Help With Constipation

Help With Constipation

Digestion is important to your overall health. It is through digestion that your body breaks down and absorbs nutrients necessary for it to function properly.  

Many factors affect your ability to digest food. You have likely experienced the negative effects of stress and certain foods, but bacteria in your intestines are also factors.

What Is Constipation?

Constipation means you have too few or trouble with the consistency of your bowel movements. It impacts your social  functioning, daily activities, and overall health. It may also affect how you feel day-to-day. Symptoms may include:

  • Decreased number of bowel movements (generally less than 3 per week)

  • Feeling bowel movements are incomplete

  • Hard, lumpy stool that’s difficult to pass

  • Belly (abdominal) cramping or pain

  • Straining 

  • Abdominal distention or bloating

Risk Factors For Constipation

Risk factors for constipation include older age, female sex, low-fiber diet, low-calorie intake, and little physical activity.

Causes Of Constipation

Primary Constipation 

Primary constipation is considered functional, meaning the gastrointestinal (GI) tract doesn’t work as it should. It is related to the following:

  • How quickly food moves through the  GI tract (gut motility)

    • Slow movement contributes to constipation

  • How the contents of the GI tract move through the mucous lining to the blood (gut permeability)

  • The balance of good vs. bad bacteria in the intestines (gut microbiome)

  • The relationship between intestinal health and emotions (gut-brain connection)

  • The increased sensitivity to pain associated with normal organ function, for example, a small increase in gas in the GI tract (visceral hypersensitivity)

Secondary Constipation 

Secondary constipation occurs often as a result of a medical condition or medication use.   

Conditions

Conditions associated with constipation include:

  • Endocrine disorders: diabetes mellitus, hypothyroidism, or hypercalcemia 

  • GI tract obstruction:  scarring after surgery, or colon cancer 

  • Neurologic conditions: stroke, neuromuscular disease

Medications

There are a number of medications that can contribute to constipation. The types include:

  • Antidepressants

  • Psychotropic drugs

  • Opioids

  • Antacids

  • Nonsteroidal anti-inflammatory drugs (NSAIDS), for example ibuprofen or naproxen

  • Calcium channel blockers (some high blood pressure and heart medicines)

  • Laxatives (long-term use)

Treatment

Constipation isn’t as simple as it might seem, and living with it isn’t easy. However, you can make changes that can help. 

High-Fiber Diet 

Fiber increases the weight and size (bulk) of stool. This helps to speed up the movement of stool through the digestive tract, resulting in more regular bowel movements. 

How Much Fiber?

Fiber intake recommendations may vary based on individual country guidelines. Generally, the recommended intake of fiber is 18-25 g/day for women and 21-30 g/day for men.

Slowly Increase Fiber

Make sure you gradually increase the fiber in your diet. Adding it too quickly may cause symptoms like abdominal discomfort and bloating. You should increase it by no more than 5 grams each day.

High-Fiber Foods

  • Aim to eat 3 to 5 servings of fruits and vegetables daily. They are good sources of fiber.

  • Unsalted nuts and seeds: almonds, peanuts, pecans, and walnuts, as well as pumpkin, sunflower, flax, and chia seeds

  • Whole grain foods: brown rice, wild rice, whole grain bread and rolls, whole grain pasta, wheat and oat bran, oatmeal, and bran cereals

  • Beans, legumes, lentils, and peas

See below for a list of some high-fiber foods and the number of grams of fiber per portion:

Fruit:

  • 1 cup (145 g) raspberries = 8 g

  • 1 cup (145 g) blackberries = 7.6 g

  • 1 cup (145 g) kiwifruit = 5.4 g

  • 1 medium apple with skin = 4.8 g

  • 1 cup (145 g) blueberries = 3.6 g

  • 1 medium banana = 3.2 g

  • ¼ (45 g) cup prunes = 3.1 g

  • 1 cup (145 g) strawberries = 3 g

Vegetables:

  • 1 cup (145 g) cooked artichoke = 9.6 g

  • 1 cup (145 g) cooked peas = 8.8 g

  • 1 cup (145 g) Brussels sprouts = 6.4 g

  • 1 cup (145 g) cooked sweet potato = 6.2 g

  • 1 cup (145 g) cooked broccoli = 5.2 g

  • ½ cup (75 g) avocado = 5 g

  • 1 cup (145 g) cooked carrots = 4.8 g

  • 1 cup (145 g) cooked spinach = 4.3 g

  • 1 medium white potato with skin = 3.9 g

Grains, Beans, Nuts, and Seeds:

  • ½ cup (75 g) high-fiber cereal = 14.0 g

  • ½ cup (75 g) lentils = 7.8 g

  • ½ cup (75 g) cooked chickpeas = 6.3 g

  • 1 cup (200 g) cooked quinoa = 5.2 g

  • 1 ounce (30 g) almonds = 3.5 g

  • 1 cup (200 g) cooked brown rice = 3.5 g

  • 1 Tbsp (7 g) flaxseed = 2.8 g

  • 1 slice whole wheat bread = 1.9 g

Meal Examples

Breakfast:

  • Smoothie: 1 banana, 1 cup (145 g) kale, 1 cup (240 mL) unsweetened almond milk or other non-dairy milk, ¼ ripe avocado, 1 Tbsp (15 g) chia seeds, 2 tsp (7 g) honey. Total fiber = 12 g

  • Almond Cinnamon Chia Pudding: ½ cup (120 mL) unsweetened almond milk or other non-dairy milk, 2 Tbsp (30 g) chia seeds, 1 tsp (7 g) maple syrup, ¼ tsp (1.25 mL) vanilla extract, ¼ tsp (1.25 g) ground cinnamon, ½ cup (75 g) apple, 1 Tbsp (15 g) chopped pecans. Total fiber = 10 g

  • Oatmeal: 1 cup (200 g) cooked oatmeal, 1 ounce (30 g) almonds, 1 banana. Total fiber = 11 g

Lunch/Dinner:

Note: Having 3 different types of vegetables at a meal can help you meet at least 60% of your fiber intake for the day!

  • Soup: 1 cup (240 mL) of lentil soup, Total fiber = 15 g

  • Grilled chicken with roasted vegetables and a side salad, Total fiber = 10 g

  • Mixed Vegetables (great for side dishes): 1 cup (145g) of broccoli, carrots, or sweet potato, Total fiber = 5-6 g

Snacks:

  • 3 cups (24 g) of popped popcorn, fiber = 6 g

  • 2 Tbsp (30 g) hummus with 1 medium bell pepper, fiber = 4 g

  • 1 cup (160 g) cooked edamame, fiber = 8 g

Simple Swaps to Increase Fiber:

  • 1 medium poppy, sesame bagel (2 g fiber) → swap for 2 slices of whole-grain bread (4 g fiber)

  • 1 cup (200 g) cooked white rice (1.5 g fiber) → swap for 1 cup (200 g) cooked brown rice (3.5 g fiber)

  • 1 cup (200 g) mashed potatoes (3 g fiber) → swap for 1 cup (200 g) cooked black beans (15 g fiber)

  • 1 ounce (30 g) potato chips (1 g fiber) → swap for 3 cups (24 g) popped popcorn (6 g fiber)

  • 1 cup (145 g) cornflakes (1 g fiber) → swap for 1 cup (200 g) oatmeal (4 g fiber)

  • 1 ounce (30 g) jelly beans (0 g fiber) → swap for 1 ounce (30 g) almonds (3.5 g fiber)

  • 1 cup (240 mL) of juice (0 g fiber) → swap for 1 cup (145 g) fresh raspberries (8 g fiber)

Low-Fiber Diet

In contrast to a high-fiber diet, a diet low in fiber may be part of the cause of constipation. Low-fiber foods include refined carbs such as white flour, white bread, white rice, plain pasta, and cereal without whole grains.

Increase Fluids 

Make sure you have enough water or other unsweetened beverages throughout the day. Fluids help to keep your stool soft, which makes bowel movements easier. Staying adequately hydrated also helps to aid in gut functioning, helping to improve digestion.  What’s more, is that increasing fiber without enough fluids may worsen your constipation.

How Much Water?

It is generally recommended for healthy individuals to drink at least eight 8-ounce (240 mL) glasses of water per day. However, multiple factors could affect daily water needs such as physical exercise, particularly in athletes, environment (hot and humid climate)  and heat stress, pregnancy and breastfeeding, overall health, and medical conditions (fever, vomiting, diarrhea, etc.).

Fiber Supplements

There are many over-the-counter (OTC) medicines and herbal supplements with fiber. For example, look for psyllium or methylcellulose on the product label.

In addition to increasing fiber and fluids, the following techniques and lifestyle changes can also help with constipation.

Abdominal Massage

Abdominal massage is a technique used to relieve constipation. Massaging the abdomen can help to move stool through your colon and lessen symptoms like abdominal pain and bloating

In general, you’ll massage in the same direction that stool moves through your colon - starting from the ascending to the transverse to the descending sections (starting from your lower left abdomen, moving upwards, across to the right, and down the right side of your abdomen).

Defecation Posture Modification Device or Squatty Potty™

A defecation posture modification device or Squatty Potty™ is a toilet stool that allows you to be in a squat-like position when having a bowel movement. You place the stool in front of the toilet with your feet on it, thus your knees are above your hips. This posture can help you have easier and more effective bowel movements.

It is suggested that the standard sitting posture may lead to increased straining, incomplete bowel emptying, and increased time on the toilet.

Managing Stress 

There is a close relationship between your intestinal health and emotions. Not only do your emotions affect your GI system, but your GI system also influences your emotional health.

Increased stress can interfere with digestion. As far as constipation, your mood and stress level can cause it to worsen.  

Relaxation techniques help to lessen your response to stressful events.  Some techniques are:

  • Progressive Muscle Relaxation (PMR): PMR helps you to identify where in your body you have increased tension and then release it.

  • Deep Breathing: Slow, deep breathing alone or as part of other relaxation methods, helps to calm your mind and body. 

  • Mindfulness: Mindfulness meditation teaches you to focus on the present moment, thus decreasing stressful thoughts and emotions.

Exercise And Movement 

Exercise and movement help to stimulate digestion and promote bowel movements. 

Regular Exercise

Regular aerobic exercise, like walking, can help improve constipation. Exercise helps to move stool through the colon and stimulates the muscles of the abdomen which further moves stool from the colon to the rectum.

Movement

Movement-based therapies such as yoga and stretching can also help to promote digestion and reduce stress. 

A Word About Sleep

Getting enough sleep is a basic part of your overall well-being and it also helps promote digestive health and improve stress management.

If constipation does not respond to lifestyle modifications and fiber supplementation, laxatives such as magnesium hydroxide, lactulose, or polyethylene glycol may help. If there is still no response, referral to a subspecialist for further workup and management is appropriate.

Constipation is often very distressing. It can be very disruptive to your daily activities. You may have pain and discomfort, have to spend a lot of time in the bathroom, and have trouble focusing on anything else. You can benefit from making some changes to your diet and lifestyle. Your Goodpath coach can help you with dietary changes, as well as suggest mind-body therapies and exercises available to you.