Are you really constipated?


The first thing you need to do is to decide if you are really suffering from constipation or if you are actually trying to force your body into an unnatural pattern.

According to one of my textbooks, constipation is described as "a disorder of the motor activity of the bowel characterised by the infrequent and difficult passage of small amounts of hard faeces".

In the same book, normal bowel frequency is defined as "between three times a day and three times a week".

So what you need to do, is ask yourself very pertinently if your bowel habits meet the criteria in the first definition. Do you really have great difficulty in passing small amounts of hard faeces very infrequently? Or do you have a normal bowel movement, say, three times a week that you think is not frequent enough?

Obsession with frequency

Many people think that if they do not have two or more bowel movements every single day of their lives that they are constipated. This is patently not true. Indeed, your body, which may have a frequency of "every other day", will resent being forced into an unnatural pattern of "once a day" and you will lose your natural rhythm. Loss of muscle tone due to repeated use of harsh laxatives will eventually cause constipation.

Unfortunately the idea that you have to be regular according to the schedule you have selected and not the one your body is geared to, is very common, particularly among women.

So please take a moment to decide if you are really and truly constipated or if you are obsessed with frequency.

Causes of constipation

For those readers who genuinely suffer from constipation, here is a list of causes that may be responsible for your condition:


  • eating too little dietary fibre, especially the non-soluble type found in wheat bran
  • using special diets to treat specific conditions, such as wheat allergy, or obesity
  • suffering from an eating disorder like anorexia

Menstrual cycle and pregnancy

Menstruation and pregnancy frequently disrupt normal bowel habits. Constipation of pregnancy is well know and expectant mothers need to get help so that they do not develop haemorrhoids or damage their bowels through straining.

Prescription and over-the-counter drugs

If you have always had normal bowel habits and they change when you start taking a new medicine, then discuss this problem with the prescribing doctor. Antacids, cholesterol-lowering drugs, antidepressants and a host of medications that contain compounds such as codeine are all know to cause constipation.

Irritable bowel syndrome (IBS)

Alternating bouts of diarrhoea and constipation are characteristic of Irritable Bowel Syndrome (IBS) and need treatment.


Patients often develop constipation, because they fear the pain of a bowel movement and avoid going to the toilet.

Conditions which affect the nervous system

Patients with multiple sclerosis and Parkinson’s disease are often plagued by constipation.

Diseases of the colon

Colon cancer, haemorrhoids and anal fissures are often associated with constipation. If you have always been regular and suddenly experience a change in bowel habit, consult your doctor for a checkup to eliminate serious illnesses like colon cancer.


An underactive thyroid gland, diabetes and use of female hormones for contraceptive or replacement therapy are also causes of constipation.

If any of the above mentioned conditions applies to you, please have a medical checkup to eliminate serious diseases. Also ask your doctor if any of the medications he has prescribed such as cholesterol-lowering drugs, hormones or antidepressants, could be causing your constipation and if this is the case, what alternatives you can used.

- (Dr IV van Heerden, DietDoc)

(Constipation photo from Shutterstock)

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