Do you suffer from constipation? Find out how nutritional therapy may help

What do we mean by constipation?

Constipation: Infrequent and frequently incomplete bowel movements. (1)

Well if you suffer from bloating, hard stools, bowel movements that are few and far between (i.e. stools are not passed every day), and you experience pain on passing, then you will probably be well aware that you suffer from constipation.

Why do we suffer?

Often we just don't drink enough liquid, and by liquid we mean water, which helps to keep the matter soft and moving along the gut.

Do we eat enough fibre?

Fibre is vital for our bowels, both soluble and insoluble. If you do suffer, don't go into overload on fibre, especially if it is not part of your normal diet; increase gradually instead. Let's be kind to our gut and not send it into shock.

Soluble fibre, as we all know, is to be found in fruit and vegetables, wholewheat grains, nuts and pulses. We require soluble fibre to maintain healthy cholesterol levels and maintain steady blood glucose. It does this by turning to a gloop like substance which slows down digestion.

Insoluble fibre passes through our bodies, relatively unchanged, and helps to sweep up debris in the colon. It is also found in whole grains, beans and pulses, and many of the same foods as soluble fibre. Most fruit and vegetables contain both. (1a)

How much fibre is enough?

The current RDA is 30g for an adult; this coincides with an increase in the recommended increase in daily servings of fruit and vegetables, increasing to 10 a day for a man and seven to eight for a woman. Of these, it is advised that only two to three are fruit, and if you are pre-diabetic or diabetic this should be no more than one or two portions, preferably berries, due to their low glycemic load.

So are you getting enough fibre?

The average UK male adult consumes 20g of fibre a day, with females consuming around 17g - both way off the 30g recommendation. (2) An average sized orange contains 3.1g of fibre, a 100g portion of cauliflower is between 1.6g, kale has 3.1g per 100g and raspberries knock them all out of range with 6.5g, so it is hard to gauge your intake. (3)

As you will see from the examples above, you need to consume your eight portions of vegetables a day to make the target of 30g in combination with the welcome addition of nuts, seeds, whole grain breads, cereals, beans and lentils which all contain decent amounts of fibre to boost your intake.

Exercise for constipation

Regular exercise and frequent movement are both vitally important to maintain a healthy lifestyle and a state of equilibrium. Without exercise our bodies become sluggish, and this reflects in the state of our gut and the length of our digestion process. (4) Whilst we do not want to be experiencing bowel movements as a matter of urgency, where food is passing straight through without nutrients being absorbed, neither do we want the process to be long and slow, leading to stagnation and blockages. (5)

How long does it take for digestion to process?

All foods break down at different rates, moving through the stomach to the small intestine and onto the colon at their own rate. The Sunday dinner of roast potatoes, cabbage and chicken you enjoyed at 1pm will not arrive in the colon at the same time. (6)

The average duration is shown below, however we are all individuals and eat a variety of foods, so transit times vary. However, a good way to check is to eat a tablespoon of sweetcorn and note the length of transit time. The husk of sweetcorn is made of cellulose and is indigestible for us humans. (6a)

• 50% of stomach contents emptied in two and a half to three hours.
• Total emptying of the stomach in four to five hours.
• 50% emptying of the small intestine in two and a half to three hours.
• Transit through the colon in 30 to 40 hours. (7)

What can you do to relieve your symptoms?

• Eat more fibre. (8)
• Drink more water - eight glasses a day. (9)
• Exercise regularly. (10)
• Add flaxseed to your food - start with a small amount and increase, to avoid diarrhoea. It provides bulk and softness. (11)
• Supplement with magnesium, which is necessary for relaxation of muscles. Again this may cause diarrhoea if taken in too large doses. (12)
• Slippery elm (13) or psyllium husk. (13a)
• Add prunes to your diet. (14)
• Reduce processed foods.
• Develop good bathroom habits, do not ignore your body and resist the urge.
• Start the day with warm water and lemon to kickstart your digestive system. (15)

Please do not introduce all of these options at once, but gradually add one change at a time and note how you feel.

Speak to your medical practitioner/nutritional therapist or health shop adviser for guidance.

If on medication, please speak to your GP/consultant before making any changes to your diet. Please note that magnesium interacts with certain medications.

This article is purely for information purposes and should not be taken as medical advice.

References

1) https://www.medicinenet.com/script/main/art.asp?articlekey=2829
1a) https://www.nutrition.org.uk/healthyliving/basics/fibre.html
2) https://www.nutrition.org.uk/healthyliving/basics/fibre.html
3) https://www.prebiotin.com/prebiotin-academy/fiber-content-of-foods/
4)https://www.hopkinsmedicine.org/healthlibrary/conditions/digestive_disorders/constipation_85,P00363https://www.hopkinsmedicine.org/healthlibrary/conditions/digestive_disorders/constipation_85,P00363
5) https://bdsra.org/wp-content/uploads/2012/01/gi-system.pdf
6) Degen LP and Phillips SF. Variability of gastrointestinal transit in healthy women and men. Gut 39:299, 1996. (6) Metcalf AM, Phillips SF, Zinsmeister AR, etc. Simplified assessment of segmental colonic transit. Gastroenterology 92:40, 1987.
6a) http://www.sciencefocus.com/qa/why-sweet-corn-not-digested
(7) Proano M, Camilleri M, Phillips SF, etc. Transit of solids through the human colon: regional quantification in the unprepared bowel. Am J Physiol Gastrointest Liver Physiol 258:856, 1990.
(8) Abdullah, M. M. H., Gyles, C. L., Marinangeli, C. P. F., Carlberg, J. G., & Jones, P. J. H. (2015). Dietary fibre intakes and reduction in functional constipation rates among Canadian adults: a cost-of-illness analysis. Food & Nutrition Research, 59, 10.3402/fnr.v59.28646. http://doi.org/10.3402/fnr.v59.28646
9) WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on November 27, 2017
10) Huang, R., Ho, S.-Y., Lo, W.-S., & Lam, T.-H. (2014). Physical Activity and Constipation in Hong Kong Adolescents. PLoS ONE, 9(2), e90193. http://doi.org/10.1371/journal.pone.0090193
11) J Ethnopharmacol. 2015 Jul 1;169:60-8. doi: 10.1016/j.jep.2015.03.064. Epub 2015 Apr 15. Dual effectiveness of Flaxseed in constipation and diarrhea: Possible mechanism. Hanif Palla A1, Gilani AH2.
12) Gröber, U., Schmidt, J., & Kisters, K. (2015). Magnesium in Prevention and Therapy. Nutrients, 7(9), 8199–8226. http://doi.org/10.3390/nu7095388
13) Kines, K., & Krupczak, T. (2016). Nutritional Interventions for Gastroesophageal Reflux, Irritable Bowel Syndrome, and Hypochlorhydria: A Case Report. Integrative Medicine: A Clinician’s Journal, 15(4), 49–53.
13a) Erdogan, A., Rao, S., Thiruvaiyaru, D., Lee, Y. Y., Adame, E. C., Valestin, J., & O’Banion, M. (2016). RANDOMIZED CLINICAL TRIAL: SOLUBLE/INSOLUBLE FIBER OR PSYLLIUM FOR CHRONIC CONSTIPATION. Alimentary Pharmacology & Therapeutics, 44(1), 35–44. http://doi.org/10.1111/apt.13647
14) Mehdi Pasalar, Maryam Mosaffa-Jahromi and Kamran B Lankarani, Toward Food Therapy for Irritable Bowel Syndrome, The American Journal of Gastroenterology, 111, 10, (1499), (2016).
15) “What Are The Side Effects of Drinking Lemon Juice?” Master Cleanse; http://lemonmastercleanse.com/what-are-the-side-effects-of-lemon-juice/