Constipation - WHAT TO DO?

Constipation - what to do
CONSTIPATION. Some call it hard stomach; some say it is “being irregular”. But it all comes down to this: The difficult passing of stools; less than 1 stool passage in more than 3 days. That moment where you are wishing and waiting for anything to happen! It is one of the most prevalent intestinal “conditions” of western populations. BUT WAIT… Just before you reach for that laxative - take a moment and read about the causes and natural treatment options for constipation. The solution may be easier than you think (and less “invasive” than those laxatives!) - as a dietician I always aim to find a solution to the CAUSE of the situation instead of just temporarily fixing the “SYMPTOM”.

WHY does it happen? ...Or in this case: Why does it NOT happen!

Bowel movements depend on many factors: Including your dietary intake; physical activity; some medications; certain disorders where bowels do not function properly and as we read last week in IBS EXPLAINED, our emotional state also plays a role. We should also note that when we continue to “hold it in”, it may cause FECAL IMPACTION which causes a painful blockage and requires urgent medical treatment.

Let’s take a closer look at some of the possible causes:

Dietary intake

A diet low in FIBER may result in constipation. The different types of fiber plays a role (IBS explained from last week, contains a great summary on the different fibers). For constipation - we generally aim for a HIGH FIBER DIET (high in all fibers) due to the different benefit each one provides. We do however focus on INSOLUBLE fiber due to the “bulking” properties it possesses: To make enough stools that can actually exit the colon.

Another very important INTAKE is adequate FLUIDS! Our system requires fluids - especially clean water - to properly form a stool; assist with nutrient absorption AND actually help getting the stool out of the body. Almost like a waterslide! Without water on the slide; you get stuck, and sometimes those plastic edges can really hurt!

Physical activity

When stool reaches the colon, the colon’s muscles perform PERISTALSIS to “push” out the stool. These muscles interact to flex and relax in certain sequences which then transports the stool. When we do exercise, it assists with healthy digestion by also toning up the muscles in the colon. Exercise also stimulates your upper digestive tract (think throat and stomach) to start initiating the motions of peristalsis. Get your tekkies, and move!

Some medications

The most obvious suspect here is PAIN KILLERS. This is because the active ingredients in most pain killers bind to the receptors in the gut which is supposed to control peristalsis - then it does not happen and the stool is left stranded in the colon. Chronic or wrongful use of laxatives may also result in a “lazy” colon where it has forgotten how to function and how to do peristaltic movements.

Disorders where bowels do not function properly

The bowel depends on many organs, hormones and bodily functions to produce and excrete a normal healthy stool. To pinpoint exactly where it goes wrong is nearly impossible! But below is list of the most common conditions that goes hand-in-hand with constipation:
  • Underactive thyroid
  • Endocrine or metabolic disorders like Diabetes
  • Gastroparesis (slow emptying of the stomach)
  • Multiple sclerosis; muscular degenerative diseases/dystrophy
  • Paraplegia or Quadriplegia
  • Cancer or undergoing cancer treatment
  • On chronic pain medications
  • Pregnancy
  • Diseases of the upper or lower gastrointestinal tract (inflammatory bowel disease; hemorrhoids; ulcers etc)
If you are experiencing constipation and/or are a “high risk” patient from the above mentioned conditions it is advised that you consult your doctor and dietician for individualised treatment.

Emotional state

Although it is still a rather new field of study - many research supports the topic that our gut and brain is linked. Some even go so far to say that the gut is in fact the REAL mastermind of the body - not our brain! With regards to constipation and the function of the bowels: Any negative emotions (like stress, worry or even anger) releases stress hormones (cortisol), which may cause increased inflammation in the body. It may also affect your digestion by stopping the release of your enzymes and hindering digestive functions in the stomach (where digestion and food breakdown starts). As we know, without the right enzymatic action, once again the stool is stuck and stranded there in the gut. Which is REALLY bad news especially if you are an emotional eater! Talk about a traffic jam.

What can you do?

  • Aim for at least 30 minutes of exercise every day
  • Eat enough fiber (25g= women; 38g=men and children 19-25g)
  • Choose whole grains over “refined flours”; include legumes, seeds and nuts
  • Eat plenty of vegetables daily
  • Eat fresh fruit everyday
  • Aim for a minimum of 2 litres of water per day (especially if you are losing hydration through exercise and tend to struggle with constipation)

By following these guidelines, you support and maintain a healthy digestive tract to prevent and even treat the common constipation. If you are unsure how to manage constipation when on chronic medications, visit a dietician to develop an individualised treatment plan to increase fiber into the diet.

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