CONSTIPATION

Constipation is one of the most common bowel problems experienced by Australians and this condition can be distressing and debilitating.

Constipation is the term used to describe when your bowel motions are less frequent and you have trouble passing them as they are often hard and dry.

The Bristol Stool Chart describes the type pf stool that indicates constipation as either separate hard lumps like nuts (hard to pass) or sausage shaped but lumpy. (see https://www.continence.org.au/pages/bristol-stool-chart.html )

At times you may only be able to pass small amounts or have difficulty passing anything at all. Other signs of constipation may include pain, cramps or swelling in the abdominal area, or perhaps you leave the toilet feeling your bowel is not completely empty.

One of the common causes of constipation occurs because the colon (part of the digestive system) absorbs too much water from your food. If the food moves through the digestive system too slowly, too much water may be absorbed. The bowel contents at the end of the digestive process are then too dry and hard.

According to the Continence Foundation of Australia (www.continence.org.au) there are many things which can cause or worsen constipation including:

• not eating enough fibre (fruit and vegetables, wholemeal bread, high-fibre cereals)
• not drinking enough water – always drink more when you increase fibre in your diet
• not doing enough exercise
• anxiety, depression, grief
• delaying the urge to go to the toilet
• using laxatives for a long time
• the side effects of some medicines (even some common ones like pain killers or iron tablets)
• pregnancy
• being overweight
• not being able to go to the toilet because of poor mobility
• some nerve diseases
• some bowel problems like haemorrhoids, irritable bowel syndrome, or diverticulitis
• anorectal pain caused by haemorrhoids, fissures (tear in the skin of the anus) or birth trauma
• a slow transit bowel which means it takes longer for the faeces to travel all the way to the rectum, so more water is removed over time and constipation is much more likely. This occurs where there is nerve damage such as with stroke, Parkinson’s, multiple sclerosis or trauma.

Our pharmacists can recommend some ways to help. One way to treat constipation is by taking a ‘laxative’. There are various types of laxatives including include bulking agents, lubricants, and stimulating/irritant laxatives and they all work differently so it’s important to talk to your pharmacist or doctor to consider which one is right for you.

The condition of severe constipation is the most common cause of faecal incontinence (or bowel leakage), especially in older people. This can occur because hard bowel motions are difficult to pass and may cause a partial blockage high up the bowel, resulting in watery bowel motions flowing around the constipated stool without warning. This is sometimes mistaken for diarrhoea.

In addition, constipation can affect bladder control and urinary continence. If you sometimes leak urine or feel that you need to frequently visit the toilet to pass urine, it could be that constipation is involved.

Another effect of constipation can be on your pelvic floor muscles. Pelvic floor muscle strength is important for both bladder and bowel control. These muscles can be weakened by straining due to constipation, pregnancy and childbirth, or perhaps heavy lifting. Strong pelvic floor muscles are necessary for bladder and bowel control – the ability to ‘hold on’. At Fresh Therapeutics we stock the Epi-No Pelvic Floor Trainer (http://www.epi-no.com.au/) or Laselle Kegel Exercisers that may be used to strengthen pelvic floor muscles.

You can also get more information on issues affecting your bowel such as the Pharmaceutical Society of Australia’s Self Care Health Information on Fibre and bowel health, Constipation and Haemorrhoids.