Constipation: What it is and how to treat it

Let’s be frank: constipation isn’t a topic many of us chat about very often. But did you know that almost everyone will experience constipation at some point in their lives? Given how common this health complaint is, it’s definitely one worth exploring further. But what causes constipation? And what can you do about constipation pain?

Constipation is difficult to define, explains nib group medical advisor Dr Hamish Black because what’s considered ‘normal’ in terms of bowel movements varies so much from person to person. For some, it might be three stools a day, while for others, three times a week is the norm.

“For some people, constipation could be having some hard stools for a few weeks; for others, it might be not using their bowels for a few days,” explains Hamish.

The symptoms of constipation are a better indication. They include:

• Having difficulty passing stools or only passing small amounts at a time

• Stools being hard and dry

• Needing to strain when going to the toilet

• Having less-frequent bowel movements than usual

• Feeling blocked or as though you haven’t emptied your bowels completely.

Additional constipation symptoms may include passing liquid stool (overflow diarrhoea), abdominal cramps, bleeding from small tears in the anus, bloating, nausea and vomiting.

Related: I have a health concern, what do I do?

There are a few potential culprits, many of them lifestyle-related. Constipation causes may include:

• Not eating enough fibre

• Dehydration

• Living a sedentary lifestyle

• Waiting to go to the toilet instead of passing a stool when you feel the need

• Stress

• Changes in routine

• Pregnancy

• Ageing.

Some medical conditions, such as diabetes, Parkinson’s disease, multiple sclerosis, irritable bowel syndrome, diverticulitis and haemorrhoids, may also be constipation causes, as are emotional issues including anxiety, depression and grief.

“So many medicines can affect your bowel habits, too,” adds Hamish, “particularly if you’re on them for a decent period of time.”

These include iron supplements, some antidepressants, opiate pain relief (such as codeine), calcium-channel blockers, aluminium-containing antacids and even an overuse of laxatives.

Not sure what to do if you’re constipated? Luckily, constipation relief isn’t difficult to come by and doesn’t necessarily require a doctor’s appointment. Symptoms can often be treated simply, with many home remedies for constipation available. In fact, there’s one tried-and-true constipation cure you can find easily on supermarket shelves: prunes.

“What you need to think about is what is good for your bowels, and prunes are a good way of keeping regular,” says Hamish.

Other great fibre sources that may help get things moving include:

• Wholegrain cereals

• Fruits

• Vegetables – “leave the peel on where you can”, adds Hamish

• Legumes.

Related: Bowel cancer prevention: Why fibre should be on your shopping list

Foods such as milk, cheese, white rice, white flour and red meat can contribute to constipation, so they’re best minimised if you’re constipated.

Other tips include:

• Drinking plenty of water (around two litres a day for adults)

• Doing regular exercise

• Going to the toilet when the need arises (don’t “hold on”)

• Putting a routine in place (ie attempting to pass a bowel movement at the same time every day)

• Placing your feet on a footstool to elevate the knees above the hips when sitting on the toilet.

There is also plenty of constipation relief available at the chemist in the form of laxatives – though it is not a good idea to use laxatives on an ongoing basis, advises Hamish. There are two main types of laxatives – bowel stimulants, which increase bowel contractions, and medications that increase the water content of the stool. Speak to a pharmacist about what’s best for you.

Related: A guide to gut health

Ongoing constipation can lead to haemorrhoids, a hernia or an anal fissure, so it’s important to not only cure but also prevent the condition – and many of the preventative measures for constipation are similar to treatments.

“The mainstay of managing your bowels in a healthy way is adequate fibre,” says Hamish, “as well as lots of water and plenty of movement by way of regular exercise. Most Australians don’t get enough fibre in their diet, but – assuming you’ve ruled out things like a change in your medicines or something more sinister – most of the problems people have with the bowel are to do with what they’re eating.”

If you struggle to get enough fibre into your diet, “a lot of people take things like Metamucil, which is a great over-the-counter source of fibre”, adds Hamish.

While constipation is a common problem and usually isn’t anything to worry about, it can be a sign of something more serious, so do keep an eye out for changes to your bowel habits.

“As doctors, we’re not worried about constipation in general,” Hamish shares. “What we’re worried about is whether it indicates you have something more serious. We’re more concerned with whether there has been a change in your bowel movements, particularly as people get older because that’s when the more serious pathologies, such as bowel cancer, become more common.”

Related: How a bowel cancer test can save your life

Of course, it’s important to remember that experiencing constipation or other symptoms doesn’t necessarily mean you have bowel cancer, so there is no need to panic. But if you notice changes and have any concerns at all, seek medical advice, suggests Hamish.

If you’re looking for more information on how to easily up your fibre intake to help keep things moving, check out our article with Dr Sandro Demaio on why fibre should be on your shopping list.

In many cases constipation can be managed at home with dietary adjustments, increased water intake, and over-the-counter remedies. However, it can also be debilitating if it continues for longer than a few weeks and can become a more serious health condition. In these cases, or if you are also experiencing bleeding, severe pain, or other concerning symptoms, you should seek medical advice.

The factor with constipation however is that it can make physical movement highly uncomfortable or even seemingly impossible and it may be better to seek online consultations, which are provided by our health partner hub.health, e-scripts and medication delivery to the door if required.  

Please note: The tips throughout this article serve as broad information and should not replace any advice you have been given by your medical practitioner.