Constipation advice

Patient information factsheet

What is constipation?

• Constipation is when your stools (poo) are hard and you go to the toilet less often than is usual for you.
• You may need to strain a lot, and it can cause tummy pain or discomfort.
• It can sometimes lead to piles (haemorrhoids) or small tears around the anus (where your poo comes out) called anal fissures.
• Constipation can be treated through making changes in your lifestyle.

Simple ways to help with constipation:

Increase fibre in your diet

• Aim for 8 portions of vegetables and fruit a day (a portion is about ¼ cup chopped vegetables or 1 piece of fruit)
• Add 2 tablespoons of crushed linseed (flaxseed) to your cereal in the morning
• Eat prunes and other dried fruit
• Eat kiwi fruit
• Eat fruit and root vegetables with skin
• Eat peas, beans, lentils and nuts
• Add tamarind to your food
• Eat cereals containing whole-wheat, whole-grain and bran
• Eat wholemeal bread or high fibre white bread
• Eat porridge oats.

Drink enough to hydrate your bowels

• Aim to drink1.5 - 2 litres (6-10 glasses) of non-caffeinated fluid a day.
• Drink enough so your urine is a pale straw like colour.

Do more physical activity

• Exercise helps your guts work better and move food through your body.
• Try to be active or go for a walk for about 30 minutes most days.

Build a good toilet routine

• Your bowel habits can be trained, and regular routines help your body work better.
• Try having a hot drink and a high-fibre breakfast to help start a bowel movement.
• After eating breakfast, try sitting on the toilet about 20–30 minutes later.
• Don’t ignore the urge to go to the toilet.

Consider use of over the counter or GP prescribed medications

• If you don’t get enough fibre in your diet, you can try a fibre supplement like Fybogel.
• If your stool (poo) is very hard, you can try a stool softener such as Laxido or Movicol.

How to open your bowels without straining

• Straining too much can weaken your pelvic floor muscles over time.
• This may lead to worse bladder, bowel, or vaginal problems later on in life.
• Follow the tips below to help you avoid straining.

Positioning

• Sit fully on the seat and relax your pelvic floor muscles: do not hover.
• Support your feet on a step so that your knees are higher than your hips.
• Lean forwards with your elbows on your knees (keep your back straight).
• Try rocking the pelvis back and forth or your knees side to side.
• Try supporting the perineum (skin between vaginal and back passage).
• If you have a vaginal prolapse, try supporting the back wall of the vagina:

Place a clean finger or thumb into the vagina and push against the back wall of the vagina toward the anus while you are opening your bowels.

Breathing tips

• Don’t hold your breath.
• Breathe out slowly and let your tummy and waist gently expand, like blowing up a balloon.
• As you breathe out, you can make a sound like “shh,” “moo,” or “idge”.
• Repeat this a few times to help your body learn the movement.

Contact our service

Whittington Bladder and Bowel Care Service

Email: whh-tr.bladderandbowel@nhs.net

Website: Bladder and Bowel Care Service

Whittington Pelvic Health Physiotherapy

Email: whh-tr.outpatienttherapy@nhs.net

Webpage: Pelvic Health Physiotherapy

North central London perinatal pelvic health service - Royal Free London

Email: rf-tr.nclpphs@nhs.net

Webpage: North central London perinatal pelvic health service - Royal Free London