Constipation

Normally people have between 1 and 3 soft, easy motions each day to 1 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 not getting enough fluid or fibre in your diet.

Constipation may also be a symptom of a more serious problem, like bowel cancer.

On this page:

• How your bowel works
• Causes of constipation
• Self-care
• Taking laxatives
• When to see your doctor
• Special considerations
  • Constipation in babies
  • Constipation in young children
  • Constipation in pregnancy
  • Haemorrhoids (piles)
  • Bowel cancer
     

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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
• pregnancy
• depression
• hormonal problems such as an underactive thyroid gland
• an underlying problem of your nerves or bowel.

Self-care

• Drink more fluids, especially water.
• Eat more wholegrain 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

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.

When to see your doctor

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.

Special considerations

Constipation in babies

Constipation is when your baby’s poos are hard and dry.

Babies can go for days without pooing – it doesn’t always mean they’re constipated. It’s normal for breastfed babies to poo anywhere from once every 7–10 days to as often they have feeds. Formula-fed babies usually poo between once every second day and 3 times a day.

It’s common for babies to strain a lot when they poo. As long as their poos are soft, they aren’t constipated.

Constipation is often caused by changing diet, milk or foods.

Home treatment

If your child is well apart from constipation, you can treat them with the simple measures below.

All babies

You can try:

• warm relaxing baths
• gentle baby massage (eg, rubbing baby’s tummy gently in a clockwise direction).

Breastfed babies

Continue breastfeeding your baby.

Formula-fed babies

• Check the formula is being made up correctly.
• Check the volume markings on your baby’s bottles are accurate – if they aren’t, the formula may be over-concentrated. Over-concentrated formula can cause constipation.
  • If the bottle has the standard mark EN14350 on it (or on its packaging) it will be accurate.
  • If the bottle doesn’t have the standard mark, take it to your local pharmacy and ask them to check the volume marks for accuracy.
• Try a different formula brand. Some formulas are easier to digest than others. Brands that are higher in casein may make your baby’s poos harder. A brand that is whey-based may make your baby less constipated.

Babies over 6 months old

If your baby is over 6 months old, try giving them more:

• plain water
• fruit and high fibre vegetables – kiwifruit, pear, plum, peach and apricots are particularly effective. Ensure that they are suitable for the stage of development (eg, soft, grated or cooked, depending on the age of the baby) to reduce choking risk.

Note that when you give your baby more fruit and vegetables, you need to give them more water as well. Otherwise the constipation could get worse.

When to see a doctor

Take your baby to your family doctor if:

• the constipation doesn’t go away
• they show other signs of illness.

Call Healthline 0800 611 116 if you’re not sure what to 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.

Haemorrhoids (piles)

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

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.