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? (See questions in Constipation in adults)
- 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 for a while (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, April 7th 2010
Useful contacts for constipation
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Comments on this article
Posted by Kathleen on 18/08/2010 at 01:39:14 am
I have a rectocele and I was looking for more information about the condition and how to manage it, but have not found any so far. If I get constipated it creates a problem.
Posted by Optional on 10/06/2010 at 10:28:11 am
i have constant constipation even my bum whole is too small to pass anything through , and wheni do the poo is very small like rabiit drooping but so much strain just to get it out
Posted by Optional on 01/05/2010 at 06:10:58 am
not moving bowels for weeks but having wet sticky poo coming out without him feeling it and he says sometimes he holds his stools in
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.
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Fascinating facts
An average person on a typical Western diet passes about 150 g (5 oz) of faeces each day. Faeces consist of about one-third solids and two-thirds water
The solid matter in faeces is cellulose from vegetables, dead cells cast off from the lining of the gut, bacteria, some salts and pigment from bile (which gives them their brown colour)
Most of the waste matter from food is passed out in the faeces within 72 hours, but in healthy people up to 30% may remain in the colon for a week or more
We think one stool a day is healthy, but this is because of the way we have trained ourselves. Actually, our bodies are designed to pass faeces more often. Other primates (such as chimps and monkeys) pass soft stools several times a day
Defaecation is a very efficient process, normally taking only 10 seconds. Presumably it has to be quick - animals (and primitive man) cannot run from a predator easily if they are in the middle of passing a stool. This is probably why it is even quicker when we are frightened
In the USA, more than $800 million is spent on laxatives each year
Constipation results in more than 2–5 million visits to doctors in the USA each year
About 4,500,000 people in the USA say they are constipated most or all of the time (National Health Interview Survey)
In a UK survey, 6% of people said they had suffered from constipation in the past year, at least once a month 13% had some difficulty in passing their faeces and 19% took laxatives at some time
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