What is a normal bowel habit ? A normal pattern of bowel movement can vary considerable from person to person. Most people will empty their bowels between three times daily and three times per week. What is constipation ? Constipation is a common problem, resulting in less frequent bowel actions. In most cases, the stool is hard and dry, and small amounts may be passed with difficulty. You may experience cramps, swelling, pain with straining and a feeling of incomplete emptying of the bowel. What causes constipation ? There are a number of factors which cause or contribute to constipation, including

• Not eating enough fibre
• Not drinking enough fluid
• Not getting enough exercise
• Long term laxative abuse
• Some medications (check with your doctor)
• Debility or frailty
• Pregnancy
• Anxiety, depression and grief
• Disorders of the bowel which may require further investigation
• Chronic illness eg. underactive thyroid, Parkinson’s Disease, multiple sclerosis

Can there be complications ? Constipation may cause faeces to pack the intestine and rectum so tightly that the normal pushing action fails and the colon is not strong enough to expel the stool. This is called faecal impaction. Accidental loss of faeces i.e. faecal incontinence can occur in those with constipation when the bowel becomes too full. Haemorrhoids can be caused by straining to have a bowel movement. Anal fissures (tears in skin around anus) are caused when a hard stool stretches the sphincter muscle. In extreme cases straining can cause a small amount of intestinal lining to push out from the anal opening causing a rectal prolapse. How can constipation effect bladder control ? Weakening of the pelvic floor muscles due to chronic straining when emptying the bowels. A full bowel pressing on the bladder can obstruct the outflow of urine, or affect the capacity of the bladder, making you feel that you need to go to the toilet more frequently than normal. How to prevent constipation. You may like to try these simple changes to your lifestyle.  Consult with your doctor or continence advisor, if you need further assistance. Drink at least six or eight glasses of fluid per day (approximately 1.5 Litres), unless advised otherwise by your doctor. People with bladder control problems often don’t drink very much fluid for fear of becoming wet, which often results in them becoming constipated and worsening the problem. Add fibre to your diet. Fibre comes from the non-digestible part of fruit and vegetables. You need approximately 30grams of

• All vegetables
• All fruits, including dried fruit
• Whole grain and wholemeal cereals and breads
• Legumes eg. baked beans, kidney and soya beans

If you can only tolerate soft foods, the following foods are a good source of fibre

• Bananas, rolled oats, fruit juices, pureed vegetables and stewed or canned fruit.