Constipation encompasses a broad range of symptoms and complaints and can mean vastly different things to different people. It can mean anything from having infrequent bowel actions to having bowel actions that are hard or dry. It can also include symptoms such as abdominal bloating, straining to evacuate or failure to completely evacuate the rectum.

What really matters is whether or not you have these symptoms and, if you do, whether or not they cause you any concern or distress. Because if they do, that is enough to say that you are constipated.

Nearly 20 years of talking to, trying to understand and then treating people with varying degrees of constipation, almost all of them women, has taught me many things I didn’t really appreciate when I started out in consultant practice as a Colorectal Surgeon. Over this period of time, I have been constantly dismayed and frustrated at how widespread is ignorance about bowel function in general and about constipation in particular. Myths and misconceptions about the normal workings of our bowels and about the causes and treatments of constipation are rife.

At times, I have been genuinely shocked at how often advice, even from so-called experts, has been wrong or has actually made things worse. I have seen sufferers regularly made to feel guilty for their inability to achieve a satisfactory bowel habit despite the fact that their problems are entirely beyond their control. They have been obliged to endure their symptoms fully aware that no-one seems to want to know about their genuinely awkward and unpleasant complaints.

As a Surgeon, I might most easily have sent these women back to their referring Doctors with the simple reply: “There is no surgical remedy.” As a designated Colorectal Specialist and supposed “expert”, however, I felt an obligation to try and help or, at the very least, to better understand what was going wrong. This process has been hindered by the fact that most people are, understandably, embarrassed about their bowels and reluctant to share the details of their bowel function, even with their own Doctors. Things are made no easier by virtue of the fact that the workings of our bowels are shrouded in misunderstanding, myth and sheer ignorance. Even worse, these myths and misconceptions are often shared by the very people advising you about your treatment.

It is little wonder, therefore, that the treatment of constipation is so frequently inadequate and that people, even with mild constipation, are unable to establish satisfactory control over their lives.

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