What is constipation?

Constipation is a common medical complaint. Up to 20% of adults report constipation. It is more commonly reported in women and increases with advancing age. The condition can be either be described as an inability open bowels as regularly or as easily as one would like. It is often associated with harder stools, straining and the feeling of an incomplete motion.

What causes constipation?

Constipation can be ‘functional’ meaning no underlying disease process, or ‘secondary’ meaning that is a result of another issue. Certain drugs (e.g. opiate pain relief medications), hormonal and metabolic disorders (underactive thyroid, diabetes), neurological disorders (Parkinson’s, stroke, paralysis), and pregnancy can be the cause.

Most patients, especially those who have had longstanding symptoms, have functional constipation. This condition can run in the family. If there is sudden onset of the condition, weight loss, bleeding with the bowel movements or abdominal pain, there may be another underlying issue causing the constipation.

How is it treated?

  • Diet: increasing fluid and fibre intake may be all that it takes to address the issue. The recommended daily fibre intake for an adult is 30gm.
  • Good toileting habits: a regular routine is recommended. The bowel is most active in the morning and after meals. Do not suppress the urge when it occurs. A small footstool under the feet when sitting on the toilet may aid getting into the best position for encouraging a bowel motion. It is not recommended to prolong toileting time and straining by sitting on the toilet for a long time.
  • Laxatives: these are usually over the counter and can be very useful if you are very uncomfortable with constipation.

Types of laxatives

  • Bulking agents are fibre supplements which draw some fluid into the bowel to make the stools softer and bulkier. They can be useful in maintaining regular bowel habits.
  • Stool softeners act by drawing more fluid into the intestine. There are several different types and preparations. Your pharmacist or GP can give you some initial advice on the one that is most appropriate.
  • Stimulant laxatives help the bowel to contract to push the stool along.

When should I see a doctor?

If constipation is a new symptom for you, please discuss with your GP as there may be an underlying cause for the constipation. Weight loss, bleeding with the bowel motions or abdominal pain are particular indications to seek medical attention.

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