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Professor Lovat
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What is constipation and what causes it?

Constipation is a condition in which you have difficulty passing stools regularly. If you are constipated, you may also likely spend longer on the toilet trying to relieve yourself. Because the stools remain within the large bowel for long periods of time, a lot of the water content is removed, resulting in them being lumpier and drier. One important cause of constipation is a poor diet which lacks foods rich in dietary fibre.

 Foods containing fibre are easy to come by, and include:

  • Fresh fruit
  • Vegetables
  • Complex carbohydrates (such as brown bread – NOT white bread)

 The most common signs and symptoms of constipation are:

  • Stomach pains
  • Bloating
  • Nausea

 Because over 70% of the stool (poo) is water, dehydration can also cause constipation. It is therefore important to drink a sufficient volume of water every day (approximately 6*250 ml glasses of water a day). You cannot effectively hydrate on caffeinated drinks such as Coke, Pepsi or Coffee because the caffeine in the drink actually causes your body to lose some water. The most effective way to hydrate is to drink water. If you do not like plain water, adding a small volume of flavouring, in the form of squash, is perfectly acceptable.

 Interestingly, it has been demonstrated by a Scandinavian group of scientists that both tea and coffee slow the rate at which food moves along the gut. This is another reason why replacing water with other drinks is not advised.

 Other significant causes of constipation include:

  • ignoring an urge to go to the toilet – as the stools remain in the gut for longer, more water is absorbed resulting in them becoming harder
  • certain medications, such as anti-depressants, painkillers, anti-diarrhoea drugs and calcium supplements
  • stress/anxiety/depression – this is because these emotions reduce the number of bowel contractions resulting in poor transit of food along the gut
  • Menstruation
  • Lack of exercise

 How is constipation diagnosed?

If you have been feeling constipated for more than a few days, and are worried, you may want to speak to a doctor. At the London Gastroenterology centre, the doctors are all experts in a variety of conditions including constipation. You can contact us to book an appointment by clicking here.

 The first thing a doctor will do is ask you some basic questions about:

  • How frequently you go to the toilet
  • How much you strain in order to pass stools
  • How long you spend on the toilet
  • The consistency of your poo. Please see more information on the Bristol stool chart here

If the doctor is concerned that you have a problem, he may carry out a physical examination in which he will press on your stomach to feel for any tenderness. Sometimes a brief internal examination is needed also.

 For more severe constipation, the doctor may refer you for an X-ray or anorectal manometry. In anorectal manometry, a small balloon is inserted into your bottom. This measures how hard your muscles can squeeze.

 Constipation can rarely be a sign of colorectal cancer. If your doctor suspects colon cancer he will probably perform a colonoscopy. This is when a camera is inserted into your rectum to view the inside of your gut. Our doctors are experts in performing these tests but will only recommend you have one if it is really needed.


The most likely treatment will be a change in diet or a simple bulking agent, which holds water within the stool. For more severe cases, laxatives may be offered. It is important to treat constipation to avoid complications, which can include:

  • Haemorrhoids (rectal bleeding)
  • Faecal impaction – this is when the stools become so hard that they will not pass naturally from the body.

 For most people, constipation is more of a nuisance than a major health problem, but for some people it can be quite difficult to treat. These patients may need specialist treatments that are not widely available. At the London Gastroenterology Centre, our nationally recognised consultants, who are considered to be among the best in their field, have all the tests and expertise available to help you.



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