Introduction
Constipation is where bowel movements stop or become irregular. Medically speaking you are suffering from constipation when you have bowel movements less than three times in a week or when faeces become very hard and difficult to pass.
Causes
Constipation may be due to simple lifestyle choices or it may be a symptom of another more serious condition. Common causes of constipation include...
- Not eating enough fibre in the diet (i.e. fruit / vegetables) / eating too much dairy-based food.
- Not drinking enough water.
- Not taking enough exercise.
- Some medications (especially antacids, iron tablets/supplements and some antidepressants).
- Changes in diet/activity levels.
- Pregnancy and having a baby.
- Psychological causes e.g. trying to avoid pain related to haemorrhoids / fear of using public toilets.
Less common causes include...
- Digestive disorders.
- Eating disorders.
- Hypothyroidism.
- Irritable Bowel Syndrome (IBS).
Symptoms
Apart from the common symptoms listed above, it is important to be aware of the following symptoms if they accompany any constipation, where you should visit your doctor...
- Unexplained weight loss.
- Fever.
- Feeling of weakness.
- Blood on toilet paper or in the bowl after a bowel motion.
In any case you are strongly advised to make an appointment with your doctor if constipation lasts longer than 21 days or if pain is severe.
Tests / Diagnosis
The following tests are used to diagnose the causes of constipation...
- Rectal exam.
- Colonoscopy.
A colonoscopy allows a medical practitioner to examine the inside of the colon (the large intestine). This involves the insertion of the colonoscope, which is a long thin tube equipped with a small light and camera, and instruments that enable tissue samples to be taken.
- X-Ray.
- MRI Scan.
- Manometry.
Manometry involves testing the pressure inside the rectum itself - this test will show whether or not the muscle tissue around the intestine is functioning as it should.
If changes to diet and lifestyle as described above do not help, laxatives may be required to treat constipation. These can be taken by mouth or via suppository or enema. A technique called 'biofeedback' which helps relax the muscles around the rectum / anus, can also be helpful for some people with ongoing constipation.