Sievering Clinic

Competence Centre for Minimally Invasive Medical Services


Patient information on maldigestion disorder

Constipation is a very common digestive system problem in which one complains of infrequent bowel movements, passing hard stools, or straining during bowel movements.

In terms of frequency, what constitutes constipation for one person may be normal for someone else. That’s because the normal frequency of bowel movements varies widely – from three a day to three a week. What’s normal for you may not be normal for someone else.

In general, though, you’re probably experiencing constipation if you pass hard and dry stools less than three times a week. In some cases, constipation also may make you feel bloated or sluggish or experience discomfort or pain.
Fortunately, a few common-sense lifestyle changes, including getting more exercise, eating high-fibre foods and drinking plenty of water, can go a long way toward preventing or alleviating constipation.

Constipation is often regarded as a trivial symptom, however for patients it can be a major disability. It is a symptom, which means different things to different people, and the term has been shown to be ambiguous and misleading. To some it implies stools that are too small, too hard, difficult to expel, while to others it refers to prolonged and repeated attempts at defecation, and even the need for digital assistance. Attention has been drawn to the importance of stool weight and transit time. However since these parameters are difficult to assess, stool frequency remains a common guide.

Constipation is passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. People who are constipated may find it difficult and painful to have a bowel movement. Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish.

Many people think they are constipated when, in fact, their bowel movements are regular. For example, some people believe they are constipated, or irregular, if they do not have a bowel movement every day. However, there is no right number of daily or weekly bowel movements. Normal may be three times a day or three times a week depending on the person. In addition, some people naturally have firmer stools than others.

At one time or another almost everyone gets constipated. Insufficient liquid intake, poor diet, stress and lack of exercise are usually the causes. In most cases, constipation is temporary and not serious. Understanding causes, prevention, and treatment will help most people find relief.

Avoiding constipation and keeping faeces soft
  • Eat plenty of fibre by eating plenty of fruit, vegetables, cereals, whole meal bread, etc.
  • Have lots to drink. Adults should aim to drink at least two litres (10-12 cups) of fluid per day. You will pass much of the fluid as urine, but some is passed out in the gut and softens the faeces. Most sorts of drink will do, but alcoholic drinks can be dehydrating and may not be so good.
  • Avoid painkillers that contain codeine such as co-codamol, as they are a common cause of constipation. Paracetamol is preferable to ease the discomfort of a fissure.
  • Fibre supplements. If a high fibre diet is not helping, you can take bran, or other fibre supplements (‘bulking agents’) such as ispaghula, methylcellulose, or sterculia. You can buy these at pharmacies or get them on prescription. Methylcellulose also helps to soften faeces directly, which makes them easier to pass.
  • Toileting. Don’t ignore the feeling of needing the toilet to pass faeces. Some people suppress this feeling and put off going to the toilet until later. This may result in bigger and harder faeces forming that are more difficult to pass later.