Constipation and Bowel Control in Maltese

This fact sheet explains what constipation is and suggests some ideas for improvement and tells you where to get more help.

Dan il-fuljett ta’ tagћrif jispjega x’inhi l-kostipazzjoni u jissuġġerixxi xi ideat gћal titjib u jgћidlek minn fejn tikseb iktar gћajnuna.

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

X’inhi l-kostipazzjoni?

Il-kostipazzjoni hija diżordni komuni meta l-azzjonijiet tal-imsaren (l-ippurgar) ma jkunux isiru faċilment u/jew ikunu inqas spissi. Is-sintomi tal-kostipazzjoni jinkludu:

• Qlalet iebsin
• Tqanżiћ żejjed
• Ma tkunx tista’ tipporga u/jew tћoss bħallikieku l-imsaren ma tbattlux gћal kollox.

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.

Xi jfisser tkun ‘Regulari’?

• Tkun tista żżom sakemm tasal sat-tojlet
• Malli toqgћod fuq it-tojlet inti tkun tista’ tibda l-azzjoni tal-imsaren
• Inti tћoss li tkun battalt l-imsaren gћal kollox
• Tmur it-tojlet x’imkien bejn 3 darbiet kuljum sa 3 darbiet fil-ġimgћa.
• Tkun ‘regulari’ tista’ tvarja minn persuna gћall-oћra.

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

X’jista’ jikkawża l-kostipazzjoni?

• Ammont mhux biżżejjed ta’ fibra fid-dieta
• Nuqqas ta’ xorb biżżejjed ta’ fluwidi kuljum
• Mhux biżżejjed eżerċizzji
• Mediċina kontra l-uġigћ bir-riċetta tat-tabib u/jew li tixtri mingћajr riċetta jew kundizzjonijiet kroniċi tas-saћћa
• Tqala u ћlas
• Diżordnijiet fl-imsaren u/jew ћsara li tkun tinћtieġ aktar investigazzjoni medika
• Prolass—dendil u/jew kollass ta’ organi interni li jaffetwa l-kontrol tal-bużżieqa tal-awrina u tal-imsaren

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.

Kif gћandu jidher l-ippurgar?

L-ippurgar tiegћek gћandu jkun kannella ċar jew skur, forma ta’ zalzetta, artab imma sod, faċli biex tagћmlu u b’riћa mill-inqas. Immira biex ikollok azzjoni tal-imsaren tip 3 jew tip 4.

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 'soiling') - 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. 

Problemi Komuni tal-Imsaren

Rass tal-ippurgar – Meta l-kostipazzjoni tikkawża li l-ippurgar jippakkja l-intestina (il-passaġġ diġestiv) hekk marsus li l-azzjoni normali tiegћek li timbotta fit-tojlet ma tkunx b’saћћita biżżejjed biex timbotta l-ippurgar ’l barra.

Inkontinenza tal-Ippurgar (xi kultant hija msejћa bћala ‘tiċpis’) – Din hija telfa aċċidentali ta’ purgar solidu jew likwidu. Dan jista’ jkun gћax il-musrana (li tistorja l-ippurgar) tkun mimlija żżejjed, iżda din tista’ tkun waћda biss mill-kawżi. Meta tboss bla kontroll huwa ta’ spiss ikkunsidrat bћala evidenza ta’ inkontinenza tal-ippurgar.

Emorrojdi (kultant jissejћu ‘morliti’) – Dan jista’ jkun ir-riżultat tat-tqanżiћ biex tipporga. Dan it-tqanżiћ (bћall-irfigћ tqil) jista’ jagћmel ћsara lill-vini tar-rectum. Dan jista’ jikkawża li joћroġ id-demm, uġigћ u ћakk.

Prolass tar-rectum – Dan jiġri meta tqanżiћ fit-tul jikkawża li ammont żgћir ta’ inforra tal-musrana joћroġ mit-toqba tal-warrani, li huwa ċirku ta’ muskoli li jinfetaћ u jingћalaq meta nippurgaw. 

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.

Kif il-kostipazzjoni taffetwa l-kontroll tal-bużżieqa tal-awrina

• Il-kostipazzjoni tista’ tikkawża taqtir aċċidentali mill-bużżieqa tal-awrina tiegћek. • Imsaren mimlijin iżżejjed inaqqsu l-volum ta’ awrina li tista’ żżomm il-bużżieqa tal-awrina tiegћek u inti tћoss il-bżonn li tmur it-tojlet ta’ spiss u bil-gћaġla.

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 your bowel fully. Remember to relax.

Dawn huma ћames modi kif iżżomm il-bużżieqa tal-awrina u l-imsaren b’saћћithom u tippreveni l-kostipazzjoni:

Kul tajjeb biex iżżomm imsarnek regulari u jkollok piż tajjeb ta’ ġismek

Kul dieta tajba sinjura fil-fibra (talanqas 30g kuljum).

Ixrob sewwa biex tippreveni l-kostipazzjoni u l-irritazzjoni tal-bużżieqa tal-awrina

Ixrob 1.5 -2 Litri (6-8 tazzi) ta’ fluwidi kuljum sakemm ma tkunx avżat mod ieћor mit-tabib tiegћek. Il-fluwidu huwa l-ilma, l-meraq tal-frott, it-te, il-kafe, l-ћalib, is-soppa, l-ġeli u l-ġelat.

Eżerċità ruћek kuljum biex tippreveni l-kostipazzjoni u tibqa’ b’piż tajjeb ta’ ġismek

Żomm b’saћћita l-biċċa t’isfel taż-żaqq gћal kontrol tajjeb tal-bużżieqa tal-awrina u tal-imsaren

Itlob il-fuljett dwar l-eżerċizzju tal-muskolu tal-biċċa t’isfel taż-żaqq billi ċċempel il-Linja Nazzjonali tal-Gћajnuna tal-Kontinenza (National Continence Helpline) 1800 33 00 66.

Drawwiet tat-Tojlet – Mur it-toilet malli jkollok bżonn u battal l-imsaren gћal kollox. Ftakar biex tirrilassa.

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

Iċċekkja l-pożizzjoni tiegћek fuq it-tojlet:

• Irkopptejk gћandhom ikunu mgћollijin ftit ’l fuq mill-livell ta’ ġenbejk
• Jista’ jkollok bżonn ta’ banketta żgћira biex tkun fl-aћjar pożizzjoni
• Ara l-istampa ta’ hawn taћt gћal iktar gћajnuna

Laxatives

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

Lassattivi

• Il-porog huma mediċini li jgћinu biex jinfetћu l-imsaren biex jipprevenu s-sadd u t-tqanżieћ.
• Tkellem mat-tabib tiegћek dwar l-użu tagћhom.
• Ġeneralment il-lassattivi gћandhom jittieћdu gћal perijodi qosra biss.

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.

Hemm tlett tipi ta’ lassattivi:

• Aġenti tat-Tagћbija ‐ Dawn iżidu l-kwantità tal-materjal (l-ippurgar). Li tixrob talanqas 6‐8 tazzi ta’ fluwidi huwa essenzjali.
• Lassattivi Lubrikanti ‐ Dawn irattbu l-ippurgar u jagћmluh iktar faċli biex jgħaddu.
• Lassattivi Stimulanti/Irritanti ‐ Dawn jagћmlu l-imsaren iktar attivi biex imexxu l-ippurgar minn ġo fihom.

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

Jekk il-kostipazzjoni hija severa u kontinwa, mur ara t-tabib tiegћek.

Who can help?

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

Min jista’ jgћin?

L-ewwel pass biex ittejjeb il-kontrol ta’ msarnek huwa li tagћmel assessjar komplut tal-kontinenza magћmul minn professjonista tas-saћћa.

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

Gћal iktar tagћrif

Hemm firxa ta’ professjonisti tas-saћћa li jistgћu jgћinuk tattakka l-kostipazzjoni.

• Ara t-tabib tiegћek jew speċjalista
• Ċempel lin-Ners li tagћti Pariri dwar il-Kontinenza fuq il-Linja Nazzjonali gћal gћajnuna dwar il-Kontinenza (National Continence Helpline) 1800 33 00 66
• Biex tuża interpretu ċempel s-Servizz tat-Traduzzjoni u l-Interpretar (Translating and Interpreting Service) (TIS) fuq 13 14 50