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Contending with Constipation


Feeling bloated? Backed up for days? Do you have hard lumpy stools?

Constipation is a common problem, but that doesn’t make it any less of a pain! In addition to impacting your quality of life, chronic constipation can contribute to bigger problems, such as hemorrhoids, anal fissures and rectal prolapse. Constipation includes the following symptoms: straining during bowel movements, less than three successful bowel movements per week, hard lumpy stools, or a sense of rectal blockage or incomplete evacuation during bowel movements.


What causes constipation?

If you are suffering from constipation, talking to your doctor can help determine the underlying cause. Constipation is often related to lifestyle factors, such as a lack of physical activity and inadequate fiber intake. However, constipation can be secondary to illnesses such as diabetes, irritable bowel syndrome, Celiac disease, thyroid disorders, lupus and some neurological diseases, such as multiple sclerosis and Parkinson’s disease. Additionally, hormonal changes in pregnancy can contribute to constipation. Constipation can also be a side effect of certain medications and supplements, such as calcium and iron, some antacids, antidepressants, antihistamines, certain pain medications and diuretics.


Five Steps to Take to Stop Constipation


  1. Increase dietary fiber intake

 Americans on average, consume 13-15 grams of fiber per day, only 50% of the recommended daily amount. Adequate fiber intake helps prevent constipation by increasing stool bulk and decreasing the length of time it takes for food to pass through the digestive system. The fiber recommendations for women are at least 25 grams of fiber per day, while men should aim to consume 38 grams per day. If you are not used to eating a high fiber diet, you should gradually increase your intake of high fiber foods. A good rule of thumb is to increase daily fiber consumption by 5g every week. Be sure to also increase water intake as you increase your fiber consumption. Increasing dietary fiber without increasing fluids at the same time could lead to worsening constipation or a bowel obstruction.


Types of Fiber

 Fiber is only found in plant foods, such as whole grains, fruits, vegetables, legumes, beans, nuts and seeds. Insoluble fiber, which is found in wheat bran, whole grains, seeds and the skins of fruits and vegetables adds bulk to stools and helps speed food through the digestive system. Soluble fiber forms a gel in the intestines, and can slow digestion, but has other health benefits and can help with IBS. Most foods have a combination of fibers, so it’s important to eat a wide variety of plant foods to ensure adequate fiber intake. Here are some tips on how to increase fiber throughout the day.

  • Breakfast: Start you day off with 1 cup cooked oatmeal and 1/2 cup of berries or 1 cup wheat flakes and 3 dried prunes. (6g fiber)
  • Snack: Stir 2 teaspoons chia seeds into Greek Yogurt. (3g fiber)
  • Lunch: Try a turkey sandwich with 100% whole wheat bread or a whole grain wrap (5-8g fiber). Add 1 cup lentil soup, or toss ½ cup chickpeas on your salad. (5g fiber)
  • Snack: Munch on 1 cup raw carrots, celery or peppers with 1/4 cup hummus or 1 small apple with 1 tablespoon of peanut butter. (4-6g fiber)
  • Dinner: Try 4oz baked chicken with 1/2 cup cooked carrots (2.5g fiber), 1 small baked potato with skin (3g fiber), and ½ cup cooked broccoli (2.5g fiber). As an alternative, try a meatless meal with 1 cup 3 bean chili (11g fiber), baked tortilla chips and light sour cream or cheese.


                                           Sample Menu Total Daily Fiber: 31-39 grams


  1. Increase your fluids

It’s important to increase your fluids as you increase dietary fiber, so as not to make constipation worse. Most people need at least 64 ounces per day of fluids. However, individual fluid needs may differ, depending on age, size, activity level, and the temperature. Although all fluids count towards your fluid needs, water is the best fluid to be drinking all day long. Not a water drinker? Try infusing water with mint leaves, cucumbers, peaches or other fruits, to make water more exciting. Prune juice has a natural laxative effect, but may not be appropriate for people who have diabetes or are trying to lose weight, as it is very high in sugar.


  1. Start walking more

Regular physical activity also helps keep you “regular”! Regular exercise, such as walking briskly, helps keep bowels active and improves blood supply to the gut. For overall health, the recommendation is to engage in moderate intensity exercise for at least 30 minutes 5 days per week. Be sure to rehydrate as you exercise!


  1. Stick to a schedule

Bowel training is another strategy that can help improve constipation. Bowel      training includes the following strategies to help create a regular schedule for bowel movements.

  • Be sure to leave enough time for sitting on the toilet for bowel movements and try to relax. Sometimes a distraction, like a magazine, can help.
  • Don’t ignore those urges to have a bowel movement throughout the day. The best time to try to have a bowel movement is when your body is ready for it.
  • Try to have a bowel movement soon after waking or 30 minutes after a meal to take advantage of the body’s natural reflexes. Try walking after a meal to get things moving.
  • Keep a journal to track daily bowel movements, any symptoms related to your digestive track, food intake and physical activity.


  1. Check Your Medications and Supplements

If you notice that constipation has increased after a change in medication or supplements, check with your doctor to see if any of your medications can worsen constipation. Your doctor may recommend a laxative or stool softener to take with certain medications or suggest an alternative medication.


Talk to Your Doctor about Persistent Constipation

Although lifestyle changes are the first line of treatment for constipation, sometimes, they are not enough. Your doctor may recommend further investigation to determine the underlying cause of your constipation, and may recommend pharmacological therapies to help decrease your symptoms.


If you you suffer from constipation and would like expert advice and help with dietary changes, we offer nutrition counseling services at Digestive Care Specialists. Schedule an appointment by calling 301-288-1319.