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Constipation - when to see your doctor

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 our section on seeing your doctor about an anal problem.)

  • Your constipation is a new symptom, and there is no obvious reason for it (see Causes of constipation).
  • 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 at a young age (generally less than 50 years old).

Rectocoele (rectal prolapse)

Sometimes, on straining, in women faeces can bulge from the rectum into the vagina and become trapped in what is known as a rectocoele. This is not dangerous, and can be treated. Sometimes the rectocoele can be helped to empty by placing a finger into the vagina or sometimes by supporting the pelvic floor muscles whilst straining. Often, a weakness in the supporting pelvic floor can be treated quite successfully using bowel retraining exercises and very specific use of certain laxatives. This is best done in consultation with your family doctor. (In men, rectocoele is uncommon, and the protrusion of the rectum is usually backwards rather than forwards.)

Underactive thyroid

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

Painful conditions

If you have a painful anal condition, look at our sections on anal pain, piles (haemorrhoids) and anal fissure. If passing faeces is painful you should see your doctor. If you are worried about discussing the problem, have a look at our section on seeing your doctor about an anal problem.

Medications

Medications that commonly cause constipation are discussed here. 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.

Shy bowel

The term ‘shy bowel’ has been used to describe difficulty in using the lavatory when other people are around. This condition can be quite problematic, and you should discuss it with your doctor, as certain psychological treatments (such as cognitive behavioural therapy) can help.

Written by: Mr Andrew Ramwell
Edited by: Mr Andrew Ramwell
Last updated: Monday, May 12th 2014

 


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Comments on this article

Posted by Optional on 13/11/2016 at 03:34

I have IBS and Diverticular disease mostly constipation but when I have a bowel movement I then suffer the awful embarrassment of overflow incontinence. I know I have a weak sphincter muscle when I was examined by a gastrologist. Also I had 3 children when I was young in a short space of time which may have caused me a problem later in life.I just wonder if anyone else suffers this problem. Thank you.

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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 the 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

Defecation 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 defecating. 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, 13% had some difficulty in passing their faeces at least once a month, and 19% took laxatives at some time

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