Constipation

Constipation is extremely common, affecting both men and women, although chronic constipation (ie when the constipation in ongoing) is approximately two times more common in women than men. In addition, more people tend to get affected by constipation as they get older.

Being regular with bowel movements is different for everyone – for some people this could mean going 3 times per day or for others, 3 times per week.

There are many different symptoms of constipation. You may have constipation if you have experienced any combination of the following for 3 months or more in the last year:

  • Straining
  • Fewer than 3 bowel movements a week
  • Difficulty passing stools
  • Hard or lumpy stools
  • Abdominal discomfort and bloating
  • Feeling like your bowel is never completely empty
  • Feeling like there is something blocking your bowel
  • Needing to use manual manoevres to empty your bowel

We often do not know what causes constipation – this could be due to medications that you may take or an underlying medical condition. It could be for unknown reasons, often referred to as idiopathic. Even if its unclear what causes the condition, it is important to get a medical evaluation to try and determine the cause.

Investigations

It is often unnecessary to have investigations for constipation. The decision to undertake tests depends on youre symptoms, age and possible whether there is a family history of bowel symptoms.  If there is a decision to undertake investigations, the following tests are usually performed:

  • Blood tests (looking for anaemia, thyroid function)
  • Flexible sigmoidoscopy or colonoscopy
  • Transit study – this is a simple test involving a single X-ray after you have swallowed some capsules which show how quickly tings move through your intestines.
  • Evacuating proctogram – this shows how the pelvic floor muscles work to evacuate a motion from the bowel

There are various different treatments for constipation, but which usually always involve some or all of the following:

  • A well balanced, health diet high in fibre – often a review by a dietician is extremely helpful
  • Drink plenty of water
  • Regular exercise
  • Never ignore an urge to have a bowel movement
  • Proper ‘toileting posture’ on the toilet
  • Consider the use of regular laxatives  - there are a variety of different laxative available, and these should be discussed with your doctor