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Patient Information Leaflet 9 Tighten your anal muscles once more when Not everyone is the same, a normal bowel you have finished opening your bowels. habit varies from between three times a day to three times a week. Your motion should be solid, but easy to pass. If after following the advice in this leaflet Patient Information you are still having problems with Leaflet constipation please seek further help from your Doctor, Nurse or Continence Advisor. Compliments, comments, concerns or complaints? If you have any compliments, comments, concerns or complaints and you would like to speak to somebody about them please telephone or email If you find that your anal muscles are 01773 525119 tightening instead of relaxing practising 4, 5 [email protected] and 6 will help to get these muscles working correctly. However if you are still unable to Are we accessible to you? This publication relax your anal muscles and are straining is available on request in other formats (for excessively for long periods you should seek example, large print, easy read, Braille or help from your Doctor or Continence Advisor. audio version) and languages. For free You may have a condition known as anismus translation and/or other format please call which simply means that the muscles in your 01246 515224, or email us anus contract when they should relax. This is [email protected] easily treated. Remember... Constipation Advice for ¨ Drink 1.5-2 litres of fluid a day Continence Advisory Service Patients ¨ Eat 5 portions of fruit / vegetables a day Alfreton Primary Care Centre ¨ Eat regularly ¨ Never ignore the sensation to go Church Street Not everyone has a bowel which works ¨ Allow yourself plenty of time and privacy Alfreton properly, but you may be able to improve ¨ Get into a routine Derbyshire your symptoms by following the advice - Exercise (within your capabilities) DE55 7AH offered in this leaflet - Do not strain. You should be able to empty your bowels with minimal effort - Sit in the correct position and use the right Tel: 01773 546960 Clinic: muscles - Avoid taking laxatives (unless prescribed) Fax: 01773 546976 - Avoid taking over the counter medicines that Contact: may make you constipated www.dchs.nhs.uk Ref number: 01/2017/CAFP V1 Review date: January 2019 Are you eating sensibly? WHAT IS CONSTIPATION? Constipation may also develop in people Constipation has a number of causes. It is Eating adequate fibre can improve your bowel habit. who have: important that the reason for your constipation It is recommended that you eat 5 portions of fruit and ¨ Irritable bowel syndrome (IBS) is known so that the correct advice and or vegetables every day. ¨ Diverticular disease treatment may be given. ¨ Diabetes Do you have a routine? Bowels benefit from routine. Try to allow yourself ¨ Parkinsons disease By reading the advice contained in this leaflet time and privacy to open your bowels. Going to the ¨ Multiple sclerosis you can find out why you may be constipated toilet about half an hour after you have eaten a meal ¨ Stroke and how you can help yourself to achieve a is the best time to try. ¨ Spinal injury more regular and normal bowel movement. ¨ Dementia Do you exercise? ¨ An underactive thyroid gland Symptoms - Being constipated affects people Regular exercise can stimulate the bowel to work ¨ And many other illnesses in different ways. Common symptoms include properly. Even if your mobility is limited you can still abdominal pain, bloating, flatulence, nausea, exercise. Any unexplained change in your normal headache, loss of appetite and bad breath. bowel habit should be reported to your Some people may develop haemorrhoids Are you taking any medicines that may make you Doctor. This includes any bleeding, pain or (piles) from having to strain to open their constipated? bowels. If you are taking medicines prescribed by your changes in your motions. doctor or buying over the counter medicines ask if The first question to ask yourself is whether these may be causing your constipation. Sometimes CORRECT POSITIONING you are constipated? Some people believe it is possible for the doctor to change the 1 Sit on the toilet so that your knees are they are constipated because they do not open prescription. Never stop taking your medication higher than your hips. Use something to rest without asking the doctor first. your feet on to make sure you are comfortable their bowels each day. If you are able to pass your motions without having to strain Can you pass your motions easily? in this position. excessively and you have your bowels opened Sitting on the toilet in the correct position and using 2 Put your hands on your waist and cough, these at least three times a week you are not the right muscles are important. Follow the guidance are the abdominal muscles that you need to constipated. given overleaf. If you have difficulty in sitting use when straining. Using these muscles, push comfortably and safely on the toilet because of a to bulge out your abdomen. Having your bowels opened between three disability tell your doctor or nurse. 3 Lean forward and put your elbows on your times a day and three times a week is knees, keeping the pressure on your abdomen. regarded as normal. COMMON REASONS FOR CONSTIPATION 4 Now tighten your anal muscles (back passage) as though you want to stop passing wind. The bowel is the 5 Keep squeezing until you can feel the What does the bowel do? What are the common causes of name given to the small and large intestine muscles lifting upwards. which is a long tube that runs from the stomach constipation? 6 Keeping your abdomen bulged relax to the back passage. Food passes through the ¨ Not drinking enough fluid your anal muscles. intestine and nutrients from the digested food ¨ Not having enough fibre in the diet 7 Check your position. You should be leaning are absorbed into the bloodstream. The ¨ Not eating regularly forward, knees higher than your hips, with your remaining undigested food (faeces) is then ¨ Medication elbows on your knees and your abdomen stored in the rectum until you are ready to visit ¨ Depression bulging. the toilet. ¨ Pregnancy 8 Now open your mouth slightly and part your ¨ Immobility teeth. Breathe out and using your abdominal ¨ Ignoring the sensation to go CHECKLIST muscles push downwards into your bottom so ¨ Not being able to sit on the toilet due to a disability that you are able to relax the anal muscles and Are you drinking enough? ¨ Not having a regular routine It is important that you drink 1.5-2 litres of fluid have your bowels opened. ¨ Anismus (difficulty in relaxing the anal muscles) every day. If you do not drink enough it makes ¨ Haemorrhoids (Piles) the motions very hard and difficult to pass. ¨ Anal fissures .
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