Constipation

Causes of constipation

To understand constipation, it helps to know how the lower part of the gut (colon, large bowel) works. As food moves through it, the colon absorbs water while forming waste products. The waste products are the ‘stool’ (faeces). Muscle contractions in the colon push the stool towards the rectum, which is the last section of the bowel before the anus (back passage). By the time the stool reaches the rectum, it is almost solid because most of the water has been absorbed.

• Are you really constipated?
• Are you taking enough fluids and fibre in your diet? In northern climates, dehydration is not usually a problem, but in hot climates, it can cause dry stools that are difficult to pass.
• Do you take enough exercise?
• Are you taking any medicines that can cause constipation (see below)?
• Are you allowing enough lavatory time to defecate?
• Has there been any change in your lifestyle? Has your job or personal relationships become more demanding?
• Are you depressed? Nerves link the brain to the gut. Reduced activity of these nerves in depression affects the muscle activity of the bowel and results in constipation in some people.
• Do you have a frequent desire to defecate, then strain to pass a few small pellets and leave feeling there is still more to come? This is typical of the irritable bowel syndrome (see useful contacts).
• After straining for some time, does the back passage seem to bulge as the stool comes halfway through? This feeling often occurs with piles (haemorrhoids).
• Do you have a painful condition, such as piles (haemorrhoids) or anal fissure? If passing faeces is painful, constipation is a likely result.
• If you are a women, do you have to put a finger in your vagina to help pass the stool from the back passage? This probably means you have a rectocele, a weakness in the supporting tissues between the vagina and rectum.
• If you are a women, did the constipation start after childbirth or after hysterectomy? Hysterectomy may sometimes damage the delicate nerve fibres connected to the bowel.
• Have you gained weight and tend to feel the cold, maybe with dry or thinning hair? You might have an underactive thyroid, which can also cause constipation.
• Do you have any other symptoms?
• Are you pregnant? About 1 in 3 pregnant women has constipation, probably because of the hormone progesterone. The best way to deal with it is to take extra fibre in your diet.
• Have you recently stopped smoking? Almost 1 in 10 quitters experience constipation (Addiction 2003;98:1563–7).

• pain-killers or cough medicines containing codeine
• antacids (for indigestion) containing aluminium or calcium.
• iron tablets
• some antidepressants (tricyclic and monoamine oxidase inhibitor types) and tranquillizers
• some drugs for Parkinson’s disease and for epilepsy (Parkinson’s disease can itself cause constipation)
• some diuretic drugs (for high blood pressure or heart failure)

Obviously, you should not stop a medicine that has been prescribed for you just because it is making you constipated – it could be an important medication for you, so discuss it with your family doctor.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Wednesday, February 24th 2010

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Comments on this article

Posted by Anonymous on 03/02/2010 at 09:57:00 pm

just took my son 2 doctor complanin of tummy pain and feeling sick he said it was constipation but my son was not complanin of havin problim goin 2 toilet worried if this is realy the problim

Posted by chrissy on 18/11/2009 at 01:44:00 am

does constipation cause body odor , recently in class . people been saying it smells like fart. and i found out its me .I haven't physically farted but my body smells like i did. But for the rest of the day. I take showers , every morning but by third period i start to smell like fart. Before this happen , i get lower abdominal pains. And sometimes feel like vomiting.

Posted by Anonymous on 17/11/2009 at 11:17:00 pm

Can I suggest that you guys have a look at a websited called www.fedupwithfoodadditives.info/ It has been the anwser for many people with bowl problems, along with a host of other complaints. Basically it supports a low chemical diet where all artificial additives and some natural chemicals are omitted from the diet. It makes very interesting reading in the least. Good luck!

Posted by HS on 29/09/2009 at 11:22:00 am

For constipation try taking "AGIOLAX" made from natural ingredients and no sideffects. Take a tbsp full with enough water everyday and it should regulate. i am taking this since 1year now and trust me its worth with no side effects being herbal!

Posted by Health Press team on 16/09/2009 at 02:31:00 pm

Dr Margaret reads the comments and addresses the most common or pressing questions when she updates the sections

Posted by Cheryl on 14/09/2009 at 07:16:00 pm

Does anyone on here ever answer anyone elses questions? That is all I see here is one question after another, so need reason to post question I suppose since no way to get an answer.

Posted by Sam on 20/06/2009 at 07:08:00 pm

When i go to the bathroom sometimes only 3/4 of my stoole comes out then im stuck going into bathrooms all day to wipe. What could cause this? I do drink and my diet was poor. I am starting to change my diet and working out. It seems to be getting alittle better but still a problem.

Posted by Jane on 08/05/2009 at 07:37:00 pm

My daughter is 10 years old, healthy, active with a very good diet (mainly vegetarian). This week she developed tunmmy pains and hasn't had a bowel mvt for 6 days where as normally she goes twice a day. What might cause this?

Posted by jane on 23/04/2009 at 11:06:00 pm

mychild suffers from constapation

Posted by Anonymous on 19/04/2009 at 08:20:00 pm

Hi i have had bowel problem since i was 3, i was put on lactose and senecot when i was young never worked. Nothing orally worked i then had to have manual evacuations under local anethetic 5 times due tp major facial impaction. Im am now not allowed to have this done again i was given movicol it does help but only if i use it now and again my bowel gets used to it. Anyway i have since found benefibre which is in chemists and not to expensive safe to use and works a treat! Just drink it in water or tea, coffee no taste and children can have it. I have been taking it for 8 months and still works :)

Posted by clodagh on 31/03/2009 at 11:43:00 am

my child still suffers from constipation;however, switching to goats milk helped dramaticaly (bowling balls to golf balls)

Posted by yas on 20/03/2009 at 09:56:00 pm

hi i have had this since i was 7. the docs hav just but me on movicol and it dosent work it makes it go all sticky. and it makes me vomit. someone help me!

Posted by yasmin on 20/03/2009 at 09:49:00 pm

i have had constipation since i was 7. it is so hard for me to talk to someone, but then i found dawn i told her everything. it wasn't just affecting me by making me vomit and be in pain but it was affecting me in my mind. i felt alone i just what someone to help me get though this nightmare. but if you have constipation go and talk to someone before it cans out off hand

Posted by MEL on 24/02/2009 at 08:40:00 pm

HI, CAN ANYONE TELL ME IF THE MOVICOL PAEDIATRIC SACHETS CAUSE SIDE EFFECTS NOT NOTED ON THE LEAFLETS? MY 10 YEAR OLD HAS BEEN PUT ON THIS DUE DUE TO FAECAL IMPACTION BUT HE IS NOW SUFFERING FROM WHAT APPEARS TO BE A POSS ELECTROLYTE IMBALANCE AND IS VERY DEHYDRATED. HE IS ALSO SUFFERING FROM WHAT APPEARS TO BE THRUSH OF THE MOUTH AND DOWN BELOW. I ASKED MY DOC ABOUT THIS AND THEY SAID THESE SYMPTOMS ARE NOT POSSIBLE ON THIS MEDICATION AS IT HAS ELECTROLYTES IN IT TO PREVENT THIS. BUT I HAVE SEEN OTHER WEBSITES WHO WARN THAT THIS MAY BE A SIDE AFFECT. WOULD LOVE TO HEAR IF ANYONE ELSE HAS HAD THESE PROBLEMS.

Posted by Anonymous on 23/02/2009 at 11:39:00 am

not going to the toilet every day. now my stools are part white.

Posted by Simon on 20/02/2009 at 07:53:00 pm

Hello everyone, recently I went to the toilet for a number 2. But it seems that a bit of faeces has got tanged in some hairs just outside the hole and it is blocking it, and I just can't get rid of it (man this is embarassing) any ideas on how to remove it? it's so close it's basically stuck to my skin.

Posted by fiona on 12/02/2009 at 10:56:00 am

hi my problem started 4 years ago after a major back operation.my bowel has to fill causing severe pain in tummt around bowel the middle bit in between vagina and anus bulges,i know i have streched know though for 2 years i have had an anul fissure had every cream there is even an ointment the same as aan angina spray.i suffer constantly with pain deep in the anus right to the very end and bleed,I have other probs but this is really hurting and getting me down please help

Posted by Andy McIntyre-Pell on 08/02/2009 at 09:23:00 pm

My life partner's grand child is three and suffer's terribly when trying to pass the smallest faeces. Its very difficult to talk to Ellie's mum as we don't get on and I talk to my partner, but it's difficult. I have 3 children none of which have had similar problems to this problem. I am trying to read up as much as possible and all ready it's a wider problem than I first thought, cheers.

Posted by Ashley on 08/02/2009 at 12:38:00 pm

I have a 3 year old daughter who has suffererd constipation since the very first day of eating solid foods. It has gradually worse and all the doctors seem to do is put her on laxtulose or Movicol! I am writing this now as the Movicol normally gives it a "sticky plaster" fix by motions in her bowel to release her distress and pain... however this time it doesn't seem to be working and she has been unable to release a "proper" bowel movement for over 2 weeks now. I am very concerned but doctor seems to be taking a more relaxed view on it. So I don't know what to do.. has anyone had similar problem? Help!!!!

Posted by Anonymous on 19/01/2009 at 11:45:00 am

My partner says his anus is getting smaller .and he said there is a medical problem but he dosent know what it is called,and also his Poo is small round balls .is this normal or is there something wrong?

Posted by Anonymous on 29/12/2008 at 04:01:00 pm

when constipated, i have to hold my legs out in frount of me, off the floor, in order to have a bowel movement. Is this crazy?

Posted by kumar on 27/12/2008 at 03:15:00 pm

i am getting anal smell too much especially in the woring times and talking with more than 2 peoples please give suggetion WHY?