We asked Dr Sarah Jarvis to explain exactly what constipation is, why it happens and some easy ways you can help ease the symptoms.
What is the definition of constipation?
Constipation means different things to different people because all our bowel habits are so different from everyone else's. A common medical definition of constipation is pooing less than three times a week. But if you normally don't go as often, then that might not seem that abnormal to you.
So perhaps more helpful is to think about constipation as going less often than normal for you. This could include having poo that's very hard or difficult to get out, needing to strain to pass poo, not feeling that you've completely emptied when you have finished, or getting pain when you open your bowels.
Why do I get constipated?
There are lots of reasons for constipation. One of the most common is not eating enough fibre in your diet. Guidelines say that we should have at least 18g of fibre in our diet as a nation. Yet on average, we get about 12g, way below what most of us need.
Fibre is important for keeping you regular. It's food that your gut can't digest, basically. It helps to bulk out your poos and make them softer (although fluid can also make a real difference). It's really important not to be dehydrated because the fluid then otherwise gets absorbed from your bowels, and that can leave those poos very hard, small, and difficult for your body to pass.
Exercise can also make a big difference. If you're not exercising, then your gut isn't going to be moving things along in the same way.
Interestingly, we're increasingly thinking that not just the food and fluid that you take in but also the bacteria that digest that food in your bowel, your so-called gut microbiota, may have an impact on constipation.
Different balances of your microbiota - the trillions of bacteria that naturally live in your gut - can affect how that food is digested. Unhealthy bacteria can produce more gas when they’re breaking down the food in your gut. This can leave you feeling windy and may well also lead to constipation. So, we know that having a good a healthy microbiota can also make a difference. And one of the keys to that is having a healthy diet with enough fibre.
What can I do to help constipation?
Constipation happens when the poos inside your gut are too hard and small, and can't be propelled along effectively by your colon (your large bowel).
Lots of factors make a difference. And those factors are the key to knowing how you can improve it.
1. Have enough fluid on board
This will prevent the fluid in your large bowel from being reabsorbed into your system, which can leave your poo small, dry, hard, and harder for the muscles in your large bowel to clamp down on to pass it along.
2. Exercise can make a big difference
Exercise doesn’t just exercise the muscles in your arms and legs - it can help your gut to move things along more smoothly as well.
3. Make sure you have enough fibre in your diet
The fibre in your diet is absolutely crucial. It helps to bulk out your poos, stopping them from getting too hard as well as making it easier for your bowel to propel them along.
Fibre is basically the digestive material that your body can't absorb back into your system.
The first is insoluble fibre - roughage, found in bran, wholemeal or whole grain foods, as well as vegetables and fruit, pulses, beans and lentils. This is great for bulking out and softening your poos but too much can leave you feeling bloated and uncomfortable, especially if you have IBS (irritable bowel syndrome).
The second form is soluble fibre, found in foods such as oats, aubergines, avocadoes, broccoli, bananas, berries, figs, many stone fruits without their skins. This forms a sort of gel inside your gut. If you struggle with pain and bloating when you increase your intake of insoluble fibre, you may find that switching to more soluble fibre, will improve your constipation without causing the same degree of bloating.
4. Look at your medications
It's also worth looking at any medications you're taking because some medications can really constipate you, particularly codeine-containing painkillers. If that is the case, you could speak to your pharmacist or your GP to see whether an alternative might be available.
Read more from Dr Sarah Jarvis
What's normal when it comes to diarrhoea and how to help
12 common bloating questions answered
