Constipation

Constipation is when your poo become hard and you find it more difficult than usual, or even painful, to pass it when going to the toilet. You may also have a feeling of being unable to completely empty your bowels. Opening your bowels may be more difficult because your poos are hard, lumpy, and dry, or because they are abnormally small or large.

Constipation is usually harmless. Being constipated occasionally is common and can affect people of all ages. In most cases, it is usually short-lived and settles within a few days to 4 weeks at the most. We’re all different when it comes to bowel habits; some of us only poo every three or four days, whereas others may go more than once a day.

How can I avoid triggers/ suggested lifestyle changes?

It may be possible to avoid constipation and its symptoms by making a few simple changes to your diet and lifestyle.

• Healthy diet – Increase your daily fibre intake by eating a higher proportion of fruit, vegetables, seeds, pulses, and cereals, or by taking soluble fibre in the form of oats. These foods help to make your poos softer and bulkier, and therefore easier to pass
• Hydration – Drink plenty of water and avoid alcohol
• Exercise – Try to exercise more, this helps your bowels digest food
• Listen to your body – Respond to your bowel’s natural pattern and do not delay going to the toilet when you feel the urge to go
• Medicine review – Some medicines can cause constipation including some pain killers. If you feel your medications may be causing you to become constipated, speak with your pharmacist, GP, or nurse for advice before stopping any medications.

How do I treat?

If the suggestions above have not worked, you may wish to try medication to treat your constipation. There are many preparations available over the counter at your pharmacy or in local shops and supermarkets. The four main types of laxative medications used to treat constipation are:

• Bulk-forming laxatives – such as ispaghula husk (also known as Fybogel Hi-Fibre) work in the same way as dietary fibre; they increase the bulk of your poo by helping them retain fluid, encouraging your bowels to push them out. These start to work within 2-3 days.
• Poo-softening laxatives – such as docusate sodium (often known as Dulcoease) increase the fluid content of hard, dry poos making them easier to pass. These take 1-2 days to work.
• Stimulant laxatives – such as bisacodyl (also known as Dulcolax) or senna speed up the movement of your bowels by stimulating the nerves that control the muscles lining your digestive tract. These start to work within 6-12 hours.
• Osmotic laxatives – such as lactulose or macrogol (brands include Movicol, Laxido or CosmoCol) draw water from the rest of the body into our bowel to soften poos, making them easier to pass. They take around 2-3 days to work.

Laxatives are not suitable for everyone, especially children (unless advised by a doctor) or those with certain health conditions, such as Crohn’s disease or ulcerative colitis.

Your pharmacist can provide advice on which type of medication is best for you and your symptoms.

Ideally, laxatives should only be used occasionally and for short periods of time. It is important to stop taking a laxative as soon as your constipation improves and to utilise lifestyle changes to reduce the possibility of constipation reoccurring.

When should I seek advice?

In rare cases, more serious underlying causes can make you constipated. See your GP if any of the following apply to you:

• Duration – You’ve been constipated or have a persistent feeling of not being able to empty your bowel completely that doesn’t go away within six weeks.
• Other symptoms – Your tummy becomes increasingly swollen, and/or you start vomiting, which could suggest that your bowels are blocked.
• Age – You are over 50 and have never suffered from constipation before.
• Medication – You think that a medication makes you constipated.
• Blood in your poo – You notice blood in your poo, particularly if you don’t have any pain or discomfort around the opening of your back passage.
• General’ symptoms – You’ve been losing weight for no apparent reason; you also feel tired all the time, ‘not quite right’, sweaty or feverish; or you find that these symptoms don’t go away within four to six weeks.

Where can I get more information?

•  NHS Choices – www.nhs.uk
   
• Your local community pharmacy