What is constipation?
You’ll feel constipated if you don’t empty your bowels often or fully enough, or have difficulty doing so.
This can be down to the sluggish movement of food through your gut (called ‘slow transit’), or how well you can actually go to the toilet (‘evacuation’).
Constipation varies from person to person, especially as some people’s normal routine is go to the toilet less often than others. While some will only have constipation for a short while, for others it can be a long-term condition causing pain and discomfort.
What are the symptoms of constipation?
The most common signs of feeling constipated include:
- Stomach ache
- Painful cramps in your intestines
- Bloating
- Feeling sick
- Loss of appetite
- Difficulty moving your bowels regularly
- Hard and lumpy stools
- Unusually large or small stools
- Straining to pass a bowel movement
- Feeling of incomplete emptying after going to the toilet
What causes constipation?
Finding out what’s causing your constipation is an important step towards helping you to take more control over your bowel movements. Some of the main causes of constipation include:
- Food moving too slowly through your gut (slow transit)
- Weak pelvic floor muscles
- Problems with the structure of your pelvic floor (such as a prolapse or rectocele)
- A lack of fibre in your diet, and/or not drinking enough fluid
- An excessive amount of bacteria in the small intestine (SIBO) or an imbalance in your intestinal bacteria
- Anxiety and/or stress
- The side effects of some medications and supplements
- Not doing enough exercise
- Pregnancy
- Irritable bowel syndrome (IBS)
- Surgery
How do we diagnose the causes of constipation?
We might suggest that we run one or more of the following tests:
- Anorectal manometry – which tests the strength of the muscles in your back passage and rectum
- Defaecography – which investigates any problems you may have when trying to open your bowels
- Endoanal ultrasound – to image the muscles in your back passage and surrounding tissues, and assess their structure.
- Whole-gut transit – a non-invasive test which looks at how long it takes for faeces to pass through your bowel
- Pudendal nerve function test – which looks at the nerves in your pelvic floor which control the muscles in your back passage
- Carbohydrate malabsorption breath test – which finds out if you have certain food intolerances (lactose or fructose)
- Small intestinal bacterial overgrowth (SIBO) breath test – which finds out if you have an overgrowth of bacteria in your small intestine (called SIBO)