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HSE Schemes explained


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.

Practical Points:
-Constipation is common in pregnancy and oral iron supplements may make this worse.

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