Constipation is a reduction in the number of defecations (bowel
movements), accompanied by hard, dry, small stools, relative to
the norm for the individual. Normal frequency varies from three
bowel movements per day to three per week. There is a wide normal
range, a thing many people, especially the elderly and young mothers
do not understand. Hard, uncomfortable stools are a better indication
when deciding that a person is constipated. Any sudden change
in bowel habit that has lasted for 2 weeks or more should not
be treated lightly.
Abdominal discomfort, bloating and nausea often accompany constipation.
Bowel obstruction in severe constipation would show with colicky
pain, a stretched abdomen and vomiting. Consult your pharmacist
or GP if you see these symptoms.
If fresh blood is present or shows on the toilet paper, it could
well be due to piles, which are often associated with constipation.
These must also be treated. It is best in these complicated cases
to talk to the pharmacist directly.
A common cause of constipation is insufficient dietary fibre,
i.e. not enough wholemeal cereals, bread, and fresh vegetables.
This should be investigated. A change in dietary habit can be
due to a change in lifestyle, i.e. job change, retirement, travel
or sickness can all reduce fibre intake. Other causes are bowel
disease, old age and lack of fluid intake.
Try to determine what exactly the bowel habit is NOW and how this
differs form what is USUAL. Note the presence of any other symptoms
(abdominal pain, nausea, vomiting, blood in stools) and discuss
these with the pharmacist. Think about any recent diet change
if in doubt about how to improve your diet, talk to a member of
staff at your local pharmacy.
Constipation must be treated fairly early. Long-term constipation
can lead to blockage of the gut or haemorrhoids (also known as
piles) when trying to pass hard stools.
If you take laxatives already you should get advise from your
local pharmacist. There are many laxatives available but they
work in a variety of different ways. Not all laxatives are appropriate
in different circumstances and therefore you should discuss your
case with a healthcare advisor at your local pharmacy.
Many medicines can cause constipation so if you have started taking
a new preparation ask your pharmacist for advice.
There are two essential principles when treating constipation:
1) Relieve the constipation in the immediate and short term by
using laxatives to start the large intestine working again.
2) Re-educate the bowel to restore the rectal reflex (urge to
defecate), so allowing normal emptying with out need for laxatives.
-Constipation is common in pregnancy and oral iron supplements
may make this worse.