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Fact Sheet: Constipation
Constipation is a very common condition that affects people of all ages. It means you are not
passing stools (faeces) as often as you normally do, you may have to strain more than usual
or you are unable to completely empty your bowels. Constipation can also cause your stools
to be unusually hard, lumpy, large or small. Constipation can be either acute or chronic and
many people only experience constipation for a short period of time with no lasting effects on
You are likely be constipated if you are experiencing any of the following:
Your bowels open less than three times a week
Stomach pain, discomfort and straining on passing a motion
Stools are hard and dry, and may be large or small in size
There may be a bad taste in the mouth, bad breath, abdominal bloating, decreased
appetite, lethargy and, for some, the inability to function normally
What causes constipation?
There are many triggers that can cause the symptoms of constipation and they can include:
Diet - dietary fibre provides the bulk that helps to speed the passage of waste food
through the bowel. Lack of fibre results in harder, more compacted stools which take
longer to pass.
Lack of fluids - the body needs around 2 litres of fluid a day to function efficiently.
Without sufficient fluids, waste matter dries out making it harder to move through the
Lack of exercise - if you don't exercise regularly, things can slow down including
muscle contractions that move waste matter through the gut.
Other possible causes of constipation include:
Some medicines, especially pain killers, e.g. paracetamol, codeine and morphine,
have a tendency to cause constipation in some people. Tell your doctor if you
suspect a medicine that you are taking is making you constipated.
Some people with neurological problems such as Parkinson's disease or Multiple
Sclerosis are prone to constipation.
Surgery around the anus can sometimes be a cause of constipation mainly due to
discomfort when emptying the bowel afterwards. e.g following surgery for
haemorrhoids, abscesses, fistulae or tears. Reluctance to go because of the
discomfort causes people to 'hold it in' leading to blockages and constipation.
Updated September 2013
Conditions such as Irritable Bowel Syndrome (IBS) may cause constipation as can
Colitis and Crohns Disease.
Pregnancy - about 1 in 5 pregnant women become constipated due to the hormone
changes associated with being pregnant. Hormones slow down bowel activity.
Slow Transit Colon is a cause of constipation and occurs when the colon does not
work efficiently to move the digested food through it. Normally food travels through
the colon within 12 - 48 hours. Water within the food is gradually absorbed during this
time producing a soft formed stool that should be easy to pass. Slow transit colon
basically means that the stool takes longer to pass through the gut and as a result
the stool becomes dry and hard. It can be associated with diet, for example a lack of
fibre, and with a decline in physical activity and mobility.
What is normal?
The normal defecation rate for an adult is between three bowel movements per day to three
bowel movements per week. If you are going less than three times a week and are
experiencing pain, discomfort and straining on passing a motion, you are probably
Since it can be hard to state what is normal regularity, some doctors use a scale to classify
the type of stool passed. This helps gauge how long the stool has spent in the bowel. One
such scale is called the Bristol Stool Form Scale. To view a copy of the Bristol Stool Form
Scale, please click here.
Constipation symptoms and signs
You may be constipated if you have;
Fewer bowel movements than normal
Pain and straining when passing stools
Stomach pain. The build up of stools in your bowels can give you cramps and make
you feel bloated and queasy. This will go away once your bowel movements return to
Small, dry, hard stools. The bowel removes water from the stools; normal stools are
usually about 70% water. This means that if the stools remain in the bowel for too
long, they dry out and become hard. If your stools are dry and hard to pass, some
can stay in the bowels after a bowel movement so that you may feel like you still
need to go.
Sore bottom. The skin around the anus can tear and become sore and cracked if you
have to strain. You might notice bright red blood or light red streaks on your stools or
underwear. Treating your constipation should help by making the stools softer and
allowing the skin to heal.
Unpleasant smell due to passing foul smelling wind.
Leaking of liquid or loose stools. When large stools get stuck and block your bowel,
liquid stools above the blockage can flow around it and out causing you to leak
watery stools into your underwear (bypass soiling).
Updated September 2013
There are various things you can do to help keep your bowels healthy and avoid becoming
As a general rule, eating more high-fibre foods such as wholegrain bread, wholegrain
breakfast cereals, fruit and vegetables can prevent constipation. However, if constipation is a
result of Colitis or Crohns disease, increasing fibre intake could have a detrimental effect.
It's always best to discuss with your GP foods that could trigger constipation and other
methods which you can use to help ease or prevent the symptoms.
There are two different types of fibre; soluble and insoluble. If you're allergic to insoluble
fibre, then you may find that even though you have a daily intake of fibre, it may not be the
`right' fibre for you thus the condition may not improve.
Soluble fibre dissolves in the intestines to form a gel type substance. This helps food
move along the digestive tract. Foods included are: oats, citrus fruits, barely,beans,
peas, apples, bananas, berries, soya beans. Soluble fibre also helps to regulate
blood glucose levels.
Insoluble fibre is not dissolvable and moves through the intestines without being
absorbed. This fibre adds bulk to bowel movements and helps to reduce
constipation. Foods included are: apple skin, cherries, grapes, pineapple, rhubarb,
oranges, melons, date, prunes and berries. Vegetables with the highest amounts of
insoluble fibre are turnips, beets, cauliflower, cabbage, sprouts and carrot, broccoli,
green beans, cucumbers, onions, sprouts, celery, tomatoes, bell peppers and corn.
Nuts/seeds such as pumpkin, flax, peanuts, walnuts, cashews, and almonds, as well
as popcorn and lentils.
It has been suggested that insoluble fibre is best eaten raw for best results.
Make sure you drink lots of fluids to keep the stools moist e.g. at least 1.5-2 litres ( 6-
8 glasses) of water based drinks per day.
If you are taking any medicines (prescribed or bought from the chemist) ask your
doctor or chemist if they could be adding to your constipation. If possible, try to
remove constipating medications.
If really necessary, try using a fibre supplement such as fybogel and possibly
suppositories or mini-enemas to help regularise the bowels, but they should not be
used long term. Some foods can act as natural laxative for some people, these
include; prunes, figs, liquorice, coffee/tea, spicy food.
If possible, increase your physical activity as this helps to increase bowel activity.
Don't wait to do a bowel motion. If you feel the urge, go now! Take enough time to sit on the
toilet. A good time for this may be after breakfast or lunch, when your bowels are most
Make sure you sit on the toilet properly. For the correct toilet position please visit our
Updated September 2013
Does constipation cause stomach pain? This can cause;severe;stomach pain. ;Constipation can cause intestinal blockages at any point in the colon. These can block the intestinal track from passing waste material, fluids or gas along the digestion pathway, producing sharp stomach pains.
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