Constipation is the passing of hard, dry bowel motions (stools) that may be infrequent or difficult to pass. The most common causes of constipation include a change in routine, not enough fibre in the daily diet, not enough fluids and lack of exercise.
See your doctor for diagnosis and treatment. It is important not to over-treat constipation with laxatives in place of seeking medical advice.
Symptoms of constipation:
less frequent than usual need to open the bowels
hard, dry stools that may be painful to pass
straining to pass a bowel motion
the sensation afterwards that the bowel hasn’t fully emptied
bloated abdomen
abdominal cramps
In some cases, constipation is caused by more serious illnesses and events, including tumours and systemic diseases.
Lifestyle factors that can cause constipation
A change in routine
Low-fibre diet
Insufficient water
Lack of regular exercise
A tendency to ‘put off’ going to the toilet
Some medications
Pregnancy
Advancing age
Illness
Complications of chronic constipation
Some of the complications of chronic constipation include:
Faecal impaction – the lower bowel and rectum become packed with faeces that the muscles of the bowels can’t push it out.
Faecal incontinence – an overfull bowel can result in involuntary ‘dribbling’.
Haemorrhoids – constant straining to open the bowel can damage the blood vessels of the rectum.
Rectal prolapse – the constant straining pushes a section of rectal lining out of the anus.
Urinary incontinence – the constant straining weakens pelvic floor muscles. This makes the involuntary passing of urine.
Diagnosis of constipation
The underlying reason for the constipation must be found. Diagnosis may include:
medical history
physical examination
detailed questioning about medications, diet, exercise and lifestyle habits
colonoscopy
Treatment for constipation
Treatment depends on the cause, but could include:
Removal of the impacted faeces – which may involve enemas, stool softeners and a short-term course of laxatives.
Dietary changes – such as increasing the amount of fibre in the daily diet.
More fluids – liquids help to plump out faeces. However, it is important to restrict the intake of diuretic drinks such as tea, coffee and alcohol.
Fibre supplements – these may be helpful if the person is reluctant or unable to include more wholegrain foods, fresh fruits or vegetables in their daily diet. As fibre supplements can aggravate or cause constipation, always check with your doctor or dietitian when using them.
Exercise – one of the many benefits of regular exercise is improved bowel function. Ideally, exercise should be taken every day for about 30 minutes.
Treatment for underlying disorder .
Laxatives – there are two main types: bowel stimulants and agents that increase the water content of the stool.
