SOME QUESTIONS AND ANSWERS
What is normal?
People vary with their bowel habit. Normal bowel function can include anything from defaecation three times a day to once every three days.
What is constipation?
This usually means the passage of hard stools. It may mean that you pass a stool less frequently than is normal for you. It may mean that you strain to pass a stool.
What causes constipation?
The usual causes are diets with insufficient fibre or fluids. Other common causes are immobility, illness or the side effects of medicines.
Some people, especially young women, are more prone to constipation.
What can you do?
1 You can improve your diet.
The amount of fibre in your diet should be increased to 20-30g per day. Unprocessed bran is cheap (but tastes terrible) and can be mixed into your usual diet, or you can change your diet to include more wholemeal breads, fresh fruit and vegetables.
2 You can increase your daily fluid intake.
You should drink about 2 litres of fluid each day.
3 You can take laxatives.
There are different types of laxatives. They work in different ways and at different speeds. You can use:
- Bulking agents (which expand and soften the faeces) like, bran, ispaghula husk (fybogel), methylcellulose and sterculia. these are slow to start to work but can be used safely for a long time.
- Stimulant laxatives like bisacodyl, or senna. These act quickly and are good for the short term relief of constipation.
- Faecal softeners like liquid paraffin are not recommended for prolonged use in anyone. They can cause a variety of side effects.
- Osmotic agents like lactulose and magnesium hydroxide mixture. These act by retaining fluid in the faeces. Magnesium salts can work within a couple of hours when given in large doses. Lactulose produces a softened stool within one to three days.
What are the best treatments for constipation?
For short term use when a quick effect is wanted a stimulant such as senna or bisacodyl is best. Bisacodyl or glycerol suppositories are an alternative.
For long term use, diet changes and a bulk forming agent are best.
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