Feeling all knotted up and tight inside? Our tips will help unravel the pain.
Constipation not only causes discomfort and bloating, it can affect all areas of your life. Our experts show you how to get things moving again.
We usually keep our bowel habits to ourselves. So, by the time we seek help for any problems in that area, we’re in a bad state. But relax, the advice on the following pages will bring relief.
Everyone’s bowel habits are different. Some people go once a day, while others need to go three times a day, or perhaps three times a week. As long as you don’t experience discomfort, pain, the need to strain, or the sensation of not being able to empty your bowels fully, then you’re probably okay!
But if you experience any of the above, or often have hard or lumpy stools, or go to the toilet less than three times a week, then you’re considered constipated. Another symptom is if you rely on taking laxatives to get loose, soft stools.
The different consistency of stools and what’s generally considered to be normal is illustrated on the Bristol Stool Chart.
What causes constipation?
Your stools are mostly made up of fibre, so rapid changes in the amount of fibre you eat can vary the frequency and hardness of your stools.
You may experience constipation just from eating more takeaways, or by significant changes to your diet such as going vegetarian or trying a gluten-free, paleo or low-carb diet. Going on holidays and eating different food can also cause constipation.
Fibre draws water into your bowel to soften the waste products. Increasing the fibre you eat without drinking more water can cause your stools to harden and become more difficult to pass.
Stress is also a common trigger for constipation. During times of anxiety, blood flow is redirected away from your gut, which slows down digestion and sometimes leads to constipation.
You may also become constipated by sitting for long periods; or by taking medications, such as antidepressants, diuretics and anti-epileptics. Iron or calcium supplements can have this effect, too.
Develop habits for a happy gut
Eat more fibre
People who eat a fibre-rich diet are less likely to be constipated. But make changes to your diet slowly and gradually over a number of weeks to avoid any discomfort. Here are our tips:
Eat a variety of vegetables and fruit every day, and include the skin and seeds where possible, as they contain the most fibre.
Swap white bread, white rice and pasta for wholegrain choices, such as soy-linseed bread, brown rice and wholemeal pasta.
Make chickpeas, lentils and other beans a regular part of your diet; and include a small handful of nuts as a snack every day.
Top your cereal with 1 tablespoon of ground flaxseed, LSA mix, psyllium husks or chia seeds. You can also add these into a smoothie.
Try a probiotic supplement — some studies show that introducing good bacteria into the gut can help relieve constipation.
Studies suggest that regular activity, such as walking, can encourage bowel motions. Some experts believe that exercise helps by reducing stress and tightening the pelvic floor muscles (when these are too loose, it can lead to constipation).
If you’re dehydrated, there won’t be enough fluid drawn into your bowels to keep the stools soft. Being in an air-conditioned office and not drinking enough water during the day can result in dehydration. So, carry a water bottle with you or keep a glass on your desk as a reminder to drink throughout the day, and keep refilling them.
You would be amazed at the number of people who don’t know how to use the toilet properly. Try these tips to make it easier:
Sit on the toilet each morning and within 30 minutes of eating a meal, as this is the time when the bowel contracts the most.
If you feel the urge to go to the toilet, do so straight away — don’t hold on until later.
Make sure your knees are higher than your hips. Try putting your feet on an old telephone book or sturdy shoe box if your knees are too low.
Don’t strain; relax and give yourself five minutes to sit.
What about laxatives?
Taking a laxative tablet or powder can help you empty your bowels. Some work by drawing more water into the bowel to gently soften your stools, while others stimulate your colon muscles to squeeze. Your doctor will help you decide which one is best for you.
Keep it moving as you get older
Although constipation affects people of all ages, it’s most common in those over 65. As you age, the muscles in both your bowel and pelvis weaken, which affects how often you open your bowels. Having a chronic disease or being on long-term medication can also cause constipation.
Tips to stay regular
Speak to your GP: If it’s just a side effect of your medication, ask to change it.
Keep active: Even walking to the letter box once or twice a day will help cut your risk of constipation.
Drink throughout the day: Drink more, but only in the morning to early afternoon, to avoid visits to the bathroom during the night.
Ignoring the symptoms
There is evidence that constant straining when going to the toilet puts pressure on the bowel lining, which causes small pockets to protrude in the bowel wall, called diverticula.
Diverticular disease affects a third of us by the age of 50 and can be partly caused by a low-fibre diet. You may not even know you have these pockets, as often there are no symptoms.
However, small nicks can occur in these pockets, causing inflammation — this is diverticulitis. Symptoms include abdominal pain, fever, nausea and vomiting. Treatment often requires a hospital stay.
Years ago, people with diverticular disease were told not to eat small, sharp foods like nuts and seeds, which were believed to worsen the condition. But research shows otherwise, so there’s no need for this.
Haemorroids is another consequence of straining. The veins around your anus stretch, and then swell up and bulge out, causing pain.
A high-fibre diet with plenty of water and activity is the best way to prevent chronic constipation.
If you’re constipated for more than three months, you should see your GP.