Constipation

Constipation

YOU ARE NEVER TOO YOUNG OR TOO OLD TO … HAVE CONSTIPATION

Constipation does not discriminate. Although some people may be more at risk of struggling with the condition, babies, children, adults and the elderly all may face constipation now and then. It is also more commonly experienced than you may think. 1,2

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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 individual is the first and most important step in understanding constipation. Not having a bowel movement every day is actually normal, so is having more than one a day. 3,4

Babies under 3 months of age could have as little as 5 bowel movements in a week, but it could be as many as 28 (if formula-fed) or 40 (if breastfed) in a week, and this is considered normal. Children ages 1 to 3 could have between 4 movements a week up to 21 movements in a week. After the age of 4, the frequency does not change, and anything between 3 and 14 movements per week (from age 3) can be considered normal. 4

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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 when they arch their back and stiffen their legs. In older children, they could cross their legs, or take on an awkward posture. Parents could easily mistake these signs for straining. 5

For adults, it could feel like they have not completely removed all stool from the bowel after a movement, or just a lack of relief/satisfaction after passing stool. 2

In order to formally be diagnosed with functional constipation, you have to show at least two of the following signs, and for a period of at least 1 week in a month: 6

  • Have only had 2 or less bowel movements in a week
  • Had at least 1 experience of faecal leakage in a week
  • Taken a stool retentive posture, or forced the withholding of stool
  • A history of painful or hard bowel movements
  • Very largely sized stools
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The causes of constipation

When you consider the possible causes of constipation, it is clear than 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 constipation 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 merely refuse to use public toilets or the toilets at school, which can lead to constipation.  5,7

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Treat and prevent with ease

Basic lifestyle and habit changes can both treat and prevent 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 have to increase your water intake as well, 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. It may also be helpful to set aside time after a meal during which you can visit the toilet undisturbed. 3,8

Laxatives are recommended when dietary measures are not feasible, when they have failed or while waiting for dietary measures to take effect. It is also important to use laxatives only for short periods of time. 8

There are a few types of laxatives available that can be purchased without a prescription, such as: 2,8

  • Bulk-forming laxatives – they bulk up stool to trigger your bowels to push it out.
  • Stimulant laxatives – they stimulate the nerves in the bowel to increase how well it moves stool through.
  • Osmotic laxatives – they work by drawing water from the body into the bowels to make stool easier to pass.
  • Stool softeners – they work on the surface of the stool itself to wet the stool and soften it in order for it to be passed more easily.

These options are mostly available as either oral or rectal treatment formats. To make sure you choose the laxative best suited to you or your family, ask your healthcare professional about how the product is used, how quickly it works and any side effects that can be expected. 8 

Microlax Microenema - for fast and gentle relief from occasional constipation

Microlax Microenema is a convenient microenema which works locally in the bowel to soften stool, and provides quick and effective relief of occasional constipation within 5 – 15 minutes 9

To learn more about the benefits of Microlax Microenema and how it works, follow this link for a quick introduction to the product 

Microlax microenema

  • Contains a small volume of solution (only 5 ml) that is administered rectally for either adults, children or even babies
  • Is fitted with a thin, flexible cannula for minimally invasive administration
  • Works by drawing water into the faecal mass, binding to the surface of the stool in order for the water to penetrate the hard stool and soften it to be passed gently and comfortably.
  • The solution provides local action, with little absorption into the body.
  • The product is generally very well tolerated. 9,10

 Microlax can be used by people of all ages, even babies*. Its small volume offers a discreet, on-the-go option to be carried with you for whenever and where-ever you need it.

Microlax Microenema

  • Suitable for all ages*
  • Works within 5 – 15 minutes
  • Predictable and effective relief
  • Small dose - only 5 ml liquid
  • Discreet and easy to use

*when used as recommended; for instruction for use, and use in children under 3 years, see package insert for details.

 

Medical References

  1. NHSinform [Online]. 13 November 2020. Accessed 25/02/2022. Available from https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/constipation.
  2. Sibanda M, et al. Chronic constipation in adults. S Afr Pharm J 2018;85(1):34-42.
  3. South African Gastroenterology Society (SAGES). [Internet] 2020. Accessed 2020/02/18. Available from https://www.sages.co.za/Patients/Constipation.
  4. Benzamin Md, Rukunuzzaman Md, Wahiduzzaman Mazumder Md, Bazlul Karim ASM. Constipation in Children : Evaluation and Management. Paed. Neph. J. Bang. 2018;3(2):83-89.
  5. Philichi L. Management of Childhood Functional Constipation. Journal of Pediatric Health Care. 2018;32(1):103-111.
  6. Levy EI, Lemmens R, Vanderplas Y, Devreker T. Functional constipation in children: challenges and solutions. Pediatric Health, Medicine and Therapeutics 2017;8:19–27.
  7. Walter AW, Hovenkamp A, Devanarayana NM, et al. Functional constipation in infancy and early childhood: epidemiology, risk factors, and healthcare consultation. BMC Pediatrics 2019;19:285.
  8. Allen S. How to deal with constipation. SAPJ 2008;75(7):23-26.
  9. Ref-00289 Microlax Company Core Data Sheet
  10. Schneider JY. Constipation in Children and Infants. Deutsche Apotheker Zeitung 2008;148:106-107.

S0 MICROLAX® Microenema. Each 1 ml contains: Sodium Citrate 90,0 mg; Sodium Lauryl Sulphoacetate 70 % 12,9 mg; Sorbitol solution 893,0 mg. Ref.No.: E911 (Act 101/1965).

For full prescribing information refer to the Professional Information approved by the Medicines Regulatory Authority.

®Trademark © Johnson & Johnson (Pty) Ltd 2022.

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