What can I do for constipation?
Constipation is something that all of us have suffered with at some point. Bowel habits vary between people. Going a couple of times per day down to only going a couple of times per week can be normal for different people.
Bowel motions are made up of water, undigested fibre, waste solids, fats and bacteria. Changes to the normal amounts of these things can cause hard stools that are difficult to pass.
This can result in
- abdominal pain
- abdominal bloating
- straining to pass the motion
- sensation that the bowel hasn’t been completely emptied
- not feeling the need to go as often
Causes of constipation
Change in normal dietary routine – we need soluble and insoluble fibre in our diet. Soluble fibre makes our stool soft. Fruits and vegetables are good sources of soluble fibre. Insoluble fibre adds bulk to the stool that makes it easier to go through the digestive tract. Wholegrains are good sources of insoluble fibre.
Insufficient water intake – water is needed to mix with the fibre so that it can move through the digestive tract. If there is not enough water and too much fibre the fibre can set like cement in the digestive tract
Change in physical routine – if we don’t move our bodies enough it is difficult for the muscles of our large intestine to also move in a wave like motion to pass the stool through. This includes lack of exercise as well as illness resulting in reduced activity.
Medications – opioid analgesics such as codeine commonly cause constipation. Most iron supplements can as well. Prescription medications such as calcium channel blockers and antidepressants can also cause constipation.
Pregnancy – the pressure of the growing baby against the intestines as well as hormones makes constipation common.
Other medical conditions – there are other causes. Speaking with your Pharmacist or Doctor can help to determine what the cause may be for you and what action to take.
Treatment of constipation
A stool softener medication or a laxative may be needed short term.
Stool softeners, such as docusate, make the stool softer (obviously) and easier to pass.
Stimulant laxatives stimulate the bowel to make it contract. Examples include bisacodyl and senna.
Osmotic laxatives cause water to enter the bowel and the stool so it can be passed more easily. Examples include lactulose, macrogol and glycerol.
Laxatives are very helpful for short and long term constipation.
There is no evidence to say that using laxatives long term makes the bowel lazy. Therefore these can be used safely after consulting with your Doctor or Pharmacist.
Other ways to treat constipation
As well as using these medications the following should be done.
Increasing fibre – Fruits, vegetables, whole grain cereals and legumes are good sources of fibre. Dairy products, white flour and white rice can make constipation worse.
Fibre supplements – these can be used if fibre can not be obtained through diet. Care must be taken to ensure fluid intake is increased so that the fibre does not cause constipation by setting in the instestines.
Increasing fluids – The stool needs fluid so that it does not get too hard and difficult to more. Avoid too much tea, coffee and alcohol as these can dehydrate and make the symptoms worse. Water is best.
Increase exercise – Our bodies need to move so that the muscles in our intestines can contract to move the stool through. Go for a brisk walk or jump up and down or use a skipping rope to get things moving.
If in doubt about what is normal and what to do please ask your health care professional. We are used to talking about this stuff so don’t be embarrassed!