Constipation

Constipation means having a hard, dry bowel motion (faeces) that is difficult to pass. It may cause straining, pain and discomfort. There may be slight bleeding from a small tear in the anus/rectum.

Constipation is common, affecting one in five people. Everyone has different toilet habits. Some people use their bowels a couple of times a day, some once every three days. 

As we get older most of us can expect to go less frequently. You are not constipated unless your bowel habits change. 

What causes constipation? 

There are some common causes of constipation.

• Not drinking enough water
• A diet low in fibre (roughage)
• A lack of exercise
• Waiting too long to go to the toilet
• Pregnancy
• Older age
• Medications including strong pain killers or long term use of laxatives
• Chronic illness – including certain bowel conditions and depression
• Changing routine – travel/work hours
• A recent operation. 

What are the symptoms?

• Straining and pain on passing a hard bowel motion
• No bowel movement for several days
• Cramping stomach pains
• Bloating and flatulence
• Not feeling hungry/weight loss
• Nausea
• General feeling of ill health
• Minor bleeding from a tear in the skin around the anus (outside of the anus/rectum). 

Treatment 

There are a few options, and your doctor will choose the right one for you.

• Laxatives such as prune juice, Movicol, Metamucil, Lactulose, Coloxyl, and liquid paraffin help to soften the bowel motion. These are taken by mouth (orally)
• Suppositories such as glycerine or Durolax. These are special ‘tablets’ which are inserted into rectum (the anus)
• Enemas such as Microlax, a special liquid which is inserted into the rectum. 

Some people need only one type of medication to help with their constipation, others may need a combination. Often, medications are only needed for a short time before the body’s natural bowel habits are restored and it becomes easier to pass bowel motions again. Occasionally it is necessary to use medication for a longer time and your doctor will discuss this with you. 

Home care 

There are some simple measures that can help combat constipation.

• Drink plenty of water
• Slowly increase the amount of fibre you eat (such as cereals, wholegrain bread, vegetables and fruit). There is little fibre in most ‘junk’ foods
• Exercise more – begin by going for a brisk 30-minute walk every day, five days a week and increase this as you get fitter
• Set aside enough time to go to the toilet
• Go to the toilet when you feel the urge. Do not ‘hold on’
• Review any medications with your local doctor or pharmacist
• See your local doctor or health-care professional if you:
  • Have bowel motions that contain blood
  • Experience bloating, vomiting or stomach pain
  • Increase your intake of fibre and fluids but your constipation does not improve

What to expect 

While constipation can cause discomfort, most people can be treated with simple measures. A few people may need further tests to look for underlying health problems. 

If constipation is ongoing it can lead to haemorrhoids or a hernia. If the bowel becomes too full this may lead to a bowel obstruction that may need hospital treatment. 

Prevention 

A high fibre intake is a good lifelong habit for everybody. Combine this with plenty of fluids and daily exercise. Go to the toilet regularly, especially when you feel the urge to.