How Often Should You Poo? Scientists Call For New Definition Of Constipation

Everyone is confused about the symptoms – here's what to look for.

There’s a lot of confusion around constipation, say scientists, who are calling for a new medical definition for the issue.

King’s College London researchers say the public’s perception of constipation differs drastically from that of doctors and from formal diagnosis guidelines. Their study found one in three patients who deemed themselves to be “healthy” were, in fact, clinically constipated but did not recognise it.

The researchers identified six key sets of symptoms that in the future could form the basis of a new medical definition for constipation, which hopefully everyone can agree on.

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People who poo less than three times a week are likely to be constipated, according to Guts UK. However Julie Harrington, from the charity, says not all constipation is the same and different people will experience different symptoms – hence why this research is important.

“Bowel problems are less likely to be picked up than other problems because people wait six to 12 months out of fear and embarrassment,” she says. “You have to tune into your body.”

Constipation is a very common condition. Although most people with chronic constipation do not visit a doctor, it is still diagnosed in more than one million GP consultations and 63,000 hospital admissions in the UK every year.

The way it is detected, however, varies considerably. Some patients self-diagnose, some doctors diagnose pragmatically, and others use formal criteria which specify combinations of symptoms experienced over a set period of time.

What Did The Research Find?

KCL researchers collected data from 2,557 members of the public (of which 934 had self-reported constipation), 411 GPs and 365 gastroenterology specialists.

They found that of those who self-reported constipation, 94% met the formal diagnostic criteria. Of the 1,623 who did not self-report constipation, 29% met these criteria too. Nearly one in three “healthy” patients were, therefore, clinically constipated but did not realise.

Infrequent bowel movements were perceived as important for diagnosing constipation by less than a third of the constipated general population, compared to 41% of GPs and as many as 65% of specialist doctors.

The study highlighted six key symptom clusters which were commonly agreed upon across the study groups, and recommends that these should form the basis for future medical guidelines.

Key Symptom Groups

:: abdominal discomfort, pain and bloating;

:: rectal discomfort;

:: infrequent bowel movements and hard stools;

:: sensory dysfunction;

:: flatulence and bloating;

:: faecal incontinence.

Professor Kevin Whelan, head of the department of nutritional sciences at King’s College London, said the study revealed that numerous symptoms are considered important for a diagnosis of constipation by the general population, which are not currently part of any medical diagnostic criteria or assessment tools.

“This is important as patients who seek medical care for their constipation-related symptoms may not have their symptoms recognised as constipation by the doctor and, therefore, may not be managed as such,” he said. “This could significantly impact patients’ access to care and treatment.”

Dr Dimidi added: “Our findings emphasise the need to re-define the current universally accepted diagnostic criteria so they reflect both patients’ and doctors’ perceptions.

“The six symptom clusters we have identified seem a logical place to start.”