Constipation

Symptoms

Constipation is when you have trouble passing your bowel motions (stools), or your motions are not as regular as usual. Some people have a bowel motion every day, while for others it is normal to go, for example, only twice a week. The main symptoms of constipation are straining to pass hard stools, only passing a tiny amount of stools, or consistently feeling as though the bowels have not been fully emptied.

See a doctor if you have any of the following symptoms:

• severe cramps or pain in your stomach
• passing blood in your stool (stools that are a very dark tar-like colour)
• your stools are leaking from your anus
• you are over 50 and your bowel patterns have changed or you have other symptoms like vomiting and diarrhoea, weight loss and you are feeling low in energy.

Causes

Constipation can be caused by not eating enough fibre, not drinking enough water, not getting enough exercise, or just by ignoring the urge to go. A change in routine such as international travel or shift work, can upset the body’s ‘internal clock’ and affect the regular bowel routine. Other causes of constipation include feeling stressed, increased hormones related to pregnancy or menstruation, avoiding pain associated with haemorrhoids, or medical conditions like irritable bowel syndrome. Constipation is more common in the elderly because intestinal muscle contractions reduce with age. Certain medicines such as iron supplements, some antidepressants and high blood pressure medicines, can also cause constipation. Young children can get constipated while learning how to toilet train.

Lifestyle options

You can help to manage constipation by:

• eating foods high in fibre such as fruits, vegetables, nuts, oats, legumes, wholegrain breads and cereals like brown rice or wholemeal pasta
• drinking plenty of water (or other fluids that are low in sugar)
• exercising regularly – at least 150 minutes at moderate pace every week. Standing up often and walking about if you sit at a desk for a long time at work
• going to the toilet immediately when you feel that urge. Learn to sit properly on the toilet – lean forward, have a straight back and put your feet flat in the floor or on a foot stool. Aim to have your knees higher than your hips as this makes passing stools a lot easier.

Pharmacy options

Always inform pharmacy staff if you are taking any other medicines, or if you have any other health conditions, because some over-the-counter medicines may not be suitable for you. Laxatives are medicines that can help you to pass a bowel motion more easily. Laxative products are available as powders, tablets, granules, syrups, enemas or rectal suppositories. Let your pharmacist know if you have a type of product preference. There are different laxative medicines that work in different ways. Your pharmacist will advise you which is the best one for you to use, depending on what is causing the constipation and how severe your constipation is, as well as your age and what other health conditions and other medicines you may be taking.

• Stimulants such as senna work on the bowel muscles and can be used as a short-term treatment to get your bowels moving quickly. They should not be used for long term treatment unless advised by your doctor (e.g. for people on opiate medicines).
• Softeners such as docusate help soften your stools making them easier to pass.
• Osmotic laxatives such as Macrogol 3350, help to draw liquid into your stools to help soften them and pass more easily. They are usually available as liquid medicines.
• Bulk forming fibre supplements are a natural source of fibre that can be used daily and long term. They may be a powder to mix with water or fruit juice, or taken as capsules. They are helpful if you are not getting enough fibre in your diet. Make sure you drink plenty of water when using these.

Some products contain docusate and senna, combining different laxative medicines and your pharmacist can advise the best combination for your needs. Ask your pharmacist for advice on the most suitable treatment for you.

More information

Health Direct: www.healthdirect.gov.au
Australian Dietary Guidelines: www.eatforhealth.gov.au
Gastroenterological Society of Australia: www.gesa.org.au

Disclaimer: The information provided is a guide only, is current at time of publishing, and is not intended to replace the advice of your pharmacist or doctor. 

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