Patient information from the BMJ Group Constipation

Patient information from the BMJ Group

Constipation

Being constipated can make you feel uncomfortable and sluggish. Eating more
fibre, drinking more fluids and taking some gentle exercise might help. If that
doesn't work you may need to take laxatives, but probably for just a short time.

We've looked at the best and most up-to-date research to produce this information.
You can use it to talk to your doctor or pharmacist and decide which treatments
are right for you.

What is constipation?

If you have constipation, you have difficulty passing stools, or you don't pass a stool very
often.

It's hard to say exactly when someone's constipated. Bowel habits vary a lot, and people
have different ideas about what's normal. A change from your regular pattern of bowel
movements is often the best way of telling if you're constipated.

Constipation is often linked to not eating enough fibre, not drinking enough fluids and
not taking enough exercise. Sometimes medicines can cause constipation, so be sure
to tell your GP if you are taking any.

What are the symptoms?

If you have constipation:

• You find passing a stool difficult or uncomfortable, even though you go to the toilet
fairly regularly

• Or, you don't pass a stool often enough.

You may also find your stools are hard or lumpy. You may feel your bowels aren't
completely empty after going to the toilet. Sometimes there are other symptoms, such
as stomach pain, or feeling bloated or tired.

Constipation is very common. You will probably not need to see your GP unless it lasts
longer than two weeks.

You should also see your doctor if you:

• Have a sudden change in your bowel habits

• Lose weight for no obvious reason

• See blood in your stools. Blood in your stools is most likely caused by piles
(haemorrhoids). But occasionally it can be a sign of a more serious condition.

© BMJ Publishing Group Limited 2015. All rights reserved.
page 1 of 3

Constipation

Your doctor may say your constipation is chronic if you have two or fewer bowel
movements a week, for two weeks.

Your doctor will probably be able to diagnose constipation by asking you questions about
your symptoms. Most people don't need any tests for constipation. You'll need tests only
if your doctor wants to make sure there isn't something more serious that's causing your
symptoms.

What treatments work?

If you're constipated eating more fibre and taking regular exercise is likely to help. You
could also try drinking more fluids, although there's less research to show this is beneficial.
Here's what we know.

• Fibre makes stools bulkier and softer. High-fibre foods include bran, root vegetables,
nuts, fresh or dried fruit, and wholemeal cereals, bread and pasta. In one study,
women who ate high-fibre rye bread were much less constipated after three weeks.
In another study, women who generally ate more fibre were less likely to be
constipated.

• A small or moderate amount of exercise, such as a daily walk or run, has been
shown to help constipation.

• Drinking more fluids should make your stools heavier and more slippery. This
might make going to the toilet easier. Drinking more fluids while also eating more
fibre has been shown to work better than just eating more fibre.

If these changes to your lifestyle don't help, then you may need to take laxatives. You
can buy these from a pharmacy without a prescription. But see your doctor if you need
to take them for longer than two weeks.

The laxative that research shows works best is one called polyethylene glycol (brand
name Movicol). Seven in 10 people who had constipation for a long time found that
polyethylene glycol helped after they'd taken it for four weeks. It doesn't seem to cause
any side effects.

Other laxatives that work well are ispaghula husk and lactulose. Ispaghula husk is a
fibre supplement that comes as granules or a powder that you mix with water. Some
brand names include Fibrelief, Fybogel, Isogel, and Regulan. You need to drink plenty
of fluids while you're taking ispaghula husk. If you don't, your bowels could get blocked.
Also, you shouldn't take this treatment just before going to bed.

You usually take lactulose as a liquid or you can mix it with a drink. Some brand names
for lactulose are Duphalac, Lactugal, and Regulose. You may get bloating, cramping
and wind from ispaghula husk and lactulose.

There are many different types of laxatives. We can't say if other laxatives work, because
there hasn't been enough good research.

© BMJ Publishing Group Limited 2015. All rights reserved.
page 2 of 3

Constipation

What will happen to me?

Most constipation lasts for just a few days. It rarely becomes serious. But occasionally
constipation can go on and on. If this isn't treated properly, it can get worse.
Rarely, constipation that isn't treated leads to large, hard stools that block the bowels.
This is more likely to happen if you're older. Your doctor will probably prescribe laxatives
to clear your bowels. As a last resort, you may need to go to hospital. Your doctor can
clear your bowels with an enema (fluid passed into your back passage) or suppositories
(medicine placed into your back passage). But most people won't need this.

This information is aimed at a UK patient audience. This information however does not replace medical advice.
If you have a medical problem please see your doctor. Please see our full Conditions of Use for this content. These
leaflets are reviewed annually.

© BMJ Publishing Group Limited 2015. All rights reserved.
Last published: Sep 16, 2015

page 3 of 3