Constipation is one of the most common digestive complaints. In general, constipation is when someone goes to the toilet less often than usual, or find it difficult to pass a stool.

It is a change from a person’s usual pattern of bowel movement. Around 1 in 10 people in the UK suffer regularly with constipation. It is common in children and older people and affects women more than men.

Causes

Common causes of constipation include a lack of dietary fibre, lack of fluid, inactivity, stress and ignoring the urge to go to the toilet. Other causes include some medication (e.g. certain painkillers), some medical conditions such as pregnancy. In pregnancy, hormonal changes affect how quickly food is passed through the digestive system and the increased pressure in the abdomen slows down the passage of waste along the bowels leading to constipation.

In older people, the bowel muscles become weaker, their appetite decreases and some people may take medicines that affect the bowels. This is why elderly people are also prone to constipation.

It is fairly common for children to suffer from constipation but it usually clears up within a few days.

Always consult your GP if symptoms are persistent and/or severe.

Constipation is often experienced by people when they are travelling or on holiday. This is because their normal routine is interrupted and the biological clock is disrupted. Unfamiliar surroundings, different toilets and change of diet are all contributing factors.

Symptoms

Passing a motion less often than usual, having to strain to pass a motion, passing ‘rabbit pellets’ that are dry and hard, a feeling of incomplete bowel emptying are all symptoms of constipation.

Sometimes straining may be ineffective and no motion is passed. Bloating, nausea, even vomiting may occur. Straining may cause piles and rectal bleeding.

Chronic (long-term) constipation can lead to a number of problems. Always consult your GP if you suffer from the following:

• Blood in the stools.
• Excessive tiredness and lethargy.
• Unintentional weight loss.
• Treatment

Constipation can be easily treated and you should always start by changing your diet and lifestyle. Eating more fibre and five portions of fruit and vegetables a day, drinking plenty of fluids and taking regular exercise may help. Never ignore the need to go to the toilet. Try to keep stress to a minimum.

If these approaches fail, taking a laxative to stimulate the bowel muscles may be of benefit. These should only be used as a temporary measure. Talk to your pharmacist about any medication you are taking to find out if it may be causing constipation.

Laxatives work in one of four ways:

Bulk laxatives (such as bran, sterculia) provide fibre in a concentrated form. They increase weight and volume of the stools whilst they are in your intestines, thus stimulating your bowels to move faster. They have to be taken with plenty of water and it can take several days before they have any effect. They are the most approrpriate type of laxative for long term use.

Stimulant laxatives (such as senna and bisacodyl) work by increasing contractions of the bowel and can cause tummy cramps. They can work within a matter of hours and are usually taken at night to produce a morning bowel action. This type of laxative is inadvisable for long term use and should not be used in children.

Osmotic laxatives work by retaining fluid in the bowel, which then softens the faeces. They can take two to three days to work.

Faecal softeners such as docusate sodium lubricate and soften the stool, making them easier to pass and can act within a day.

Children should not be given laxatives without first consulting your GP or pharmacist. You should never take laxatives on a regular basis unless advised to do so by your GP.

Constipation can rarely be a sign of a more serious disease, if you are in any doubt consult your GP.

Prevention

A number of additional measures can be taken to avoid constipation:

• Eat plenty of fibre such as bran, wholemeal bread, fruit and vegetables.
• Have a regular routine in the morning and allow your bowels time to work.
• Reduce your intake of processed food.
• Drink more water and avoid caffeine, alcohol and fizzy drinks.
• Keep active by exercising regularly.
• When travelling, consider taking bran supplements, drink bottled water and avoid sitting still for too long.