preventing constipation

Overview

Constipation happens when poop becomes hard, dry, or difficult to pass. It may also mean having fewer bowel movements than what is normal for you.

Very common. Many people have it from time to time.

People of all ages, but it is more common in older adults, pregnant people, and those who eat a low-fiber diet.

Symptoms

Common symptoms

• Fewer than three bowel movements a week
• Hard, dry or lumpy stools
• Straining or pain when passing stools
• Feeling that you have not emptied your bowels completely
• Bloating or stomach ache

Symptoms in children

• Having fewer than three poos in a week
• Poos that are large, hard and difficult to push out
• Soiling in the underwear
• Tummy pain or cramps
• Feeling irritable or eating less

Symptoms in older adults

• Very dry, hard stools
• Going for long periods without a bowel movement
• Needing to push very hard
• Leaking liquid stool (a sign of a blocked bowel)
• Confusion or restlessness linked to discomfort

Causes

Main causes

• Not eating enough fiber — for example fruit, vegetables, whole grains
• Not drinking enough water
• Not being active enough
• Ignoring the urge to go to the toilet
• Changes in routine, travel or stress
• Certain medicines, such as some painkillers, iron tablets or antacids
• Pregnancy or childbirth
• Long-term conditions like diabetes, thyroid problems or irritable bowel syndrome

Risk factors

• Being over 60
• Eating a low-fiber diet high in processed foods
• Taking certain medications
• Having limited mobility or being on bed rest
• Anxiety or depression
• Pelvic floor weakness

When to see a doctor

See a doctor urgently if:

• Constipation lasting more than three weeks despite home remedies
• No bowel movement for 5 to 7 days despite feeling the urge
• Severe bloating or cramping that does not improve
• Blood in the stool
• Unexplained weight loss or loss of appetite

Book a routine appointment if:

• You are over 50 and notice a change in bowel habits
• You have a history of bowel conditions
• Constipation is interfering with your work or daily life
• You feel a painful lump in your bottom (possibly a hemorrhoid)
• You need to use a laxative regularly to have a bowel movement

Diagnosis

Your doctor will ask about your symptoms, medical history, how often you open your bowels, and what your stools look like. They may feel your tummy and, with your permission, do a quick rectal exam (a check using a gloved finger) to feel for a blockage.

Tests that may be done

• Blood tests to check for thyroid problems or diabetes
• Stool sample (poo test) to look for signs of infection or inflammation
• X-rays or scans to look at your bowel
• A colonoscopy or sigmoidoscopy — a thin tube with a camera that looks inside your bowel (usually done if you have warning signs or are over 50)

What to expect at your appointment

A doctor will take time to listen to your story. Most people do not need tests. If tests are needed, they will explain why and how to prepare for them.

Treatment

Treatment focuses on easing symptoms and helping you return to a normal bowel habit. It often involves lifestyle changes like eating more fiber and drinking enough fluid. Your doctor may suggest a plan that is safe for you.

Self-care at home

• Eat more fiber-rich foods such as oats, wholemeal bread, apples, pears, vegetables and beans
• Drink plenty of water — aim for 6 to 8 glasses a day unless your doctor says otherwise
• Try to be physically active every day — even a short walk helps
• Set aside time to sit on the toilet after meals, when your bowels are naturally more active
• Do not ignore the urge to go to the toilet
• Gently massage your tummy or rock forward while sitting on the toilet to help with passing stool

Medical treatments

If lifestyle changes are not enough, your doctor or pharmacist can suggest a laxative (a medicine that helps you pass stool). Laxatives come in different types, such as bulk-forming, osmotic, stimulant or stool softeners. They should only be used as directed and for a short time unless a doctor advises otherwise.

Living with this condition

For most people, constipation is a temporary problem. If it continues, you will need to build habits that help your bowels work well. Be patient, as it may take a few weeks to get back into rhythm.

Lifestyle tips

• Keep a regular toilet schedule
• Have a high-fibre breakfast every day
• Stay hydrated throughout the day
• Move your body regularly
• Limit processed foods, high-fat foods and excessive caffeine
• Avoid smoking and limit alcohol

Diet and exercise

Eat plenty of fruits, vegetables, whole grains and legumes. Drink at least 1.5 to 2 litres of water a day unless you have fluid restrictions. Exercise like walking or swimming can help stimulate the muscles in your digestive tract.

Mental health and emotional wellbeing

Constipation can be uncomfortable, embarrassing and frustrating. It can affect your mood and quality of life. Talking to your doctor or a counsellor can help you manage these feelings.

Prevention

Yes, in many cases. A fiber-rich diet, enough fluids, and regular activity are the most effective ways to prevent constipation. Learning to respond to the urge to go to the toilet and making time for it also helps.

Screening programmes

There is no routine screening for constipation. However, if you are over 50 or have symptoms like blood in the stool, your doctor may recommend a screening test like colonoscopy to rule out bowel cancer.

Complications

If left untreated

• Hemorrhoids (swollen veins around the anus)
• Anal fissures (small tears in the skin around the anus)
• Fecal impaction (a hard mass of stool stuck in the bowel)
• Prolapse (a part of the rectum pushes out through the anus)
• In severe cases, bowel obstruction (a blockage in the bowel) leading to vomiting and severe pain

Long-term outlook

The outlook for constipation is very good. Most people improve quickly with simple lifestyle changes. If a medical condition is the cause, treating that condition will often ease the constipation. With the right help, you should be able to pass stools comfortably and regularly.

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