Healthy from the Gut! Key Points for Managing Adult Bowel Movements
Is constipation a "disease"? — What you need to know about chronic constipation
Do you think, "It's just constipation..."?
It is well known that chronic constipation is more common in women. In fact, according to the 2023 Clinical Practice Guidelines for Functional Bowel Disorders, which were created based on the Ministry of Health, Labour and Welfare's "Comprehensive Survey of Living Conditions" (2022), the prevalence of constipation is reported to be higher in women at 4.4% compared to 2.8% in men. While the tendency for it to be more common in women is clear, especially in those under 50, it is also shown that there is almost no difference between men and women once they reach the age of 70.
In other words, it is characterized by being more common in women during youth and middle age, and as people age, constipation increases in both men and women, spreading across the entire elderly population [1].
What is the difference between constipation and chronic constipation?
What is constipation?
Constipation is defined as "a condition where stool that should normally be excreted remains in the large intestine, resulting in hard or rabbit-like pellet stools, decreased frequency of bowel movements, a feeling of incomplete evacuation, strong straining during bowel movements, a feeling of blockage in the rectum or anus, or difficulty passing stool."
In other words, it is understood to include not just "not going," but also the nature of the stool and the sensation of bowel movements [1].
What is chronic constipation?
"Chronic constipation" refers to a condition where these symptoms of constipation persist chronically and interfere with daily life [1].
There are criteria for diagnosis,
for example
Having bowel movements less than 3 times a week
Frequent hard or rabbit-like pellet stools
Strong straining during bowel movements or a feeling of incomplete evacuation
A feeling of blockage in the rectum or anus
If multiple symptoms such as these continue for 3 months or more, it is diagnosed as "chronic constipation."
Everyone experiences temporary constipation, but prolonged constipation is a sign from your body. Caution is required.
Background of constipation and its impact on life
Constipation is more common in women and is influenced by various factors, such as the Westernization of dietary habits, lack of exercise, an aging population, and medication (especially drugs that are prone to causing constipation).
The guidelines also position chronic constipation as a disease that significantly impairs QOL (Quality of Life).
Specifically,
Inability to concentrate on daily life, work, or studies due to discomfort or a feeling of incomplete evacuation during bowel movements
Decreased motivation for activity due to abdominal bloating or discomfort, leading to avoiding going out or interacting with others
Negative impact on mental health, such as sleep disorders or feelings of depression
In the elderly, it has also been reported that constipation is associated with an increased risk of delirium and falls
As shown, constipation is emphasized as a condition that affects not only "abdominal discomfort" but also the entire mind and body, and is a disease that requires medical intervention.
Points for improving constipation through diet based on guidelines
1. Intake of dietary fiber and water is fundamental
First, improving your diet (especially the intake of dietary fiber and water) is important.
Dietary fiber is abundant in "vegetables, fruits, seaweed, and legumes," and for Japanese people, dietary fiber derived from rice and legumes leads to the improvement of constipation. Furthermore, its effectiveness is enhanced when combined with water, which softens stool and promotes bowel movements [1].
2. What foods help improve constipation? Foods indicated in the guidelines
We would like to introduce foods that are easy to incorporate into your daily diet for those suffering from constipation [1].
Kiwifruit
It has the effect of increasing the water content in the intestines and activating intestinal movement to promote natural bowel movements. Incorporating it into your daily breakfast is useful for improving bowel movements.
Prunes and psyllium (plantain)
Clinical trials have shown that they improve the frequency of natural bowel movements and the ease of defecation. Prunes can be eaten as they are or mixed into yogurt for easy consumption. It is common to consume psyllium by mixing it with water or yogurt.
Yogurt (lactic acid bacteria food)
It has been reported that increasing good bacteria in the intestines and regulating the intestinal environment is useful for improving bowel movements. It is recommended to incorporate a little plain yogurt every day.
Exercise and constipation improvement
The "Clinical Practice Guidelines for Functional Bowel Disorders 2023 (Chronic Constipation)" also recommends improving exercise habits as a basic part of lifestyle guidance [1].
It is known that lack of exercise slows down intestinal movement and is a common cause of constipation.
In particular, light aerobic exercise (walking, jogging, climbing stairs, etc.) has the effect of promoting intestinal peristalsis and assisting bowel movements.
Even for the elderly or those with low physical strength, exercise within a reasonable range is recommended.
Summary
Since chronic constipation affects quality of life, it is important not to leave it untreated and to take measures.
First, review whether you are lacking in diet, exercise, or water intake.
If it still does not improve or if it persists, it is important to consult a medical institution as soon as possible.
[References] Accessed September 8, 2025
[1] Clinical Practice Guidelines for Functional Bowel Disorders
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