Constipation

Constipation is a very common problem that can affect anyone, including formula-fed babies. It is not being able to poo or straining when trying to poo, which can cause discomfort and even lead to faecal impaction if it goes on too long. Sometimes a person will experience a stomach ache, bloating or feeling sick with it. Signs to look out for include; not pooing at least three times per week, poo is difficult to push out or larger than normal, or it is dry or lumpy. It can usually be treated at home with a fibrous diet and lifestyle changes.

A breastfed baby will rarely experience constipation and may go up to one week without moving their bowels. In formula-fed babies and toddlers; look out for lack of energy, crankiness, soiling themselves in toilet trained children, a loss of appetite and a firm tummy.

There are many possible causes behind constipation, and sometimes there's no obvious reason. It is a symptom, rather than a condition by itself. It is very common during pregnancy and for up to six weeks post-partum. In rare cases, a medical condition may be behind it, such as; IBS, diverticulosis, diabetes and many more. Diet and lifestyle changes may help, including while pregnant. Speak to your midwife or doctor before undertaking anything radical or if you have any questions. Please speak to your doctor about any medical conditions you might have and whether constipation can be experienced with them. Constipation is also a listed side-effect on various medications, including painkillers, diuretics, iron supplements, antihistamines, antidepressants and many more.

A very common cause is not eating enough fibre. Increase dietary fibre. This is suitable during pregnancy.

Long-term constipation can lead to faecal impaction, which is when poo builds up inside the rectum. The main symptom is diarrhoea after a long bout of not being able to poo. It can be treated with prescription laxatives, suppositories, enemas or surgical removal.

Seek medical advice if there's been no improvement with diet and lifestyle changes and treatment with laxatives hasn't helped. Speak to a doctor or pharmacist if there's regular, long-lasting constipation or extreme bloating, or feel tired all the time. Seek quick medical advice if there's blood in the poo or experience unexpected weight loss, or in children if they haven't grown or gained weight.

In babies and toddlers switching to formula or follow-on milk and weaning can be behind constipation. Like adults, weaned babies need plenty of fluids and fibre. Chopped and pureed is easier for toddlers to swallow. Do not force-feed children. This leads to stress in both the children and adults, which can lead to constipation.

Some children may experience stress and anxiety related to toilet training, especially if their normal routine has changed, such as starting school or nursery. Allow them plenty of time to go, even if it means waking up earlier. Encourage and support them, but without pressure and do not tell them "there aren't any monsters in the toilet or drains" as chances are, they weren't thinking about that in the first place.

If dietary and lifestyle changes don't help, over-the-counter laxatives are available. The GP prescribes laxatives for children. Everyone else can seek them out from the medicines aisle in the supermarket, pharmacy or online pharmacy. Most will work within three days. Ask your pharmacist for the best ones to suit your needs. Always read the label for dosage instructions. Store in the original container out of sight and reach of children. Laxatives are intended for short-term use only.

Look out for cereals with a higher-fibre content. Swap white bread and pasta for a wholemeal, granary and wholewheat varieties. Have brown rice instead of white. Keep the skin on the potatoes. Beans, lentils and chickpeas can be added to curries, stews and chillies. They also make an excellent meat substitute and are cheaper than meat alternatives. Eat plenty of vegetables either as a side or main or they can be chopped up and added to sauces (especially great for getting a toddler to eat them). Eat fruit, including dried and tinned varieties in natural juice, but save them for dessert instead of snacks. Fresh fruit can be snacked upon, as well as vegetable sticks, oatcakes and unsalted nuts and seeds. Papaya is a natural and very sweet laxative; children love it.

Drink plenty of fluids to soften poo and avoid alcohol.

Stick to a daily toilet routine with a regular time and place to go. Allow plenty of time to go and do not ignore the urge. Resting feet on a stool, so the knees are above the hips on the toilet may help.

A sedentary lifestyle may contribute to constipation. Walking or running daily can help keep bowels regular.

Avoid: Stress, anxiety and depression may also be contributory factors to constipation.

If dietary and lifestyle changes don't help, over-the-counter laxatives are available. Most will work within three days. Ask your pharmacist for the best ones to suit your needs. Always read the label for dosage instructions. Store in the original container out of sight and reach of children. Laxatives are intended for short-term use only. A pharmacist can advise pregnant women on which ones are safe for use.

Constipation is prevalent and can be painful. If you're embarrassed to talk about it, a pharmacy can provide a private consultation room or laxatives can be ordered online.