Constipation in Adults explained

How do I know if I am constipated?

Constipation is a common problem and does not mean that you necessarily have a disease. It is a symptom that can mean different things to different people but the usual meaning is that a person has difficulty in opening their bowels. Doctors define constipation in a number of ways:

• opening the bowels less than three times a week

• needing to strain to open your bowels on more than a quarter of occasions

• passing a hard or pellet-like stool on more than a quarter of occasions

If you have any of these complaints you may be one of the approximately one in seven otherwise normal people who are just constipated. Two particular groups of people who are most likely to be troubled by constipation are young women and the elderly – especially those who need to take regular medicines. Constipation may be part of the irritable bowel syndrome (see our separate leaflet), especially if abdominal pain is also present.

Can being constipated cause any complications?

Although people often worry about it, there is no reason to believe that constipation causes a “poisoning” of the system. You may feel sluggish and bloated, but there is no evidence that bugs or any toxins leak from your bowel into any other part of the body. Another common idea is that constipation may lead to cancer. There is no evidence at all that long-term constipation increases your chances of getting bowel cancer. Patients can be alarmed if they notice blood when they open their bowels. You may notice some blood on the tissue after straining or passing a hard stool – this is usually due to haemorrhoids (or rarely a painful tear at the anus). This explanation will need to be confirmed by a doctor. Elderly or immobile patients may get so badly constipated that they quite literally get bunged up ("faecal impaction") and this will need prompt treatment by either the GP or hospital.

What goes wrong with the body to cause constipation?

Most commonly the muscles of the intestines and colon do not seem to work properly and this results in slow movement of contents through the bowel. The urge to open your bowels may not be felt very often since, when the bowel is sluggish, the stool can become hard and small. In some people there can be a problem just inside the anus with the way that the rectum squeezes out its contents.