Constipation

Constipation is used to describe a decrease in the number of regular bowel movements and/or difficulty in passing motions. This may be a symptom of a serious underlying disorder or it may simply be due to not eating enough fibre or drinking enough water. 

Constipation often may be eased by eating foods which contain high fibre (eg. fruit, vegetables and cereal). Drinking plenty of fluid often will also ease constipation, as will taking regular exercise. Where these approaches fail, further investigations and laxatives may be necessary.

Other causes of constipation

As well as diet and exercise choices as outlined above, other causes of constipation may include:

  • Change from usual diet or exercise routine
  • Certain medicines (particularly pain medications, antidepressants and iron supplements)
  • Pelvic floor weakness 
  • Psychological reasons eg fear of using public bathrooms 
  • Eating disorder
  • Hypothyroidism (under active thyroid)
  • Irritable bowel syndrome
  • Intestinal obstruction

Other symptoms to aware of if they occur with constipation are:

  • Blood in the toilet or on toilet paper
  • Fever
  • Weight loss
  • Persisting anal or abdominal pain

You should see a doctor if you have any of these symptoms with constipation, or if your constipation lasts for longer than a few weeks.

Diagnosis of conditions that cause constipation

In order to diagnose possible causes of constipation, the following tests and examinations may be necessary.

Rectal examination
The doctor examines the anus and checks the inside of the anus a short way with a finger

X-ray/CT scan
Scans are often needed to help exclude blockages in the bowel.

Colonoscopy/sigmoidoscopy
The doctor examines the large intestine (also known as the colon) with an instrument called a colonoscope - a long thin tube inserted via the anus that allows the doctor to view the inside of the colon. Colonoscopy also allows the doctor to take tissue samples for testing.

Manometry
A manometry measures the pressure inside the rectum and will indicate whether or not the muscles around the intestine are functioning correctly

Treatments for constipation
Treatment for constipation can be non-specific for such as changes in diet and lifestyle outlined above and use of laxatives (either orally, suppository or as an enemas)

However some conditions causing constipation may require specific treatment such as 'biofeedback' which is a process where the patient learns how to relax the muscles and allow bowel movements to take place.