What is Constipation?

Overview  |  Symptoms  |  Complications  |  Causes  |  Diagnosis  |  Treatment 

Constipation is an extremely common condition which can occur at any age; most of us will experience it at some point in our lives. Constipation means a change in your bowel habits, whether that is  passing hard and painful stools or emptying your bowels less than usual.

Symptoms of Constipation

Bowel habits differ from person to person. Some people may pass stools once a day or less whereas others may empty their bowels more frequently.  If you are constipated, you may suffer from the following problems:

  • straining when you are passing stools
  • going to he toilet less frequently than you usually would
  • passing lumpy/hard stools
  • passing unusually small or large stools
  • abdominal discomfort: cramping, bloating and/or pain
  • when you do pass stools, you may feel like you have not fully emptied your bowels

Complications of Constipation

If constipation becomes chronic and is left untreated, complications may arise.

Haemorrhoids (piles): Swollen blood vessels found inside and outside of the anus  is often as a result of straining while passing stools.

Rectal bleeding: Rectal bleeding may be caused by tears around the anus from straining and  passing hard faeces. Bleeding may also occur if haemorrhoids are present.

Faecal impaction: If you suffer from chronic constipation then there is a risk that the hardened faeces, which is difficult to pass, collects in your rectum. Faecal impaction will need treatment as it comes with its own complications, such as rectal swelling, leaking faeces, rectal prolapse and loss of sensation around the anus.

What Causes Constipation?

There are various reasons why people suffer from constipation and generally, causes of constipation are nothing serious. However, some cases may be caused by underlying health condition and sometimes the cause may be idiopathic – unknown. Common causes of constipation include:

  • not enough fiber: the recommended amount of fibre you should eat a day is 18g, but, most people eat 12g or less
  • dehydration: not drinking enough fluids may lead to constipation, or potentially exacerbate the condition
  • medication: a side effect to some medication is constipation – calcium/iron supplements, some painkillers and antidepressants
  • pregnancy: some women suffer from constipation during pregnancy.
  • not going to the toilet when you need to
  • stress
  • irritable Bowel Syndrome (IBS)
  • haemorrhoids
  • rectal or colon cancer
  • nervous system conditions
  • underactive thyroid

How is Constipation Diagnosed?

Constipation does not usually require a visit to the doctors as it should improve by itself. If you do visit a doctor, they can usually make the diagnosis based on symptoms. However, if constipation is chronic or other symptoms develop – unexplained weight loss, passing blood, family history of inflammatory bowel disease/colon cancer, diarrhoea or anything else – your doctor to check for an underlying health condition. Diagnosis of constipation may include a rectal examination, blood test, abdominal X-ray, CT scan and colonoscopy.

Treating Constipation

There are several methods of treatment for constipation; they all depend on the severity and how long you have had it for.

Lifestyle changes

Doctors often recommend that patients with constipation change their lifestyle. Constipation is often caused by a lack of fibre in the diet, therefore you will be advised to increase your intake of fibre along with fluids. Food high in fibre includes, but is not limited to, wholemeal bread, wholemeal pasta and brown rice, fruit, vegetables and whole grain breakfast cereals.

Usually, the effects of a high-fibre diet can be seen within days, although in some cases it may take a few weeks. Bloating may occur but this will usually ease. If the self-help treatment plan does not work, it is likely that you will be prescribed laxatives.


Laxatives are used to treat constipation when adapting your diet has proved unsuccessful. There are different types of laxatives and each one can affect your digestive system differently.

Bulk-forming laxatives

Bulk-forming laxatives sometimes referred to as fibre supplements, are the first laxative that your doctor will advise you to take. These laxatives work by bulking up your bowel and stimulating the muscles that help to empty it, which is essentially what dietary fibre does.

Stimulant laxatives

These laxatives stimulate the muscles in your bowel, making them work harder than usual, which helps stools to pass through. They are usually prescribed if your stools are soft, but you have trouble passing them.

Osmotic laxatives

Osmotic laxatives work by the process of osmosis, increasing fluid levels in the bowel by retaining it. This helps soften stools, making them easier to pass.

Your doctor will usually advise you on which laxatives are suitable based on your symptoms. Some laxatives take quicker to work than others. Laxatives should only be taken for a short time and not relied on as a method of keeping the bowels regular.