Constipation
Experiencing regular bowel movements (aka ‘doing a poo’) is a very normal part of life, however for some people, the simple act of going to the toilet can be challenging if the person is constipated.
Constipation is the passing of hard or dry stools/poo during a bowel movement, which may be difficult to pass, and infrequent (e.g. a few times a week or less).
Constipation is one of the most common digestive problems and is an extremely common health complaint; in fact, it affects around 1 in 5 Australians.
Constipation can be painful and uncomfortable, and may lead to other health concerns, so it is important to know the common causes and symptoms, how to prevent it, and when to seek help.
Symptoms of constipation
Each person’s experience of a ‘normal’ bowel movement can differ, where some people will go three times a day while others may go less. If you’re constipated, common symptoms may include*:
Hard or dry stools that are difficult to pass
Straining or pain during bowel movements
Going to the toilet less frequently (less than 3 times per week)
The sensation of fullness or not having completely emptied the bowels after a poo
Bloating and flatulence
Abdominal cramps or nausea
Rectal blockage (when a large, hard mass of faeces gets stuck in the bowel where poo normally passes through)
Needing to sit on the toilet longer than usual
It’s important you seek medical advice from your GP if constipation persists or if you’re experiencing other symptoms (such as blood in your stool, abdominal pain, and weight loss), as there may be an underlying medical problem you are not aware of.
What causes constipation?
Constipation can be caused by a number of different lifestyle or medical factors that often work in combination, including the below.
Lifestyle factors:
Low-fibre diet: one of the most common causes of constipation. Fibre adds bulk to faeces, helping it pass more easily along the digestive track. A diet lacking in fibre can result in poo compacting and becoming difficult to pass.
Dehydration: not drinking enough liquids (water) can dehydrate our body and our poos, making them painful or difficult to pass, so it’s important to keep fluids up.
Lack of exercise: inactivity may cause our bowels to become sluggish
Medicine: constipation can be a side effect of some medications, such as some strong pain relief medications, antacids, anti-nausea drugs, anti-depressants, supplements and chemotherapy drugs.
Not pooing when you need to: When poo remains in the gut longer than usual, it may compact, making it more difficult to pass later on.
Change in routine: travel or other changes in routine can disrupt regular bowel motions, and create constipation.
Pregnancy: constipation can be common in the early stages of pregnancy due to the hormone progesterone causing the bowel to become more relaxed than normal³.
Medical factors:
Anal fissure: tiny tears in the skin of the anus can cause pain that may deter someone from going to the toilet
Obstruction: an obstruction of the rectum or anus (e.g. haemorrhoids or rectal prolapse)
Surgery: a combination of changes in routine post-surgery (particularly abdominal or gynaecological) can cause constipation
Irritable bowel syndrome: digestive issues such as IBS can cause abdominal pain, bloating and either constipation or diarrhoea
Endocrinal system issues :an underactive thyroid or diabetes can cause constipation
Who is at risk of constipation?
Diet and exercise play a big part in regular bowel movements. However, even certain healthy people may be at greater risk of constipation:
People aged 65+ years – this can be due to changes in lifestyle as we get older including inactivity, underlying disease and poorer diets.
Women or children – women tend to have more frequent episodes of constipation than men, and children are often affected more than adults.
Pregnant women – hormonal changes and the pressure of a baby pushing against intestines and organs can lead to constipation.
Anyone requiring bed rest – people recovering from illness or hospitalisation after surgery may experience constipation due to a number of factors including change in routine, pain and pain relief medication.
Constipation in Children
Constipation is quite common among children and babies, with normal bowel habits varying. A child may be experiencing constipation if they’re pushing out very hard poos or going to the toilet infrequently. For parents who think their child may be constipated, the signs to look out for include:
Discomfort or pain while doing a poo
Irritability, tantrums or refusing to go to the toilet
Tummy pain
Rocking, fidgeting, or looking like they’re trying not to poo
Lack of appetite
Pooing in their pants (may be an indication of ‘overflow diarrhea’ where the bowel leaks out watery stools around a blockage from higher up in the bowel)
There can be a number of contributing factors to this that are covered above in causes of constipation, however there are plenty of things parents can do to help a constipated child. A big part of treating and preventing constipation in children comes down to teaching healthy bowel habits. Our pharmacists recommend to aid parents in this:
Create routine, and encourage children to use or sit on the toilet after every meal
Reward children when they go to the toilet (in training stages) and speak to them if they’re worried about going to the toilet
Help child to get comfortable by providing a small stool or step for child’s feet to touch, if they can’t touch floor - a sitting position can make it easier to poo
Encourage child to drink lots of water, including during every meal
Ensure your child is eating a healthy, balanced diet and encourage them to chew each mouthful well before swallowing – the chewing action can stimulate the body to release acids and enzymes needed to break down food in the stomach
Try to limit ‘junk food’ – anything high in fats, salts and sugar, as well as sugary or fizzy drinks
Encourage your child to be active for at least an hour a day, through organised sports, visiting a local park, or playing with friends
Accidents will happen – try not to make a big deal out of it, and encourage your child to speak up if an accident does happen
How to treat and prevent constipation
The easiest and fastest way to help treat and prevent constipation is usually with lifestyle changes to diet and exercise. Depending on the case, the following techniques may assist:
Increase fluid intake. Aiming for 1.5L (or 6-8 cups) of water daily is recommended to help keep the body hydrated
Increase physical activity. Aim for 30 minutes of exercise daily at least 5 days a week in whatever way you enjoy most – walking with a friend, running, swimming, skipping rope, or even dancing
Increase fibre intake in diet through fibre-rich foods, such as raw fruit and vegetables, whole grains, prunes, or bran cereal. You can also add fibre supplements to your diet, as recommended by your GP or pharmacist.
Reduce intake of low-fibre foods such as meat, milk, cheese and processed foods as these can block you up
Reduce intake of alcohol and caffeinated drinks
Stimulant laxatives – these should be used sparingly. Laxatives are a short-term solution to help soften stools, and if used for an extended period (e.g. longer than 2 weeks), your body can become dependant on them for proper colon function
Bulk-forming fiber supplements, osmotic laxatives are other alternatives to aid with constipation
Probiotics can assist when added to your diet, particularly for those with chronic constipation or digestive problems
If you need to go, don’t hold back as the longer you wait the harder your stool can become. Let it go!
When to seek help
Normally constipation is a temporary issue, however for some people it can become an ongoing issue. If you’re experiencing chronic constipation (lasting an extended period), or you are experiencing other bowel symptoms alongside constipation, it is important that you speak with your GP.
For most of us, constipation is to be expected at times – however you can make it a little easier to return to regular bowel movements with the right support. At MediADVICE, we have a range of products to assist with constipation.
Our team of friendly pharmacists are on hand to provide expert advice on a range of digestion issues, and recommend products that may be right for you.
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