Constipation


Updated July 2006

Difficult and infrequent passage of small, hard stools.

An individual is normally suffering from constipation when he or she has small and hard stools, or if they have to strain to pass them. The frequency with which stools are passed are considered less important than their composition because healthy people have bowel movements at widely differing intervals, ranging from three times a day to three times a week. Most people tend to have a regular routine, and bowels usually function best if they are allowed to follow a consistent pattern.

Bouts of constipation are usually harmless, but occasionally may indicate an underlying disorder. A doctor should be consulted if constipation becomes severe, lasts more than two weeks, particularly if it first occurs after the age of 50, or if blood is present in the faeces.

A diet that is low in fibre and fluids is the most common cause of constipation. Drinking too much alcohol or caffeine, which leads to dehydration, can also make faeces hard and difficult to pass. Other factors that decrease the frequency of bowel movements are taking too little exercise and long periods of immobility. Increasing immobility in elderly people makes constipation much more common in these age groups.

In order to prevent constipation or reduce its severity:
  • increase daily fibre intake (bran, wholemeal bread, cereals, fruit, and beans are fibre-rich)
  • reduce daily intake of highly refined and processed foods (cheese or white bread for example)
  • increase daily fluid intake
  • avoid drinks containing alcohol or caffeine
  • do not use stimulant laxatives persistently – the colon may become reliant on them to function
  • do not ignore the urge to defecate – the longer that faeces remain in the colon, the drier and harder they become
  • try to achieve a regular routine for bowel movements.
If constipation persists despite taking these measures, consultation with a doctor should be sought.

Further information
- American Gastroenterological Association
- BBC Health – Constipation
- CancerResearch UK – Constipation
- MedlinePlus Medical Encyclopaedia - Constipation
- MedlinePlus – Constipation
- National Institute of Diabetes & Digestive & Kidney Diseases (US)
- NHS Direct Online – Constipation
- MedlinePlus Interactive Tutorials – Colonoscopy

© British Medical Association 2008

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