Why Your Constipation Is Not Improving
You have tried everything — increased fibre, drank more water, taken laxatives, changed your diet. Yet, constipation (also commonly searched as kabj or constipation hindi) simply refuses to go away. If this sounds familiar, you are certainly not alone.
Millions of people across India deal with this problem every single day. The frustrating truth is that most people end up treating the symptoms rather than the actual cause. When the root cause is not identified correctly, no treatment — however standard — will give lasting relief.
India’s leading Female Gastrophysiologist in Pune, Dr. Rupali Bandgar-Jankar, is India’s first Consultant Gastrophysiologist and Biofeedback Specialist, with over 8 years of expertise in treating complex digestive and pelvic floor disorders. As the Head of the GI Motility Department at Kaizen Gastro Care in Pune, she specialises in advanced diagnostics like Anorectal Manometry and non-invasive Biofeedback Therapy for chronic constipation — making her one of the most experienced specialists for Biofeedback Therapy in Pune.
In this detailed guide, Dr. Rupali Bandgar-Jankar explains the real reasons why your constipation is not improving, what the right diagnosis looks like, and what treatment options are actually available for your specific condition.
What Is Constipation?
Many people believe that constipation simply means not going to the toilet often enough. However, the medical definition is much broader. In India, constipation is commonly referred to as kabj — and understanding kabj kya hota hai or constipation kya hota hai is the first step towards solving it.
Medically speaking, constipation is diagnosed when one or more of the following are present:
- Fewer than three bowel movements per week
- Stools that are hard, lumpy, or extremely dry (constipated poop / constipation poop)
- Significant straining or difficulty to pass stool
- A persistent feeling that the bowel has not emptied completely
- A sensation of blockage, or that poop won’t come out and it hurts
These are the classic symptoms of a constipation — and also what most people refer to as kabj ke lakshan in everyday language.
Acute vs. Chronic Constipation — Why the Difference Matters?
- Acute constipation is short-term — usually triggered by travel, stress, a change in diet, or a new medication. It typically resolves within one to two weeks with simple home remedies.
- Chronic constipation is persistent — lasting three months or more. This type requires proper medical evaluation. Home remedies and over-the-counter laxatives rarely solve it on their own.
Common Treatments People Try — And Why They Often Fail:
When constipation strikes, most people reach for the same standard solutions:
- Increasing dietary fibre (bran, salads, fruits)
- Drinking more water
- Over-the-counter laxatives such as Isabgol or Dulcolax
- Light exercise or walking
These are the most widely shared quick remedies for constipation at home, and they do work — but only for certain types of constipation. The core problem is that constipation is not a single condition. It has multiple distinct subtypes, each requiring a different approach. Applying a generic solution to a specific problem is why so many people struggle to find instant constipation relief.
Constipation is not a one-size-fits-all condition. The treatment that works for your colleague may do nothing for you — because your underlying cause could be entirely different.
The Real Reasons Your Constipation Is Not Improving:
This is the most important section of this article. Below are the most common — and most commonly missed — reasons why constipation does not improve even after treatment.
1. You Are Treating the Symptom, Not the Root Cause:
This is, without doubt, the main reason for constipation treatment failing. Several underlying medical conditions slow down digestion and cause persistent constipation that will not improve until the condition itself is addressed.
Common overlooked medical causes include:
- Hypothyroidism: A sluggish thyroid gland slows the entire digestive system, causing the classic symptoms to constipation — infrequent, hard stools and bloating
- Diabetes-related gut neuropathy: Poorly controlled blood sugar damages the nerves that control gut movement
- Hormonal imbalances: Elevated progesterone during pregnancy or certain phases of the menstrual cycle slows bowel movement significantly
According to Dr. Rupali Bandgar-Jankar, many patients who visit her clinic have never had a basic thyroid test done. A simple blood test can reveal the cause that has been missed for years.
2. Your Medications Are the Culprit:
One of the most frequently overlooked constipation causes of chronic cases is the medication a patient is already taking for another condition. This explains why constipation occurs in many otherwise healthy individuals.
Medications known to cause or worsen constipation include:
- Opioid painkillers such as Tramadol and Morphine — among the strongest constipation-causing agents
- Iron supplements — especially common during pregnancy
- Calcium or aluminium-based antacids
- Certain antidepressants and blood pressure medications
Important: Never stop any prescribed medication without consulting your doctor first. Always discuss this concern during your next appointment
3. You Have Slow Transit Constipation:
Slow transit constipation is a specific subtype in which the colon itself moves its contents too slowly — regardless of how much fibre or water you consume. It is one of the leading causes of extreme constipation and directly contributes to persistent bowel movement problems.
In this condition, adding more fibre can actually make the problem worse — producing more bulk without any improvement in movement. This is why constipation happens even in people who appear to be eating well.
- Diagnosis: A Colon Transit Study — a specialised test in which you swallow a capsule containing small markers, and their progress through your colon is tracked via X-ray over several days. This test is available at Kaizen Gastro Care, Pune.
- Treatment: Prescription motility agents such as Prucalopride, which stimulate the colon to contract more regularly and effectively.
4. Pelvic Floor Dysfunction / Dyssynergia — The Most Commonly Missed Cause
This condition is the answer to why do constipation occur in a large number of patients — particularly women — and it is frequently missed even by general physicians.
Normally, when you attempt to pass stool, the pelvic floor muscles and the anal sphincter must relax to allow the stool to exit. In pelvic floor dyssynergia, these muscles do the opposite — they tighten and contract, creating a blockage.
Key symptoms that suggest this condition:
- Excessive straining even when stool is soft
- A persistent feeling of incomplete evacuation after each visit
- Needing to use fingers or pressure to assist stool passage
- Spending a long time on the toilet with little result
No laxative can fix a mechanical coordination problem. The gold-standard treatment for this condition is Biofeedback Therapy — a non-invasive, drug-free technique in which patients are trained to coordinate their pelvic floor muscles correctly.
Dr. Rupali Bandgar-Jankar is one of India’s foremost specialists in this area. She provides Biofeedback Therapy for constipation in Pune at Kaizen Gastro Care, using state-of-the-art equipment and a structured rehabilitation programme.
Biofeedback Therapy is a scientifically proven, completely drug-free treatment. Studies consistently show success rates of over 70% in patients with pelvic floor dysfunction. It is available at Kaizen Gastro Care, Pune.
5. Wrong Type of Fibre or Insufficient Water:
Not all fibre is the same — and choosing the wrong type is a surprisingly common hard bowel movement cause.
- Soluble fibre (Isabgol/psyllium husk, oats, banana): Absorbs water and softens stool — ideal for those with outlet dysfunction or hard stools.
- Insoluble fibre (wheat bran, certain vegetables): Speeds up transit — better suited for slow transit constipation.
Consuming fibre without adequate water intake is another very common mistake. Without water, fibre forms a dry, compacted mass that is even harder to pass. This is precisely why constipation occurs in people who increase fibre without increasing fluids — and why do constipation occur even when diet appears healthy.
6. Laxative Overuse and Dependency:
Many people seeking constipation immediate relief turn to stimulant laxatives such as Senna or Bisacodyl on a daily basis. While effective in the short term, long-term daily use can lead to serious problems.
Over time, the bowel becomes reliant on external stimulation and loses its natural ability to contract on its own — a condition informally referred to as ‘lazy bowel syndrome’. The same dose stops working, and patients need progressively higher doses to achieve the same effect.
Safer long-term alternatives: Osmotic laxatives such as Polyethylene Glycol (PEG / Movicol / MiraLax) are considered much safer for regular use — but even these should be taken under medical supervision.
7. The Gut-Brain Connection: Stress, Anxiety, and Lifestyle Factors
The digestive system and the brain are directly connected through the vagus nerve — a pathway known as the gut-brain axis. Stress and anxiety have a proven, measurable impact on gut motility. This is a significant but often overlooked reason for bowel movement problems.
Other lifestyle factors that worsen constipation:
- Repeatedly ignoring the urge to defecate — this gradually dulls the rectal reflex and is one of the key reasons why constipation happens in otherwise healthy people
- A sedentary lifestyle — physical inactivity significantly slows gut motility
- Disrupted routines due to travel, night shifts, or irregular meal timings
Managing stress through yoga, mindful breathing, or structured relaxation techniques can meaningfully improve bowel regularity, particularly when combined with other treatments.
8. Structural or Anatomical Problems:
In some cases, the cause of constipation is a structural problem that cannot be resolved with diet or medication alone. These include:
- Rectocele: The rectum bulges into the vaginal wall, creating a pocket where stool collects and cannot be fully expelled — common in women who have had vaginal deliveries
- Rectal prolapse or intussusception: Partial or complete protrusion of the rectum
These conditions are diagnosed through Anorectal Manometry and Defecography — both of which are available at Kaizen Gastro Care under the expert care of Dr. Rupali Bandgar-Jankar.
How to Identify Which Type of Constipation You Have?
Accurate diagnosis is the foundation of effective treatment. The following tests help identify the exact cause of chronic constipation:
Self-diagnosis very often leads to the wrong treatment — and wasted months of effort. If you have been struggling with persistent constipation, consulting a specialist like Dr. Rupali Bandgar-Jankar at Kaizen Gastro Care, Pune, will provide clarity through the right diagnostic pathway.
Constipation Danger Signs — When to See a Doctor Immediately:
A common question people ask is: is constipation dangerous? In most cases, constipation is uncomfortable but not dangerous. However, certain warning signs — known as constipation danger signs — require urgent medical attention.
Do not delay — see a doctor immediately if you experience any of the following:
- Blood in stools or rectal bleeding
- Unexplained weight loss alongside constipation
- Constipation and diarrhoea alternating with each other
- New-onset constipation after the age of 50 — this must always be investigated
- Severe, persistent abdominal pain that does not resolve
- Significant bloating with nausea or vomiting
These symptoms may indicate serious underlying conditions including colorectal cancer, inflammatory bowel disease, or complete bowel obstruction. Please do not ignore them.
The Right Treatment for the Right Cause:
This is the core principle that Dr. Rupali Bandgar-Jankar follows in her clinical practice — matching treatment precisely to the diagnosed cause:
Practical Tips That Support Any Treatment Plan:
Whether you are looking for ways to cure constipation at home or are already under specialist care, these evidence-based habits will support your recovery and improve bowel regularity:
- Correct Toilet Posture: The ideal posture for defecation is a squat position, which straightens the anorectal angle and makes stool passage significantly easier. On a Western-style toilet, place a small footstool under your feet so that your knees are raised above the level of your hips. This one simple change can provide noticeable relief.
- Establish a Scheduled Toilet Time: The gastrocolic reflex — the natural wave of movement in the colon triggered by eating — is strongest in the morning, approximately 20 to 30 minutes after breakfast. Use this window consistently every day. Over time, your bowel will adapt and begin to respond reliably at that time.
- Morning Routine Adjustments: Begin your day with a glass of warm water, which gently stimulates bowel activity. Warm lemon water or plain warm water both work well. This is among the most effective and simple immediate constipation home remedies available.
- Address Stress Actively: Given the strong gut-brain connection, managing stress is not optional for those with chronic constipation. Daily yoga, breathing exercises, or even a 20-minute walk can have a measurable positive impact on bowel function.
- Maintain a Bowel Diary: Tracking your bowel habits — frequency, consistency, effort required, and diet — helps identify patterns and triggers. This information is also invaluable to your specialist. Monitoring your symptoms to constipation over time gives your doctor the clearest possible picture of what is happening.
- Daily Habits to Help Cure Constipation at Home:
- Hydration: Aim for at least 8 to 10 glasses of water per day. Increase this in summer or after exercise.
- Physical activity: Even a 30-minute daily walk significantly improves gut motility.
- Never ignore the urge: When you feel the need to go, go immediately. Repeatedly suppressing the urge weakens the rectal reflex over time — and this is one of the key reasons why constipation happens in otherwise healthy individuals.
Conclusion:
If your constipation is not improving despite treatment, please understand — this is not a reflection of your willpower or your efforts. It is almost always a sign that the root cause has not been correctly identified.
Constipation — whether you know it as kabj or simply a persistent bowel movement problem — is a complex condition with multiple distinct types. Each type requires a different, targeted treatment. The good news is that once the cause is found, effective solutions exist.
If you are based in or near Pune and have been struggling with chronic or treatment-resistant constipation, consulting Dr. Rupali Bandgar-Jankar at Kaizen Gastro Care would be a wise and informed step. Her expertise in Anorectal Manometry, Biofeedback Therapy for constipation in Pune, and Colonic Transit Study means you will receive an accurate diagnosis and a treatment plan tailored specifically to you.
Track your symptoms, be honest with your doctor about everything you have tried, and do not hesitate to seek specialist care if standard treatment has not worked. The right diagnosis changes everything.
Book your appointment today — because better digestive health is not a luxury. It is something you deserve.
Frequently Asked Questions:
The most common kabj ke lakshan include hard or lumpy stools (constipated poop), straining during bowel movements, a feeling of incomplete evacuation, fewer than three bowel movements per week, and abdominal discomfort. These are also the standard symptoms of a constipation as defined medically.
In most cases, constipation is not dangerous — but it significantly impacts quality of life. However, constipation danger signs such as blood in stools, unexplained weight loss, or new-onset constipation after age 50 can indicate serious conditions and must be evaluated urgently. So while routine constipation is manageable, it is important to know when is constipation dangerous enough to warrant immediate attention.
For immediate constipation home remedies, try: drinking a glass of warm water first thing in the morning, gentle abdominal massage in a clockwise direction, light walking or movement, and the correct squatting posture on the toilet. These provide the best chance of constipation immediate relief without medication. However, if the problem is chronic, please consult a specialist.
This is one of the most common questions — and the answer is that constipation causes of go well beyond diet. Pelvic floor dysfunction, slow transit constipation, thyroid disorders, and certain medications can all cause or worsen constipation regardless of what you eat. This is precisely why constipation occurs in people with otherwise healthy lifestyles.
If you feel that my poop won’t come out and it hurts, do not strain forcefully as this can cause haemorrhoids or anal fissures. Try warm water, a footstool for posture correction, and gentle abdominal massage. If this happens regularly, it likely indicates pelvic floor dysfunction or severe slow transit constipation — both of which require specialist evaluation. Do not ignore the difficulty to pass stool if it is a recurring issue.
Permanent relief from constipation requires identifying and treating the root cause — not just managing symptoms. Depending on your diagnosis, how to get rid of constipation permanently may involve Biofeedback Therapy, motility medication, dietary changes, or a combination of approaches. A consultation with Dr. Rupali Bandgar-Jankar at Kaizen Gastro Care, Pune, will give you a clear, personalised roadmap.