Learn about symptoms and causes of constipation, self-help treatment options, medication and when to seek medical help.

What is constipation?

Constipation is generally described as a difficulty or decrease in frequency of passing stools (also known as having a bowel movement). The stools are usually hard and dry.

The normal bowel movement is different from individual to individual and can range from two to three times a day to three times a week. If you notice a decrease in your frequency of bowel movement or have difficulty having a bowel movement, this can be considered constipation. 

What are the possible causes of constipation?

Constipation can be caused by a variety of reasons such as:

• Not having enough water or fluids 
• Not having enough fibre in your diet
• Lack of regular exercise
• Not emptying your bowels when you feel the urge to pass motion
• Medical conditions such as irritable bowel syndrome, pregnancy or cancer
• Use of certain medications such as 
  • Supplements like calcium or iron
  • Medications for your heart or blood pressure like Nifedipine or Verapamil
  • Medications for stomach problems like antacids
• Change in your diet, daily routine or lifestyle
• Stress

What are the symptoms of constipation?

The symptoms of this condition can include the following:

• Difficulty passing stools 
• Passing small, hard or dry stools 
• Feeling bloated 
• Feeling like you have not cleared your bowels completely 

What can I do to treat constipation?

Constipation can be treated in the following ways and you can approach your pharmacist to get the following medications. 

• Bisacodyl Tablets or Suppositories
• Fleet Enema
• Glycerin Suppository and Gel
• Ispaghula Husk
• Lactulose Syrup
• Senna Tablets
• Macrogol powder
• Forlax powder

When do I need to see a doctor?

Although constipation can be treated without a doctor’s consultation, there are times where the condition might be more serious. 

If your condition does not get better in a week or gets worse, you should see a doctor. You should also see a doctor if you experience any of the following:

• Fever 
• Nausea and/or vomiting
• Black or sticky stools 
• Blood in the stools 
• Very bad stomach pain or cramping 
• Very bad stomach wind 
• Sudden changes in bowel habits, especially if you also have weight loss 
• Changes in the type/texture of stools 
• No appetite to eat 
• History of Inflammatory Bowel Disease (IBD), a medical condition that causes inflammation in your intestines, causing pain, cramping and weight loss
• Constipation alternating with diarrhoea
• Needing to use constipation medicine regularly (for example, every 2-3 days or  more often)
• Liquid or soft stools leak out of your anus

What else can I do to manage constipation?

Other than using medications to treat the condition, constipation can also be managed by the following methods:

• Increase your intake of fluids 
• Increase your intake of fibre in your diet to encourage bowel movement. However, remember to drink more water, otherwise your constipation might become worse. 

The following are some suggestions to prevent constipation from happening again:

• Have more fibre in your diet. Examples include vegetables, fruits, cereals and wholegrain breads. You should aim for about 25-30g of fibre every day to encourage bowel movement 
• Increase the amount of fluids you drink. You should aim for at least six to eight cups of fluid or water a day 
• Exercise regularly 
• Empty your bowels whenever you feel the urge to pass motion 
• Your sitting position on the toilet can affect bowel function. It is best to lean forward with a straight back, and with feet flat or on a foot stool, so that the knees are above the hips.
• Check with your doctor or pharmacist if any of your long term medications can cause constipation and if you can be given another medication instead

Disclaimer

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

The content above is solely for informational purposes only and is not intended as a substitute for the advice provided by your physician, pharmacist or other healthcare professional. You should not use the information for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Always speak with your physician, pharmacist or other healthcare professional before taking any medication or supplement, or adopting any treatment for a health problem.