Constipation and diarrhoea
What are constipation and diarrhoea?
There's a good deal of confusion about what healthy bowels are and aren't. Most people feel happy if they go once a day, usually in the morning, but doctors say a "healthy" bowel movement can vary from three times a day to three times a week. In fact, research suggests that "normal" bowel function — going to the lavatory once a day — is enjoyed by only half the population.
Faeces should be solid, but soft, and you should pass them without straining. How healthy are your stools?
- If your stools are hard and difficult to pass, and you open your bowels less than three times a week, you are constipated. (Each bowel movement will probably also produce a total stool weight of below 100 g [4 oz].) You may also feel bloated and sluggish.
- Diarrhoea occurs when the stools are too frequent or loose. You may also have abdominal pain (colic), which fades away after you have been to the lavatory. Diarrhoea can be acute (it comes on suddenly and lasts a few days) or chronic (it lasts more than three weeks). Vomiting, cold sweats, fever and stomach pains often accompany acute diarrhoea.
Between 20 and 40% of people strain when they go to the lavatory, and research suggests that 14 million people in Britain suffer from constipation each year. 1% of the population consults their doctor every year for this reason.
Virtually everyone suffers a bout of diarrhoea at least once in their life.
To understand what causes constipation and diarrhoea, it's important to know how the gut works.
- The colon (large intestine) absorbs water from the food passing through it and forms the waste food into a stool. The contractions of the colon move the stool towards the bowel.
- By the time you're ready to pass it, most of the water will have been absorbed. If the stool is too hard and dry, too much water has been absorbed because it has passed through the colon too slowly. In the case of diarrhoea, there is too much fluid because the waste matter has passed through the colon too fast for liquid to be absorbed.
Common causes of constipation
- Not enough fibre in the diet.
- Ignoring the urge to defecate.
- Not enough fluid.
- Medications, such as narcotics, antidepressants, iron supplements and antacids containing aluminium.
- Lack of exercise.
- Too many laxatives.
- Emotional upsets.
Constipation can also be caused by these conditions:
- Irritable bowel syndrome (IBS)
- Haemorrhoids and anal fissures.
- An underactive thyroid gland.
- Damage to the nerves of the spinal cord.
- Obstruction of the bowels by inflammation or tumours.
Common causes of diarrhoea
- Viral or bacterial infections, usually brought about by drinking contaminated water, eating undercooked meat or eggs, or poor personal hygiene.
- Anxiety. About one in five people suffer from "performance anxiety diarrhoea" related to their work or social interactions. If you're going to be Best Man, the chances are you'll get diarrhoea before your speech.
- Too much alcohol.
- Antibiotics that alter the intestinal bacterial flora.
- Irritable bowel syndrome.
- Food intolerance, most commonly to diary products or wheat.
- Gut inflammation such as ulcerative colitis or Crohn's disease.
- Poor diet.
- Poor absorption of food caused by coeliac disease or pancreatic disease.
- Hormonal changes such as an overactive thyroid gland or diabetes.
- Bowel cancer.
- Eat a well-balanced diet full of fresh fruit, vegetables and fibre, and drink plenty of fluids.
- Don't ignore the urge to defecate. If you do the stool dries out and becomes hard.
- Set aside time after breakfast or dinner to go to the lavatory undisturbed.
- Wash your hands thoroughly after going to the lavatory.
- Take precautions when you are travelling to cut the risk of infection.
- Cut back on alcohol.
Yes, if you find you are using laxatives for more than three weeks. Whether you have constipation or diarrhoea, see your doctor immediately if your stools contain blood or if there is a significant change in bowel habits.
The doctor may examine your rectum and take a blood test to check your thyroid function. You may be referred to a hospital specialist who will carry out further tests.
Diarrhoea usually clears up after a few days. If it continues, go to your doctor. He or she may arrange a laboratory examination of a stool sample.
- Most cases will clear up if you add more fibre to your diet.
- Your doctor may recommend fibre supplements or stool softeners.
- You will not usually need laxatives. Overuse of laxatives and suppositories can damage the colon and lead to constipation.
- Recent research suggests that a stress-reduction technique called "biofeedback" may help constipation.
- Usually you can treat diarrhoea yourself, but your doctor may prescribe antibiotics if a severe infection is suspected.
- Eat a healthy diet full of fibre and drink plenty of fluids.
- Drink plenty of fluids and use rehydration solutions to replenish lost salts.
- Wash your hands immediately after going to the toilet in case the diarrhoea is infectious
- If you are in the middle of a holiday or business trip take an anti-diarrhoeal drug such as loperamide (sold as Immodium), which can be obtained without prescription.
Page last fully updated 2005.
Page created on January 21st, 2010
Page updated on May 11th, 2011