Dietary Constipation Remedies
Wanna Go but Can’t?

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Spotlight on Constipation Remedies:  What is constipation and why is it such a problem?

Constipation is when you don’t void (poop) on a regular basis and you suffer symptoms of constipation. 

It's one of the most talked about or least talked about subjects, depending on the crowd you hang out with.

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Statistics suggests that constipation is one of the most common ailments for which people seek medical attention. The $500 million North American laxative industry attests to this.

Aside from taking over-the-counter or prescription laxatives that may have a useful place in your medical treatment or life circumstances, dietary and herbal remedies for constipation can be very effective with generally less cost and, in the case of diet, better long term results for health and wellbeing than long term reliance on drugs.

Without a doubt, diet (the right diet that is) is one of the best constipation remedies going.

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Spotlight on Constipation Remedies:  How often should you go?

Everyone is different in how often and how much they “go”.

 What may be a regular schedule for some is the definition of constipation for another.

 The A.D.A.M. Medical Encyclopaedia defines constipation as “having a bowel movement less than 3 times per week”.

Many people go once a day - others don’t go for two or three days and it is normal. In some cultures, especially those with a high fiber diets as the work of Dennis Burkitt attests, defecating two or three times a day can be normal.  Babies, as any Mother knows, can go several times a day. All of these can be normal, depending on your fiber intake; age; physical activity level; etc. although aiming for once a day for a pain free softish bowel movement is a reasonable goal.

What is fiber or fibre? It’s the indigestible part of plants that helps soften stool so it can transit easily through the digestive track and sweep the tract of old fecal matter at the same time. Another role of fiber is to act as a prebiotic and nourish vital gut bacteria.

A delay in your usual routine along with the presence of any of the symptoms of constipation (see below) is the best gauge for determining whether you are constipated.  Bottom line (excuse the pun): You know it when you’ve got it.

But don’t stress about it!  You’ll see later how stress and the release of stress hormones can contribute to constipation.

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Spotlight on Constipation Remedies:  What are the symptoms of constipation?

You know the symptoms and none are pleasant.

They can include, abdominal, back and leg pain and discomfort; gas; bloating and abdominal distension;

• loss of appetite;
• feeling of fullness;
• lethargy;
• nausea;
• difficulty or pain  passing stool;
• hard, dry or small stool; and
• delayed transit time.

Want to Read more on Poo? If you want details on the differences of some cultures (including figures on fecal weight, size etc. along with grainy b&w photos of same), check out the work of Denis Burkitt the iconoclastic doctor for whom Burkitt’s Lymphoma is named and whose work among rural Africans lead him to ponder why they had lesser rates of colon cancer and other diseases than Westerners. He determined that differences in intake of fiber-rich foods played a role. While some of Burkitt’s theories on the effects of fiber have been superseded by later scientific research, his is ground breaking and fascinating work on how diet and dietary fiber differ between cultures and affects health.

Spotlight on Constipation Remedies: Determining transit time

Want to know how long your food takes to get from one end to the other? A simple way is to eat 125 ml/1/2 cup of cooked beet root  and see how long until you have dark red stool. If you prefer another colour than blood red, which can be unsettling, consider charcoal tablets available from a pharmacy or cooked corn kernels.

 

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Spotlight on Constipation Remedies:  What do you need to avoid or deal with constipation?

To get to basics, you need enough of the following four to avoid constipation –

1. Food (if you don’t eat enough, you won’t go). It’s why anorexics and some dieters get constipated. Aim of course to increase intake of the right kind of foods for best effect – namely, fiber rich food but a minimum volume of any food is necessary to get things moving;
2. Fiber or as the British say fibre, are the indigestible part of plants whether whole grains, seeds, nuts, fruit and vegetables. Fiber softens and adds bulk to stool to aids transit. Insoluble fiber performs a broom like action that sweeps the colon of fecal matter. Soluble fiber softens stool and forms a gel like substance that helps move stool along the tract – as well as slows cholesterol absorption and regulates blood sugar levels;
3. Water - Water greases the tract so to speak. It works with insoluble fibers to form a gel-like substance that helps stool move down the pike. A big part of avoiding constipation is making sure you consume enough water.
4. Exercise – Exercise and good muscle tone, especially in the abdominal area, are key constipation remedies.

 

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Spotlight on Constipation Remedies: How much fiber do you need?

The US government suggests that adult women get around 25 grams of fiber per day; with adult men getting 38 grams. For those over age 50, the amount is 21 grams for women  and 30 grams for men.

Some cultures, including rural African, average from 50 grams to 100 grams per day.

The average daily intake of fiber in the US is a paltry 10 to 15 grams!

What is insoluble fiber? Fiber that dissolves in water to form a gel-like consistency that can soften stool and speed transit time. It’s found in large amounts in fruits and veg as well as beans, nuts and seeds. What is soluble fiber? Fiber that retains its form while it passes through the digestive track, giving stool bulk and functioning much like a broom. It is the dominant type of fiber in whole grains including the bran of the wheat or rice.

The typical Western diet is fiber deficient. Aside from constipation which is thought to affect 25% of the population in the last 6 months and is linked to conditions like bowel cancer, diverticulitis and haemorrhoids among others, this dearth of fiber-rich foods is thought to contribute to blood sugar problems that can lead to insulin resistance and type II diabetes; as well as high cholesterol that can lead to heart disease.

If you’re like me, the thought of the above makes me want to crunch on an apple.

TOP TEN NATURAL CONSTIPATION REMEDIES

The top ten natural constipation remedies are as follows:

 

1.       Increase your intake of whole grains, legumes, nuts and seeds as well as intake of whole fruits and veg.  Include whole wheat, barley and oatmeal with a focus on unprocessed versions that have not been overly pulverized.  For example, opt for large flake old fashioned slow cooking oats over quick cooking or instant oat versions.   For fruit and veg, raw or unprocessed kinds are best. For example, skip the fruit juice in favour of the whole fruit – See Foods for Constipation for guidance as to what to eat and how to prepare to maintain fiber content. Keep prunes, apple, pears and avo in your larder.

 

What are Probiotics? Probiotics are foods or supplements containing beneficial gut bacteria. They can help recolonize the gut with good bacteria that may have been eliminated via poor diet, sickness or use of antibiotics. Kefir, yogurt or fermented sauerkraut or pickles containing live bacteria are good probiotic foods.

2.       Eat probiotic foods including kefir, yogurt or fermented sauerkraut or pickles that contain live bacteria or take a probiotic supplement to maintain healthy gut flora and good digestive function.

 

3.       Eat prebiotic foods or take a prebiotic supplement to fuel healthy gut flora.

4.

What is a prebiotic? Prebiotics are indigestable carbohydrates that feed colonic bacteria and contribute to healthy gut flora and efficient mineral absorption including calcium and magnesium. Prebiotics include fructo-oligosaccharides (FOS), resistant starches, galacto-saccharides and soybean oligosaccharides. Foods that are natural prebiotics include artichokes, oatmeal, garlic and onion, chicory root and beans and lentils.

4.       Sprinkle ground flax seeds on your salads and soups or mix a table spoon of seeds in a glass of water and drink after soaking overnight.

5.       Coffee in moderation – coffee can have a mildly purgative effect but don’t overdo. Too much caffeine can promote the release of stress hormones that can impede bowel action.

6.       Vitamin C Supplements. Taking 2 grams or more can create loose stool.  Decrease your intake once you achieve this  “bowel tolerance” level. Press here for more on the Benefits of Vitamin C including Vitamin C as a constipation remedy.  

7.       Exercise and Proper Breathing – Diaphragm breathing, abdominal massage and exercise are clinically proven constipation remedies.

8.       Water, water, water.... essential for life and your bowels including the function of fiber to prevent constipation. Drink a minimum of 2 liters per day.

9.       Avoid foods to which you are intolerant or allergic. Major culprits that can cause constipation, among other digestive disorders, are gluten (including wheat bran), dairy and sometimes even psyllium seeds, a common ingredient in many bulk forming laxatives.

10.       Minimize processed foods and animal products – They lack fiber and, therefore, promote constipation.

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Spotlight on Constipation Remedies:  What causes constipation?

There are a number of factors that can lead to constipation.

• Lack of fiber
• Dehydration

• Lack of exercise

• Lack of food

• Suppressing the urge to go

• Anxiety

• PMS

• Pregnancy

• Old Age

• Over use of laxatives

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Spotlight on Constipation Remedies: Conditions that can cause constipation

While a lack of fiber, exercise and water can lead to constipation there are also medical conditions for which constipation (in some cases interspersed with diarrhoea) is a symptom. These include the following:

• Irritable bowel syndrome (IBS)

• Spastic colon

• Colitis

• Chron’s disease

• Bowel/colon cancer
• Hypothyroidism
• Parkinson’s disease

 

 

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Spotlight on Constipation Remedies:  What are health conditions linked to chronic constipation?

Health conditions linked to chronic constipation include

• Colon cancer

• Anal cancer

• Haemorrhoids

• Diverticulitis

         

See a doctor whenever you have abdominal or bowel area pain or blood in your stool to rule out serious conditions.

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Spotlight on Constipation Remedies: The poop on laxatives

An article about constipation remedies wouldn’t be complete without a mention of laxatives, both pharmaceutical as well as the natural or dietary kinds.

Laxatives can be an effective way of dealing with constipation, with certain types especially good for occasional or severe constipation when fast action is needed. Some laxatives are prescription meds, others over-the-counter; the remainder are herbal and dietary remedies, the last of which we deal with at length in this page.

There are 6 major types of laxatives available for general use each having different effects on the colon or fecal matter:

1. Bulking agents give stool weight, size and softness and help it move along the tract. Examples of these are psyllium husk (Metamucil), methylcellulose (Citrucel), wheat bran as well as foods like apples, pears and prunes, which I discuss further here.  All of these can be taken long term and included as part of a healthy balanced high fiber diet.
   
2. Stool Softeners (surfactants) like Colace and Correctol Soft Gels draw fat and water into the stool to speed transit.
3. Lubricants (emollients) like mineral oil grease the stool so it passes more quickly. The drawback of mineral oil is that it prevents absorption of fat soluble vitamins and minerals.
4. Osmotics or hydrating agents. These include saline solutions like sodium phosphate, magnesium citrate, magnesium hydroxide (Milk of Magnesia or Cream of Magnesia) and magnesium sulfate (Epsom Salts) and other osmotic agents like glycerine suppositories, sorbitol, lactulose and polyethylene glycol (PEG) many of which are used prior to surgery or colonoscopies or in the event of cases of poisoning. These draw and retain water in the colon, increasing colonic pressure and therefore softening stool. All of these work quickly and effectively (if not overused) but can affect fluid and electrolyte balance and nutrient absorption – not good in the long term.
5. Stimulant or Irritant laxatives affect the intestinal lining and nerve pathways to change water and electrolytes balance as well as the muscles in the colon responsible for peristaltic action that pushes stool through the tract. Some of these are OTC or prescription meds, while others are “natural” substances and include castor oil, senna, cascara and aloe vera.  While stimulant laxatives are effective constipation remedies, they can be dangerous for their powerful effect on fluid balance and colon muscles. In fact, cascara and aloe vera cannot be marketed in the US as a laxative due to the health concerns. See the FDA ruling for details. Good for short term occasional use; these laxatives are not long term solutions.
6. Chloride Channel Activators are used for chronic idiopathic constipation including IBS. They work by softening stool and promoting more effective transit. These are generally taken under medical supervision.

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Spotlight on Constipation Remedies – The downside to over-use of laxatives and why diet and lifestyle factors are the most effective long-term constipation remedies

The problem with the more than occasional use of laxatives, other than bulking agents, is that the colon muscles can stop functioning on their own. Peristaltic function can become dependent on laxatives to keep things moving.

What is peristaltic function? The action of the muscles and nerves of the digestive tract which propel feces through the colon.

The ironic result of excessive use of laxatives is constipation!

Obviously laxatives can play an important role especially in the case of a temporary medical condition that bar physical exercise or fiber rich foods, or that require meds that  may cause constipation as a side effect.

It follows that the safest and most effective long term constipation remedy is a healthy balanced fiber rich diet along with exercise and adequate water.

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Spotlight on Constipation Remedies:  Eat enough of the right foods

Some people (often men or women who are ill, bed ridden, chronically diet or suffer anorexia) just aren’t eating enough for stool to form, let alone move matter along the canal. You need a minimal amount of food or bulk in the intestinal tract to keep things moving. If it doesn't it can become dry and impacted.

Luckily, the fibre rich foods that are good for constipation are often low cal and nutrient dense. These fiber rich foods that include whole fruits, veg , legumes and whole grains, can play a part in a healthy balanced diet to maintain a healthy weight.

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Spotlight on Constipation: What is fiber?

As the indigestible part of plants, fiber is a type of carbohydrate.

When combined with water, fiber can soften stool and speed its transit through the large intestine. The only source of fiber is plants – it’s why a whole foods vegetarian diet, especially a vegan one, is good to avoid constipation.

Food processing often involves removal or destruction of fiber, whether by outright removal as in the case of refined flours and sugars; or by heating or pulverizing grains, fruit or vegetables. 

In contrast to whole plant foods, animal foods don’t contain fiber.

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Spotlight on Constipation: The different types of fiber and how they function

There are two different types of fiber.

 

• Soluble fiber is mainly found in fruits and vegetables, although not exclusively.  For example, oatmeal is a good source of soluble fiber. Soluble fiber dissolves in water and forms a gel like substance that softens stool and helps it transit through the colon, although not necessarily faster.  Aside from relieving constipation, soluble fiber has other health benefits.  It helps decrease cholesterol and stabilize blood sugar as well as makes a person feel full longer. The appetite suppressing aspect of fiber makes it an ideal component to weight loss. Insoluble fiber can be comprised of gums, including beta-glucans, mucilages, alginates, carrageenans, pectins and some hemicelluloses.

 

• Insoluble fiber adds weight and bulk to stool and speeds transit time.  While also in fruits and vegetables, it is abundant in cereal grains like wheat bran. As its name suggests, insoluble fiber does not dissolve in water but absorbs up to 20 times its weight in water. Insoluble fibers include cellulose, lignins and some hemicelluloses.

 

 

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Spotlight on Constipation Remedies: Tips on consuming fiber 

Water Water

• Drinking enough water is  important especially when consuming insoluble fiber – 2 to 3 liters a day between meals. A person can suffer constipation or bowel obstruction, if consuming too much insoluble fiber without sufficient water.

 

Increase Fiber Gradually

• Whenever you increase your intake of fiber, do so gradually over several days or weeks in order to avoid bloating or gas. It is the carbohydrates in fiber rich foods that cause most of the gas and digestive discomfort. It may take time for your digestive tract to acclimatize to the increase in vegetable matter so ramp up your fiber intake gradually to give your body time to adjust.

 

Avoiding Gas and Improving Digestion of Fiber Rich Foods

• Soak beans overnight before cooking. Consume high fiber foods with a glass of water containing a tablespoon of apple cider vinegar to improve stomach acidity needed for effective digestion.

 

Consume Probiotic Foods or Supplements

• Probiotics, either via probiotic foods like kefir, yogurt or sauerkraut as well as probiotic supplements can help repopulate healthy gut bacteria and improve gut flora, preventing gut permeability and improving digestion including bowel function. The by-product can  be improved regularity and prevention of infant diarrhoea. Both freeze dried and live probiotic bacteria are available as supplements including bifidobacteria, lactobacilli (including acidophilus,  l. Reuteri, kefir and yoghurti) and streptococci .

 

A 2010 meta-analysis of research about probiotics to prevent or cure constipation published in World of Gastroenterology concluded that their use was “investigational”.  Certain strains of bacteria seemed better for constipation than others.  Improved  constipation was observed with Bifidobacterium lactis DN-173 010, Lactobacillus casei Shirota, and Escherichia coli Nissle 1917.  In children L. casei rhamnosus Lcr35 but not L. rhamnosus GG bacteria showed benefit.

 

 

Don’t Forget Prebiotics as Food or Supplements

• Don’t forget to eat enough prebiotic foods as well. As stated, prebiotics are indigestible carbohydrates that beneficial gut bacteria feed on. Certain foods are good sources of prebiotics including garlic and onions, artichokes, chicory root, oats and beans.

 

 

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Spotlight on Constipation Remedies:  Fiber’s prebiotic role in preventing constipation

While fiber is not a nutrient in that we don’t digest it; it plays a biochemical role in digestion by feeding beneficial bacteria that live in our gut. Healthy gut flora contributes to effective digestion.

Many conditions like Colitis, Chron’s Disease and IBS, of which constipation, often alternating with cramps and diarrhoea, plays a role, have been linked to imbalance in gut bacteria. Sufficient fiber, especially insoluble kinds, has been linked with improved symptoms.

 

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Spotlight on Constipation Remedies:  Foods that cause constipation

While it is important to consume foods to prevent constipation, it is also key to limit foods or substances that cause constipation.

Two types of foods that can cause constipation are as follows:

1. Processed foods including those made with refined grains, sugars, fruit juice etc. where the fiber has been removed or pulverized.
2. Animal products including meat, fish, eggs and dairy.

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Spotlight on Constipation: Why low carb/high protein diets or diets high in refined carbs can promote or worsen constipation

Because getting enough fiber is key to keeping things moving and is one of the top constipation remedies, it’s no surprise that low carb/high protein diets (that are high in animal protein or fats and low in carbs) such as the Atkins diet, can contribute to constipation.  A 2009 Australian comparison study of low carb diets found that, while they were effective for short term weight loss, their long term effect on bowel function  including constipation may not be good.

Why? Dairy and meat do not contain fiber.

Similarly, a diet consisting largely of processed carbs, in which all or most of the fiber rich parts of the plants are removed or broken down will lack fiber.

Diets high in refined carbs or animal products are a recipe for chronic constipation.  This pretty much sums up the typical Western Diet especially for someone who routinely visits fast food joints for their grub.

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Spotlight on Constipation Remedies:  Drugs and supplements that can cause constipation

Similarly, there are many pharmaceuticals whose side effects involve constipation including many pain killers or narcotics, heart meds, anti-depressants, cholesterol lowering drugs, hypertension meds and drugs that affects the nervous system. The last can slow the peristaltic action of the colon muscles that moves stool through the digestive tract.  Be especially careful with drugs containing paracetamol/acetaminophen, oxycodone and morphine. They are common ingredients in many meds and may inadvertently be contributing to your constipation.

Some supplements can also be a problem. Iron supplements taken to prevent anaemia including ferrous gluconate or ferrous sulphate can contribute to constipation. Many multi-vitamins/multi-minerals contain iron especially those designed for women. 

 

Always, check with your doctor or pharmacist to see if a new drug may cause constipation.  Consider implementing constipation remedies when you have to take any of the above types of drugs or supplements.

 

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Spotlight on Constipation Remedies – Exercise and massage

Don’t underestimate the effects of exercise. Even if you’re getting enough fiber rich food, you may remain constipated, if you don’t get enough physical activity.

Exercise Prevents Constipation In a comparison study between seniors suffering constipation and those not, there was no statistical difference in fiber intake between the two groups. The only difference was that the non-constipated group did more regular exercise than the constipated group. The lesson? Get moving if you want things to move.

Sometimes gentle “colonic” massage on the lower abdomen area in the direction the stool travels (pushing up the ascending colon on the right side of your abdomen – horizontally from right to left on the transverse colon - and down the descending colon on your left ) relieves discomfort and helps fecal matter get a move on.

Abdominal Massage and Diaphragm Breathing Exercises an Effective Constipation Remedy – A 2013 Brazilian Study published in Colorectal Disease found that diaphragm breathing exercises, abdominal massage and isometric abdominal muscle training as taught by a physiotherapist along with laxatives improved constipation symptoms significantly in a group of 4 to 18 year olds over those who only took laxatives.

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