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‘Constipation’ is when your bowel motions (‘poos’) are hard. They may be knobbly and difficult to get out. It is a common problem in the community.
Normally people have between one and three soft, easy motions each day to one every other day.
If you or a family member has constipation, it can be caused by a number of factors, most common of which include lack of sufficient intake of fluid or fibre in your diet.
Constipation may also be a symptom of a more serious problem, like bowel cancer.
How your bowel works
Your bowel is the organ for removing solid waste left over from what you eat. Fibre in the food you eat bulks out this waste and helps it move along your bowel more easily.
Causes of constipation
Eating plenty of vegetables and fruit will generally give you enough fibre to have regular, easy bowel motions.
However, if you eat a lot of meat, or processed or refined foods, there might not be enough fibre in your bowel. The waste will move slowly, causing constipation and wind.
Also, if you don’t drink enough and get dehydrated, your bowel will absorb more fluid which will dry out the food waste – making your motions harder and difficult to pass.
As well as diet, constipation can be caused by:
- waiting too long to go to the toilet
- not getting enough physical activity
- travel or other change in routine
- prolonged periods of immobility
- taking certain medicines – especially some pain-killers or using laxatives for too long
- hormonal problems such as an underactive thyroid gland
- an underlying problem of your nerves or bowel.
- Drink more fluids, especially water.
- Eat more whole-grain cereals, vegetables and fruit – including the skins, if they’re edible.
- Prunes, broccoli, rhubarb, kiwifruit, corn, dried fruits and liquorice can all help move your bowels.
- Be physically active.
- Don’t delay bowel motions – go when you feel the urge.
- Avoid straining or forcing a motion, as this can cause haemorrhoids (piles).
Taking laxatives is generally not recommended without medical supervision, but if you do try them, try to avoid using them on a regular basis.
Once your constipation has cleared, stop taking the laxatives and try other remedies, like diet and physical activity, to prevent the constipation from returning.
You should see your doctor if:
- you have constipation for a week or more after a normal bowel motion
- there is blood or slime in your motions, or alternating diarrhoea and constipation
- you also have abdominal pain or bloating
- you’re still constipated after changing your diet or trying other remedies
- you are losing weight without trying.
Call Healthline 0800 611 116 if you're unsure what you should do.
Constipation in young children
Children with constipation will usually pass hard poos, like sheep pellets, and this will often be painful.
They may ‘hold on’, cross legs, run around or refuse to go to the toilet because it is painful to pass a hard ‘poo’. This results in further drying out of the ‘poo’ as it sits in your child’s bowel, resulting in a vicious cycle.
They may also have a tummy pain that comes and goes.
Sometimes chronic constipation in children can lead to ‘overflow’ of loose poos which looks like diarrhoea.
Constipation in children that is persistent will usually require assessment by your family doctor and over-the-counter laxatives should be avoided.
If you have questions about your child’s bowel motions, call PlunketLine on 0800 933 922.
Constipation in pregnancy
Constipation is common in pregnancy.
- In early pregnancy it is caused by high levels of the hormone progesterone, which can slow down the bowel.
- In late pregnancy the increasing size of the baby puts pressure on the bowel.
- It can also be a side effect of iron supplements.
See your family doctor or consult your midwife if you are concerned. Laxatives and over-the-counter medications should not usually be used without medical supervision.
Piles are swollen veins inside the anus, which can result from repeated straining to pass a bowel motion. They can be painful and/or bleed. For further information refer to Bleeding from the anus.
Bowel cancer is a malignant growth in the bowel. Its first symptoms may be a change in bowel habits – either diarrhoea or constipation, sometimes with blood or mucus (slime).
Sometimes bowel cancer can actually block the bowel, so the person has no bowel motions for a few days, and has a swollen tummy. (This is not the same as constipation.)
Anyone can get bowel cancer, though it is most common after the age of 40 and in people with a family history of the disease.
Your doctor will be able to help detect and treat any cancer.