What does normal bowel movements mean?
Think about your week so far. Can you recall how many times you had a bowel movement in the last week? Once, twice, one bowel movement every day, three movements in one day? Determining what is normal for you as an individual is the first and most crucial step in understanding constipation. Not having a bowel movement every day is actually normal, and so is having more than one a day. 3,4
Babies under three months of age could have as little as five bowel movements in a week, but it could be as many as 28 (if formula-fed) or 40 (if breastfed) in a week, which we consider to be normal. On the other hand, children ages 1 to 3 could have between 4 movements a week up to 21 movements in a week. After age 4, the frequency does not change, and anything between 3 and 14 movements per week (from age 3) can be considered normal. 4
The common tell-tale signs or symptoms of constipation.
When a baby is constipated, they may be withholding their stool. A sign of this is arching their back and stiffening their legs. Older children could cross their legs or take on an awkward posture. Parents could easily mistake these signs for straining. 5
Adults could feel like they have not entirely removed all stool from the bowel after a movement or just a lack of relief/satisfaction after passing stool. 2
For a medical professional to diagnose you with functional constipation, you have to show at least two of the following signs and for at least one week in a month: 6
- Have only had two or fewer bowel movements in a week
- Had at least one experience of faecal leakage in a week
- Taken a stool retentive posture or forced the withholding of stool
- A history of painful bowel movements or hard stool
- Very largely sized stools
The causes of constipation
When you consider the possible causes of constipation, it is evident that most people, at some time or another, could be experiencing constipation. These causes include: 2,3
- Not eating enough fibre
- Not drinking enough fluids
- Lack of physical activity (you are twice as likely to have constipation)
- Poor bowel habits
- Travel
- Stressful life events
- Depression
- Use of certain medication
- Pregnancy
- Advanced age
Babies may experience infant constipation, or later on when their diet is changed as they grow up, like when you introduce solid foods or cow’s milk protein. For toddlers and small children, poor toilet training, being in a hurry when having a bowel movement or finding it difficult to stop playing to go to the toilet could cause constipation. Older children often experience stress in their family or school environment, or they may refuse to use public bathrooms or the toilets at school, which can lead to constipation. 5,7
Treat and prevent with ease
Basic lifestyle and habit changes can both treat and prevent mild or severe constipation: 2
- Consider some changes in your diet. Add more fibre-rich food such as cereals, citrus fruits, legumes and wheat bran. Whenever you eat more fibre, you must also increase your water intake, as they work hand in hand to prevent constipation. Make sure you have at least 2 litres of water every day
- Get at least 30 to 60 minutes of moderate physical exercise every day – this will activate the movements of the intestines and move stool through quicker. Mild physical activity will also reduce bloating.
- Respond to the urge to pass stool immediately. The longer stool stays in the colon, the more water is absorbed from it, making it more difficult to pass. Setting aside time to visit the toilet undisturbed after a meal may also be helpful. 3,8
Medical professionals recommend laxatives when dietary measures are not feasible, when they have failed or while waiting for them to take effect. It is also important to use laxatives only for short periods. 8
There are a few types of laxatives available that you can purchase without a prescription as a constipation solution, such as the following: 2,8
- Bulk-forming laxative – they bulk up a stool to trigger your bowels to push it out.
- Stimulant laxative – stimulate the nerves in the bowel to increase how well it moves stool through.
- Osmotic laxative – work by drawing water from the body into the bowels to make stool easier to pass.
- Stool softener – they work on the surface of the stool itself to wet the stool and soften it so you can pass it more easily.
These options are mostly available as either oral or rectal treatment formats. To make sure you choose the best laxative to suit you or your family, ask your healthcare professional how to use the product, how quickly it works and any side effects that you can expect. 8
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