What is constipation?

Constipation is the term used when we do not move our bowels frequently enough. However, what we don’t really know is how often is ‘enough’.

Doctors would generally say that moving your bowels 3 times a week is sufficient and anything less would suggest that you are constipated, especially if your stools are hard and difficult to pass, or if going to the toilet causes you pain.

Naturopaths and herbalists, however, take the view that we need to open our bowels at least once a day – if not twice. They believe that good regular bowel habits will help one avoid many ailments in the digestive system, and other health conditions.

Certain people are naturally (genetically) more prone to constipation than others. Although the problem can affect both men and women, the fairer sex is 2 or 3 times more likely to suffer from constipation.

Pregnancy does not help – it has been estimated that up to 40% of pregnant women are constipated. In addition, people who are under stress are more likely to suffer from the condition. Also, as one gets older, constipation becomes more frequently encountered.

Constipation is more frequently seen in developed countries and this has been attributed to higher stress levels and a diet of refined foods. What is clear is that diet is a major factor leading to constipation.

Symptoms of constipation can come on suddenly and in these circumstances, is often related to a change in external factors such as diet, routine, stress or the menstrual cycle. In most, constipation resolves within a few days, with the adoption of a few lifestyle or dietary changes. However, some may feel the need for a constipation remedy to help things along.

If you experience sudden, unexplained constipation accompanied by tummy pain, blood or mucus in stools, seek advice from your doctor.

This gradually creeps up on you over months or years. Again, diet and lifestyle factors are usually responsible and bowels become increasingly ‘slow’.

You may not feel the urge to pass faeces and may find yourself going to the toilet only once or perhaps twice a week. Although many in this situation feel that this frequency is ‘normal’, chronic constipation can lead to a number of other health issues or complications (see below).

Hence, it is recommended that if your constipation persists for longer than one week, you should seek to do something about it.

Constipation occurs because the large bowel becomes inefficient at moving faeces along the last part of your digestive tract. This causes more water to be absorbed by the body, resulting in hard, small stools which become in turn, more difficult to pass.

A variety of factors can cause constipation, including:

• A diet which does not contain enough roughage or fibre
• A diet high in refined foods, sugars, coffee and wheat
• Lack of exercise
• Stress
• Other psychological factors (eg. embarrassment when opening bowels)
• Pregnancy
• Getting older
• Changes in routine – moving to a new house, travelling
• Prescribed medicines and those from your pharmacy
• Various intolerances to foods (eg. milk or wheat)
• Various bowel conditions (eg. irritable bowel syndrome)
• Previous bowel surgery, especially gallbladder removal
• Other illnesses, especially those reducing mobility (eg. strokes)
• Dehydration
• A reluctance to use public loos (including the ones at work). This causes people to ‘hang on’ until they get home – and if it happens frequently enough, the large bowel becomes stretched, making it work less effectively.

Over the short term, constipation does not generally lead to complications. However, if one is prone to the condition or if it is long-standing, several problems can develop:

• Haemorrhoids are small swollen veins around your anus. They come about because of increased pressure in the tissues brought about by the presence of hard faeces as well as the need to strain when passing stools. Haemorrhoids may bleed and at later stages, can give rise to pain
• Hernias can develop in the walls of your tummy, especially the lower tummy and pelvis, giving rise to prolapses. Excessively straining when passing stools can lead to bulging at weak points of your abdomen
• Diverticulitis – this is a condition of the large bowel where small sacs develop because of an increase in pressure inside the bowels due to the accumulation of faeces. Often, this condition exists silently, but over time, these sacs can become infected, inflamed and bleed
• Anal fissures are small tears in the anus – the last bit of the bowel where faeces pass. This gives rise to pain when bowels open.

Although not every healthcare professional might agree, it is also thought that prolonged constipation can lead to a variety of other health conditions and digestive disorders, ranging from a general feeling of feeling bloated (with wind) to the Irritable Bowel Syndrome (IBS).