A low blood count or anaemia can lead to tiredness and breathlessness. This is may be due to loss of blood from the gut (especially if there is evidence of low body iron stores)...

Constipation

  • Normal bowel habit (frequency of bowel motions) varies greatly from person to person.

    • For 9 out of 10 people this is between one bowel motion every 3 days to 3 bowel motions per day.
    • A bowel habit outside of this range is more likely to be abnormal.

  • Constipation can be defined as

    • Having  less than one bowel motion per 3 days and having symptoms of abdominal bloating, lower abdominal discomfort and nausea.
    • AND / OR a sensation of difficulty passing a bowel motion with excess straining and hard bowel motions.
    • It is possible to have significant constipation even with a bowel movement once per day if that movement is small or ineffective.
    •  This is usually, but not always, associated with the symptom of incomplete emptying. That is a feeling that there is "still more to pass".
    • Sometimes there is a sensation of a "blockage" with straining. This problem can be defined as "obstructed defecation". This symptom usually relates to problems with co-ordination of pelvic floor muscles or to underlying problems such as prolapse of the rectal mucosa or a rectocoele (section on "obstruction" for further details).




  • Management is discussed in detail in the next sections

  • There are a wide variety of treatment options


  • The simple advice to have a high fibre diet, take plenty of water and have regular excercise can be helpful for many but if this doesn't work then you need to read on...!!


  • My pick for best three laxatives suitable for long-term use

      • Kiwi Crush  - a glass a day of concentrated kiwi fruit juice
      • Movicol  -  a sachet of powder that draws in or retains water in the colon
      • MgLax  - a capsule containing Mg  - like old-fashioned Epsom salts in a capsule (more details in section on osmotic laxatives)

  • Constipation is more common in the elderly (see section).

  • Many people find that they develop constipation with travel (see section).
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