Facts about constipation
You need to drink approximately 6-8 glasses (1.2 litres) of water or other fluids a day to avoid becoming dehydrated and help keep your stools soft. Whilst good hydration can be used to prevent constipation, increasing your fluid intake by more than the recommended daily amount may not always relieve constipation if it has already occurred. This is because when water reaches the bowel most of it is used to hydrate the body and not retained by the stool. In essence, water hydrates the body before it can hydrate the bowel.- Constipation is a common condition - constipation can occur in babies, children and adults, and affects twice as many women than men. Approximately 40% of pregnant women experience constipation during their pregnancy. For example, in pregnancy your body produces more of a hormone called progesterone which acts as a muscle relaxant and slows down the action of muscles that line the bowel. Pregnant women should consult their doctor or pharmacist before using any medicines.
- The most common causes of constipation include:
In rarer cases constipation can be a symptom of another underlying medical condition such as Irritable Bowel Syndrome (IBS), inflammatory bowel disease, an underactive thyroid gland, bowel cancer, and other conditions (see below).
There are two main types of constipation:
- Acute constipation: This is constipation that occurs suddenly and is usually a reaction to a change in diet or routine, stress/anxiety or hormonal changes such as a period starting. Your body may normally return to its usual rhythm within a few days, but laxatives such as a product from the Dulcolax® range may be needed.
However, in some cases it can also be a symptom of a physical obstruction somewhere in your intestines so if you experience stomach pains or see traces of blood or mucus on your stools, or cannot pass wind, consult professional medical advice immediately.
- Chronic constipation: This is when constipation becomes a persistent problem which usually needs the intervention of your doctor. The bowel is not able to function efficiently and this can be due to a variety of factors including stressful lifestyle, sedentary/inactive lifestyle, poor diet or as a side effect of medication prescribed for high blood pressure, depression or chronic pain. If your constipation persists for more than a week or reoccurs after treatment, it’s important for you to get medical advice.
The best foods to help constipation are those rich in dietary fibre. These are found in cereal foods such as:
- Wholemeal bread
- Brown rice
- Oats
- Beans and pulses
- Breakfast cereals
- Nuts
- Lentils
- Fruit and vegetables
Fibre is important because it absorbs water and increases the bulk of waste matter within the bowel which helps digested food move through the body more easily. Around half of people with constipation find eating more fibre can help ease their symptoms. You should aim to eat 18-30g of fibre a day. Most people in the UK eat far less – the average for women is 12.6g per day and 15.2g a day for men.
Aim to include a high fibre food at each meal, eat five portions of fruit and vegetables a day and sprinkle more bran on your food. However, if you don’t eat much fibre normally you should increase it gradually to help avoid bloating and wind.
- Constipation can also be a symptom associated with:
- Irritable Bowel Syndrome (IBS): This is the medical name for a group of symptoms involving abnormal bowel habits including diarrhoea and constipation (sometimes alternating between the two) as well as abdominal pain, bloating, abdominal swelling and a feeling of incomplete emptying of the bowels. For more information go to www.ibs-relief.co.uk
- Periods: Some women find they get constipated around the time of their monthly menstrual period due to hormonal changes which affect the gut.
- Peri-menopause/menopause: Older women who are approaching or going through the menopause can also experience constipation due to hormonal changes.
- Constipation symptoms can include:
- A change in frequency – you have started to go less often or feel that you haven’t completely emptied your bowel: There are no set rules on how often you should go to the loo – the normal range is between three times a day to three times a week. What’s important is noting any changes in what is normal for you.
- Consistency changes – hard, dry stool: The stool can be unusually small or large and sometime resemble rabbit droppings. This may cause straining when going to the loo.
- Feeling that you haven’t completely emptied your bowel.
These symptoms may also be accompanied by bloating, nausea and stomach cramps, headaches and a general sluggish feeling.
- Complication associated with chronic/severe constipation include:
- Haemorrhoids: These are swollen veins in the rectum (bottom) which can protrude outside if big enough, and can be caused by too much straining when going to the loo. They can sometimes cause bleeding. If you suspect you have haemorrhoids, please consult your pharmacist or doctor.
- Faecal impaction: This happens when your bowel gets blocked. This can be treated by a doctor. If you suspect you have faecal impaction, you should consult your pharmacist or doctor.
- Prolapse: Part of the rectum or womb may protrude as a result of excessive straining and muscle weakness/strain and may require surgery to repair the damage. If you suspect you have a prolapse, please consult your pharmacist or doctor.
- Occasionally constipation can be a sign of something more serious. This is unusual, but it can be a symptom of:
- Diverticular disease: This is a condition caused by small pouches or bulges developing in the lining of the small bowel as the muscles get weaker with age.
- Inflammatory bowel disease (IBD): This is a disease which causes the intestines to become inflamed.
- Underactive thyroid: Constipation can also be a symptom of an underactive thyroid gland. The thyroid gland controls metabolism and if it doesn’t produce enough of certain hormones the body needs, your metabolism can slow down causing a range of symptoms including constipation, lethargy, feeling cold, thinning hair and a croaky voice.
- Bowel cancer: If constipation is a change in your normal bowel habit and you’ve had it for more than six weeks and have other symptoms such as blood in your stool, unexplained weight loss or extreme tiredness – get checked out by your doctor. As with all cancers, the earlier bowel cancer is diagnosed the better the chance of a positive outcome, so it is important you don’t delay in seeing your doctor. Don’t be put off because of embarrassment!
- Parkinson’s disease: This is a neurological condition which affects the co-ordination of body movements.
- Multiple Sclerosis (MS): This is a degenerative condition which affects the nervous system.
- Damage to the spinal cord: Injuries can affect the nerves leading to the bowel.
If you suspect you have any of these, talk to your pharmacist or doctor.
