Everything You Need To Know About Constipation / HARTMANN Information Centre

The HARTMANN Team

What Is Constipation?

Constipation is a common problem suffered by many. People of all ages can be affected by constipation for a wide variety of reasons. It usually means that you do not pass stools regularly, and in some cases, the condition prevents you from completely emptying your bowels. This results in stools that are lumpy and hard, or abnormally small or large.
Constipation usually occurs when the colon absorbs too much water from food. This causes food to move too slowly through the digestive tract, and even more, water is absorbed by the colon. As a result, faeces become dry and hard, and emptying the bowels can become difficult and painful.

People experience varying degrees of constipation. Some only have this problem for a short time, but for others, it is a chronic condition that can be extremely painful and uncomfortable, and negatively affect their quality of life.

How Long Does Constipation Last?

Constipation can last differing amounts of time for different people and depends on the underlying cause. For some people, constipation occurs infrequently, and the problem is resolved within a few days or a week. For others, it becomes a lifelong condition that reoccurs again and again, and causes discomfort and pain.

What Causes Constipation?

Many different factors and conditions can contribute to constipation, and it can be difficult to pinpoint the exact cause. Here are some of the most common factors that contribute to constipation:

  • Not having enough fibre in your diet, including fruit, vegetables and whole grains
  • A change in your typical routine or lifestyle, particularly if you have changed your eating habits. People often find that they become ‘backed up’ on holiday or when stressed.
  • Becoming dehydrated or not drinking enough water and fluids
  • Ignoring the urge to defecate for a prolonged period of time
  • An adverse reaction or allergy to certain foods
  • Anxiety and depression
  • Limited privacy when you are trying to use the toilet
  • Being overweight or underweight
  • In children, a fear of using the toilet during toilet training can cause constipation
  • A lack of exercise or immobility
  • Psychiatric issues, including those that are triggered by sexual abuse or trauma

Toilet

Constipation and Medications

Constipation can also be one of the side effects of certain medications and supplements. The most common medicines that cause constipation include:

  • Antidepressants
  • calcium supplements
  • aluminium antacids (medicines used to treat indigestion)
  • antiepileptics (epilepsy medicines)
  • antipsychotics (used to medicate schizophrenia)
  • iron supplements
  • morphine, codeine and other opiates
  • diuretics (water tablets)

If you are experiencing constipation caused by medications, the problem will likely be eased when you stop taking them. If you are taking these medications on a long term basis, speak to your GP about potential laxatives or alternative medications.

Pregnancy and Constipation

Approximately 40% of women will experience some degree of constipation during their pregnancy. This is often at its worst during the early stages and at the end of the third trimester. Constipation in pregnancy often occurs because your body is producing more progesterone, a female hormone that can act as a muscle relaxant.

In order for the bowel to work properly, stools and waste products move through to the anus by a process called peristalsis. The muscles that line the bowel start to ripple and relax, and this moves the stool along the system. Progesterone prevents the bowel muscles from contracting, and the waste products do not move along as smoothly. If you are suffering from constipation in your pregnancy, consult with your GP or midwife for treatments that are safe for you and your foetus.

Constipation can be a sign of a serious underlying condition

In certain cases, constipation can be a sign of a more serious underlying condition. This is important to remember if you suffer from constipation for a prolonged period of time, or if it recurs again and again.

These conditions can include:

  • irritable bowel syndrome (IBS)
  • diabetes
  • inflammatory bowel disease
  • an underactive thyroid gland (hypothyroidism)
  • muscular dystrophy
  • hypercalcaemia ( too much calcium in the bloodstream)
  • multiple sclerosis
  • Parkinson's disease
  • a spinal cord injury
  • an anal fissure
  • bowel cancer

What to Eat For Constipation

  • Prunes – Prunes are packed with fibre, as well as sugar alcohol called sorbitol that is not absorbed well by the body. They also contain phenolic compounds, known to stimulate beneficial gut bacteria.
  • Apples – Apples are loaded with fibre, including a lot of insoluble fibre that stimulates the bowel. The soluble fibre in apples is called pectin, which is quickly fermented in the gut and forms short-chain fatty acids. These attract water into the colon, and this softens your stool.
  • Artichokes – Research has shown that artichokes promote good gut health and regularity. They are loaded with prebiotics and fibre.
  • Pears – Pears are rich in fibre, and are high in fructose and sorbitol, both of which are natural laxatives.
  • Spinach, Broccoli, Kale and Brussels Sprouts – Greens are often lauded as ‘super foods’ owing to their high levels of fibre, Vitamin C, folate, and Vitamin K. They add bulk to stools, allowing them to pass more easily through the bowel.
  • Kiwifruit – Kiwifruit are higher in fibre than you might think, with nearly 10% of your recommended daily intake in just one fruit. The fibre helps to soften the stool, as does an enzyme known as actinidain.
  • Beans, Peas and Lentils – Lentils, beans and peas are also known as pulses, and they are packed with both insoluble and soluble fibre. They soften stools, and add bulk and weight to them in order to facilitate easier

When Does Constipation Become Serious?

If you have been constipated for more than three weeks, you should make an appointment with a GP. You should also seek immediate treatment if you notice any of the following:

  • Your stomach is painful or hard
  • You have blood in your stools
  • You are losing weight rapidly and without trying

If you leave your constipation untreated for too long, it can lead to haemorrhoids and even a rectal prolapse, a condition caused by straining in which parts of the intestine push out through the anus. It can also lead to incontinence over time, requiring you to utilise incontinence products.

How To Get Rid Of Constipation

Try some of these simple tips to get rid of constipation. If you have chronic or extremely painful constipation, visit your GP.

  • Drink more water and fluids and keep hydrated.
  • Eat more fibre found in fruits, vegetables and legumes.
  • Get more exercise, including walking, jogging and gentle stretching.
  • Have a cup of caffeinated coffee to stimulate the bowel.
  • Try the herbal laxative Senna (but do not take this, or any laxative, too often).
  • Eat probiotic foods, including fermented foods.
  • Follow a low-FODMAP diet to determine if your constipation is a symptom of irritable bowel syndrome (IBS).
  • Take a magnesium citrate supplement.

How To Relieve Constipation When On The Toilet?

If you are struggling to defecate while sitting on the toilet, try squatting (rather than sitting). The squatting position puts gravity on your side, meaning that you do not have to strain and push. The weight of your torso presses on your thighs, and this compresses your colon and unkinks your intestines.

What Can and Cannot Cause Constipation

Can stress cause constipation? Yes, stress is a common factor leading to intermittent constipation. It prevents the bowel and rectum from relaxing.
Can co-codamol cause constipation? Yes, all medications that contain codeine can cause constipation.
• Can bananas cause constipation? While ripe bananas will not cause constipation, unripe or green bananas can, as they are high in starch (which is hard for the body to process).
• Can eggs cause constipation? On their own, eggs cannot cause constipation. However, a diet low in fibre and high in fat and protein can.
• Can paracetamol cause constipation? In some rare causes (approximately 5%), paracetamol can cause stomach distress and constipation.

Summary

In many cases, constipation is not serious and will pass quickly. However, in rare cases it can be a symptom of something more serious – always visit your GP If you have any concerns.

 

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