Constipation is a relative term.
There is wide variability is what is considered normal patterns of bowel elimination. While some healthy people may have consistently soft or near runny stools others may have consistently hard firm stools but no difficulty in passing them. When the stool is hard, infrequent, and requires significant effort to pass, the person has constipation. Constipation may cause discomfort with passage of stools, and passage of large caliber stools may tear the mucosal membrane of the anus, especially in children, causing bleeding and the possibility of an anal fissure . Constipation can be caused by changes in diet, decrease in physical activity , lack of toilet facilities, behavior and psychological problems, dehydration , diseases of the bowel, neurological diseases, congenital diseases, medications, and many other causes.