When is Constipation an Emergency? Learn the Danger Signs

Most of the time, a simple over-the-counter constipation treatment will be enough to treat a bout of constipation. However, in rare cases, infrequent bowel movements may be an indication of a more serious underlying issue. Here's what you need to know if you’re having problems passing stool.

What causes constipation?

First off, let’s define constipation. You’re suffering from constipation if:

• You’ve passed fewer than three times within the past week.
• Passing stool is uncomfortable and painful. You may feel as though you’re struggling and straining to do so.
• Any stool that is passed is large and dry.

Along with the key indicators listed above, you may also feel:

• Bloated, gassy or overly full.
• Sick, with a stomach ache.

Constipation may be caused by any number of factors. These include:

• Diet — to avoid constipation, ensure your diet is high in fibre. Fibre is found in fruit, vegetables and cereals. Breakfast is a great meal to pack in plenty of fibre, so don’t skip it! Fluids are important, too. The NHS Eatwell Guide recommends you should drink between 6-8 cups of water a day (around 1.2 litres).
• Exercise — constipation is more likely to occur if you spend long periods sitting or lying down without exercising.
• Mental health — stress, anxiety and depression can all trigger changes in your bowel’s function, including causing constipation.
• Pregnancy — constipation during pregnancy is caused by an increase in progesterone hormones that relax the intestinal muscles. As a result, waste is processed at a slower rate, and may be difficult to pass.
• Certain medical conditions — in rare cases, constipation may be caused by underlying health conditions. These include irritable bowel syndrome (IBS), diabetes, and hypercalcaemia.
• Medication — some medications can cause constipation, especially opiate-based painkillers such as co-codamol, codeine or tramadol.

How long can constipation last?

Constipation is incredibly common — it’s estimated that around 1 in 7 adults and 1 in every 3 children in the UK are affected by it at any one time. It’s also far more likely to affect women than men and is more common in older adults.

Constipation may be unpleasant, but it will usually go away on its own. However, if you haven’t passed a stool within the last three days, you may consider seeking treatment. Constipation relief medicine is readily available over the counter at most pharmacies or supermarkets.

Most importantly, listen to your body. Everyone is different — some people suffer from constipation more often than others and find it little more than a slight inconvenience. In these cases, constipation medicine or a change in diet may be all that’s required to correct it.

However, if your constipation comes on suddenly and you’re someone who rarely experiences it — or your constipation is persistent and unresponsive to treatment — you should visit your GP.

When should I be worried about constipation?

Constipation is usually little cause for concern, but if you experience any of the following, it’s best to seek medical attention:

• The inability to pass stool for over three days
• Severe bloating or abdominal pain
• Experiencing constipation frequently, despite using constipation relief medicine or making lifestyle changes
• Noticing blood in your stool — it may appear black or tarry
• Experiencing sudden and unexplained weight loss
• Feeling tired all the time

Complications of chronic constipation include:

• Haemorrhoids (piles) — straining to have a bowel movement may cause swelling in the veins in and around your anus.
• Anal fissure — small, painful tears can form in the anus when a stool is large or dry.
• Faecal impaction — constipation can lead to an accumulation of hardened stool in your intestines. This can be life-threatening if left untreated.
• Rectal prolapse — when straining to pass stool, the rectum may protrude from the anus. Stool softeners, suppositories, and other medications can sometimes be used to treat rectal prolapse, but in many cases, surgery may be required.

How can I treat constipation?

If you’re suffering from mild constipation, it’s best to make some adjustments to your lifestyle to see if it helps. This could include:

• Increasing the amount of fibre in your diet. Fibre is highest in fruits, vegetables and foods containing whole grains.
• Drinking plenty of fluids to avoid dehydration — the NHS recommends we drink around 1.2L of water per day.
• Resting your feet on something when you go to the toilet so that your knees are above your hips. This should ease the passing of stools.

If these changes don’t seem to have much of an effect, constipation tablets for adults and children are available. Most of these come in the form of laxatives, of which there are three types:

• Stimulant laxatives — an instant constipation relief medicine to relieve the symptoms quickly, these laxatives work by stimulating the muscles in your digestive tract, helping to progress the stool through the large intestine and into the anus. Stimulant laxatives are best suited for constipation where stool is still quite soft. Some examples of popular stimulant laxatives include Dulcolax Suppositories or Senna Tablets.
• Bulk-forming laxatives — these laxatives increase the weight of your stool while helping to keep them soft, making them easier to pass. Examples of bulk-forming laxatives include Docusate Capsules, Fybogel, and Normacol. If you decide to use bulk-forming laxatives, it’s important to stay hydrated. Bulk-forming laxatives usually take around 2-3 days to have an effect.
• Osmotic laxatives — these are similar to bulk-forming laxatives. Osmotic laxatives (such as Laxido) work by increasing the amount of fluid in the bowels. You may find that your GP recommends osmotic laxatives if bulk-forming laxatives prove ineffective.

In more serious cases of constipation, your GP may recommend the use of an enema such as Clean (Fleet) Enema or Micralax Micro-Enema — this involves instilling fluid into the rectum to stimulate the emptying of the bowel.

While constipation is usually nothing to worry about, it’s important to be aware of the warning signs which could indicate a more serious issue. If your constipation is persistent and unresponsive to any of the lifestyle changes or treatments above, visit your GP — you may require prescription medication or surgical intervention.