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Constipation

What causes bowel problems?

Many different things, such as diet, fluid intake, medication or even a change to your lifestyle and daily routine can affect the bowel, sometimes causing constipation.

Constipation is a common problem, affecting approximately one adult in six.

What is constipation?

The frequency of bowel opening varies from person to person, with some people having their bowels open daily or as often as three times a day.

However, you may be one of a group of people who have their bowels opened only every third day or even less frequently.

People often use different terms to describe constipation, but it is usually associated with:

  • A delay in passing a motion/stools so a stool is not passed every day
  • The consistency of the stool becoming hard
  • The stool becoming difficult or uncomfortable to pass.

When food is eaten it is broken up into smaller pieces by the teeth and goes down into the stomach to be broken up further. (This process is called digestion)

From the stomach, food passes into a tube called the small bowel or intestine/colon.

The small bowel is where food is made into a thick liquid (a bit like vegetable soup).

The last part of the journey is through a larger tube called the bowel or colon.

As the food passes along the bowel tiny blood vessels, which run alongside the bowel absorb all the useful parts of food (nutrients).

Gradually all the nutrients are absorbed and these help to keep our bodies healthy and give us energy.

Left behind are the waste products that are not needed, these gradually become more solid as liquid is absorbed back into the body.

The stool eventually reaches the far end of the bowel (called the rectum). The rectum expands as it senses its arrival. A message is then sent along the nerves to warn us that the stool is there and we will need to find a toilet soon.

The feeling we get in our rectum varies. Some people are not able to recognise this feeling and if this happens there may be a delay in passing a stool.

If the journey of food takes a long time, the body will absorb more fluid. This will make the stool harder in consistency and uncomfortable to pass and make you put off a visit to the toilet.

How will I know if I am constipated?

All of these may be symptoms of constipation:

  • Poor appetite, not eating so well
  • Lethargy, lack of energy
  • Irritability, feeling unhappy
  • No regular bowel habit
  • Distended or bloated stomach
  • Occasionally passing a very large stool
  • Passing a small hard stool
  • Overflow of loose stools, soiling or staining
  • Pain or discomfort when passing a stool
  • Bleeding after passing a stool

How can I prevent constipation?

Stools are different according to what we eat. Some foods leave lots of waste by the time they reach the large bowel. These are high fibre foods. It may be helpful to increase the high fibre in your diet. This will help speed up its journey through the large bowel. It will also make the stool softer and easier to pass.

Fibre

Fibre is found in many foods, but some foods have more fibre than others.

Good examples of high fibre foods are:

  • Granary or wholemeal bread
  • Cereals, such as Weetabix, All Bran, Shreddies
  • Raisins, Wheats and Porridge
  • Wholemeal pasta and brown rice
  • Baked beans and sweetcorn
  • All fruit (leave the skin on where possible)
  • Jacket potatoes with the skin left on and eaten
  • Digestive biscuits, Fig Rolls and Hobnobs

Many cereals can be made into delicious cakes and biscuits, which you may prefer. Make the change to a high fibre diet slowly, this should take a few weeks.

Too much fibre will make you feel too full and may cause problems with wind and could reduce your appetite. Certain foods like eggs can also cause constipation if eaten in large amounts. Try to vary the amount of fibre in the diet once you have found the most suitable amount.

Fluids

It is important to make sure you have enough to drink. Extra fluid is needed when you increase the amount of fibre in the diet. This will help the fibre to swell and keep the stool softer. Six to eight mugs of fluid are usually needed each day in the form of a mixture of drinks, tea, juices, water etc.

Sweet, milky or fizzy drinks often give a feeling of fullness, reducing the amount you may want to eat. Extra drinks are also needed during an illness like a cold, in hot weather or following exercise.
 

Exercise

Try to improve the natural movement of the gut by keeping active. Exercise does not have to be strenuous. Gentle activities, such as walking, help to speed up the process of digestion, promoting a regular and trouble-free bowel action.

Bowel Routine

A regular routine will help to prevent constipation. Food works like a starter motor for the bowel. It warns the bowel to make room for more.
The best time to encourage the bowel to work is about 20-30 minutes after a meal. After breakfast is usually a good time to sit on the toilet, especially after a warm drink and bowl of cereal or food. If your bowel movements are irregular at first, try sitting on the toilet after each meal, until a pattern emerges. If you are successful at one particular time, try not to vary the time each day.

It is important to allow sufficient time to sit, as sometimes after one stool is passed, another one follows. About 10 minutes sitting in a comfortable position is usually long enough.

Pay attention to your bowel signals and don't ignore the message to go, as this may cause constipation.

10 Steps to maintaining a healthy bowel

1. Do change to a high fibre diet
2. Don't increase the fibre in your diet too quickly
3. Don't vary the amount of fibre too much
4. Do avoid an excess of sweet sugary foods and drinks
5. Do make sure you have enough to drink, six to eight mugs per day
6. Do increase your daily exercise
7. Do try to develop a regular bowel routine
8. Do allow sufficient time to sit on the toilet
9. Don't ignore the message to go
10. Do ask for advice if you recognise any of the symptoms of constipation