- Jan Clementson
Nutrition and Lifestyle Solutions for Constipation Relief
Introduction
Constipation is a common digestive issue that affects millions of people worldwide of all ages. It occurs when bowel movements become infrequent or difficult to pass and can lead to discomfort, bloating and abdomianl pain. While occasional bouts of constipation are generally harmless, chronic constipation can lead to more severe complications. Fortunately, many cases of constipation can be alleviated or prevented through simple changes in nutrition and lifestyle. In this blog, we will explore what constipation is, its common causes and provide practical nutrition and lifestyle recommendations that you can incorporate into your daily routine for effective constipation relief.
Constipation Statistics
The impact of constipation is far-reaching and shocking. Many treat it as a minor condition and not worth mentioning, whilst others are embarrassed to speak of it. Yet a 2017/2018 survey in England revealed the true extent of this problem, while NHS data translated these statistics into costs, which are stagerring. These figures and costs were projected to increase year-on-year.
People Affected by Constipation (2017-2018)
1 in 7 adults and 1 in 3 children
6.5 M people in England (approx)
Women twice as likely to suffer
Older adults 5 times as likely
NHS Data & Costs (2017-2018)
71,430 admitted to hospital with constipation (196 per day)
52,715 unplanned emergency admissions (144 per day)
£162 M spent by NHS on treatment
£91 M spent on prescriptive laxatives (not including OTCs)
£9 M on GP consultations (around 6 per day)
North/South divide - more hospital admissions in the North than the South
Understanding Constipation
The NHS advises that normal stool movement can be anywhere between 3 bowel movements per day to 3 bowel movements per week, depending upon what is normal for the individual. And defines constipation in the following bowel terms:
Bowel movement frequency - less than 3 times per week
Needing to strain to open bowels on more than 1/4 of occasions
Passing a hard or pellet-like stool on more than 1/4 occasions
However, a technical review by the American Gastroenterological Association expands that definition to other symptoms that can be characteristic of constipation, irrespective of frequency. These include:
Lumpy or hard stools
Straining to move stools
Blockage feeling in the rectum that prevents bowel movements
Emptying problems from the rectum
Having to press the abdomen to pass a stool
Circadian Rhythm Connection
Your circadian rhythm refers to your natural body rhythms governed by the 24-hour night-day cycle. More and more research is emerging into how this natural cycle affects our body's functions and mechanisms........and the gut is no exception. A recent 2020 review paper found that colonic motility follows a circadian pattern. The pattern is for elevated morning activity - with the bowel being primed for morning evacuation - increased daytime activity and reduced nocturnal activity. Dysregulation of this natural pattern has been linked to constipation, as well as other digestive conditions such as diarrhoea, abdominal pain, IBS.
This emergence of the gut natural circadian patterns points towards us requiring a stool movement every morning at the very least.......that is what we are being primed for. Hence, anything less than that could potentially be considered constipation. As waste products can be reabsorbed into the blood stream from the gut if they remain too long in the colon, then this would also add credence to the suggestion that you should be having a stool movement at least once per day, especially in the morning. However, our modern way of living has disconnected many of us from living fully in alignment with the day-night cycles.....and this can have an impact on our guts and lead to constipation.
Constipation Symptoms
Pain, bloating and discomfort are common symptoms. However, prolonged periods or chronic constipation can lead to additional complications, whilst certain other health conditions have been associated with constipation.
Complications
Haemorrhoids - straining can cause swelling of veins around the anus
Anal fissure - large hard stools can cause tears in the skin in the anus
Faecal impactions - hardened stools get stuck in the intestine, reducing stool movement
Rectal prolapse - straining can cause some of the rectum to stretch and protrude from the anus
Common Associated Conditions
Mechanical - anal fissure, diverticula, colon cancer
Metabolic - diabetes, hypothyroidism
Other - depression, joint disease, cognitive impairment
Medical Advice
If your symptoms don't go away or if you have any of the following symptoms seek medical advice:
Bleeding from the rectum
Blood in your stool
Persistent abdominal pain
Pain in the lower back
Feeling that gas is trapped
Vomiting
Fever
Unexplained weight loss
Sudden change in bowel movements
Gastro-Intestinal Tract Transit Time
It can take between 2-5 days for food eaten to transit your gastro-intestinal tract and emerge via stool defecation. The time varies between individuals, whilst women have a slower digestive system owing to their colon being located adjacent to their reproductive system. You can determine the speed of your GI tract very simply by eating some fresh sweetcorn (which is not digested very well) and seeing how long it takes before it emerges in your stool.
Common Causes of Constipation
Inadequate Fibre Intake - A diet low in fibre is one of the primary culprits behind constipation. Fibre adds bulk to the stool, softens it, and helps it pass through the digestive tract more easily. Insufficient intake of fruits, vegetables, whole grains, and legumes can contribute to constipation.
Dehydration - Lack of proper hydration can lead to dry and hard stools, making them difficult to pass. Water is essential for maintaining healthy digestion and preventing constipation. Drinking an adequate amount of fluids throughout the day is crucial.
Sedentary Lifestyle - Physical inactivity can slow down the natural contractions of the intestines, known as peristalsis. Regular exercise promotes healthy digestion and helps prevent constipation.
Ignoring the Urge - Ignoring the urge to have a bowel movement can disrupt the natural rhythm of the digestive system and lead to constipation. It's important to listen to your body's signals and respond promptly.
Disrupted Circadian Patterns - Gut function and stool movement is governed by the natural 24-hour body clock of the day-night cycles. Travel, changes to routines and sleep disturbances disrupt these patterns.
Gut Dysbiosis - Alterations of gut microflora are common with constipation. Often, there is significantly different gut bacteria composition with higher levels of methane producing bacteria which slows down intestinal transit time.
Medication Side-Effects - Some medications are known to cause constipation such as iron supplements, antacids, ibuprofen, diuretics, overuse of laxatives, anti-depressants, blood pressure and pain medications.
Food Intolerances - This is often overlooked. Common food intolerances include dairy, eggs, yeast, wheat, gluten, soya and peanuts.
Nutrition Solutions
Fibre Intake - One of the most effective ways to combat constipation is to consume an adequate amount of dietary fibre. Fibre adds bulk to the stool, making it easier to pass. Include fibre-rich foods such as fruits, vegetables, whole grains, legumes, and nuts in your diet. Aim for at least 25-30 grams of fibre per day or half of your food plate to include these foods.
Hydration - is KEY - dehydration can contribute to constipation, so it's crucial to drink enough water throughout the day. Aim for at least 1.5-2.0 L of water or other hydrating fluids. Herbal teas and fresh fruit or vegetable juices can also be beneficial; as can high-water content food such as watermelon, cucumbers and soups.
Specific HIgh-Fibre Fruits and Vegetables - Certain fruits and vegetables have higher fiber content and can aid in relieving constipation. Opt for choices like berries, prunes, pears, apples, broccoli, spinach, Brussels sprouts, and avocados. These can provide both soluble and insoluble fiber, promoting healthy digestion.
Whole Grains - Replace refined grains with whole grains like brown rice, quinoa, whole wheat bread, and oats. These grains are higher in fibre and can aid in regulating bowel movements.
Healthy Fats - Include sources of healthy fats in your diet, such as avocados, nuts, seeds, and olive oil. They help lubricate the intestines and promote smooth bowel movements.
Natural Laxatives - Prunes, pears, apples and their juices contain a type of fibre called sorbitol, which helps soften the stool. Kiwi fruit, papaya and figs contain specific enzymes that help to break down foods and improve digestion.
Magnesium Rich Foods - Provide a laxative and osmotic effect by helping to retain water in the colon. These include nuts, seeds, dark green leafy vegetables, legumes, fatty fish, avocado and bananas.
Live Cultures - Include fermented foods and drinks such as sauerkraut, kimchi, kefir, kombucha. These provide probiotic beneficial bacteria to help rebalance the gut microflora.
Foods To Reduce - Processed foods (lack fibre); fried foods (trans-fats generated with frying slows down transit time and clogs up digestion); alcohol (increases urine production and fluid loss); caffeine (problematic for some).
Food Intolerances - If you are unsure which foods may be problematic for you, take a home finger-prick test such as the YorkTest Premium Food Intolerance Test. Use the code: PENERGY for a £5 discount.
Lifestyle Solutions
Regular Exercise - Physical activity stimulates the muscles in your intestines, promoting bowel movements. Engage in moderate exercise such as walking, jogging, cycling, or yoga for at least 30 minutes a day.
Establish a Routine - Try to establish a regular bowel movement routine by visiting the toilet at the same time every day. This helps train your body to anticipate and respond to the urge to eliminate waste.
Avoid Holding Back - When you feel the urge to have a bowel movement, don't delay or ignore it. Ignoring the body's signals can lead to more constipation and disruption in the natural digestive process.
Manage Stress - High levels of stress can disrupt digestive processes, including bowel movements. Practice stress management techniques like deep breathing, meditation, or engaging in hobbies that help you relax.
Avoid Laxative Dependence - While laxatives can provide short-term relief, prolonged use can lead to dependence and further constipation. Consult a healthcare professional before using laxatives and rely on them as a last resort.
Practice Mindful Eating - Chew your food thoroughly and eat at a relaxed pace. Mindful eating promotes better digestion and allows the body to process food efficiently.
Body-Clock Reset - Get outside into the sunlight morning and lunchtime. Avoid blue light at night from electronic devices by switching to night-time settings and avoiding watching TV 30 minutes before bed. Go to bed by 10.30 pm most nights.
Toilet Posture - Use a squatty potty or foot stool to elevate your knees whilst sitting on the toilet. This tips the angle of your rectum to downwards facing rather than upwards tilting when sitting.
Pelvic Floor Exercises - Strengthening your pelvic floor muscles with specific exercises can help improve defecation.
Consider Nutrition Supplements - Magnesium (300-400 mg) and Vitamin C (1,000-2,000 mg) can both help with stool movement. Use a good quality brand such as Viridian, Cytoplan or Pure Encapsualtions. Good quality supplements can be obtianed from Natural Dispensary. Use code: JCL10 for a 10% discount. Consult your doctor before taking any supplements
Conclusion
Constipation can be a frustrating and uncomfortable condition that can significantly impact the quality of your life. But with the right nutrition and lifestyle changes, you can find relief. Incorporate some of the recommendations provided including high-fibre foods, increased hydration, regular physical activity, and better management of stress. Be patient with the changes that you make, as it can take time for your body to adjust. If your constipation persists or becomes severe, consult a healthcare professional for further guidance. Take charge of your digestive health and enjoy a life free from the discomfort of constipation.
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