Constipation

Constipation is defined as a condition in which bowel evacuations occur infrequently, or in which the faeces are hard and small, or where passage of faeces causes difficulty or pain (Oxford Dictionary of Nursing, 1998). It can be a feeling that, having been to the toilet, a person may feel they haven't emptied their bowels completely, have only passed a small amount and feel they could go again a short while later. In a person with healthy bowel function, bowels should move at least once a day or after every meal.

Consequences

Faecal matter which doesn't move through the bowel quickly enough can lead to a build up of toxic material in the colon. Peristalsis (the action of the bowel which pushes material along the digestive tract) can be suppressed due to long-term constipation. Haemorrhoids (piles) can result from chronic constipation. Continued straining to pass a stool can result in the blood vessels surrounding the anus becoming swollen. At its worst, constipation over long periods can result in physical blockages or distension of the bowel which can lead to diverticulosis.

Causes

When constipated, water is reabsorbed from stools leading to even harder stools which become more difficult to pass. The main reasons for constipation are:

• Insufficient water intake
• Not going to the toilet when we initially feel the need
• Eating too many concentrated foods e.g. bread, pasta
• Diet too low in fibre
• Lack of exercise can lead to poor muscle tone of the bowel
• Obesity
• Stress
• Habitual use of laxatives
• If peristalsis is weak, constipation can result

Research has shown the major factor in chronic constipation is diet and although dietary changes can help with constipation, it is not always enough to cleanse the colon.

The UK is the most constipated nation in the world. The healthy transit time for food to pass through our bodies should be 24 hours, but on average in the UK, it is 60 hours for men and 70 hours for women.