Constipation
The word ‘constipation’ can mean different things to different people. Some people think it just means not going to the toilet for a bowel motion very often, but that is not the case. It's not so much how often you go, but what happens when you get there, that determines if you've got constipation.
Although most adults open their bowels on average once a day, anything from 3 times a day to once every 3 days can be regarded as ‘normal’. As we get older most of us can expect to go less often.
It is when we have difficulty in emptying the bowel, despite a feeling of wanting to, that we have constipation. What we pass (known medically as ‘faeces’ or ‘stools’) will be hard and relatively small, often requiring great muscular effort and accompanying pain.
Constipation is usually related to diet and for the majority of people the problem will go away with a diet rich in fibre (cereals, fruit and vegetables) and, most importantly, drinking plenty of fluid.
Children with constipation
Children are particularly prone to constipation and it often happens when there is a transition in the diet, for example, when a baby is weaned or in the toddler years when new tastes are being developed.
Some children will develop chronic constipation, with stomach aches, irritability and a ‘bloated’ belly common symptoms. Sometimes the child will have numerous ‘accidents’, soiling their underwear with liquid faeces. Parents may mistake this for diarrhoea, but it is usually due to constipation with ‘overflow’.
Children should be encouraged to go to the toilet when they feel the urge, and not to put it off because they are too busy playing with their friends. Adults should also not put off going to the toilet when they are busy.
Occasionally, constipation is a symptom of some underlying disease. A small number (1 in 5000) of children are born with absent nerve cells in the lower intestine — a condition called Hirschsprung's disease. This is usually detected soon after birth and there may be other family members affected. Other conditions that cause constipation include an under-active thyroid gland and the use of some drugs such as pain killers, antacids and sea-sickness pills.
Laxatives should not be used as the first line of attack in constipation. Although they can help in very stubborn cases, their use for long periods can make the problem worse.
Any adult who develops a change in the bowel habit that does not respond to increased fibre and fluids should see the doctor to exclude bowel cancer as a cause for the symptoms.
Last Reviewed: 10 July 2001
