Constipation is the most common digestive complaint and can result in anorectal complications such as anal fissure and haemorrhoids.

Most people think of constipation as reduced frequency of stools. While this is part of the definition of constipation (less than 3 times a week), it is not all. Straining or passing a hard stool more than 25% of the time (1 in 4) is also defined as constipation. Incomplete emptying of the rectum gives a feeling of constipation despite having soft stools and opening the bowels frequently.

It is very important to report any change in bowel habit (whether it be diarrhoea or constipation) that lasts more than 4 weeks. This is because a change in bowel habit is one of the most common symptoms of left sided colon cancer. It may need to be excluded by having a colonoscopy and it is important to discuss this with your doctor.

Constipation may be due to a number of medical conditions or a side effect of medications. It is important to see your doctor for a detailed history of your symptoms as well as a clinical examination. It may take multiple appointments and investigations to reach a diagnosis of the cause of constipation. This is especially so in long-standing cases where the patient may suffer from slow bowel function.

In most cases, however, constipation is due to a combination of poor intake of fibre and fluids and lack of regular exercise. 

Prevention & treatment of constipation:

A combination of fluids, fibre and mild regular exercise usually prevents constipation.

  • Fluids – 2 litres / day (8-10 glasses) unless you are on a medical fluid restriction (such as for heart failure).
  • Fibre – A healthy diet should contain at least 30g of fibre. If you find it difficult to fit enough fibre in your regular diet, you may wish to seek advice from a dietitian or nutritionist.Fibre supplements such as Metamucil, Benefibe or Normacol should be used at least until dietary fibre usage is adequate. These supplements can be used on a long-term basis especially if it is difficult to change one’s diet.Gradually increase the amount of fibre supplementation. Start with once a day for a week and build up to twice a day over the following 1-2 weeks. For more information about a high fibre diet, follow this link: Click here
  • Walking – 30 mins/day on most days of the week. This obviously depends on your age and cardiovascular fitness and should be discussed with your doctor if you have any concerns.
  • The addition of Movicol (1-3 sachets/day) can help especially until the above three steps can be incorporated into your lifestyle.
  • Laxatives such as lactulose and coloxyl (+/- senna) are only useful in the short-term and should not be used as long-term treatment of constipation.