Constipation

What is constipation?

Constipation is when your bowel movements are less frequent and more difficult than normal. Normal bowel habit can vary with each individual and this can be anything from 3 stools per day to 3 per week. A stool should be solid but moist and easy to pass.

Constipation is a common problem, which most of us will experience at some point in our lives. However, constipation is more common in the elderly and during pregnancy.

What causes constipation?

Constipation can be caused by certain types of medicine such as, certain antidepressants, iron supplements, painkillers, cough medicines (containing codeine) or antacids (containing aluminium or calcium for indigestion).

Constipation is more likely to occur if you have a diet low in fibre, yet high in fats, found in foods such as cheese, eggs and meat. Good sources of fibre include fresh fruit and vegetables, brown bread, brown rice and potatoes with their jackets.

Constipation can also occur if you don’t empty your bowels when you need to, have a change in diet or when you travel abroad. On rare occasions constipation may also be a side effect of an underlying illness. Illnesses that can cause long term constipation include irritable bowel syndrome,strokes, diverticular disease and colon cancer.

What are the symptoms of constipation?

Constipation can be uncomfortable but it is rarely anything to worry about. The main symptom of constipation is the lack of bowel movements from what you are used to. Then when you do go finally manage to go to the toilet you find you are straining and feel like your bowel has not been completely emptied. The stools when they do come, are usually hard and dry and are often described as ‘rabbit droppings’.

Other symptoms you may experience with constipation may include a bloated stomach and flatulence. Women may find sexual intercourse is painful if the bowel is very full.

If constipation carries on it can lead to problems such as haemorrhoids.

How can I avoid getting constipation?

To avoid getting constipation you should stick to a healthy balanced diet, get regular exercise, drink plenty of water and avoid foods that might make your constipation worse, such as eggs.

What is the treatment for constipation?

Constipation can usually be treated at home. Try the following to ease the symptoms:

• Eat a healthy balanced diet with lots of high fibre foods, such as wholemeal bread, pasta, bran cereals, fruit and vegetables. Prunes and beans are especially good.
• Try to drink at least 8-10 glasses of water or other fluids a day. Fruit juices are very good to drink.
• Get plenty of exercise.
• Try to get in a regular pattern of bowel movements, try to go the first hour after breakfast.
• Always go to the toilet when you need to and avoid straining too much, sit there for at least 10 minutes, regardless of whether you manage to go.
• Rather than use laxatives, try taking 1-2 dessertspoonfuls of vegetable oil.
• Take fibre supplements, such as Fybogel™, which comes as a powder and is mixed up, then drank.

Use laxatives as a final resort, as long term use of laxatives can damage nerve cells in the colon and the colon will begin to rely on laxatives to bring on bowel movements.

If none of the above methods work ask your local pharmacist for advice.

Do I need to go and see a doctor?

Constipation will usually improve on its own or after you treat yourself (see above). However, you should go and see your doctor if:

• You have severe or persistent constipation.
• There is any blood in your stools. (We offer a bowel disorders test on this website, which looks for the presence of blood in stools)
• You are losing weight without knowing why.
• Your bowel movements are painful.
• You have pain in your lower abdomen.

When you visit your doctor he/she may want to perform a general examination and may examine your abdomen and the back passage with a gloved finger.

If the doctor is unsure about the cause of constipation then he/she may want to check whether the colon is normal by arranging further tests. Tests you may have could include:

• Barium enema x-ray – a liquid called barium is put into the bowel via the rectum and shows up on an x-ray, allowing the doctor to see any abnormalities.
• Sigmoidoscopy – a thin tube is passed through your back passage to look inside the colon.
• Colonoscopy – similar to a sigmoidoscopy, but the tube is longer and more flexible.