Constipation is common and affects people of all ages, with studies suggesting that 20% of the population currently struggle with achieving a regular bowel movement. You can usually treat it at home with simple changes to your diet and lifestyle.
Top Tip “If you notice any persistent change in your bowel habit, such as needing to go to the toilet more often, having looser stool, bleeding from your bottom or stomach pain please visit your GP, as these symptoms could indicate other problems.”
It’s likely to be constipation if:
- you have not had a bowel movement at least 3 times in a week
- your bowel movements are frequently difficult to complete,
or larger than usual - your bowel movements are often dry, hard or lumpy
You may also have a stomach ache and feel bloated or nauseous.
“If there is inadequate fluid intake, then the body will try to hold onto water and one way it does this is by making stools harder.”
What causes constipation?
Constipation in adults has many possible causes. Sometimes there’s no obvious reason.
The most common causes include:
- not eating enough fibre – such as fruit, vegetables and whole grains
- not drinking sufficient fluids
- being less active and not taking frequent exercising
- often ignoring the urge to go to the toilet
- changes in your diet or daily routine
- a side effect of medicine
- stress, anxiety or depression
- during pregnancy and for 6 weeks after child birth
Water helps to keep the stools soft. If there is inadequate fluid intake, then the body will try to hold onto water and one way it does this is by making stools harder. This makes it more difficult for them to move through the bowel.
Fibre helps to bulk up the stools, which makes it easier for the stools to move along the bowel and be passed. If there is not enough fibre stools tend to be smaller and harder. There is information about fibre in the Bladder & Bowel UK information library.
Exercise helps to stimulate the muscles in the bowel wall and helps to move stools on through.
Ignoring the urge to go to the toilet or not responding to the sensation of needing to pass a stool will result in the stool remaining in the bowel longer than it should. This can result in stools becoming harder, drier and more difficult to pass.
A change in eating patterns or a change in routine, such as a new job or going on holiday. The bowel can be sensitive to change and just knowing what triggers your constipation can help you to manage the symptoms.
Medications can cause constipation. Some of the most common medications which can cause constipation include:
- Aluminium antacids (medicine to treat indigestion)
- Antidepressants
- Antiepileptics (medicine to treat epilepsy)
- Antipsychotics (medicine to treat schizophrenia, manic conditions and anxiety)
- Calcium supplements
- Diuretics (water tablets)
- Iron supplements
Pregnancy, and the associated changes in hormones, affect the bowel wall muscles and can make them sluggish.
Other conditions that can cause constipation include:
- Neurological conditions including Parkinson’s Disease and Multiple Sclerosis
- Colon or rectal cancer
- Diabetes or Hypercalcaemia (where there is too much calcium in your blood stream)
- Underactive thyroid
- Muscular dystrophy (a genetic condition which causes muscle wasting)
- Spinal cord injury
- Anal fissure (a small tear of the skin just inside the anus)
- Inflammatory bowel disease (a condition that causes the intestines to become inflamed)
- Irritable bowel syndrome (IBS)
Constipation can develop without any of the above issues. This may be due to the bowel working more slowly (slow transit constipation). It may also be due to difficulties with the pelvic floor. People with learning disabilities are also more prone to constipation. For more information on this see the Bladder & Bowel UK information libraries.
Constipation is more common as we get older because as we age we tend to eat and drink less, become less active or less able to exercise, and have greater difficulty reaching a toilet. We are also more likely to be taking medicines that cause constipation, and have medical conditions that affect the bowel. People in hospital are especially prone to constipation.
Help is available, however. Your GP may refer you to your local Continence Service or Specialist Physiotherapist. You may be referred to a Gastroenterologist first particularly if you present with a range of symptoms or your bowel habit has changed recently.
This article is part of the Education Spotlight on Constipation, supported by Renew Medical. You can also read more about constipation in our information library here.
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