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  • Constipation

    Constipation – a pain in the bum?
    What is constipation?

    Constipation is when your bowel movements are less regular than normal. This is usually under 3x a week, however, it is very dependent on the individual and what is considered ‘normal’ for them. The stool may become hard or difficult to pass, causing discomfort. You may notice it in yourself or your child through feeling irritable, being less hungry, having a firm stomach, and/or a lack of energy.

    What causes constipation?

    Everyone is likely to have experienced some form of constipation in their lives. Sometimes, there may be no clear reason, but, generally, it can be caused by a number of factors, including:

    • Stress, anxiety, and depression – research has shown that the gut and mind are highly interdependent, so our mood changes can have a big effect on bowel movements.
    • Dehydration and a lack of fibre – water and fibre are essential for bulking up the stool and allowing it to pass more easily.
    • Decreased movement or exercise
    • Side-effects from medications e.g. morphine derivatives such as codeine
    • Changes in diet or routine, including a change of time zones
    • Being pregnant or in the postpartum period

    How can I treat constipation?

    Before buying any medication, there are a few easy at-home interventions you might like to try:

    • Ensure you are staying hydrated, aiming to consume around 1.5 – 2 litres of water each day.
    • Increase your amount of daily exercise, but be aware than a drastic change in activity levels may also affect your bowels.
    • Consuming more dietary fibre is an effective way to improve symptoms of constipation by bulking up the stool and allowing its easier movement through the bowel. The Scientific Advisory Committee on Nutrition (SACN) recommends 30g per day. Good sources of fibre include fruits and vegetables, pulses, nuts, seeds, wholegrain cereals and oats. Eating the skins of fruits, vegetables, and roots such as potatoes and pears also is a great way to increase your fibre intake.
    • Furthermore, western toilets often do not allow us to be in an optimum posture. Try to ensure that your legs are angled up, with your knees above your stomach, and let gravity do its work. You can rest your feet on a stool to help with this.

    What products are available?

    If you have tried the above, but are still experiencing discomfort, you may want to think about using something else. If it’s your first time buying constipation relief products, speaking to your pharmacist will enable you to make an informed and effective decision on what to try first.

    • Fybogel (ispaghula/psyllium husk) is a high-fibre sachet drink and a good option to try if you are finding that adding more fibre to your diet is not as effective as hoped. It generally takes 2-3 days to work.
    • Osmotic laxatives such as Lactulose and Macrogol work by drawing more water into the colon so be sure to take them with plenty of water. You may also need to take them for 2-3 days to see effects.
    • Bisacodyl, Docusate Sodium, Glycerol suppositories, and Senna are types of laxatives that stimulate gut motility. Docusate Sodium is also a stool-softener so can be particularly useful if you find that your stools are hard. Typically, stimulant laxatives take 6-12 hours to work.

    Some of these medications may be inappropriate for pregnant women and those with certain medical conditions. They should be used under the supervision of a pharmacist or doctor, so please consult a healthcare professional before trying any of these treatments.

    References:

    https://www.nhs.uk/conditions/constipation/
    https://www.nhs.uk/conditions/laxatives/