It’s estimated that 14 per cent of the world’s population suffer from chronic constipation, which tends to affect women more often than men. Constipation can feel very uncomfortable, but, fortunately, it’s often easy to manage.

What is constipation?

A person with a healthy gut will usually pass well-formed stools once per day or at least on alternate days, with at least three stools a week. However, there is a large range for what's still considered 'normal' bowel habits, from passing stool two to three times a day to two to three times a week. It's a change from your normal pattern that may indicate constipation. Constipation can be defined as:

• Less frequent passage of stools than normal

• Passage of harder, smaller stools than normal

• The feeling of incomplete passage of stools

• Straining to produce stools

Constipation can sometimes be accompanied by abdominal pain, bloating and feeling sick.

Long-term constipation is when you have symptoms for an extended period, either uninterrupted or on and off.

What are the causes of constipation?

Constipation can often have no clear cause. However, there are certain factors that can contribute towards symptoms of constipation.

Vegetables and fruit contain lots of fibre that goes undigested in the intestines. This helps to soften the stools and move them more easily through the bowels. If your diet lacks fibre, this may be a factor in causing your constipation.

Another common cause of constipation is dehydration. The intestines absorb water from stools as they go through the bowel. If you are dehydrated, more water is absorbed than usual to help with the normal functioning of your body. This leaves stools hard, making passing them more difficult and sometimes painful.

Certain medicines, such as codeine, can cause constipation. Ask your pharmacist for advice if you think that a medicine you’re taking is causing constipation.

Irritable bowel syndrome (IBS) is also a common cause of constipation. In IBS, your symptoms can switch between constipation and diarrhoea. You should visit your Doctor if you think you might have IBS.

What can I do to treat constipation?

The symptoms of constipation can usually be treated with some simple lifestyle changes:

• Eat plenty of fruit and vegetables. Choose wholemeal bread and pasta over refined varieties

• Drink lots of fluids. Six to eight cups of water a day is a good target for most people. It’s important to remember you may need to drink more on hot days or if you sweat during exercise

• Avoid alcohol as this make dehydration worse

• Get regular exercise, which can help to get your bowel moving

Are there any medicines for constipation?

If you still find it difficult to pass stools, consider using laxatives. There are different types of laxatives available:

• Osmotic (water-retaining) laxatives. These trap water in the bowel, producing softer stools

• Bulk-forming laxatives which are fibre supplements. Unprocessed bran is a good alternative and can be sprinkled over yoghurt, soups and cereals

• Stimulant laxatives like glycerol and senna help increase movement in the intestines

When using laxatives, make sure that you take the manufacturer’s recommended dose. Your pharmacist will also be able to guide you. Laxatives should only be used as a short-term solution, unless your doctor advises you otherwise.

When should I see my Doctor?

If you find that you’re still getting symptoms of constipation despite having a high intake of fibre and water, or taking laxatives, make an appointment with your Doctor. If you’re regularly constipated and your constipation lasts for a long time, it is also advisable that you visit your doctor.

If you notice any other symptoms like blood with stools, black stools, loss of appetite, or unexplained weight loss, speak to your Doctor as soon as possible.

Next steps

• Eat more fibre, drink more water and exercise

• Ask your pharmacist for advice on laxatives

• Visit your Doctor if your symptoms don't improve or if you have persistent constipation