Irish Visitors Click HereWhat is constipation? - by Dr Mark Porter
Doctors talk about someone being constipated if they don't have their bowels open regularly enough, and / or have to strain excessively when they do. Unfortunately different people have very different ideas about what is "regular". Hardly surprising given that there is tremendous individual variation - if you eat a Western European diet it's perfectly "normal" to have your bowels open anywhere between 2 - 3 times a day, and 2 - 3 times a week!
This large variation can make diagnosing constipation tricky - some of my patients get worried if they don't go every day, while others think it perfectly acceptable to go once a week!
How do I know if I'm constipated?
Try this simple questionnaire. Over the last three months:
1. Have you had to strain at least quarter of the times that you have been to the loo?
YES | NO
2. Have your stools been hard or lumpy at least a quarter of the times you have had your bowels open?
YES | NO
3. Have you been left with a feeling that your bowel is not completely empty at least a quarter of the times you have been?
YES | NO
4. Have you averaged two, or fewer, bowel movements a week?
YES | NO
Answering 'yes' to two or more of the above questions suggests that you have a problem with constipation that needs addressing.
YES | NO
YES | NO
YES | NO
YES | NO
Who gets constipation, and why?
Constipation is extremely common in the UK thanks, in part, to our relatively low fibre diet. Around 1 in 10 of the UK population suffer from ongoing constipation - a figure that rises to closer to 1 in 5 in the elderly. In childhood it tends to be more of a problem in boys, but in adult life it mainly affects women who have naturally slower bowels than men. Constipation can be caused by a number of underlying problems. Here are some of the more common ones:
- Dietary: Not eating enough fibre or drinking enough fluid
- Lack of physical activity: Particularly in the elderly and in people confined to bed.
- Pregnancy: Hormones tend to slow the bowel, and pregnant women often complain that they have difficulty opening their bowels.
- An under-active thyroid gland (hypothyroidism)
- Prescribed drugs: Particularly anti-depressants, some painkillers, water tablets (diuretics) and some drugs used to treat high blood pressure and angina.
- Over-the-counter medicines: Such as antihistamines, indigestion remedies, cough medicines and drugs used to treat diarrhoea.
- Nerve damage: Caused by underlying conditions such as diabetes and multiple sclerosis.
- Psychological problems: Including depression, ignoring the need to go because you are too busy, and reluctance to use public loos.
- Bowel disorders: Anything that makes going to the loo painful - such as piles and tears to the muscle - irritable bowel syndrome (IBS), rare abnormalities of the bowel muscle and, occasionally, cancer of the colon (this is more likely to cause looseness than constipation - other warning signs include bleeding when opening your bowels and unexplained weight loss).
How is constipation likely to affect me?
The Victorians were obsessed with regular bowel movements because it was believed that if you didn't have your bowels opened daily toxins would escape into your blood and make you ill - a condition that became known as autointoxication. We now know that this isn't a problem but constipation can still have a surprising impact on your general health and wellbeing. As we will be discovering next month, constipation can affect everything from your sex life, to your chances of developing piles and diverticular disease. Click here to read Dr Porter's next article »
- View interactive animations of how the digestive system works »
- Find out what the symptoms of constipation are »
- Click here to use our treatment advisor to help find an appropriate treatment »
