Constipation is when you have to strain to open your bowels or you go for a poo less often. This is usually less than three times a week, as a guide, and stool can become hard and difficult to pass. You can get bloating, tummy pain or nausea. This is very common and is usually helped with diet and lifestyle changes or by some gentle over-the-counter medication to soften stool up and move it along. Certain things can make you more likely to become constipated, but often there’s no obvious cause. Common causes include dehydration, eating too little fibre, doing too little exercise or not going to the toilet when you first feel the need to. Some medications, such as painkillers, can cause constipation, and pregnancy is another risk factor.
During pregnancy, hormone levels change rather dramatically. Rising oestrogen and progesterone levels can slow down the bowels, putting you at risk of constipation.
Constipation can usually be resolved with dietary changes, including making sure you're drinking plenty of water. If that's not enough, your pharmacist can recommend some laxatives. In most cases, it's best to start with a mild osmotic laxative such as lactulose solution or Movicol, which can act gently to draw water into the bowel. If a second laxative is needed alongside, a stimulant laxative can be helpful such as senna. If the constipation is related to pain relief such as codeine, senna is first choice as it can be good specifically for opioid-induced constipation.
You should book to see your doctor if you have tried these lifestyle changes and over-the-counter treatment without improvement, or if medication could be causing your constipation. If you have constipation alongside weight loss, feeling very tired or breathless or you have noticed blood mixed in with the stool, you should book an urgent appointment. The doctor will ask you about your symptoms and will examine your tummy. With your consent, sometimes a doctor may need to feel your back passage (rectal examination) to rule out other causes. Depending on their assessment, they may recommend a laxative regime, advise on any possible causes, or they may refer you to a specialist team.
You are fit for work if you have constipation, providing you feel up to it.