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Constipation is a very common problem

April 2012


Constipation is a very common problemIt is not a health problem we easily talk about, but in fact constipation, or a lack of easy regular bowel movements, affects many people of all ages and is very common.

Sometimes it is simply caused by lifestyle - not eating enough fibre in the diet, not exercising enough or even being too busy to visit the toilet and putting off natural rhythms. In modern life, these are all important contributory causes of constipation.

However, as people age, constipation can become more of a problem. Some of our normal functions can become less active and vigorous. Exercise can become more difficult due to health or physical restrictions. Certain medications, such as certain painkillers and blood pressure tables, can contribute to constipation. For some people, constipation becomes such a serious problem that it affects their day to day life and wellbeing.

Defining constipation is difficult because most people have different patterns in their natural bowel movements. Some people have regular motions every day, or even two or three times a day while others will generally have a motion perhaps just three times a week. Generally you will know if you are constipated because your stools (faeces) may become hard and difficult to pass. You may feel “full” in your lower abdomen. In more severe cases you may suffer pain in the abdomen or even feel sick.

Two very common causes are simply not having enough fibre in the diet and not drinking enough fluid.
Ideally most people should take in around 18 or more grams of fibre a day. Fibre is not digested but acts as a bulk carrier, helping to pass the waste from other foods through the six metres of intestines in your gut. Most people today know that vegetables, beans, pulses, nuts and lentils, fruit, cereals and wholemeal foods all contain good levels of fibre.

It is also so important to drink enough - the recommended level is about six to eight glasses of water a day (or other fluid).

Being active and exercise is also good as it helps all the body to work well and will contribute towards keeping your gut active and moving as well. If you are in bed for any length of time due to an illness, then constipation can become very likely.

If you have problems that you can’t improve with just diet and exercise, then obviously a visit to your medical practitioner is advisable just to check the situation isn’t a symptom of a more serious problem such as impactation, an underactive thyroid gland, bowel cancer or irritable bowel syndrome.

Laxatives can be a good starting point in the next stage of treatment and these are available in four main types. Bulk forming laxatives come as fibre supplements and do the same job as natural fibre. Many commercial products such as Fybogel and Ispagel contain ispaghula; while others such as Celevan contain methylcellulose. They all work by absorbing water and helping for form softer, bulkier faeces which are easier to pass. It is important to drink enough fluid when taking these and they can cause early bloating.

Another type of laxative is the stimulant laxative, which encourages activity in the nerves of the large intestine, causing the muscles in the wall to squeeze with more vigour to push the faeces through the system. Products in this group include Dulcolax, which includes bisacodyl and Senokot which contains senna.

Another type of laxative is the osmotic laxative which helps by retaining fluid in the large intestine. This type of laxative takes a while to have effect and can cause side effects such as abdominal pain and bloating. It is sold in products such as Duphalac and Movicol.

The fourth main type of laxative is the faecal softener to help a motion become easier to pass through. They usually include docusate sodium which has a gentle stimulant action as well.

Generally any laxative should only be used for a short time while other measures are investigated including medication, diet and exercise, to improve the situation. For some people though constipation remains a major problem and medical practitioners will then undertake further investigations.

There is a lot of research being undertaken now because constipation is such a common problem, and investigations are being made on neurotransmitters, the chemicals that help our nerves communicate with each other. Scientists are hoping to develop drugs that will adjust the nerves of the colon to ensure its muscles contract and propel its contents properly.


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