Constipation - Homerton University Hospital

Constipation
Homerton
Homerton University Hospital NHS Foundation Trust
Homerton Row, London, E9 6SR
T 020 8510 5555
W www.homerton.nhs.uk
E enquiries@homerton.nhs.uk
Women’s Health Department
Homerton Hospital
Outpatients Physiotherapy: 0208 510 7835
Community Pelvic Floor Dysfunction Service: 0208 510 5914

Signs & Symptoms
- Excessive straining
- Small, dry, hard
stools
- Tummy
ache/bloating
- Pain
- Feeling like you
aren’t finished
- Sore bottom (maybe
bleeding)
- Leaking of liquid or
loose stool
Other things that contribute:
- travel
- pregnancy
- change in diet
- repeatedly ignoring the
urge to open your bowels
- lack of interest in eating
- lots of convenience foods
- getting older
- poor teeth so unable to
chew harder foods.
What is constipation
Constipation is having difficulty opening
your bowels. This usually leads to you
going to the toilet less often.
It is normal to open your bowels anywhere
between 3 times a day to 3 times a week –
it doesn’t matter how often is normal for
you, the problem arises when you become
less frequent and need to strain.
It is normal to get this occasionally, but if
you need to strain more than a quarter of
the time it becomes a problem.
Causes
There may be several causes, possibly
happening at the same time. The most
common are:
- inadequate fibre intake in the diet
- inadequate fluid intake
- a sedentary lifestyle
- environmental changes
- lifestyle/routine changes
- certain medications e.g. painkillers
(especially if they contain codeine or
morphine)
If you have pain, e.g. from hemorrhoids,
abscesses, fistulae or following some
surgery in the area this can cause people
to ‘hold on’. See your doctor for advice
about this.
The correct position for opening
your bowels
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Laxatives
Many people believe that laxatives are the cure for
constipation. But long term or excessive use of
laxatives is not usually necessary and can be habit
forming – the body begins to rely on them to bring on
bowel movements and over time, the natural emptying
mechanism fails to work without the help of these
drugs.
There are many different types of laxative available –
they usually should only be used for a short time –
discuss with your GP if you have any queries about
what you are taking.
FACTS!
Around 80% of
people suffer
with constipation
at some point in
their lives.
Older people are
5 times more
likely to report
problems with
constipation than
younger people
Good Foods
It is widely known that we should be aiming to
eat five portions of fruit and vegetables a day –
this would certainly make up your required
amount of daily fibre (approx. 18g a day).
Foods high in dietary fibre are:
- Cereals containing wholeweat, wholegrain,
bran
- Wholemeal bread or high fibre white
- Porridge oats
- Root vegetables
- Potatoes with skin e.g. jacket potatoes
- Fruit with skin e.g. apples, pears, grapes
- Dried fruit e.g. currents, raisins, prunes,
dates, figs
- Fibre containing biscuits e.g. digestive,
garibaldi, fig rolls
- Peas, beans, lentils and nuts
- Linseeds (usually available from healthfood
shops)
Water – why should you drink more
Your body needs 1.5-2 litres of fluid (approximately 6-8 glasses) to
function during each day. Without sufficient fluids, waste matter
dries out making it harder to move through the bowel.
Any type of liquid can be included but caffeinated drinks should be
kept to a minimum
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Treatment
Often simply increasing the amount of water and fibre in your diet
can really improve your symptoms.
Bowel and food diary
This can be useful to analyse in a bit more detail what you eat, when
you go and what happens when you do.
The key is balance – you don’t want to increase your daily intake by
simply sprinkling bran over everything… try and gradually introduce
foods high in fibre.
Date
5
Food
Drink
Bowels
Opened
Consistency
Size
S/M/L
Blood/
mucus
Fibre supplements are often recommended but can take more than 2
weeks to reach full effectiveness. These are neither harmful or habit
forming.
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7
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Try to stay active – even taking a brisk walk after dinner can help
tone your muscles, which helps the transit of your food.
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10
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Try not to ‘hold on’ or put off going for long periods of time –
sometimes this cannot be helped, but the longer your stool spends
inside your body, the more water gets absorbed from it and the
harder it gets.
Midday
1
2
3
Warning signs
4
5
There are certain things you should get checked out by your GP.
6
7
If you have had a change in bowel habit over a few weeks that
can not be explained by a change in diet or lifestyle
8
9
10
Any bleeding or mucus from your back passage should also be
11
investigated.
midnight
1
It is worth knowing that bowel cancer is an uncommon cause of
constipation. Even if you have had constipation over many years
2
3
there is no increased risk of bowel cancer.
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