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Constipation

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Constipation refers to both the infrequent passing of bowel motions and the passing of stools that are hard or dry. In many cases it is due to inadequate fibre intake.

Symptoms

  • Hard stools that may be difficult or painful to pass  
  • Bowel movements less frequently than usual
  • Abdominal cramping (colic) and bloating may occur 
  • Bowel emptying may feel incomplete 
  • Need to sit on the toilet for a long time to pass a bowel motion 
  • Passing a bowel motion may cause discomfort and/or require straining 
  • Straining may lead to the development of haemorrhoids

Causes

Constipation is commonly caused by inadequate amounts of fibre in the diet, but other contributing factors may include:

  • Not drinking enough water.
  • Not getting enough exercise.
  • Putting off going to the toilet after you get the urge. (This increases the length of time the stool remains in the bowel, and can result in more water being extracted from the stool, making it more difficult to pass. It may also dampen the body’s recognition of the signals that indicate it is time to go to the toilet).
  • Pregnancy. This occurs due to a combination of hormonal factors, reduced activity levels, and the physical pressure of the uterus and baby on the digestive system.
  • Use of certain medications, including some iron supplements, blood pressure medicines and narcotics (e.g. codeine).
  • Changes in routine such as travel or doing shift work.
  • Getting older.

Some people put off going to the toilet for fear of pain that occurs when they have a bowel motion. Amongst other causes, this may be due to an anal fissure (tear).

Other reasons for constipation may include irritable bowel syndrome, hypothyroidism, colorectal cancer, diabetes, Parkinson's disease, multiple sclerosis, and bowel obstruction or constriction (for example due to haemorrhoids or a hernia).

Natural therapies

  • Laxative herbs that have traditionally been used to relieve constipation include senna, cascara and buckthorn. Some products are also prepared with psyllium fibre to gently assist functioning of the colon.
  • Probiotics such as Lactobacillus reuteri, Lactobacillus acidophilus, and Bifidobacterium animalis may help to support normal bowel function by restoring, balancing and maintaining healthy gut flora.

Diet and lifestyle

  • Although laxatives may help to relieve occasional constipation, they are not recommended for ongoing use. Dietary and lifestyle changes are the preferred way to address most cases of constipation. Seek professional advice if the problem persists.
  • Stools are largely composed of fibre, which is only found in plant foods, so make sure your diet contains plenty of high-fibre foods such as fruits, vegetables, legumes and whole grains. Avoid processed foods and large quantities of meat, which may contribute to your constipation problem. 
  • Adequate fluid is also vital for bowel regularity. Aim to drink around two litres of water per day, but avoid beverages with diuretic properties (such as tea, coffee, and alcohol) . 
  • Some people may also benefit from taking a fibre supplement; psyllium is a good source, but should always be consumed with plenty of water.
  • Regular exercise helps to maintain bowel regularity. Aim for around 30 minutes of activity every day or more.
  • If your constipation is related to an underlying health problem, working with your healthcare professional to manage your condition may also reduce your bowel problems.

Important notes

  • Consult your doctor if your stool contains blood or mucus, looks like it contains coffee grounds, or if you experience alternating episodes of constipation and diarrhoea.
  • You should also seek medical advice if you suspect your constipation may be related to your prescribed medicines or if you (or your child) have not passed a stool for more than one week
  • If faeces are impacted (built up in the bowel and unable to be passed), medical intervention may be required to remove the impaction before normal bowel habits can be restored. Talk to your doctor for more information.

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Anonymous
Anonymous 18 Sep 2015
After surgery I am having problems with trapped wind, laxatives only help to a certain extent , any suggestions please?
Anonymous
Anonymous 14 Feb 2013