What is constipation?
There is a wide variation in “normal” bowel habits and for some individuals this is three times a day and for others three times a week. The use of the term “constipation” can cover a variety of symptoms for both the public and health care professionals. These can include
- infrequent passage of stool (fewer than three bowel movements a week)
- passing firm or hard stool
- straining or difficulty when you trying to have a bowel movement
- feeling as though you haven’t fully emptied your bowels
- pain or discomfort in your tummy (abdomen)
Constipation is common and usually self-limiting. If you symptoms do not resolve you seek medical attention.
Common causes for constipation include
- Not eating enough fibre/roughage
- Poor fluid intake
- Lack of exercise
- Medications such as painkillers, antidepressants or iron tablets
- Medical conditions such as underactive thyroid, depression and Parkinson’s.
Constipation can also occur because of more serious conditions affecting the bowel such as bowel cancer or a narrowing due to diverticular disease.
Some people still suffer with constipation despite having a high fibre diet, drinking plenty of fluid and not taking any medication that can cause constipation. This is known as functional constipation and may be due to an underactive bowel. Most cases occur in women, often starting in childhood/adolescence and continuing into adult life.
During your appointment, your Consultant will ask questions regarding your symptoms, bowel habit, diet, medical and medication history. This will be followed by an examination including an examination of the back passage.
As constipation can sometimes be a symptom of an underlying bowel condition you may require further investigation of your bowel by a colonoscopy.
Treatment for constipation will be tailored depending on the cause and severity of your symptoms and may include:
- Increasing the amount of fibre/roughage in your diet
- Drinking more fluids.
- Bulk-forming laxatives work by bulking up your faeces and the water they hold on to.
- Osmotic laxatives work by increasing the amount of water in your bowel, making stool softer and easier to pass.
- Stimulant laxatives work by stimulating the muscles in your bowel to contract more often and with more force.
- New effective tablet based laxatives for chronic constipation are now available. These are usually only prescribed if you’ve tried at least two different types of laxatives for at least six months and they haven’t worked.
Biofeedback / Bowel retraining
- Often helpful for people who have difficulty with evacuating stool, straining and the sensation that they have not fully emptied their bowels.