Constipation and Bowel Control in Karen

What is constipation?

Constipation is a common disorder where bowel actions ('poo' or faeces) are not easily and/or less frequently passed. Symptoms of constipation include:

• Hard stools
• Excessive straining
• Being unable to pass faecal matter and/or feeling as though your bowels are not completely emptied

What does being 'Regular' mean?

• You can 'hold on' to your bowel action until you get to the toilet
• Once you are sitting on the toilet you can start a bowel action
• You feel that you have emptied your bowel fully
• Going to the toilet anywhere between 3 times a day to 3 times a week.
• Being 'regular' can vary from person to person.

What can cause constipation?

• Insufficient fibre intake in the diet
• Insufficient daily fluid intake
• Insufficient exercise
• Prescription and/or over-the-counter pain relief medications or chronic health conditions
• Pregnancy and childbirth
• Bowel disorders and/or damage that require further medical investigation
• Prolapse - a sagging and/or collapsing of internal organs which interferes with bladder and bowel control

What should your 'poo' look like?

Your poo should be light or dark brown, sausage-shaped, soft but firm, easy to pass and with minimal odour. Aim to have a type 3 or type 4 bowel action.

Common Bowel Problems

Faecal Impaction - When constipation causes faeces to pack the intestine (digestive tract) so tightly that your normal pushing action in the toilet is not strong enough to push the faeces out.

Faecal Incontinence (sometimes referred to as 'spoiling') - This is the accidental loss of liquid or solid faeces. This can be due to the bowel (which stores the faeces) being too full, but this may be only one of the causes. Uncontrolled flatus ('wind') is often considered evidence of faecal incontinence.

Haemorrhoids (sometimes referred to as 'piles') - This can be the result of straining to have a bowel movement. This strain (similar to heavy lifting) can damage the rectum's veins. This can cause bleeding, soreness and itching.

Rectal Prolapse - This occurs when long-term straining causes a small amount of bowel lining to push out from the anus, which is a ring of muscle that opens and closes when we pass a bowel motion. This type of prolapse is called a rectocele.

How constipation affects bladder control

Constipation can cause accidential leakage from your bladder. An overfull bowel will cut down the volume of urine your bladder can hold and you will feel the need to go to the toilet often and in a hurry.

Here are five ways to keep your bladder and bowel healthy and prevent constipation:

Eat well to keep your bowels regular and to have a healthy body weight

Eat a healthy diet high in fibre (at least 30g per day).

Drink well to prevent constipation and bladder irritation

Drink 1.5 -2 Litres(6-8 glasses) of fluid each day unless advised otherwise by your doctor. Fluid is water, fruit juice, tea, coffee, milk, soup, jellies and icecream.

Exercise daily to prevent constipation and keep a healthy body weight

Keep your pelvic floor strong for good bladder and bowel control

Request a pelvic floor muscle exercise leaflet by calling the National Continence Helpline 1800 33 00 66.

Toileting habits - Go to the toilet as soon as you need to and empty you bowel fully. Remember to relax.

Check your toileting postion:

• Your knees should be raised slightly above the level of your hips
• A small footstool might be needed to get you into the best position
• See the diagram below for further help

Laxatives

• Laxatives are medicines that will help loosen the bowel to prevent blockages and straining.
• Talk to your doctor about using these.
• Generally, laxatives should only be taken for short periods of time.

There are three types of laxatives:

• Bulking Agents - These increase the bulk of the stool (faeces). Drinking at least 6-8 glasses of fluid daily is essential.
• Lubricant Laxatives - These soften the faeces and make them easier to pass.
• Stimulant/Irritant Laxatives - These make the bowel more active in moving faeces through the bowel.

If constipation is severe or continuing, go to your Doctor.

Who can help?

The first step to improving your bowel control is to have a full continence assessment carried out by a health professional.

For more information

There are a range of health professionals who can help you deal with constipation.

• Visit your GP or specialist
• Telephone a Continence Nurse Advisor on the National Continence Helpline 1800 33 00 66
• To use an interpreter, ring the Translating and Interpreting Service (TIS) on 13 14 50