What is constipation?
Constipation is a condition that can cause stools to be lumpy and hard, and smaller or larger than normal. Some people may experience 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.
What are the symptoms of constipation?
Everyone has 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're experiencing any of the following symptoms, you may be constipated:
- 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, making them harder to pass.
There are several factors that can contribute to this problem:
- a 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);
- a 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 can include:
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 increased production of the hormone progesterone, 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.
Underlying health conditions
In some 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 are common, and the NHS reports that 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.
Can constipation cause trapped wind?
One side effect of constipation is trapped wind, which can contribute to abdominal bloating, pain and discomfort. Cutting down on some 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 are 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.
Can constipation cause weight gain?
Constipation can sometimes make you feel bloated or heavier than usual, but it doesn't typically cause weight gain. If stools remain in the bowel for longer than normal, this can lead to temporary changes in your weight until your bowels return to their usual pattern.
In some cases, constipation and weight gain may be linked to the same underlying cause, such as changes to your diet, reduced physical activity or certain health conditions. If you're experiencing persistent constipation alongside unexplained weight gain, speak to your GP to rule out any underlying health concerns.
How to prevent 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.
Foods that may help relieve constipation
A significant part of treatment involves making changes to your diet. It is particularly important to ensure you are eating plenty of fibre. Current guidelines recommend that those aged 16 and older should eat at least 30g of fibre a day. Fibre adds bulk and softness to stools, which helps them to pass through the colon more effectively. This helps keep bowel movements regular.
High-fibre foods include:
- 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 six to eight cups or glasses of fluid a day can help to prevent a blockage in the gut, which may occur if the body is dehydrated. This is because stools need to have enough moisture to pass through the colon.
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 can also help improve your mood and energy levels, as well as your general fitness.
Treating constipation with 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 may 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 that all work in different ways, so make sure you seek professional advice before taking any.
How can a nutritionist help with constipation?
A nutrition professional can devise a tailored constipation diet plan specific to your individual requirements. Education is the first step toward treating the condition, and a nutrition professional 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 can share expert advice relevant to your constipation symptoms to make living with the condition easier.
If you've tried making changes to your diet and lifestyle but your symptoms persist, working with a nutrition professional may help. They can provide personalised advice to support your digestive health and help you build eating habits that work for you.
