Constipation

What is constipation?

Constipation means having difficulty pooing (passing stools), having fewer poos than usual, or having poos that are hard, dry, or painful to pass.

Some people with constipation can feel the need to strain to pass the poo, or feel that their bowels have not emptied completely.

This information leaflet discusses constipation in adults. For constipation in children, see our information leaflet called Constipation in children.

You may be constipated if:

• Your poo is hard and difficult or painful to pass.

• You're pooing less frequently than usual.

• You have stomach ache or cramps.

• You feel bloated or sick.

• It does not feel as though you have emptied your bowel or 'finished' after pooing.

How long does constipation last?

Constipation can last for just a day, or several days, depending on the cause and if steps are taken to improve it.

Chronic constipation lasts for at least 12 weeks out of the past 6 months.

Common causes of constipation include:

• Not eating enough fibre - this is found in foods such as fruits, vegetables, and cereals.

• Not drinking enough fluids - which can lead to dehydration.

• Lack of physical activity.

• Certain medicines – such as painkillers (especially ones with codeine), antacids, antidepressants such as amitriptyline, iron tablets, and some blood pressure medicines.

• Medical conditions - such as an underactive thyroid gland, irritable bowel syndrome, diverticular disease and colon cancer.

• Pregnancy - caused by hormonal changes and pressure from the growing womb. About 1 in 5 pregnant women will become constipated.

Constipation can also be caused by:

• Ignoring the urge to poo when you need to go to the toilet.

• Changes to your routine.

• Changes to your diet.

• Stress, anxiety, and depression.

• Difficulty accessing a toilet.

Functional constipation

Some people develop constipation despite a healthy diet, good fluid intake, and no underlying illness or medicines. It causes chronic (long term) constipation and has no identifiable cause. This is known as functional (primary) constipation.

It is common, affects women more often than men and it usually begins in childhood or early adulthood.

Lifestyle and diet changes

• Gradually increase the fibre in your diet to 30g daily. Wholegrains, fruit and vegetables are higher in fibre than other foods. For information on increasing fibre in your diet see the information sheet on fibre by the British Dietetic Association (BDA) in Further Reading below.

• Ensure you drink enough water each day to stay hydrated. The BDA information sheet on Fluid in Further Reading below shows why water is important and how much you need to drink.

• Being physically active encourages your bowel to move food along through your gut, avoiding constipation.

• Go to the toilet to poo as soon as you feel the need to.

Over-the-counter medicine

• Some medicines to help short term constipation can be bought over the counter at a pharmacy or supermarket. These medicines can be used for up to one week. If your constipation lasts longer than a week you should see a doctor. If you are pregnant or breastfeeding you should discuss your constipation with a pharmacist so they can advise you which laxatives are safe to use.

You can help prevent constipation by following the diet and lifestyle advice in the section "How to treat constipation" above.

Can paracetamol cause constipation?

No, paracetamol does not cause constipation.

Are bananas good for constipation?

Ripe bananas can help improve constipation as they are high in fibre, but unripe bananas may contribute to constipation.

What foods should you avoid when constipated?

There are no particular foods to avoid, but try to focus on increasing wholegrain foods which are high in fibre and making sure you are drinking enough water.

How long should I sit on the toilet if I'm constipated?

There are no set rules. Instead, make sure you are relaxed when sitting on the toilet, sitting upright with your feet flat on a steady surface and stay on the toilet until you feel you have emptied your bowels.