Constipation is a condition of the digestive system in which you have hard stools (faeces) that are difficult to expel. This usually happens because the colon absorbs too much water from the food. If the food moves through the gastro intestinal tract too slowly, the colon may absorb too much water, resulting in faeces that are dry and hard. Defecation may be extremely painful, and in severe cases (faecal impaction) lead to symptoms of bowel obstruction.
Some of the complications of chronic constipation include:
- Faecal impaction - the lower bowel and rectum become so packed with faeces that the muscles of the bowels can’t push any of it out
- Faecal incontinence - an overfull bowel can result in involuntary ‘dribbling’ of diarrhoea
- Haemorrhoids - constant straining to open the bowel can damage the blood vessels of the rectum
- Rectal prolapse - the constant straining pushes a section of rectal lining out of the anus
- Urinary incontinence - the constant straining weakens pelvic floor muscles. This makes the involuntary passing of urine more likely, especially when coughing, laughing or sneezing
Signs & Symptoms:
- infrequent or hard stools
- difficulty passing stools
- discomfort passing stools.
- constipation pain during the passage of a bowel movement
- inability to pass a bowel movement after straining or pushing for more than 10 minutes
- no bowel movements after more than 3 days
Constipation can be a sign of a more serious condition. See you doctor if:
- you swing between constipated and having diarrhoea (especially if over 40)
- bowel motions are painful to pass
- motions are blood-stained or black and tar-like
- you need to use laxatives regularly
- you feel unwell or tired, are vomiting, have lost weight, have a headahe or have a fever when you are constipated
Causes of Constipation can include:
- Not eating enough fibre
- being less active, especially after surgery or travel
- putting off passing a bowel motion
- being pregnant or have recently had a baby
- some medicines, both prescription and non-prescription
After serious illnesses have been ruled out, treatment depends on the cause, but could include:
- Removal of the impacted faeces - which may involve enemas, stool softeners and a short term course of laxatives
- Dietary changes - such as increasing the amount of fibre in the daily diet. Good sources of fibre include wholegrain cereals, fruits, vegetables and legumes. The intake of foods such as milk, cheese, white rice, white flour and red meat should be restricted, because they tend to contribute to constipation
- More fluids - liquids help to plump out faeces. However, it is important to restrict the intake of diuretic drinks such as tea, coffee and alcohol
- Fibre supplements - these may be helpful if the person is reluctant or unable to include more wholegrain foods, fresh fruits or vegetables in their daily diet
- Exercise - one of the many benefits of regular exercise is improved bowel motility. Ideally, exercise should be taken every day for about 30 minutes
- Treatment for underlying disorder - such as surgery to repair an abdominal hernia, hormone replacement therapy for hypothyroidism, or anaesthetic cream and sitz (salt water) baths for an anal fissure
- Laxatives - there are different types of laxatives:
- Bulk-forming laxatives work by adding extra fibre and bulk to the diet and by drawing water into the bowel which softens the motions.
- Some laxatives soften the bowel motions making them easier to pass
- Some laxatives increase the activitgy of the bowel muscles, encouraging the passing of a motion.
Prolonged use of laxatives can lead to electrolyte imbalance.