Infrequent or difficult bowel movements. Fewer than 3 bowel movements per week, hard stools, straining, or a feeling of incomplete emptying. Very common and usually manageable with diet and hydration.
Increase fluid intake immediately — drink at least 2 litres of water daily. Dehydration is the most common cause of constipation in warm climates.
Increase fibre intake. Eat fruits — pawpaw, mango, oranges. Eat vegetables, whole grains, and legumes. Fibre adds bulk to stool and speeds intestinal movement.
Physical movement helps bowel movement — a 20 to 30 minute walk stimulates intestinal contractions. Do not remain sedentary.
Establish a toilet routine. Sit on the toilet at the same time each day, preferably 15 to 30 minutes after breakfast when the gastrocolic reflex is strongest.
Do not ignore the urge to use the toilet — suppressing the urge consistently trains the bowel to ignore signals.
Warm prune juice, pawpaw, or a warm drink in the morning stimulates bowel movement naturally.
Elevate the feet on a small stool when sitting on the toilet — the squatting position is more anatomically effective for bowel emptying.
If no bowel movement after 3 days: a glycerine suppository or mild osmotic laxative such as lactulose or macrogol is safe and effective.
Avoid regular use of stimulant laxatives — they cause dependency over time.
Blood in the stool or on toilet paper.
Unexplained weight loss with change in bowel habit.
Constipation alternating with diarrhoea.
Abdominal bloating and pain with no bowel movement for more than 5 days.
Constipation with vomiting — possible bowel obstruction.
New onset constipation in a person over 40 with no dietary explanation.
Do not strain excessively — straining causes haemorrhoids and can trigger cardiac events in the elderly.
Do not use strong stimulant laxatives regularly — bowel becomes dependent.
Constipation in a newborn or young infant is not normal — see a doctor.
Sudden change in bowel habit in anyone over 40 needs medical investigation.
✓ What Helps
· Lactulose syrup — gentle osmotic laxative, safe long term, particularly good for children and elderly
· Macrogol sachets (Movicol) — effective and gentle
· Glycerine suppositories — work within 30 minutes for immediate relief
· Senna tablets — stimulant laxative for short-term use only
✗ What To Avoid
· Regular use of stimulant laxatives — causes bowel dependence
· Codeine and opioid pain medication — severely worsens constipation
→ Ask The Pharmacist For
· Lactulose or macrogol for mild to moderate constipation
· Dietary and fibre counselling at a clinic
· Colonoscopy referral if new onset over 40 with unexplained change in bowel habit
🏥 Get Professional Help
See a doctor for blood in stool, unexplained weight loss, constipation alternating with diarrhoea, no bowel movement for more than 5 days despite laxatives, or any new onset change in bowel habit in someone over 40.