Irish Visitors Click HereWhat are the possible consequences of being constipated? - by Dr Mark Porter
Constipation affects people in a number of different ways. In most cases it's nothing more than an inconvenience, but in some people it will have a significant impact of the quality of their day-to-day life.
Doctors tend to focus on the possible physical complications that arise from the need to strain, and changes in the muscular bowel wall resulting from it having to work harder than normal. There are three common ones - fortunately all respond well to dealing with the underlying constipation, and, in most cases, that's all the treatment that is required.
- Piles (haemorrhoids) - swellings of the veins and surrounding tissue lining the anal canal. Constipation is by far the most important cause of piles. The more you have to strain when you go to the loo, the more likely you are to develop them.
Piles are mainly a problem in people aged between 20 and 50, and half of us will develop them to some degree by middle age.
Telltale signs include bleeding - typically noticed as blood on the paper after wiping - an itchy or sore bottom, and, in more advanced cases, a noticeable lump just outside of the anus after opening your bowels. Treatment depends on the severity, but preventing constipation is a key first step. - Diverticular disease (diverticulosis) Ideally it should take food between 12 and 48 hours to travel the length of the gut, but it takes closer to 70 hours for people eating a typical low fibre British diet. Fibre traps water in the bowel and helps keep the bowel contents soft and easy to move - the lower the fibre content, the harder and drier the motions and the more difficult it is for the muscular bowel wall to move them along. With time this extra effort causes changes in the bowel wall that leads to a development of pouches or diverticulae - I often describe them as looking similar to the sort of deformity you see in the side of a tyre where a weakness has allowed the inner tube to bulge out. Bits can get stuck in these diverticulae leading to inflammation (diverticulitis).
Diverticular disease is almost unheard of in Africans who rarely suffer from constipation, but 6 out of 10 Britons will eventually develop it. There are no reliable symptoms and an attack of diverticulitis may be the first and only sign - symptoms of which include diarrhoea, blood loss, abdominal pain and a high temperature. It can mimic appendicitis (although the pain tends to be on the left rather than the right). - Anal fissure this is a tear in the lining of the anus caused by straining and passing a hard bulky stool. The classic symptoms include a sharp pain on opening your bowels accompanied by bright red blood on the paper. Caught early fissures are relatively easy to treat, but if the constipation persists they can become chronic and may require surgery. Whether acute or chronic, treating the constipation is the key to preventing recurrence.
Although doctors may be most interested in the above complications, the general public often have very different concerns.
- Over half of men and women with constipation questioned in a recent survey at one of the country's leading bowel hospitals said that it's the accompanying pain and bloating that eventually persuaded them to seek medical help.
- Fifty percent said their constipation affected their ability to concentrate at work.
- Around a third complained of backache when constipated, three-quarters said it made them feel tired and / or irritable
- Nearly half said constipation made them feel depressed.
- And 1 in 4 said it seriously affected their love life.
- View interactive animations of how the digestive system works »
- Find out what the symptoms of constipation are »
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