Constipation

What is constipation?

graphic showing constipation

Constipation is common and can affect people of all ages. People with learning disabilities are more at risk of constipation than the general population.  People with a learning disability are also more at risk from complications if constipation is left untreated and it can become a life-threatening issue.

Constipation occurs when poo remains in the colon (large intestine) for too long, and the colon absorbs too much water from the stools making them hard and dry.

Signs that you may have constipation

  • You have not had a poo at least 3 times during a week
  • The poo is large and dry, hard or lumpy
  • You strain or are in pain when you are having a poo
  • You have a stomachache and feel bloated or sick 
  • You may have a lack of appetite
  • You may feel irritable and unhappy
  • You may have lots of smelly wind or stop passing wind – this can be a sign of severe constipation

Faecal impaction

graphic showing impacted bowels

Long-term constipation can lead to faecal impaction. This is where hard poo has built up in the colon (large intestine) and as more poo is made, this is unable to pass the blockage. Soft and watery stools can leak around the blockage. It is important not to confuse watery stools with diarrhoea and stop taking any laxatives.

The link between constipation and keeping your chest healthy

Non-urgent advice: Constipation can have an impact on your chest health due to bloating which can lead to:

·      reduced lung expansion as the lungs have less room to expand

·      reduced movement of the diaphragm (the muscle between the chest and the stomach which helps you breathe) causing you to take small, short breaths.

·      the production of excessive saliva, feeling or being sick which can increase the risk of aspiration pneumonia

·      an increase in reflux which can increase the risk of aspiration pneumonia

·      an increase in seizure activity

How can you prevent constipation?

Simple lifestyle changes to prevent constipation

Finding a comfortable position to use the toilet

Graphic of someone sitting comfortably on the toilet with their feet on a box and thighs higher than hips

Being relaxed and comfortable when you’re using the toilet, putting your feet on a low stool and leaning forward can help your position

Medications

graphic of doctor with speech bubble with medicines to show 'giving medicine advice'

Lots of medications can cause constipation, make sure you have a regular medication review with your GP or speak to your GP or pharmacist if you have any concerns. People with learning disabilities are more at risk of constipation than the general population.  People with a learning disability are also more at risk from complications if constipation is left untreated and it can become a life-threatening issue.

The Bristol Stool Chart

graphic showing where bowel is

Your bowel health can change quickly for lots of reasons. It’s important that you, or anyone supporting you, understand what is normal for you.

It can be helpful to track your bowel movements each day so that you notice any changes early.  The Bristol Stool Chart is a visual guide to the types of stool you might do.

Type 1 – Separate hard lumps, like nuts which are hard to pass

Type 2 – Sausage shaped but lumpy

Type 3 – Like a sausage but with cracks on the surface

Type 4 – Like a sausage or snake – soft and smooth

Type 5 – Soft blobs with clear-cut edges

Type 6 – Fluffy pieces with ragged edges – a mushy stool

Type 7 – Watery – no solid pieces – entirely liquid

Each type of stool means…

  • Types 1 and 2 can indicate constipation
  • Types 3 and 4 are the easiest to pass
  • Types 5 and 6 may indicate diarrhoea
  • Type 7 may be a sign of illness, for example, food poisoning or overflow incontinence caused by faecal impaction

Any significant changes to your bowel movements or any concerns over your health and well-being should be reported to your GP. You should call 111 if you believe you need immediate help

image of phone with phone 111 number on it

or 999 in an emergency

graphic showing phone 999

More information on constipation

You can find out more on the website POO Matters – Information for families and carers

NHS England also have some resources NHS England » Constipation resources

There is also more information about Constipation from the NHS website here