Constipation

1 in 7 adults in the UK are suffering from constipation at any one time. Constipation is having fewer than 3 bowel movements in a week, passing hard stools, straining or not emptying your bowel completely so you have to go back to the toilet.

What should my stools be like?

Aim to:

• Have a bowel movement every 1-2 days
• Pass a soft, formed stool – like a smooth sausage or a snake – type 4 on the stool chart
• Go to the toilet without straining

While you are seeing the Nurse do fill in a bowel diary for each appointment so you can see what works and what doesn’t.

Drinks

• Drink 2 litres per day
• If you don’t drink enough your body will take the water out of your stools making them hard and difficult to pass

Food and Fibre

• Have 3 regular meals and eat breakfast every day
• Eat a high fibre breakfast cereal eg porridge, weetabix or shredded wheat
• Add a teaspoon of linseeds with your cereal or mixed with yoghurt
• Eat 5 portions of fruit and veg per day (includes fresh, frozen, dried and tinned)
• Choose wholemeal bread or higher fibre white bread
• For snacks, try fresh fruit, vegetable sticks, rye crackers, oatcakes and unsalted nuts or seeds
• Add beans, lentils or chickpeas to soups, stews, curries and salads
• If eating more fibre makes you more constipated tell your Nurse

Exercise

• Exercise every day e.g., walking, pilates, water aerobics or housework
• Or try sitting exercises https://www.nhs.uk/live-well/exercise/sitting-exercises

If you can’t exercise then abdominal massage can help:

• Amber study: self massage video https://youtu.be/ee3o8Es6sPc
• Amber study: carer massage https://youtu.be/B8MzbOpMZeI

Position and timing

• About 20-30 minutes after your breakfast and a warm drink, and after your main meal, go and sit on the toilet
• Allow time for your bowel to empty fully
• Use the correct position for sitting on the toilet – you will need a step or stool to put your feet on.
• If you feel your bowel isn’t emptying you can practice the brace and bulge technique every day to teach the muscles how to empty the bowel properly.

Brace and bulge technique to help with bowel emptying

• Sit with your knees higher than your hips
• Lean forwards
• Rest your forearms on your thighs
• Relax, breathe, don’t hold your breath
• Brace your tummy muscles – place your hands on your waist. Expand your waist and feel your hands being pushed out sideways (it may help to say mmmm)
• Relax your anus to allow the stool to pass. Only push down from above once the anus is relaxed.
• Relax very slightly for one second, maintaining pressure without the push, then brace outwards and push down again.
• Repeat the steps, don’t worry if you aren’t making progress, try again the next day.

More information and advice on Bladder and Bowel problems is available from Bladder and Bowel UK https://www.bbuk.org.uk/ Helpline 0161 214 4591

Bowel Record Chart

Please fill in this chart every time you have a bowel movement for 2 weeks.

Name:______________________________________________ Date of Birth:__________________