Constipation: what you need to know
What is constipation?
Constipation is when you experience a change in normal bowel habits, with the time between bowel motions becoming longer than usual or bowel motions (faeces) that are very hard and difficult to pass. Constipation is often accompanied by feelings of bloating and discomfort in your abdomen.
Why do I get constipated?
You may get constipated because you don’t eat enough fibre, drink enough water or do enough exercise, or because you often ignore the ‘urge’ to go to the toilet. Some medicines such as painkillers, iron tablets, antidepressants, antacids and medicines for high blood pressure can also cause constipation. Ongoing use of laxatives can contribute to the development of constipation.
Another reason for constipation is that the pelvic floor muscles, which support the bladder and bowel, aren’t working properly. These muscles may fail to relax as you’re trying to pass a bowel motion, making it very difficult to push out the motion.
Pregnant women may become constipated due to hormonal changes or because their uterus (womb) puts pressure on their bowel.
Some people may have constipation because of another condition, such as a stroke, Parkinson’s disease or scleroderma. These conditions can affect the nerves or muscles of the bowel. Depression can also cause constipation. Occasionally constipation results from a specific problem within the colon or rectum itself.
How is constipation treated?
- Eating regular, balanced meals containing adequate fibre is recommended for normal bowel movements. The National Health and Medical Research Council recommends at least 30 g of fibre per day for men and 25 g of fibre per day for women. Include wholegrain or wholemeal breads and cereals, legumes (e.g. chickpeas and kidney beans), fruit and plenty of vegetables in your diet each day. For example, a bowl of high-fibre breakfast cereal (10 g fibre), 2 slices of wholemeal or wholegrain bread (3–8 g), 3 pieces of fruit (9 g), a cup of cooked wholemeal pasta (9 g) and a large serve of cooked vegetables (5 g) will provide 30–40 g of fibre. Increase fibre slowly or you may feel bloated and have problems with gas.
- Drinking plenty of fluids a day (about 8 glasses) but cutting down on alcohol and coffee.
- Exercising every day, standing up and moving around as often as possible.
- Regularity: try to have a ‘sitting’ at the same time every day, and when you feel the urge to go, make sure you go! This is particularly important for children, who often get too ‘busy’ or involved in their projects and neglect this urge. Commonly, the urge to open your bowels occurs after a meal — this is called the gastro-colic reflex.
- Taking a fibre supplement such as psyllium (for example, Metamucil or Nucolox) can help to make stools softer. These supplements are not suitable for all types of constipation, so check with your doctor first. Drink extra fluids if you are taking a fibre supplement.
- Taking laxatives: you should only use laxatives if your constipation has not improved after following the above measures. As different laxatives work in different ways, your doctor can advise you on which laxative may be suitable for you. Generally, laxatives should only be used for as short a time as possible. Long-term use or use of the wrong type of laxative can make constipation worse.
- Using suppositories or enemas: generally these are only used if you are very constipated, and are best used under the guidance of a health professional.
- Pelvic floor muscle retraining: this can be useful if your pelvic floor muscles are not working properly. Your doctor may suggest special exercises to retrain your pelvic floor muscles.
When to see a doctor
Constipation can occasionally be a symptom of a more serious disease, so you must see your doctor if you have a marked change in your bowel habit. Such changes include suddenly becoming constipated, developing constipation that alternates with diarrhoea, a change in stool consistency that lasts more than 2 weeks, or a feeling that your bowels aren’t emptying properly. Also see your doctor if you have strong pain in your abdomen, blood in your stools, vomiting, considerable bloating, ongoing tiredness or unexplained weight loss.
If you are pregnant, don’t take any medicine for constipation without checking with your doctor first. Your doctor can advise you on the right anti-constipation products to use and tell you whether any medicines you are taking could be making the condition worse.
Last Reviewed: 25 November 2009
- 1. Constipation [revised September 2006]. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; 2009 Nov (Accessed 2009 Dec 4.) http://www.tg.org.au/
2. Australian Government Department of Health and Ageing, National Health and Medical Research Council [website]. Nutrient reference values for Australia and New Zealand, including recommended dietary intakes; 2006. Available at: http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/n35.pdf (accessed 2009, Dec 4)