What is constipation?
Constipation describes a range of problems passing stool such as stools that are too hard, too dry or too small, stools that are difficult to pass and infrequently passing stools.
Constipation is a very common problem that affects people of all ages. Most people only have constipation for a short time, but some people will have chronic constipation.
What are the symptoms of constipation?
The symptoms of constipation are:
- having to sit on the toilet for much longer than usual
- straining to pass a motion
- passing hard, lumpy, dry or small stools, sometimes with pain
- feeling like your bowel isn’t empty after going to the toilet
- needing to pass stool less often than usual (e.g. less than three times per week)
- feeling bloated
- abdominal cramps.
What causes constipation?
There are several things that contribute to developing constipation. They include:
- not eating enough fibre (a diet low in vegetables and fruit)
- not drinking enough fluids
- a change in your routine, such as a change in eating habits or travelling
- lack of regular exercise
- ignoring the urge to pass stool
- pregnancy
- illness (acute or chronic)
- medication side effects
- conditions such as depression and anxiety.
Constipation occurs more often as you get older. In women it may also be related to changes in their hormonal cycle.
How is constipation diagnosed?
Constipation can usually be diagnosed based on your: medical history and a physical examination. In adults, a digital rectal examination might be performed. This is where your doctor inserts a gloved, lubricated finger into the anal canal and feels for anything abnormal.
Your doctor may suggest further testing in some situations. For example, if you have had a recent change in bowel habits, blood in the stool, weight loss or a family history of colon cancer. Tests may include blood tests, X-rays and colonoscopy.
How is constipation treated?
In most cases, you can treat constipation at home without seeing a doctor. You should see your doctor if:
- your constipation symptoms have lasted longer than 3 weeks
- your constipation symptoms are severe
- your symptoms are not typical (e.g. you have rectal bleeding, weight loss, fever or weakness)
- you do not pass a bowel motion within a few days of home treatment.
Diet and lifestyle changes are usually the first treatment for constipation.
Behaviour changes
The signals to have a bowel movement are often strongest following meals or after getting out of bed. If you ignore your body’s signals to have a bowel movement, the signals become weaker and weaker over time.
By paying close attention to these signals, you may have an easier time moving your bowels.
Exercise
Regular exercise improves bowel motility for many people. This can be a simple as a daily 30-minute walk.
Adding fibre to your diet
Increasing dietary fibre may reduce or end constipation. Fibre works by absorbing water into the stool, which increases stool bulk and softens stool.
You can add fibre to your diet by eating more vegetables and fruits, or by using fibre supplements.
Start with small amounts of fibre and increase it slowly until stools become softer and more frequent. Drink plenty of water when you increase your fibre intake.
Laxatives
If adding fibre does not relieve your constipation, laxatives can be helpful.
Suppositories and enemas
These may be needed if you have faecal impaction, which occurs when stool become dry and hard and collect in your rectum.
Note that some over-the-counter products contain ingredients that may be harmful for some people.
Prescription medications
There are some relatively new prescriptions medications available for severe constipation.