Constipation
Constipation is when your bowel motions ('poo' or faeces) are less frequent and you have trouble passing them as they are often hard and dry. You may only be able to pass small amounts at a time or have difficulty passing them. Other signs you may be constipated are pain, cramps or swelling in the abdominal area or perhaps you leave the toilet feeling your bowel is not completely empty.
What causes constipation?
Constipation usually happens because the colon (part of the digestive system) absorbs too much water from your food. If the food moves through the digestive system too slowly, too much water may be absorbed. The bowel motions at the end of the digestive process are then too dry and hard.
Many things can cause or worsen constipation including:
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not eating enough fibre (fruit and vegetables, wholemeal bread, high fibre cereals)
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not drinking enough - always drink more when you increase fibre in your diet
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not doing enough exercise
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anxiety, depression, grief
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delaying the urge to go to the toilet
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using laxatives for a long time
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the side effects of some medicines (even some common ones like pain killers or iron tablets)
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pregnancy
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being overweight
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not being able to go to the toilet because of poor mobility
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some nerve diseases
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some bowel problems like haemorrhoids, irritable bowel syndrome, or diverticulitis
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anorectal pain caused by haemorrhoids, fissures (tear in the skin of the anus) or birth trauma, or
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a slow transit bowel which means it takes longer for the faeces to travel all the way to the rectum, so more water is removed over time and constipation is much more likely. This occurs where there is nerve damage such as with stroke, Parkinson's, multiple sclerosis or trauma.
If you think you have constipation, talk to your doctor who can recommend some ways to help. One way to treat constipation is by taking a type of medicine called a 'laxative'. There are various types of laxatives and they all work differently so it's important to talk to your doctor before taking laxatives. Types of laxatives include:
- bulking agents
- lubricants, and
- stimulating/irritant laxatives.
How does constipation affect my bowel?
Severe constipation is the most common cause of faecal incontinence (or bowel leakage), especially in older people. This is because hard bowel motions are difficult to pass and may cause a partial blockage high up the bowel, resulting in watery bowel motions flowing around the constipated stool without warning. This is sometimes mistaken for diarrhoea.
You can use the Bristol Stool Chart to check what your bowel motions should look like.
How does constipation affect my bladder?
Constipation can affect bladder control and urinary continence. If you sometimes leak urine or feel that you need to frequently visit the toilet to pass urine, it could be that constipation is involved. An over-full bowel (due to constipation) can press on the bladder, reducing the amount of urine it can hold or making you feel like to need to pass urine urgently.
Constipation can also affect your pelvic floor muscles. Pelvic floor muscle strength is important for both bladder and bowel control. These muscles stretch like a trampoline from the pubic bone at the front to the coccyx (tail-bone) at the back. They can be weakened by straining due to constipation, pregnancy and childbirth, or perhaps heavy lifting. Strong pelvic floor muscles are necessary for bladder and bowel control - to be able to 'hold on'.
