Constipation

If the stools become dehydrated and therefore difficult and potentially painful to pass, resulting in the individual defaecating less frequently than is usual, they could have constipation.

Most cases of constipation are harmless, happening for a variety of reasons such as dehydration, low fibre intake, ignoring the urge to go to the toilet, or hormonal changes, for example during pregnancy.  However, medication can be to blame, or it could also be the sign of a health condition such as colon cancer or dementia, which may or may not have been picked up on previously.

There are some accompanying symptoms that warrant a medical referral. These include abdominal pain (rather than discomfort), vomiting, blood or mucus in the stools, unexpected weight loss, severe pain when defaecating and alternating constipation and diarrhoea. There are also some patient groups who should be seen by a doctor if they experience constipation, including young children, anyone who has constipation for seven days without it improving or recurrent symptoms, pregnant women, individuals who are taking laxatives regularly or long-term without the knowledge of their GP, and if there is a suspicion that medication or an underlying condition may be responsible.

Lifestyle changes can make a significant difference for a large number of constipation sufferers. Increasing intake of fruit, vegetables, wholegrain foods and fluids; taking regular exercise; and going to the toilet when the urge strikes are all sensible recommendations. Any changes may take a few days to have an effect.

There are several medicines that can help. Stimulant laxatives such as bisacodyl, senna and sodium picosulfate promote bowel movements, while bulk-forming laxatives such as ispaghula, sterculia and methylcellulose increase the mass of the stools, making them move along the large intestine more rapidly. Osmotic laxatives such as lactulose and macrogols retain fluid in the faeces, while faecal softeners such as docusate sodium and glycerin suppositories lubricate the stools, both of which can make it easier to go to the toilet.

Remember

Bowel habits are a very personal matter, so it is important not to make judgements. Some people go to the toilet several times a day while others might go a few days in between emptying their bowels. Always check what is normal for someone before trying to work out if it is more or less frequent than expected.

People with lower gastrointestinal complaints may be embarrassed about asking for help, so remember to be sensitive to their feelings when broaching the topic.