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Digestive health centre

Constipation: Symptoms, treatment and prevention

What is constipation?

Constipation is when a person is not passing stools, or poo, regularly, or cannot completely empty their bowels.

Constipation is a common problem and can affect people of any age, but is more common in older age and pregnancy.

The digestive system

Your digestive system is remarkably efficient. In the space of a few hours it extracts nutrients from the foods you eat and drink, processes them into the bloodstream and prepares leftover material for disposal. That material passes through six metres or more of intestine before being stored temporarily in the colon, where water is removed. The residue is excreted through the bowels, normally within a day or two.

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Depending on your diet, your age and your daily activity, regularity can mean anything from three bowel movements a day to one every three days. Nonetheless, the longer faecal material sits in the colon, the harder the stool becomes and the more difficult it is to pass. A normal stool should not be either unusually hard or soft, and you shouldn't have to strain unreasonably to pass it.

What causes constipation?

Our busy, modern lifestyles may be responsible for most cases of constipation: not eating enough fibre or drinking enough water, not getting enough exercise, and not taking the time to respond to an unmistakable urge to go to the toilet. 

Emotional and psychological problems can contribute to the problem. Persistent, chronic constipation may also be a symptom of health conditions, including irritable bowel syndrome, colorectal cancer, diabetes, Parkinson's disease, multiple sclerosis, an under-active thyroid gland and depression.

Bowel habits tend to vary with age and circumstances. Bottle-fed babies, for example, tend to have firmer stools and more bouts of constipation than breast-fed babies. Some children become constipated when they start school or other activities because they are embarrassed to ask permission to use the toilet. Toddlers often become constipated during toilet training if they are unwilling or afraid to use the toilet. Being sensitive to pain, children may avoid the toilet if they have minor splits or tears in the anus from straining or other irritations.

Older people, especially those who are more sedentary, tend to develop constipation more often as well.

Some medications can also cause constipation, including narcotic-type pain killers such as codeine, iron supplements and some medicines used to control blood pressure.

What are the symptoms of constipation?

  • Hard, compacted stools that are difficult or painful to pass
  • Straining during bowel movements
  • No bowel movements in three days
  • Stomach aches that are relieved by bowel movements
  • Bloody stools due to haemorrhoids and anal fissures
  • Leaks of wet, almost diarrhoea-like stool between regular bowel movements.

Complications of constipation

In the long-term, constipation can cause dry, hard poo to collect in the rectum, called faecal impaction.

Leakage of liquid stools is also possible, called faecal incontinence.

Straining on the toilet and constipation can also lead to piles, another name for haemorrhoids.

WebMD Medical Reference

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