Constipation ED

• Constipation is a very common problem and affects people of all ages, although it is more common as we get older. As we age we tend to eat and drink less, become less active / 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.

• Your stomach and bowels (large and small intestines) remove nutrients and water from the food you eat. Anything your body cannot use is left behind as waste, forming solid lumps we call stool (poo). The muscles of the intestine push the stool through your bowel towards your rectum (the end section of the bowel). The stool is stored in the rectum until it is ready to leave your body.

• Constipation refers to how easily stool passes out of your body and how often. Passing stool is often called a bowel movement. If this does not happen very often or if your bowel movements become less regular than normal and are hard to pass, you may be constipated.

• This article explains what constipation is, what can cause it and how it can be prevented or treated.

• People often think that they should pass stool every day to have a normal bowel habit. However, how often people pass stool differs from one individual to another. Most people will have a bowel movement between three times a day and three times a week.

• It is when your bowel movements become less frequent than is usual for you that you may need to consider whether you are constipated. A normal bowel motion should be well formed, soft and easy to pass. 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.

Many things cause constipation, such as:

• A lack of fibre (the non-digestible part of plant foods).

• Not drinking enough.

• Being less active.

• Ignoring the urge to pass stool.

• Poor, or lack of, toilet facilities.

• Certain medicines, such as painkillers containing codeine, anti-depressants, diuretics (water tablets) and iron supplements.

• Pregnancy and childbirth.

• Factors such as having to use a bedpan, commode or needing help to get to a toilet.

• Emotions such as stress, anxiety, depression and grief.

• Medical conditions such as diabetes, stroke, Parkinson’s disease, bowel disorders which may need further investigation.

• Neurological conditions.

Constipation can make it painful to pass stool and may make you bloated, sluggish or have stomach cramps. You are more likely to develop other problems, such as haemorrhoids or piles (swollen blood vessels in your back passage).

Rarely, stool can block your bowels. This is known as faecal impaction and can cause abdominal pain, confusion or lead to problems passing urine.

Constipation can also contribute to urinary incontinence by

• Weakening your pelvic floor muscles.
• Putting pressure on the urethra, due to hard stool in your rectum.

There are a number of ways that you can prevent or treat constipation.

• Increase the amount of exercise you do where possible.

• Make it easier for yourself to use the toilet. You may find handrails or a raised toilet seat at home helps.

• Practice toilet training. Every morning before or after breakfast, sit on your toilet for three to five minutes if you can. Do not strain, but lean slightly forward, with your elbows on your knees. Keep your feet on the floor or slightly raised on a foot rest.

• Increase your daily fluid intake to about two litres Increase the amount of clear fluids you drink. Include fruit juices and vegetable soup for variety and fibre.

• Eat more foods that are high in fibre, such as fruit, vegetables and wholemeal bread, pasta and rice. Try to have at least five servings of fruit and vegetables each day. Increase the amount of fibre and liquids in your diet slowly, as any sudden increase can give you stomach pains and wind.

• If you are still constipated after following the previous suggestions, you may wish to consider using laxatives. These are medicines that encourage bowel movement. However, they should not be considered until you have tried the advice above and with advice from your pharmacist.

• The NHS website provides online health information and guidance
• GUTS UK offers information on digestive disorders
• Your pharmacist and GP can also help you if your symptoms persist.

General support

• For general medical advice please use the NHS website, the NHS 111 service, walk-in-centres, or your GP.
• NHS website provides online health information and guidance 
• There are walk-in and urgent treatment services at Brighton Station, Crawley Urgent Treatment Centre, Lewes Victoria Hospital, Horsham Minor Injuries Unit and Bognor Regis War Memorial Hospital.It is important to drink well to ensure your urine is light (unless you have a restriction to your fluid intake for example due to heart failure).

The information in this article is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.