Constipation is infrequent or difficult bowel movements. It can cause discomfort and pain that affects your daily life.
The definition of constipation is when you have any of the below signs:
Constipation is a common condition. At any time, one in seven adults is constipated, with women twice as likely to be affected as men. It’s also estimated that one in three children suffers from constipation, often linked to toilet training. Irritable bowel syndrome can also cause constipation and you can experience abdominal pain or anal pain.
Although constipation can affect you at any age, you’re more likely to have it as you get older. If you are looking after someone with dementia, it can be easy to miss that they have constipation — look out for behavioural changes that suggest they are uncomfortable or in pain.
Constipation is also common during pregnancy and after having a baby.
Constipation may happen suddenly and only for a short time (acute) or may be gradual and long-term (chronic). However, whether acute or chronic, simple lifestyle and diet changes usually bring constipation relief.
It’s often difficult to pinpoint the cause of acute or chronic constipation. In many cases, it is caused by not eating enough fibre (eg fruits, vegetables and cereals), not drinking enough fluids, not taking enough exercise or repeatedly stopping yourself from passing stools when you feel the urge. Sitting or lying down for long periods of time can also cause constipation.
You can also develop constipation if the movement of your stools is slowed or stopped by blockages or damage to your colon or rectum. This can occur due to:
Nerve problems can cause constipation too by disrupting your body's ability to pass stools. They include conditions such as multiple sclerosis, Parkinson's disease, spinal cord injury and stroke.
Other common causes of constipation include:
Very occasionally, severe constipation can be a symptom of a medical condition, including:
Diabetes and nerve or muscle disorders, such as multiple sclerosis and Parkinson’s disease, can also cause severe constipation.
You should see your GP if you:
If you are taking medication (eg opioid painkillers) that is causing your constipation, you should see your GP to discuss solutions — do not stop taking any prescribed medications until you have discussed this with your GP.
You should also see your GP if current treatments and/or lifestyle changes for your constipation are not working.
Your GP will discuss your symptoms and medical history with you and may carry out a physical examination.
Your GP may refer you for further tests, such as:
Your GP may also refer you to a gastroenterologist, a consultant who specialises in the digestive system.
In most cases, simple changes to your diet and lifestyle should bring constipation relief. Home remedies for constipation include:
If you continue to be constipated, your GP might prescribe laxatives or another medication. Your GP might also refer you to a dietitian for specialist advice about constipation relief.
If changes to your diet and lifestyle are not improving your constipation symptoms, you can speak to a pharmacist. They may recommend an over-the-counter laxative. Laxatives help you pass stools more regularly and usually start working within three days. However, they should only be used in the short term.
Long-term constipation can cause faecal impaction. This occurs when stools accumulate in your rectum. The most common symptom is diarrhoea after a long period of constipation.
Faecal impaction can be treated with:
Long-term constipation can also cause haemorrhoids. This occurs when veins around your anus swell — this can happen when you often strain to pass a stool. Straining to pass stools can also cause a rectal prolapse where part of your rectum stretches and bulges out of your anus.
Long-term constipation can cause anal fissures too — small tears around your anus — due to the strain of passing large or hard stools.