Constipation

Overview

Constipation occurs when bowel movements are too infrequent (<3x/week) and difficult, often accompanied by pain. There are many causes (bowel problems, stress, malnutrition, etc.) which can be classified, for example, according to how long they last (acute, chronic). Preventive measures include a high-fibre diet, sufficient fluid (water) intake and regular exercise.

Symptoms

• Bowel movements
  • Irregular, infrequent (<3x/week); normal frequency is between 3x/day and 3x/week
  • Often painful straining
  • Stool consistency is hard
• Abdominal pain, bloating, feeling of fullness
• Colic, nausea and vomiting
• Feels as if bowel isn’t completely emptied

Causes and treatment

Causes

• Very diverse - an exhaustive list can't be provided
• Often, the cause can't be determined

Non-specific

• Sluggishness of the bowels
  • Usually women, young children and older people
  • Genetic predisposition
  • Pregnancy
• Medication, e.g. opiates (morphine)
• Psychological stress
• Lack of exercise
• Unhealthy diet
  • Diet that is low in fibre
  • Inadequate fluid intake
  • Unfamiliar food while travelling
  • Constipating foods: cocoa, bananas, blueberries, white rice, biscuits, strong black tea, cinnamon

Bowel diseases

• Diverticulosis, ulcerative colitis
• Appendicitis
• Intestinal constriction (e.g. tumours)
• Anal disorders
  • Tears in the lining of the anus (anal fissure) or haemorrhoids
  • Arbitrary avoidance of bowel movements
• Bowel prolapse

Other causes

• Febrile illnesses and confinement to bed
• Hormone disorders, e.g. thyroid
• Scleroderma
• Neurological disorders

Further treatment by your doctor / in hospital

Possible tests

• Abdominal examination (incl. rectal examination)
• Blood test
• Stool analysis
• Ultrasound
• Colonoscopy

Possible therapies

• Laxatives
• Treatment of an underlying disease

What can I do myself?

• Sufficient exercise
• Adjust diet
  • Fibre-rich and low-fat food: vegetables, salad, fruit, whole grain products
  • Avoid constipating foods, if necessary
• Drink enough, approx. 1.5 litres per day (more for fever and sweating)
• Go to the toilet regularly ("bowel training")
• Don't suppress the urge to defecate
• Abdominal massage
• Warm stomach poultices, cold apple cider vinegar compresses
• Avoid constipating foods, if necessary
• Household remedies to take internally:
  • Prunes
  • Figs, apple sauce
  • Sauerkraut juice
  • 1 to 2 spoons of linseeds or wheat bran with at least ½ a litre of water
• Glycerine suppositories
• Enemas (preparations from the pharmacy)

When to see a doctor?

• Acute, severe abdominal pain, nausea or vomiting
• Acute constipation
• Changes to bowel habits in the second half of life
• Constipation alternating with diarrhoea
• Swollen stomach
• Unexplained weight loss
• Repeated or persistent change in stool colour or stool consistency
• Blood, mucus in stool or on toilet paper, pencil-thin stools
• Thickened stones of faeces in the rectum (faecaliths)
• Evacuation problems, e.g. with bowel prolapse, haemorrhoids, anal fissure

Synonyms

constipation