• Anal Itching
• Anal Pain
• Bowel Cancer
• Constipation
• Diverticular Disease
• Faecal Incontinence
• Haemorrhoids
• Rectal Prolapse

Constipation

Description

"Normal" bowel habit depends on the individual. For some this can mean opening their bowels 3 times a day, for others 3 times a week. Common causes of constipation are:

• A diet low in roughage i.e. lacking fruit and vegetables

• Lack of fluid intake

• Lack of exercise

• Medications

• Ignoring the urge to "open your bowels"

• Illness

• Changes in everyday routines i.e. post surgery

Symptoms

Constipation is not a disease, it is a common problem and many people will experience this at some stage in their life. It can be more widespread in:

• the elderly

• pregnant women

• people who are immobile or confined to bed

• People taking certain medications (your GP or pharmacist can advise you further)

If you open your bowels less than 3 times a week, have difficulty passing "stools" or pass very hard stools these are signs of constipation.

Diagnosis

Diagnosis is fairly straightforward as you will have opened your bowels less than 3 times in a week, experience difficulty, including straining and taking a long time on the loo passing stools and you may be passing very hard stools.

IMPORTANT
Never hesitate to seek medical advice to ensure you receive treatment / intervention for your symptoms. Should you notice any bleeding or changes in your usual bowel pattern please visit your GP promptly because it may mean that you have a different bowel problem that will require tests.

Treatment

Treatment will be specific to you as an individual depending on the cause and severity of your problem. However, often simple measures will help.

• Try to eat more fruit, vegetables and other foods that are rich in fibre (wholemeal bread, beans and nuts).

• Make sure you eat regularly and do not go for long periods without food

• Drink enough water or other fluids. (equivalent to 6 glasses of water a day)

• Exercise regularly

• Listen to your body and when you get the urge to open your bowels always try to make time to respond and go to the toilet.

Try these measures first before you reach for laxatives or 'opening 'medicine. Small changes in your diet and lifestyle can often remedy the problem without the need for any medicine.

Laxative medicine used for a long time can make the bowel more sluggish and less likely to work effectively on its own.

Outcomes and further sources of support

Although a common problem, chronic constipation can lead to haemorrhoidal bleeding, rectal or womb prolapse (where a part of the body moves from its normal position), anal fissures, colonic obstruction, ulcers, hernia, incontinence (from straining) or a build up of hard faeces in the rectum leading to liquid faeces (like diarrhoea) leaking around the blockage.

Some women find that when they strain it does not reach as far as their pelvis. This is known as under-active bowels and may require the muscles to be retrained to work properly.

Some people find that they become dependent on laxatives and their colon may be unable to function without them. This is why laxatives should only be taken as a temporary measure.

The information on these pages is reproduced from material put together by the Colorectal Development Unit at the Royal London Hospital, part of Barts and the London NHS Trust. An information leaflet prepared by the Colorectal Development Unit, Barts and the London NHS Trust will soon be available to download here.