What is constipation?

“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

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.

How is constipation diagnosed?

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.

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.

How is constipation treated?

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.

Bladder and Bowel UK produces a range of useful information on bowel and bladder problems in adults and children.

The NBRC leads the UK's largest trial into chronic constipation
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The National Bowel Research Centre is coordinating the largest programme of research into the treatment of chronic constipation in the NHS in the UK.

The aim is to determine the most effective treatments for improving constipation symptoms and quality and of life for individuals living with chronic constipation. The research will address the acceptability of these treatments to patients, cost of treatments to the NHS and also help to reduce variations in treatment across the country.

Constipation is defined as chronic when symptoms last for 6 months or more, and where simple lifestyle measures such as increasing fluids and exercise, changes to diet and use of medication such as laxatives have failed to make a difference.

The programme includes three trials of non-drug therapies and will be recruiting around 800 people in over 10 NHS centres nationwide.