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Bowel Problems

Constipation, diarrhea, gas, bloating and bowel leakage are common and usually manageable — but blood in the stool, a lasting change in bowel habits or unexplained weight loss needs a doctor, and screening for colorectal cancer starts at 45.

Call 911 or go to the emergency room if you have:

See a doctor right away if you have:

Make an appointment soon for a change in your bowel habits that doesn’t go away, diarrhea or constipation that lingers, a feeling that your bowel doesn’t empty all the way, belly cramps that don’t go away, unexplained weight loss, or low iron (anemia). These can be signs of colorectal cancer — though they often have other causes, and only a doctor can tell (CDC). Most colorectal cancers are found in people 45 and older (USPSTF). If you are 45 or over and haven’t been screened, see our screening section.

What is “normal”?

There is no single normal. People have different bowel patterns, and only you know what’s normal for you (NIDDK). You don’t need a bowel movement every day — but if your bowel habits change, check with your provider (MedlinePlus). Passing gas is normal too: studies suggest people pass gas about 8 to 14 times a day, and up to 25 times is considered normal (NIDDK).

Constipation

Constipation can mean fewer than three bowel movements a week; hard, dry or lumpy stools; stools that are difficult or painful to pass; or a feeling that not all the stool has come out. It is not a disease, but it can be a symptom of another problem (NIDDK). About 16 in 100 adults have symptoms of constipation, rising to about 33 in 100 adults aged 60 and older (NIDDK).

Common causes include too little fiber, fluid or physical activity; ignoring the urge to go; travel, pregnancy, aging and other changes in routine; and some medicines and supplements, such as narcotic pain medicines, iron supplements, antacids containing aluminum and calcium, some antidepressants, calcium channel blockers and diuretics. Health problems such as irritable bowel syndrome, diabetes, an underactive thyroid, Parkinson’s disease, celiac disease and blockages, including tumors, can also cause it (NIDDK). Don’t stop a medicine on your own — ask your provider (NIDDK).

Diarrhea

Diarrhea is loose, watery stools three or more times a day, or more often than is normal for you. Acute diarrhea usually lasts less than a week and goes away on its own; diarrhea lasting at least 4 weeks is called chronic (NIDDK). Research suggests people in the United States have acute diarrhea about once a year, and up to 5% have chronic diarrhea (NIDDK).

The most common causes of acute diarrhea are viral infections of the intestines (such as norovirus), food poisoning and medicine side effects. Longer-lasting diarrhea can come from infections, food allergies and intolerances (such as lactose intolerance), sugar alcohols like sorbitol, celiac disease, Crohn’s disease, ulcerative colitis, irritable bowel syndrome, past abdominal surgery or long-term medicines (NIDDK). Antibiotics can upset the gut’s helpful bacteria and lead to C. diff infection, which causes diarrhea and can be life-threatening (CDC).

The main danger is dehydration. People who are pregnant, over 65, taking antibiotics or living with a weakened immune system are more likely to have complications and should keep in touch with their doctor (NIDDK).

Gas and bloating

Everyone has gas, and many people are bothered by it at times. Research suggests 16% to 31% of people experience bloating — a feeling of fullness or swelling in the belly (NIDDK). Gas comes from swallowed air (chewing gum, fizzy drinks, eating fast, smoking, loose dentures) and from gut bacteria breaking down carbohydrates that weren’t fully digested (NIDDK). Irritable bowel syndrome, lactose or fructose intolerance, celiac disease, constipation and gastroesophageal reflux disease can all add to gas symptoms (NIDDK); see our Acid Reflux guide. Talk with a doctor if gas bothers you, changes suddenly, or comes with belly pain, constipation, diarrhea or weight loss (NIDDK).

Accidental bowel leakage (fecal incontinence)

Fecal incontinence is the accidental passing of stool or mucus. With urge incontinence you feel the need but can’t hold it until you reach a toilet; with passive incontinence, leakage happens without you knowing (NIDDK). Between 7 and 15 in 100 adults living at home have it, and it is more common in older adults (NIDDK). Diarrhea is the most common risk factor; constipation, muscle or nerve damage (including from childbirth or long-term straining), hemorrhoids, rectal prolapse and physical inactivity can also play a part (NIDDK).

It can feel embarrassing, but it isn’t something to be ashamed of — it’s a medical problem, it can often be treated, and it usually won’t go away without treatment (NIDDK). See a doctor if leaks are frequent or severe or are affecting your life (NIDDK). Many people with bowel leakage also have bladder leakage (NIDDK); see our Bladder Problems guide.

Seeing your provider

Expect questions about your bowel habits, your stools, any blood, your diet, activity, medicines and family history; tracking your bowel movements for a few days or weeks beforehand helps. A rectal exam, blood and stool tests, or a look inside the colon may follow (NIDDK). MBHA’s separate guides on Irritable Bowel, Crohn’s Disease, Colitis and Hemorrhoids are being written.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Fiber, fluids, activity and bowel training first; then over-the-counter laxatives by type, prescription medicines and biofeedback for constipation. Fluids and oral rehydration for diarrhea, with testing or antibiotics only for some infections. Pelvic floor exercises, biofeedback and other options for leakage; diet changes for gas. Screening colonoscopy: often $0 under ACA-compliant plans and Medicare (with caveats); about $1,250–$4,800 without insurance. Physical therapy about $50–$350+ a session without insurance. Medicine prices: cost estimate being researched. Most short-term constipation and diarrhea settles with self-care. Simple treatments improve bowel leakage symptoms by about 60%. Lasting changes or warning signs need testing.
Chiropractic Being researched — coming soon.
Acupuncture Electroacupuncture (needles with a mild electrical current) for long-lasting functional constipation, usually as a series of sessions. About $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90. Medicare covers acupuncture only for chronic low back pain. One large trial found more complete bowel movements than sham treatment over 8 weeks of sessions; only about a third of people reached three a week. Little evidence for other bowel problems.
Herbal medicine Psyllium fiber for constipation; senna as a short-term stimulant laxative; probiotics (mixed evidence); peppermint oil mainly for IBS. Cost estimate being researched. Fiber supplements, especially psyllium, help many people with chronic constipation. Probiotic results vary by type. Ask before combining with medicines.
Massage therapy Abdominal massage — for example slow, circular strokes over the belly — for constipation. About $50–$90 for 45–60 minutes at clinics, gyms and spas. Reviews suggest it may increase bowel movements and ease constipation, but the studies vary widely in quality. It didn’t reduce laxative use.
MBHA Wellness Coach Adding fiber slowly, enough fluids, a regular toilet routine, daily activity, a food and symptom diary, and handwashing and kitchen hygiene to prevent diarrhea. Cost estimate being researched. Habit changes treat and prevent much constipation and help find food triggers. They support — not replace — a check-up and screening.

Approach 1 of 6

Conventional medicine (AMA)

Most bowel problems can be treated at home at first, guided by your provider; testing and prescription treatment come next if symptoms continue or warning signs appear.

1. Constipation

  • Food, drink and activity: eat more high-fiber foods, drink plenty of water and other liquids — especially as you add fiber — and get regular physical activity (NIDDK). See the Wellness Coach section for practical steps.
  • Bowel training: try to go at the same time each day; 15 to 45 minutes after breakfast can help, because eating gets the colon moving. Give yourself time, go as soon as you feel the urge, and try resting your feet on a footstool (NIDDK).
  • Over-the-counter laxatives, for a short time. Your provider can tell you which type suits you: fiber supplements, osmotic agents (which draw water into the bowel), stool softeners, lubricants such as mineral oil, and stimulants. Stimulants are meant only for severe constipation or when other treatments haven’t worked. If you can’t go without a laxative after long use, ask your doctor how to taper off slowly (NIDDK). We don’t list doses.
  • Prescription medicines if self-care hasn’t worked: lubiprostone, which adds fluid to the gut; linaclotide or plecanatide, for irritable bowel syndrome with constipation or long-lasting constipation without a known cause; and prucalopride, which helps the colon move stool (NIDDK).
  • Biofeedback therapy can retrain the muscles that control bowel movements when they aren’t working together. Surgery is rarely needed — for example for rectal prolapse — and only if other treatments fail (NIDDK).

2. Diarrhea

  • Replace fluids and salts first. Drink water plus liquids with electrolytes, such as broth and sports drinks, or an oral rehydration solution (ORS) from a pharmacy. Older adults and people with a weak immune system, diabetes or kidney disease should ask their doctor before using ORS (NIDDK). CDC notes that sports drinks help with mild dehydration but may not replace important minerals, and that over-the-counter oral rehydration fluids are most helpful (CDC). For severe fluid loss, ORS made from packaged oral rehydration salts is best (CDC Yellow Book).
  • Eating: once your appetite returns you can usually eat normally. While the diarrhea lasts, avoid alcohol, caffeine, very sugary or fatty foods, sugar-free sweets and, for some people, milk products (NIDDK).
  • Over-the-counter medicines such as loperamide and bismuth subsalicylate are usually safe for adults with acute diarrhea, but doctors typically advise against them if you have bloody stools or a fever. See a doctor if diarrhea gets worse or lasts more than 2 days while you take them (NIDDK).
  • Antibiotics are only sometimes needed. They may help some digestive infections (NIDDK), but they don’t help viral infections such as norovirus (CDC), and they raise the risk of C. diff infection (CDC). For travelers’ diarrhea, CDC guidance for clinicians does not recommend antibiotics for mild cases, says they can be used for moderate cases, and advises them for severe cases — which include any bloody diarrhea (dysentery) (CDC Yellow Book).
  • Tests help find the cause when symptoms last or warning signs appear: for example, stool tests can show blood, infection and inflammation, and blood tests can show anemia or celiac disease (NIDDK). Doctors may treat the cause of chronic diarrhea — for example Crohn’s disease, irritable bowel syndrome or ulcerative colitis — or suggest avoiding foods that trigger a food allergy or intolerance (NIDDK). Severe dehydration may need IV fluids in a hospital (NIDDK).

3. Gas and bloating

Your doctor may suggest swallowing less air (skipping gum, hard candy, fizzy drinks and straws, eating slowly), smaller and more frequent meals, and cutting back on foods that bother you (NIDDK). Common culprits include beans, peas and lentils, cruciferous vegetables such as broccoli and cauliflower, some fruits and juices, dairy products, whole grains, and sweeteners ending in “-ol” such as sorbitol. Your doctor may ask you to keep a diary of what you eat and drink and your gas symptoms to find your own triggers (NIDDK). If a condition such as celiac disease, lactose intolerance or irritable bowel syndrome is behind it, a special diet — gluten-free, lower in lactose, or a short trial of a low-FODMAP diet for IBS — may help; a registered dietitian can guide you (NIDDK). Over-the-counter products, such as lactase for lactose intolerance, and prescription medicines for some causes are also options (NIDDK).

4. Accidental bowel leakage

Simple treatments — diet changes, medicines, bowel training and pelvic floor exercises — can improve symptoms by about 60 percent and stop leakage in about 1 in 5 people (NIDDK).

  • Treat the stool problem: medicines for diarrhea, or fiber, fluids and laxatives if constipation is behind the leaks (NIDDK). Fiber such as psyllium can thicken loose stool (MedlinePlus).
  • Bowel training — going at set times, such as after meals; it can take weeks to months to help (NIDDK).
  • Pelvic floor (Kegel) exercises strengthen the muscles of the anus, pelvic floor and rectum (NIDDK). A doctor, nurse or pelvic floor therapist can check you are using the right muscles (NIDDK); see the pelvic floor section of our Bladder Problems guide.
  • Biofeedback therapy uses devices to help you learn these exercises, sense when the rectum is filling and control strong urges; it can be more effective than learning the exercises on your own (NIDDK).
  • If those aren’t enough: sacral nerve stimulation, a vaginal balloon device for women, bulking injections, prescription medicines for the underlying cause, or surgery such as repair of a torn anal sphincter (NIDDK).

What it costs

  • Colonoscopy: without insurance, about $1,250–$4,800, with about $2,500 a useful all-in planning figure; ambulatory surgery centers tend to run about $1,250–$2,500 and hospital outpatient departments about $2,500–$4,800 or more (The Pricer). Ask whether a quote includes the doctor, facility, anesthesia and pathology. A colonoscopy done to look into symptoms is diagnostic, not preventive screening, so the $0 screening rules don’t apply (The Pricer); see the screening section for when it can cost $0.
  • Pelvic floor physical therapy or biofeedback: a cost guide puts physical therapy at about $50–$350 or more a session without insurance; with insurance, typically a $10–$75 copay or 10%–50% coinsurance (CostHelper). Medicare Part B covers medically necessary outpatient physical therapy when your provider certifies you need it; you pay 20% of the Medicare-approved amount after the deductible (Medicare.gov).
  • Prescription medicines and other procedures: cost estimate being researched.

Find a medical doctor in our directory

Approach 3 of 6

Acupuncture

The best evidence for acupuncture in bowel problems is for long-lasting functional constipation — constipation without a disease causing it. We found little good evidence for diarrhea, gas or bowel leakage.

What the research says

  • The largest trial: a 2016 study at 15 hospitals in China (1,075 adults with chronic severe functional constipation) compared 28 sessions of electroacupuncture over 8 weeks with a sham version at non-acupuncture points. The real treatment added about one more complete bowel movement a week compared with sham, and the difference lasted through 12 weeks of follow-up. About 31% of the electroacupuncture group averaged three or more complete bowel movements a week during treatment, compared with 12% of the sham group. Side effects were infrequent and mild. Limits: acupuncturists couldn’t be blinded, and longer-term results weren’t studied (Liu et al., Annals of Internal Medicine, 2016).
  • A 2020 review of 6 studies (1,457 people) also favored electroacupuncture over sham, with no serious side effects reported, but noted that the effect faded somewhat after treatment ended and that studies differed in points, needle depth and frequency (Zhang et al., 2020).

If you want to try it, see a provider first to rule out other causes — especially if you have any warning sign above — and use it alongside, not instead of, fiber, fluids and activity.

Safety

Relatively few complications have been reported, but improperly delivered acupuncture can cause serious harm such as infections. The FDA requires needles to be sterile and single-use, and most states license acupuncturists (NCCIH).

What it costs

Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics charge about $50–$90 (The Pricer). Medicare Part B covers acupuncture only for chronic low back pain, so it won’t pay for bowel treatment (Medicare.gov).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

A few plant-based products have real research behind them for bowel problems; most others don’t. We don’t list doses or brands — follow the label or your provider’s advice.

Psyllium and other fiber supplements

  • Psyllium is a bulk-forming laxative: it absorbs liquid in the intestines and swells to form a soft, bulky stool that is easier to pass (MedlinePlus).
  • A 2022 review of 16 trials (1,251 adults with chronic constipation) found that 66% of people responded to fiber supplements, compared with 41% on control treatments, and that fiber made stools more frequent and softer. Psyllium was among the fibers with clear effects, and benefits showed up more with at least 4 weeks of use. Flatulence was more common with fiber, and the studies varied considerably (van der Schoot et al., 2022).
  • Take it with plenty of liquid as the label directs. Call a doctor right away for trouble breathing, trouble swallowing, stomach pain, rash or vomiting. Psyllium can affect some medicines, such as digoxin, aspirin and nitrofurantoin, so ask a pharmacist how far apart to take them, and tell your provider if you have diabetes, kidney disease, rectal bleeding, a bowel blockage or trouble swallowing. Don’t use it for longer than a week unless your doctor says to (MedlinePlus).

Senna

Senna is a stimulant laxative used short-term to treat constipation (MedlinePlus). Don’t take it for more than a week without talking to your doctor: frequent or continued use can make you dependent on laxatives. Adults 65 and older usually shouldn’t use it long-term, and rectal bleeding means stop and call your doctor (MedlinePlus). NIDDK advises using stimulants only for severe constipation or when other treatments haven’t worked (NIDDK).

Probiotics

  • The evidence is mixed. NCCIH notes some evidence of benefit for constipation in adults and a small benefit in older people, and moderately certain evidence that probiotics can lower the risk of C. diff diarrhea in people taking antibiotics. But in most cases we still don’t know which probiotics help, how much, or who is most likely to benefit (NCCIH).
  • For diarrhea in general, many doctors and professional societies don’t believe the evidence supports probiotics for treatment or prevention (NIDDK).
  • Safety: the risk of harm is greater in people with severe illness or a weakened immune system, and some products have contained microbes not listed on the label. Talk with your provider first, especially if you have health problems (NCCIH).

Peppermint oil

Research on peppermint oil focuses mainly on irritable bowel syndrome: a 2022 review found enteric-coated capsules eased overall IBS symptoms and belly pain better than placebo, but with more side effects, mostly mild reflux and indigestion (NCCIH). We found no good evidence that it treats constipation, diarrhea or gas on their own. Taken by mouth, it can cause heartburn, nausea, belly pain and dry mouth (NCCIH) — worth knowing if you also have acid reflux.

Safety with any herbal product

Supplements can interact with medicines, and “natural” doesn’t always mean safe (NCCIH). If you take any medicine, talk with your provider before using an herbal product (NCCIH), and don’t treat warning signs such as bleeding, weight loss or a lasting change in bowel habits on your own.

Approach 5 of 6

Massage therapy

Abdominal massage — techniques such as circular massage of the belly, acupressure or aromatherapy massage — has been studied mainly for constipation (Huang et al., 2025).

What the research says

  • A 2025 review of 23 studies (1,431 adults with chronic constipation) found abdominal massage increased bowel movements by about one and a half a week, shortened the time stool takes to pass through the gut, and eased constipation symptoms compared with control groups. It did not reduce laxative use. The studies varied widely and included some that were not randomized, so the results should be read with caution (Huang et al., 2025).
  • An earlier review found only four controlled trials, none free of design flaws, and called massage “promising” but said more rigorous trials were needed (Ernst, 1999).

We found no good evidence that massage treats diarrhea or bowel leakage. A belly that is suddenly very painful, or rigid and hard to the touch, needs urgent medical care, not massage (MedlinePlus).

Safety

The risk of harm from massage appears low, but rare serious side effects such as a blood clot, nerve injury or bone fracture have been reported, some involving vigorous techniques or people at higher risk such as older adults (NCCIH). Tell your therapist about your health conditions.

What it costs

Clinics, gyms and spas charge about $30–$50 for 30–45 minutes and $50–$90 for 45–60 minutes (CostHelper).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you turn your provider’s advice into steady daily habits and track what helps. These steps support — but don’t replace — a check-up, especially if any warning sign above appears.

Fiber, a little at a time

Fluids

Drink water and other liquids, such as clear soups, to help fiber work and soften stools. Ask a health care professional how much is right for your size, health and activity (NIDDK).

A regular toilet routine

Move every day

Regular physical activity may help relieve constipation (NIDDK). Long hours sitting or lying down can let stool build up and contribute to leakage, especially in frail older adults (NIDDK).

A food and symptom diary

Write down what you eat and drink, when symptoms happen, and which foods seem to make them worse, then take the notes to your doctor (NIDDK, NIDDK). For gas, eating slowly, sitting down to eat and skipping gum and fizzy drinks can help (NIDDK).

Preventing diarrhea: clean hands, safe food

  • Wash your hands with soap and clean running water for at least 20 seconds, especially after using the toilet, before, during and after preparing food, before eating, and before and after caring for someone with vomiting or diarrhea (CDC). Hand sanitizer does not work well against norovirus, so use soap and water (CDC).
  • Clean, separate, cook, chill: keep hands and surfaces clean, keep raw meat, poultry, seafood and eggs away from other foods, cook to a safe temperature using a food thermometer, and refrigerate perishable food within 2 hours (1 hour if it’s above 90°F) (CDC).
  • If you are sick with vomiting or diarrhea, don’t prepare food or care for others until at least 2 days after symptoms stop (CDC).

Living well with bowel leakage

Use the toilet before leaving home, carry a bag with cleanup supplies and a change of clothes, know where restrooms are, and use absorbent pads or disposable underwear. Washing and drying the skin after a bowel movement and using a moisture-barrier cream can ease soreness (NIDDK). A coach can help you prepare to raise it with your provider — talking openly is an important step toward treatment (NIDDK). If you are 45 or older, a coach can also help you keep track of when your next colorectal cancer screening is due.

Another approach

Colorectal cancer screening

Colorectal cancer almost always starts from growths called polyps. Screening can find polyps so they can be removed before they turn into cancer, and find cancer early, when treatment works best (CDC). Polyps and early cancer often cause no symptoms, which is why regular screening matters (CDC). Colorectal cancer is the third leading cause of cancer death for both men and women in the U.S. (USPSTF, 2021).

Who should be screened

  • Ages 45 to 75: the U.S. Preventive Services Task Force recommends screening for all adults aged 50 to 75 (an “A” grade) and, since its 2021 update, for adults aged 45 to 49 (a “B” grade) (USPSTF, 2021).
  • Ages 76 to 85: a personal decision with your clinician, based on your overall health, past screening and preferences; people never screened before are more likely to benefit (USPSTF, 2021).
  • The recommendation is for people without symptoms and at average risk. You may need to start earlier or test more often if you have inflammatory bowel disease (Crohn’s disease or ulcerative colitis), a personal or family history of colorectal cancer or polyps, or a genetic syndrome such as Lynch syndrome. If you have symptoms, doctors use diagnostic tests to find the cause rather than screening (CDC).

Your options

  • Stool tests at home: the fecal immunochemical test (FIT) or the guaiac-based fecal occult blood test, once a year; or the stool DNA test (FIT-DNA), every 3 years (CDC).
  • Colonoscopy: every 10 years for people not at increased risk. The doctor checks the whole colon and can remove most polyps during the test (CDC).
  • Flexible sigmoidoscopy (the lower part of the colon) every 5 years, or every 10 years with a yearly FIT; or CT colonography (“virtual colonoscopy”) every 5 years (CDC).
  • A positive result on a stool test, sigmoidoscopy or CT colonography means you need a colonoscopy to finish the screening. Talk with your doctor about which test is right for you (CDC).

What it costs

  • Marketplace and most private plans (ACA): colorectal cancer screening for adults 45 to 75 is on the list of preventive services that all Marketplace plans and many other plans must cover without a copayment or coinsurance, even before you meet your deductible, when you use an in-network provider. Coverage may vary, and $0 isn’t guaranteed in every case (HealthCare.gov).
  • What’s included: federal guidance says plans may not charge cost sharing for items that are part of a screening colonoscopy — including a required specialist visit beforehand, prescribed bowel-prep medicine, anesthesia, polyp removal and the pathology exam — or for the follow-up colonoscopy after a positive stool test, sigmoidoscopy or CT colonography (U.S. Departments of Labor, HHS and Treasury, 2022).
  • Medicare: Part B covers screening colonoscopy (every 10 years if you aren’t at high risk, every 2 years if you are, with no minimum age), and you pay nothing if your provider accepts assignment — but if a polyp or other tissue is removed, you pay 15% of the Medicare-approved amount for the doctor’s services, plus a 15% facility coinsurance in a hospital outpatient department or surgical center. The follow-up colonoscopy after a positive stool or blood-based screening test is covered as screening (Medicare.gov).
  • Medicare also covers, at no cost when your provider accepts assignment: a fecal occult blood test once a year from age 45 with a referral (Medicare.gov); a stool DNA test every 3 years for people 45 to 85 at average risk and without symptoms (Medicare.gov); and a blood-based screening test every 3 years, where available, under the same conditions (Medicare.gov).
  • Without insurance: a colonoscopy costs about $1,250–$4,800 (The Pricer). If you pay yourself, ask for an all-in price that covers the doctor, facility, anesthesia, polyp removal and pathology (The Pricer).

Still being researched: Chiropractic. We add each approach once its costs and results are sourced. Are you a practitioner with experience treating Bowel Problems? Tell us.

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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