When you are constipated you produce a bowel motion less often than you usually do.  Your normal bowel habit is normal to you.  Some people produce a bowel movement three times a week, other three times a day.

When the lack of bowel movements starts causing discomfort or hard dry bowel movements that are difficult to pass then you need to change your diet, fibre and fluid intake in order to address this and get your bowel regular again.

Constipation may also be caused by stress, decreased exercise, unfamiliar surroundings such as a long flight or journey when access to a toilet is not available, comfortable or familiar to you.

Bowel habits are also changed by pregnancy when hormonal changes or physical obstruction from the pressure of the baby on the intestines prevents he bowel emptying completely.  Some medications may also cause constipation.

Whenever your bowel habit has changed, you need to consider what else may have changed.  When you are busy or stressed by work or personal circumstances, your diet and fluid intake may also be changed.  

If the change in bowel habit is caused by medication then the best first treatment is also to increase the amount of fluid, preferably water, that you drink; and to increase your fibre intake.  This doesn’t mean existing on bran with each meal, but ensuring that some fibre is eaten at each meal.

Breakfast should always be fibre rich, so porridge or high fibre cereal containing bran is a good start, with or without some fruit if possible.  Lunch should include salad vegetables, in high fibre bread if sandwiches are your usual lunchtime meal.  Add a piece of fruit such as a kiwifruit which is rich in fibre.  Your evening meal should always consist of several vegetables and a source of protein, and if you were looking for desert then consider a fruit based dessert.  Limiting caffeinated drinks such as tea and coffee is also helpful.

If these measures have not relieved your constipation then you should continue increasing the fibre and fluid in your diet and talk to your community pharmacist about treatments available to relieve this distressing condition.

Treatments available without prescription include medicines that increase the liquid retained in the bowel to make it easier to form a soft motion, as well as stronger medications that act as laxatives to increase the frequency of the bowel movement, relieving the constipation.

If you notice a small amount of blood in the toilet or the toilet paper after passing a bowel motion, discuss this with your community pharmacist at once.  They will be able to determine if you need to seek further help and will refer you for prompt diagnosis and treatment of what might be occurring.  

Prolonged bouts of constipation or straining to pass a bowel motion may lead to haemorrhoids or ‘piles’ which may be relieved by medicines also available from your pharmacist.  Large amounts of blood or black bowel motions are a sign of more serious problem and are best referred immediately to your doctor for diagnosis and prompt treatment.

If in doubt, or you experience a change in bowel habit, then consult your community pharmacist, they can give you help and advice which can put your mind at rest, as well as help to relieve the discomfort of constipation.