Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies

Continue

Constipation

Constipation is a very common condition that affects your usual pattern of bowel movements. Your bowel movements may occur less often than usual, or they may be difficult and uncomfortable to pass.

People’s bowel habits vary – for example, some people go more than once a day, while others may go every other day. Neither of these is necessarily a problem if there has been no change in your bowel movements and you aren’t having any difficulties. However, if you have constipation, there are two main ways in which you may be affected.

  • You may not have bowel movements as often as you expect.
  • You may have regular bowel movements, but it’s uncomfortable and you have to strain.

Constipation can happen for many reasons, and is particularly common in pregnant women and elderly people. Constipation can occur at any age and is a common reason for people going to see their GP.

Read more Close

Details

  • Symptoms Symptoms of constipation

    The main symptoms of constipation include:

    • straining when trying to have a bowel movement
    • feeling as though you haven’t fully emptied your bowels
    • passing faeces that are either unusually large or small (‘rabbit droppings’)
    • passing faeces that are hard and/or lumpy
    • having fewer than three bowel movements a week
    • pain or discomfort in your abdomen (tummy)

    A healthy lifestyle, such as eating enough fibre and exercising regularly, can help prevent and ease symptoms of constipation. However, if your symptoms persist or if you notice any other changes in your usual pattern of bowel movement, you should seek medical advice. In particular, if there is blood from your back passage (rectum) or in the toilet, or if you experience diarrhoea alternating with constipation, you should arrange to see your GP without delay.

  • Diagnosis Diagnosis of constipation

    Your GP will ask you about your symptoms and examine you – this may include an examination of your rectum. He or she may also ask about your medical history.

    Your GP may refer you for further tests to rule out other medical conditions. These tests are listed below.

    • Blood tests.
    • Sigmoidoscopy. This procedure involves using a narrow, tube-like telescope (called a sigmoidoscope) to look inside your rectum and lower part of your bowel.
    • Colonoscopy. This procedure involves using a narrow, flexible, tube-like telescopic camera (called a colonoscope) to look inside your large bowel.
    • Barium enema X-ray. This test involves placing a fluid containing barium (a substance which shows up on X-rays) into your bowel via the rectum. X-ray images of your abdomen then show the inside of your bowel more clearly.
  • Treatment Treatment of constipation

    There are several things you can do to help relieve mild symptoms of constipation.

    Self-help

    It’s important that you include enough fibre in your diet, not only to treat constipation, but to maintain your general health. Adults should aim to have 18 to 30g of fibre in their diet each day, but most people in the UK don’t eat enough. Fibre is found in all types of plant-based foods, such as fruit and vegetables. The UK Department of Health recommends that everyone eats five portions of fruit and vegetables a day.

    There are two types of fibre; insoluble and soluble. It’s important to include both types in your diet to get the balance right.

    Good sources of insoluble fibre include:

    • fruit and vegetables, preferably eaten raw and in their skins
    • wholegrain breakfast cereals
    • wholegrain bread
    • brown rice
    • wheat bran

    Good sources of soluble fibre include:

    • oats
    • seeds
    • pulses, such as peas and beans

    Soluble fibre can also reduce cholesterol in your blood and help control your blood sugar levels.

    If you don’t currently eat much fibre, it’s important to increase the amount in your diet slowly, otherwise you may get bloating and wind. You should continue with a high-fibre diet even if your symptoms don’t immediately improve as it may take up to four weeks to have an effect.

    It’s also important that you increase your fluid intake; you should aim to drink between eight to 10 cups of fluid a day. This is because insoluble fibre absorbs water and increases the bulk of waste matter in your bowel, which helps to move digested food through your bowel more easily. Increasing the amount of exercise you do may help to ease constipation too.

    Medicines

    If lifestyle changes don’t help to relieve constipation, your GP may suggest a laxative. You may need to try more than one type to help improve your symptoms. The types of laxative to help relieve constipation are listed below.

    • Bulk-forming laxatives (ispaghula husk, methylcellulose and sterculia). These are recommended if you can’t manage to increase the fibre in your diet. They contain a type of fibre and work by increasing the amount of content in your bowel. As this builds up, it stimulates your bowel muscles to move and push faeces out. It may take a few days for bulk-forming laxatives to work. You need to make sure you drink enough fluid if you take these to stop your bowel becoming blocked.
    • Osmotic laxatives (macrogols or lactulose). These work by increasing the amount of water in your bowel, making faeces softer and easier to pass. These take a few days to work and it’s important to drink enough water if you take these laxatives as they can be dehydrating.
    • Stimulant laxatives (senna or bisacodyl). These work by stimulating the muscles in your bowel to contract more often and with increased force. These work more quickly than other types of laxative. If you take them at night, you’re likely to have a bowel movement in the morning. Stimulant laxatives can sometimes cause abdominal pain.

    Once your bowel movement pattern returns to usual, you may be able to stop taking laxatives and try to maintain a healthy bowel habit by eating a balanced diet with enough fluids and fibre. For children, it’s important to ensure a regular bowel habit for several weeks after a regular pattern of toilet training has been established, and to taper the dose of laxatives very gradually over several months. For more information, see our frequently asked questions.

    You can buy laxatives over the counter from a pharmacist without a prescription. However, it’s a good idea to see your GP before trying laxatives because he or she may be able to give you advice on how to relieve your symptoms without needing to use medicines. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

  • Worried about your colon health?

    Get a picture of your current health and potential future health risks with a Bupa health assessment. Find out more today.

  • Causes Causes of constipation

    There are several reasons why you may develop constipation, including:

    • your diet, such as not eating enough fibre or drinking enough fluid
    • taking certain medicines, such as antidepressants, calcium or iron supplements, or painkillers (eg codeine or morphine)
    • being inactive
    • ignoring the need to go to the toilet – because you’re busy or because you worry people can see or hear you
    • stress or depression
    • pregnancy – around four in 10 women who are pregnant have constipation

    Constipation can also be a symptom of certain medical conditions, for example:

    • piles
    • anal fissure
    • tears to the anus following childbirth
    • irritable bowel syndrome (IBS)
    • underactive thyroid
    • inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
    • conditions affecting your nervous system, such as Parkinson’s disease or multiple sclerosis
    • spinal cord injury
    • rectal or colon cancer

    If you’re worried about what could be causing your constipation, seek advice from your GP.

  • Complications Complications of constipation

    If constipation isn’t treated, it can cause complications, including those listed below.

    • Faecal impaction. This is when hard faeces collect in your rectum and you reach a point where you probably won’t be able to have a bowel movement without treatment.
    • Overflow incontinence. This is when small amounts of loose faeces leak out around the impacted faeces, without you feeling it.
    • Bleeding from your anus.
    • Psychological problems. Particularly in childhood, pain on defecating can lead to fear of going to the toilet, and there may be feelings of guilt or blame.
    • Urinary tract infection.
    • Haemorrhoids (piles).
  • Prevention Prevention of constipation

    You can reduce your risk of constipation by eating a balanced diet with lots of fibre, drinking enough fluids and taking regular exercise.

  • FAQs FAQs

    Can I give my child laxatives for constipation?

    Answer

    You shouldn’t give your child a laxative without seeing your GP first. Laxatives can help treat constipation and your GP may advise your child to take them alongside changes to their diet and lifestyle.

    Explanation

    It’s important to be sure that your child really is constipated before giving him or her any treatment. The symptoms of constipation in children include:

    • not having regular bowel movements
    • straining when trying to have a bowel movement
    • pain when having a bowel movement
    • abdominal (tummy) pain
    • small, hard faeces or occasional very large bowel movements
    • faeces leaking onto underwear
    • being irritable
    • not wanting to use the toilet or straining to stop going
    • poor appetite
    • low energy
    • wind

    If you think your child may be constipated, take him or her to see your GP. Your GP may prescribe an osmotic laxative, which can help to soften faeces. If symptoms are severe, treatment isn’t working or your GP thinks that there may be an underlying cause, then he or she may refer your child to see a paediatrician (a doctor who specialises in children’s health).

    Your GP will also give you advice about diet and fluids for your child. It’s important that your child has enough fibre in their diet, such as fruit, vegetables, baked beans and wholegrain cereals. You will also need to make sure that your child is drinking enough fluids. For example, fruit juice, particularly prune juice, can help soften faeces naturally.

    It’s important to try to help your child stay relaxed about going to the toilet, ensuring that time on the toilet is not hurried and is regular. If you’re toilet training him or her, it may help to include rewards for using the toilet.

    Is constipation common during pregnancy?

    Answer

    Yes, this is a common problem during pregnancy. Around four in 10 pregnant women get constipated at some point during pregnancy.

    Explanation

    There are several reasons why pregnant women are more likely to get constipated. The hormones (chemicals produced naturally by your body) produced during pregnancy can affect your bowel, causing it to work more slowly. If you’re taking iron supplements, these can also lead to constipation.

    You can try to reduce constipation by eating a diet that includes lots of fibre; the recommended intake is 18 to 30g of fibre a day. Foods that are high in fibre include fruit (especially prunes) and vegetables, wholegrain bread and cereals, beans and pulses. You can also increase your fibre intake by adding bran or wheat fibre to your food. Drinking enough water helps to soften faeces and may ease constipation – try to drink around eight to10 cups a day. You may also find it helpful to take regular, gentle exercise.

    It’s important to speak to your midwife, pharmacist or GP before taking any medicines to treat constipation, such as laxatives.

    Is there any other treatment for constipation if oral laxatives haven’t worked?

    Answer

    If your symptoms of constipation haven’t improved through eating more fibre or taking oral laxatives, your GP may suggest a suppository or an enema.

    Explanation

    Before taking any medicines for constipation, it’s best to try to relieve your symptoms by making lifestyle changes, such as eating more fibre, drinking enough water and taking regular exercise. If this doesn’t work, your GP may suggest that you try laxatives tablets or solutions.

    If these don’t help to ease constipation, your GP may advise using a glycerol suppository. This is a stimulant laxative that increases your bowel’s activity. A suppository is inserted through your anus into your rectum – you can usually do this by yourself at home. This can cause a bowel movement within half an hour. They are generally only for occasional use to get rid of impacted faeces.

    It’s also possible that your GP will offer you an enema to soften the faeces in your bowel or to stimulate your bowel to move. You may need to have more than one enema to clear your bowel if the faeces have become very hard.

  • Resources Resources

    Further information

    Sources

    • Constipation. Prodigy. www.prodigy.clarity.co.uk, published January 2008
    • Constipation. BMJ Best Practice. www.bestpractice.bmj.com, published 14 May 2012
    • Understanding constipation. American Gastroenterological Association. www.gastro.org, accessed 30 May 2012
    • Constipation in adults. Core. www.corecharity.org.uk, accessed 23 April 2012
    • Hamilton W, Sharp D. Diagnosis of colorectal cancer in primary care: the evidence base for guidelines. Family Practice, 2004; 21(1):99–106. doi:10.1093/fampra/cmh121
    • Rubin G, Dale A. Chronic constipation in children. BMJ, 2006; 333(7577):1051–5. doi:10.1136/bmj.39007.760174.47
    • Codeine/paracetamol. electronic Medicines Compendium. www.medicines.org.uk, published 3 January 2012
    • Morphine. electronic Medicines Compendium. www.medicines.org.uk, published 3 January 2012
    • Constipation, haemorrhoids, and heartburn in pregnancy. BMJ Clinical Evidence. www.clinicalevidence.bmj.com, published 3 August 2010
    • Bowel cancer tests – sigmoidoscopy. CancerHelp UK (Cancer Research UK). http://cancerhelp.cancerresearchuk.org, published 13 October 2011
    • Dietary fibre. British Nutrition Foundation. www.nutrition.org.uk, accessed 25 April 2012
    • Fibre. Core. www.corecharity.org.uk, accessed 25 April 2012
    • Joint Formulary Committee. British National Formulary. 62nd ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2011
    • Constipation in children. Prodigy. www.prodigy.clarity.co.uk, published September 2010
    • Constipation in children and young people. National Institute for Health and Clinical Excellence (NICE), May 2010. www.nice.org.uk
    • Arulkumaran S, Symonds I, Fowlie A. Oxford handbook of obstetrics and gynaecology. 1st ed. Oxford: Oxford University Press, 2004:58
    • Constipation in pregnancy or while breast feeding. Prodigy. www.prodigy.clarity.co.uk, published January 2008
    • Antenatal care: routine care for the healthy pregnant woman. National Institute for Health and Clinical Excellence (NICE), March 2008. www.nice.org.uk
    • Laxatives for constipation. Map of Medicine. www.medicinenet.com, accessed 31 April 2012
  • Related information Related information

  • Tools and calculators Tools and calculators

  • Author information Author information

    Produced by Natalie Heaton, Bupa Health Information Team, July 2012.

    We welcome your feedback on this topic
    Submit an FAQ on this topic

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
    Information standard logo
  • HONcode

    We comply with the HONcode for trustworthy health information: verify here
    HON code logo
  • Plain English Campaign

    We hold the Crystal Mark, which is the seal of approval from the Plain English Campaign for clear and concise information.
    Plain English Campaign logo

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.

Readable

In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.

Reliable

We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.

Relevant

We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Don’t just take our word for it. Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information.

  • HONcode

    We comply with the HONcode (Health on the Net) for trustworthy health information. Certified by the HONcode for trustworthy health information.

  • Plain English Campaign

    Our website is approved by the Plain English Campaign and carries their Crystal Mark for clear information. In 2010, we won the award for best website.

    Website approved by Plain English Campaign.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: healthinfo@bupa.com. Or you can write to us:

Health Content Team
Bupa House
15-19 Bloomsbury Way
London
WC1A 2BA

Find out more Close

Legal Disclaimer

This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

^ Calls may be recorded and may be monitored.