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Constipation – what is considered normal?

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Constipation is defined as the difficult and irregular passing of stool. It can also be constipation when a person strains or has a feeling of incomplete evacuation.

Many people believe that it’s unhealthy to not have a daily bowel movement. What is a healthy frequency? 1a,b,c

In healthy individuals, bowel movement frequency could vary from three times per day to three times per week. It’s therefore important to rather look at what’s normal for you to determine if you’re constipated.

Constipation may occur occasionally for a variety of reasons but often resolves in time and with some dietary changes. 1c,d, 2a

What causes constipation?

Constipation may be caused by lifestyle choices: 2b,c

A poor diet

Not drinking enough fluids

Dieting

Not getting enough exercise 

Suppressing the urge to go to the toilet

If constipation is not treated, it may cause serious complications. This could include bowel obstruction where stools are too hard to pass; haemorrhoids; rectal bleeding and small anal tears; and faecal and urinary incontinence. 1f, 2d

How do I get relief from constipation? 

Eat a well-balanced, fibre-rich diet, drink plenty of fluids and exercise regularly. It’s also important to set aside time for undisturbed visits to the bathroom, as an urge to go should not be ignored. 1g

A laxative can be used to relieve discomfort while waiting for lifestyle changes to take effect.

Laxative

How it works

Oral or rectal

Benefits

Drawbacks

Bulk-forming laxatives2h,m,n

Add mass to faeces to activate the intestine movement.

Oral

Useful if stools are small and hard

Does not provide immediate relief, as it takes 2-3 days to work.

Stimulant laxatives 2i,j,m

Work directly on the nerves of the colon and increase intestinal movement.

Oral

Taken before bed, they produce a bowel movement the following morning.

Not for immediate relief.

Tend to cause abdominal cramps.

Not for long-term use.

Rectal

Suppository take effect in 20-60 minutes

Some suppositories could cause local inflammation.

Osmotic laxatives 2l,o,m,p

Retain and draw water into the intestines.

Oral

Some preparations provide fast relief, some take up to 2-3 days to act.

Will not provide immediate relief; tend to cause flatulence and abdominal discomfort.

Rectal

The time to take effect varies based on the ingredient and could work within 15 min or take several hours.  

Faecal softeners2k,m

Softens the impacted stool to make it easier to evacuate

Rectal

Generally, works within 15 – 60 minutes.

Microlax is a convenient microenema which can easily be disposed of after use; the solution attracts water into the stool to soften it and make it easier to evacuate. It provides quick and effective relief of constipation within 5–15 minutes. 3

It can be used by all ages, even babies*. There is only 5ml solution in each enema, so it is small and discreet, and can be carried with you for whenever and wherever you need it. 3

Microlax Microenema is: 

  • Suitable for all ages.* 3
  • Works within 5–15 minutes. 3
  • Predictable and effective relief.
  • Small dose – only 5ml liquid. 3
  • Discreet and easy to use.

*For instruction for use, and use in children under three years, see package insert for details. 

Microlax®: Each 1 ml contains: Sodium Citrate 90,0mg; Sodium Lauryl Sulphoacetate 70% 12,9mg; Sorbitol liquid 893,0mg. Ref. No. E911 (Act 101/1965). For full prescribing information, refer to the package insert approved by the Regulatory Authority. ®Trademark © Johnson & Johnson (Pty) Ltd 2020. Zinc no.: ZA/MX/20-1095

References: 
1. Constipation. South African Gastroenterology Society. [Internet] 2020. Accessed 2020/02/18. Available from https://www.sages.co.za/Patients/Constipation.2. Allen S. How to deal with constipation. SAPJ 2008;75(7):23-26.3. Company core data sheet (CCDS) for sodium citrate/ sodium lauryl sulfoacetate/ sorbitol, sodium citrate/ sodium lauryl sulfoacetate, sodium 

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