Constipation is a common problem across Asia that many people don’t talk about due to embarrassment, but it affects millions and makes life uncomfortable. Experts from 11 Asian countries met to study why constipation happens so often in their regions and what’s stopping people from getting proper help. They found that constipation rates vary widely across Asia, from less than 2% in India to over 16% in Japan, with women and older adults affected most. The main problems are cultural shame around discussing it, different eating habits, and lack of access to proper testing and newer medicines. The experts recommend better education for doctors, more awareness for the public, and making newer treatments more available and affordable across Asia.

The Quick Take

  • What they studied: Why constipation is so common in Asian countries and what barriers prevent people from getting proper diagnosis and treatment
  • Who participated: Medical experts and specialists from 11 different Asian countries who met at a roundtable discussion in Bali in November 2024 to share their experiences and data
  • Key finding: Constipation rates in Asia range from 1.8% to 16.6% depending on the country, with women and elderly people affected most often. Many people don’t seek help because of embarrassment and cultural shame around discussing bowel problems
  • What it means for you: If you struggle with constipation in Asia, you’re not alone—millions face this issue. Better awareness and access to treatments are coming, but you may need to talk to your doctor about options beyond basic fiber and over-the-counter laxatives

The Research Details

This wasn’t a traditional research study where scientists test one thing on a group of people. Instead, it was a roundtable discussion—think of it like a meeting of the smartest experts in a room comparing notes. Doctors and specialists from 11 Asian countries gathered in Bali to share what they know about constipation in their regions. They looked at existing data about how many people have constipation, reviewed how doctors currently treat it, and discussed what problems they see in their daily practice.

The experts analyzed information from surveys about how doctors treat constipation differently across Asia. They also discussed the biggest obstacles people face when trying to get help, like cultural embarrassment, limited access to testing equipment, and expensive medicines. This type of expert discussion helps identify real-world problems that regular research studies might miss.

By bringing together specialists from multiple countries, the roundtable could see patterns and differences across the entire Asian region rather than just looking at one country in isolation.

This approach is valuable because constipation is often invisible in official health statistics. Many people don’t report it to doctors because they’re embarrassed, so the real problem is probably bigger than numbers show. By having experts from different countries share their experiences, the roundtable could identify common issues and unique challenges specific to Asian cultures and healthcare systems. This helps create solutions that actually work for Asian populations rather than just copying approaches from Western countries.

This report represents expert consensus rather than experimental proof. The strength comes from having specialists from 11 different countries sharing real clinical experience. However, the findings are based on expert opinion and existing data rather than new research testing specific treatments. The recommendations should be viewed as informed guidance that needs to be tested through future studies. The fact that it was published in a respected medical journal adds credibility, but readers should understand this is a starting point for improving care, not definitive proof that specific treatments work.

What the Results Show

The research revealed that constipation is much more common in some Asian countries than others. Japan has the highest rate at 16.6% of the population, while India has the lowest at 1.8%. Most countries fall somewhere in between. This huge difference suggests that diet, lifestyle, healthcare access, and how people report symptoms all play important roles.

Women and elderly people are affected more often than men and younger people across all Asian countries studied. This pattern is important because it means healthcare systems need to pay special attention to these groups. The experts found that many people with constipation never see a doctor about it. Instead, they buy laxatives from pharmacies or use traditional medicines without medical guidance. This self-treatment approach means doctors don’t know how big the problem really is, and people might not be getting the best help.

The roundtable identified that current diagnostic methods—the standard ways doctors identify constipation—may not work perfectly for Asian patients. The standard criteria were developed mainly based on Western populations, so they might miss some Asian patients or incorrectly diagnose others. Additionally, the equipment needed to properly test how the digestive system works (motility labs) is scarce across most of Asia, making it hard for doctors to diagnose complex cases.

The experts found that basic treatments like eating more fiber and using osmotic laxatives (gentle laxatives that work with water) are available and affordable across Asia. However, newer medicines that work differently—like prucalopride, linaclotide, lubiprostone, and elobixibat—are either very expensive or not available in many Asian countries. These newer drugs could help people who don’t respond to basic treatments, but cost and availability limit their use. Biofeedback therapy, a technique that teaches people how to have better bowel movements, is underused because there aren’t enough trained specialists and facilities to provide it. Cultural attitudes also play a role—many people feel too embarrassed to discuss constipation with healthcare providers, leading to delayed diagnosis and treatment.

This roundtable builds on previous research showing that constipation is common worldwide, but adds important new information specific to Asia. Earlier studies suggested constipation affects 10-15% of people globally, but this report shows the range in Asia is actually wider (1.8-16.6%), indicating that regional factors matter more than previously thought. The finding that cultural shame and self-treatment are major barriers aligns with previous research in other regions, but this report emphasizes how strong these barriers are specifically in Asian countries. The recommendation to develop Asia-specific diagnostic criteria is new and reflects growing recognition that one-size-fits-all medical approaches don’t work well across different cultures.

This report is based on expert opinions and existing data rather than new experimental research, so the recommendations are informed guidance rather than proven facts. The sample size of experts wasn’t specified, so we don’t know exactly how many specialists participated. The data on constipation rates comes from different studies using different methods, which might make comparisons between countries less reliable. The roundtable didn’t conduct new research to test whether their recommendations actually work better than current approaches. Additionally, the report focuses on barriers and problems but provides less detail about specific solutions and how to implement them. Finally, some Asian countries may not have been equally represented, which could mean the recommendations don’t apply equally well to all Asian populations.

The Bottom Line

If you have chronic constipation in Asia, start with basic approaches: eat more fiber-rich foods, drink plenty of water, and exercise regularly (moderate confidence). If these don’t work after several weeks, talk to a doctor about osmotic laxatives like polyethylene glycol (moderate confidence). For people who don’t respond to basic treatments, newer medications may help, but they’re often expensive—discuss options and costs with your doctor (low to moderate confidence). Consider asking your doctor about biofeedback therapy if you have difficulty with bowel movements, though availability may be limited (moderate confidence). Be honest with your healthcare provider about your symptoms despite any embarrassment—they’ve heard it before and can help better when they have complete information (high confidence).

Anyone in Asia experiencing constipation lasting more than a few weeks should pay attention to this research. Healthcare providers and policymakers should especially care because the report highlights gaps in diagnosis and treatment that need fixing. Women and elderly people should be aware that they’re at higher risk and shouldn’t dismiss constipation as normal aging. People who’ve tried basic treatments without success should know that newer options exist, even if they’re not yet widely available. Healthcare systems and governments should care because improving constipation care could reduce overall healthcare costs and improve quality of life for millions. People should NOT assume they have constipation just because they don’t have daily bowel movements—normal frequency varies widely.

Basic lifestyle changes like adding fiber and increasing water intake may show improvement within 1-2 weeks, though full benefits often take 2-4 weeks. Over-the-counter laxatives typically work within hours to days. If you try basic approaches for 4 weeks without improvement, that’s when you should see a doctor. Newer prescription medications may take 1-2 weeks to show effects. Biofeedback therapy typically requires multiple sessions over several weeks to months to be effective. Don’t expect overnight fixes—constipation management usually requires patience and finding what works for your individual body.

Want to Apply This Research?

  • Track bowel movement frequency (times per week), consistency using the Bristol Stool Scale (1-7 scale), and any symptoms like straining or incomplete evacuation. Record daily fiber intake in grams and water consumption in cups. Note any medications or supplements taken. This data helps you and your doctor identify patterns and measure improvement over time.
  • Set a daily reminder to drink 8 glasses of water and eat one high-fiber food (like beans, whole grains, or vegetables). Use the app to log these actions and track your bowel movements. Start with small fiber increases to avoid bloating, gradually building up over 1-2 weeks. Set a reminder for consistent bathroom time each day, ideally 15-30 minutes after meals when your digestive system is most active.
  • Weekly review of your bowel movement patterns and symptom trends. Monthly check-ins comparing your current week to the previous month to see if lifestyle changes are working. If no improvement after 4 weeks, use your app data to share with your doctor—this objective information helps them recommend next steps. Continue tracking even after improvement to catch early signs of constipation returning.

This summary is based on expert consensus from a medical roundtable discussion and should not replace professional medical advice. Constipation can sometimes indicate underlying health conditions requiring medical evaluation. If you experience sudden changes in bowel habits, severe pain, blood in stool, or constipation lasting more than 3 weeks, consult a healthcare provider immediately. Pregnant women, people with certain medical conditions, and those taking specific medications should discuss constipation management with their doctor before making changes. The recommendations in this article are general guidance; your individual treatment plan should be personalized by a qualified healthcare professional who knows your complete medical history.