Constipation

Constipation is a common condition that is characterised by abnormal bowel movements. If you are constipated, your bowel movements may occur less often than usual, or they may be uncomfortable and difficult to pass.

Constipation can also cause stools to be lumpy and hard, and smaller or larger than normal. Some people may even experience severe bloating - often caused by trapped wind - as well as cramping pains in the abdomen.

There are many different reasons why constipation occurs, and while for some symptoms may only be temporary, for others they can be ongoing. In cases where constipation becomes chronic (long-term), complications such as haemorrhoids can develop.

This page will explore the condition in more detail, highlighting the symptoms of constipation and the types of treatment used to manage and prevent these. One particular method is through lifestyle changes - including dietary changes that can help alleviate symptoms.

Symptoms of constipation 

Each individual will have different bowel habits. While some people go more than once a day others may go every other day. Neither of these habits is abnormal, unless they represent a sudden change in bowel movements and cause discomfort. 

Constipation tends to affect people in two ways: 

  • Bowel movements become less frequent.
  • Bowel movements are still regular, but cause significant discomfort.  

If you are concerned that you may be constipated, take a look at the list below which highlights common symptoms of constipation: 

  • Straining when trying to pass a bowel movement.
  • Feeling as though you haven't fully emptied your bowels.
  • Passing stools that are unusually small (like 'rabbit droppings') or large.
  • Passing stools that are hard and lumpy.
  • Experiencing pain and/or discomfort in your abdomen.
  • Having fewer than three bowel movements a week. 

What causes constipation? 

Constipation can affect people of all ages, but typically occurs when stools remain in the large intestine (colon) for too long and too much water is absorbed. This makes stools hard and dry; affecting how smoothly they pass through the gut. 

There are several factors that can contribute to this problem. Please see below a list of what causes constipation: 

  • Lack of dietary fibre - not eating enough fibrous foods such as fruit, vegetables and whole grain breads and cereals. 
  • A change in routine or lifestyle - particularly eating habits.
  • Dehydration - not drinking enough fluids.
  • Lack of exercise and physical activity.
  • Ignoring the urge to pass stools.
  • Having a high temperature.
  • Being underweight or overweight.
  • Having limited privacy when going to the toilet. 

Other causes of constipation 

Pregnancy 

It is common for women to experience bowel problems during pregnancy - particularly during the early stages. According to the NHS, constipation affects around two in every five pregnant women. This is due to the increased production of the progesterone hormone which acts as a muscle relaxant. As a result, the muscles lining the bowel - which produce the rippling, wave-like motion to pass stools through the colon - stop working properly. This means stools will remain in the colon for longer - leading to constipation. 

Medication 

Some medications can cause constipation as a side effect. Antidepressants, calcium supplements, iron tablets and medicines to treat epilepsy and schizophrenia are among these.

Health problems 

In rare cases, persistent or chronic constipation could be a sign of an underlying health problem, such as irritable bowel syndrome (IBS), diabetes, underactive thyroid gland, multiple sclerosis and inflammatory bowel disease (IBD) to name a few. You should make an appointment with your GP if you have persistent unexplained bowel changes or weight-loss which do not improve after changing your lifestyle and eating habits.

Constipation in babies and children 

Irregular bowel movements in babies and children is common, and the NHS reports up to one in every three children in the UK has constipation at any one time. There are various causes of constipation in babies and children, including poor diet and poor toilet training. In some cases the cause is simply unknown. For others, a fear of using the toilet may also be a factor.

Although it is rare, irregular bowel movements in babies and children may indicate an underlying health problem. It is important to make an appointment with your GP if you have any concerns.

Constipation and trapped wind 

One side effect of constipation is trapped wind, which can contribute to abdominal bloating, pain and discomfort. Cutting down on specific foods such as beans, broccoli, cabbage, onions and cauliflower can help to reduce trapped wind, but you should up your intake of other fruit and vegetables to ensure you not eliminating too many nutrients from your diet. Lifestyle changes such as drinking more water and keeping physically active can also make a big difference.

What helps constipation? 

There are several ways you can help to prevent and manage mild symptoms of constipation, and these measures typically involve lifestyle changes - specifically to your diet and everyday routines.

Constipation diet

A significant part of treatment involves making changes to your diet. It is particularly important to ensure you are eating plenty of fibre - around 18-30g a day. Fibre adds bulk and softness to stools, which helps them to pass through the colon more effectively. This will help to keep bowel movements regular.  

High-fibre foods include the following: 

  • whole meal breads, rice, pasta and flour
  • whole grain breakfast cereals such as bran, Weetabix and muesli
  • fruit and vegetables
  • seeds and nuts
  • oats.

It may take anywhere between a week and a month to start seeing the effects of a high-fibre diet, and over the first few days you may feel bloated and experience trapped wind as your gut gets used to the extra fibre. Drinking more water and cutting back on caffeine and alcohol is essential when upping your fibre intake. Drinking eight to 10 cups of water a day (two litres) will help to prevent a blockage in the gut, which can occur if the body is dehydrated. This is because stools need to have enough moisture to pass through the colon.

Please ensure you consult a professional before making dietary changes that may help alleviate symptoms, as fibre intake should be increased gradually. 

Lifestyle changes 

Below is a list of further lifestyle changes that can help to prevent constipation and keep symptoms at bay.

  • Toilet habits - Do not ignore the urge to go to the toilet as this can lead to constipation. When you use the toilet give yourself enough privacy and time to pass stools comfortably.
  • Exercise - Aim to do at least 150 minutes of physical activity a week to avoid the risk of becoming constipated. More exercise will also help to improve your mood and energy levels as well as your general fitness.  

Medication 

Medication such as laxatives is often prescribed if lifestyle changes to help relieve symptoms do not work well. If you are suffering from chronic (persistent) constipation your GP will probably prescribe a dose of laxatives to be used over a period of time to keep your bowels moving. 

Over-the-counter laxatives are generally used for short-term, uncomplicated cases of constipation and are stopped once stools are passed. But chronic constipation may be a result of a build-up of faeces in the bowel, which can cause blockages. There are several different types of laxatives which all work in different ways so do make sure you seek professional advice before taking any. 

How can a nutritionist help? 

A registered nutritionist or dietitian will devise a tailored constipation diet plan specific to your individual requirements. Education is the first step towards treating the condition, and a nutritionist can teach you about the nutritional value of certain foods so you can reclaim control of your life and choose the right products to suit your needs. A nutritionist will deliver expert advice relevant to your constipation symptoms in order to make living with the condition easier.  

Content reviewed by dietitian, Christina Merryfield. All content displayed on Nutritionist Resource is provided for general information purposes only, and should not be treated as a substitute for advice given by your GP or any other healthcare professional.

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