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What is constipation?

Constipation means you find it difficult to do a ‘number two’. You may have a bowel movement—but you have to strain to do it. Or you may go days without passing anything at all.

It usually involves dry, hard stools.

Under normal circumstances, our colon (the main part of the large intestine) does a great job of absorbing water and electrolytes from residual food on its journey to be expelled as waste. The muscles in the colon help to move the waste contents towards its final destination – the rectum.

However, if the journey takes too long and too much water is absorbed, the stools become dry and hard.

Other conditions associated with an increased risk of constipation include:

  • Pregnancy
  • Depression
  • Under-active thyroid
  • Irritable bowel syndrome (IBS)
  • Diverticulitis

What causes constipation?

The most common causes of constipation are:

  • Lack of fibre in the diet (such as fruit and vegetables)
  • Inadequate intake of water/fluids
  • Not doing enough exercise or movement

However, some medicines can also contribute to the problem:

  • Analgesics (painkillers) containing codeine (or other opioids)
  • Diuretics (‘fluid’ tablets), used to treat high blood pressure
  • Other antihypertensives (drugs used to lower blood pressure)
  • Some antidepressants
  • Some supplements that include aluminium, calcium or iron
  • Overuse of laxatives (ironically, the medicines used to treat constipation, if overused, can cause it)

Other conditions associated with an increased risk of constipation include:

  • Pregnancy
  • Depression
  • Under-active thyroid
  • Irritable bowel syndrome (IBS)
  • Diverticulitis

How to treat or prevent constipation

The most common treatment for constipation is a laxative, of which there are several types.

  • Bulk forming laxatives or fibre supplements, that work by absorbing water, bulking up faecal content and stimulating bowel movement. It’s important to drink lots of water when taking this kind of laxative.
  • Stool softeners (such as laxatives containing docusate) cause more water to move back into the colon/bowel, softening the stool
  • Stimulant laxatives (containing bisacodyl, senna or sodium picosulphate) work by stimulating contractions in the bowel
  • Osmotic laxatives (containing lactulose, sorbitol or magnesium) also work by drawing fluid into the bowel to soften and expand the stool

However, there are many simple things you can do to prevent constipation.

  • Increase the amount of dietary fibre in your diet by choosing wholegrains (in bread, cereals and rice)
  • Ensure you eat plenty of fruit and vegetables – raw or cooked. These are also a great source of other nutrients that will help maintain good health
  • Avoid over processed foods
  • Include beans, lentils and chickpeas in your diet
  • Add some nuts and seeds to your diet – they can be added to cereals or salads, or can be used as a healthy snack
  • Drink plenty of fluid (around 8-10 glasses per day). This includes tea and other fluids, but drinks containing a lot of caffeine will actually deplete fluid
  • Exercise regularly. Believe it or not, regular exercise helps regularity, by increasing muscle activity in the bowel. Remember to stay hydrated

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