CONSTIPATION

What is it?

Constipation is delay or difficulty in passing stools. But people vary a lot. It may be normal for some people to go twice a day while others only go three times a week. As a general guide, straining on passing a stool is a good sign that you may be suffering from constipation. Some people with severe constipation may also suffer from stomach pain, bloating, wind, nausea, headache and a general feeling of being under the weather.

Who gets it?

Children, the elderly and pregnant women are more prone to constipation. But it can occur at any age and in either sex. Most people will usually suffer from the problem sometime in their life.

What causes it?

What we eat is very important. A lack of fibre in the diet is the most common cause of constipation. Fibre is important because it makes the stool bulky and soft. Other causes of constipation include not taking enough fluids, lack of exercise, certain medicines, ignoring the urge to go and stress.

How can I help myself?

• Increase the amount of fibre in your diet. The best supply of fibre is whole-grains, fruit and vegetables, lentils and beans. Look at the foods you already eat - including bread, pasta, rice and cereals - and change to high fibre or whole grain versions. Do not expect results overnight. Allow at least a week for your dietary changes to start working. However, it is advisable to increase the amount of fibre in your diet slowly to avoid gas attacks.
• Are you getting enough liquids? An adult should drink a minimum of between six and eight glasses of liquid per day. Water is the best fluid to drink but one or two glasses of fruit juice a day will also help relieve constipation.
• Exercise regularly. Not only is exercise good for the heart and lungs but it also helps you go.
• A regular brisk 20-minute walk or a gentle workout will help move food through the bowels.
  Cut down anxiety or stress by using tapes, videos or books on relaxation techniques.
• Toilet train yourself. The most natural time to go to the toilet is after a meal. Pick a meal and every day following that meal sit on the toilet for ten minutes. You will soon train your bowels to open naturally and regularly.
• Do not strain. You risk giving yourself piles or tears in the back passage which can be very painful.
• Try a laxative from your chemist. Natural or vegetable laxatives are safe and not addictive. Ask your pharmacist for advice in choosing one. A short course of laxatives can help make you regular. Once you are regular cut the laxative down over a week and stop.
• If you are really miserable and 'bunged up'try a glycerine suppository from your chemist. Suppositories should not be used regularly otherwise your bowel will get used to them and the constipation will get worse.
• Check your tablets. Some medicines can cause constipation or make it worse. These include painkillers that contain codeine such as co-proxamol, iron tablets, antacids, antidepressants, antihistamines, diuretics, 'water tablets' - and anti-Parkinson's disease drugs. If your medicines seem to be causing the problem discuss the situation with your doctor.

When should I contact my GP?

Serious causes of constipation are extremely rare. If you find that self-help measures do not work see your GP for more advice. If your symptoms are severe, such as bad stomach pains or you see blood or mucus in the stool consult your GP. Young children and babies with constipation can be helped by your local health visitor.

A DOCTOR information leaflet for patients