Constipation in adults

Are you really constipated?
Constipation is difficult to define. What one person regards as constipation, another person may regard as normal for them. So try the following questions.

• Do you have to strain to pass faeces at least one time in four?
• Are your faeces lumpy or hard at least one time in four?
• Do you feel that you haven’t emptied your bowel completely, at least one time in four?
• Do you pass faeces only once or twice a week?

If you answered ‘yes’ to two or more of these questions, and you have had the problem for more than 3 months, then you do have constipation.

Alarm signals
Constipation is usually just a nuisance. There is no scientific evidence that ‘toxins’ from faeces in the bowel can affect your health. However, very occasionally it is a sign of serious disease such as cancer of the colon (large bowel). So it is very important that you see your doctor if any of the following applies to your symptoms. (If this is difficult for you, have a look at Seeing your doctor about an anal problem.)

• Your constipation is a new symptom, and there is no obvious reason for it.
• It is severe and changing your diet hasn’t helped.
• The constipation alternates with diarrhoea.
• You have noticed other symptoms, such as bleeding from the back passage (even if you think this is caused by piles), passing slime from the back passage, tummy pain, weight loss, and/or pain in the back passage when you strain to pass faeces.
• Anyone in your family has had colon cancer.

You should also see your doctor if you are a woman and find that putting a finger in the vagina helps to pass a stool, because this may mean a weakness in the supporting tissues (known as a ‘rectocele’). This is not dangerous, but can be treated by a gynaecologist.

An underactive thyroid is an often overlooked cause of constipation, so see your doctor if you are also chronically tired, over-sensitive to cold, gaining weight or have thinning hair.

• Causes of constipation
• Improving constipation
• Useful contacts