without effort and often without any control.

Severe dehydration combined with fermentation can cause leaks often.

Fermentation and gas force the liquid matter to push towards the rectum.

Liquid fecal matter evacuates with ease than dry fecal matter.

Dehydration is one of the most common causes of dry stool.

Medical experts from The American Gastroenterological Association state that:

“Fecal incontinence associated with constipation is thought to be a result of fecal impaction, either as involuntary overflow incontinence or as stool leakage from the rectum as feces approaches the anus.”


Mucus leaks are one of the most common severe symptoms of constipation because dry stool blocks the fecal matter to evacuate.

The mucus protects the intestines by creating a protective layer against bacteria, acids, and some enzymes.

The mucus is a liquid with the following properties:

  • thick;
  • gelatinous;

Also, it helps the stool to evacuate by acting like a lubricant inside the intestines.

A small quantity of mucus in the fecal matter is a good thing.

The mucus works also as a protective barrier, and its presence outside the rectum is a problem.

Mucus leaks rarely appear without squeezing the rectum.

Squeezing the rectum can force the evacuation of mucus and liquid matter.

If the only thing that evacuates is transparent mucus, then the patient is suffering from severe dehydration and constipation.

Usually, this combination of these two symptoms lasts for 1-3 days until the dry stool inside the rectum evacuates.

According to a medical study called “Intestinal mucus components and secretion mechanisms: what we do and do not know”:

“Damage to the colon mucus barrier, the first line of defense against microorganisms, is an important determinant of intestinal diseases such as inflammatory bowel disease, colorectal cancer, and disorder in extraintestinal organs.”


Gastroesophageal reflux occurs when the acidic matter of the stomach returns to the esophagus.

The presence of acidic matter in the esophagus area creates irritation of the mucosa lining.

Here are other symptoms that occur with gastroesophageal reflux:

  • Burning sensation in the head of the chest.
  • Difficulty in swallowing food.
  • Frequent regurgitation.

There are a few causes that lead to this process. One of the causes is the inability to move the stool from the small intestine.

Large quantities of dry stool inside the large and small intestines can lead to a blockage of the digestive tube.

The fecal matter that stays for days inside the intestines can block the food from evacuating the stomach.

As a result, acid reflux occurs, and the irritation is present both in the esophagus and below the stomach.

Dry stool can stay inside the intestines for days. Dry stool can stack up to the small intestine.

According to a medical review called “Complex Gastroesophageal Reflux Disease”:

“Gastroesophageal reflux represents the presence of typical esophageal symptoms (heartburn and regurgitation) and an assessment for symptomatic response to empirically prescribed PPIs or other medical therapies.”


Nausea or vomiting can occur if you suffer from severe dehydration and severe constipation.

Nausea is one of the most recognizable symptoms of constipation because it suggests that dry stool blocks the food from digesting.

Also, nausea is a crucial sign that the intestines contain rotten food. It is essential to evacuate this type of fecal matter quickly.

The fecal matter that combines with the new food can lead to vomiting.

The same thing applies if digestion cannot take place under normal circumstances.

Also, fermentation can lead to nausea or vomiting because it can make the food degrade.

Last medically reviewed on 22.03.2024


1. Rome Foundation Clinical Diagnostic Criteria for Disorders of Gut-Brain Interaction. Douglas A. Drossman, Jan Tack

2. Peripheral and central mechanisms of visceral sensitization in man. P. Anand, Q. Aziz, R. Willert, L. Van Oudenhove

3. Physical activity and intestinal gas clearance in patients with bloating. Albert Villoria, Jordi Serra, Fernando Azpiroz, Juan-R Malagelada

4. Development of Quality Measures for the Care of Patients With Gastroesophageal Reflux Disease. Rena Yadlapati, Andrew J. Gawron, Karl Bilimoria, Nathaniel Soper, Marcelo F. Vela

5. Prevalence, Recognition, and Risk Factors of Constipation among Medically Hospitalized Patients: A Cohort Prospective Study. Jawahar Al Nou'mani, Juhaina Salim Al-Maqbali, Nahid Al Abri, Maryam Al Sabbri



My name is Sebastian D., and I am the senior editor of With the help of my mentor, Dr. Horia Marculescu, I decided to create a practical guide to constipation relief.. read more

Copyright © 2017-2023. All rights reserved. ConstipationGUIDE does not provide medical advice, diagnosis or treatment.