No one wants to talk about constipation, but just about everyone has to deal with it at some point. Remedies for constipation vary, but most of us would rather resolve it without the use of medications.
Constipation, usually defined as having fewer than three bowel movements in a week, may be linked to diet and hydration issues, or to an underlying medical condition.
“For most people, eating a wide variety of high-fiber plant foods, exercising, and drinking plenty of water will help with constipation,” says Colleen Webb, RDN, CDN, a registered dietitian at Weill Cornell’s Jill Roberts Center for Inflammatory Bowel Disease. “However, there are situations when these interventions are not enough, and additional dietary modifications or a more thorough evaluation are required.”
QUICK TIPS: REMEDIES FOR CONSTIPATION
- The so-called “BRAT diet”—bananas, rice, applesauce and toast—is often prescribed to help relieve diarrhea, but it may have the unintended result of causing constipation. Be careful not to overdo it.
- Unexplained weight loss, rectal bleeding, increased fatigue, nausea and vomiting, appetite loss, and abdominal pain should prompt an immediate visit to your doctor.
- Chronic constipation can lead to hemorrhoids, tearing of the skin in the anus, and rectal prolapse (a protrusion of rectal tissue through the anus).
Constipation: Dietary Causes
Constipation may be the result of your eating habits. “The typical ‘Western’ diet is full of animal products and highly processed foods, and lacks nourishing high-fiber foods,” Webb says. “Animal fats and proteins, especially in dairy foods, are common triggers for constipation.”
Poor hydration is another common cause of constipation. While every person has his or her own specific water needs, Webb says the average woman should try for at least 64 ounces of water a day unless otherwise instructed by her doctor.
Focus on Fiber
A balanced diet rich in fruits, vegetables, legumes, nuts, seeds, beans, and whole grains can lead to healthy bowel movements. Consuming enough dietary fiber can be especially helpful in preventing constipation or reducing its symptoms.
There are two types of dietary fiber. Soluble fiber (found in foods such as fruits, oats, barley, and legumes) allows more water to remain in the stool, which makes it softer and easier to pass. Insoluble fiber (found in wheat, rye, and other grains) does not dissolve in water. This type of fiber adds bulk to the stool, which also makes it easier to pass.
One caveat: You must drink a lot of water if you eat a lot of insoluble fiber. “By bulking up the stool without drinking water, the stool will remain in the colon, and you’ll feel more constipated and bloated,” says Meira Abramowitz, MD, also with the Jill Roberts Center for Inflammatory Bowel Disease, at Weill Cornell.
How Much Fiber?
For the average, healthy women over age 50, Webb recommends consuming at least 25 grams of fiber daily. While some processed foods, such as cereals and granola bars, are touted for being high in fiber, Webb says they are not as effective at combating constipation as the fiber in whole foods, including fruits, vegetables, beans, and lentils.
“Many plant foods, including dark, leafy greens, stone fruits, and sweet potatoes, also contain magnesium or other osmotic carbohydrates that help with constipation,” says Webb.
However, there are exceptions: Webb notes that certain gastrointestinal conditions, such as diverticulitis, previous abdominal surgery, or irritable bowel syndrome, might require a low-fiber diet. If you have any of these conditions, talk with your doctor about the dietary fiber regimen that’s best for you.
If more water and fiber in your diet don’t do the trick, Dr. Abramowitz says that some over-the-counter (OTC) remedies may be helpful, but they should be used only for a few days.
“There are some high-fiber supplements, such as psyllium husk, that can be tried,” advises Dr. Abramowitz. “If your constipation does not improve after using psyllium husk, try OTC osmotic laxatives, such as polyethylene glycol (Miralax), or stimulant laxatives, such as senna or bisacodyl (Dulcolax, Correctol). If your constipation does not improve after a short period of using OTC laxatives, you need to see a physician for evaluation.”
Underlying Causes of Constipation
If changing your diet and taking laxatives don’t alleviate your constipation, you and your doctor may have to do some detective work to find out what’s wrong.
Constipation can be a symptom of low thyroid function (hypothyroidism) or high calcium levels in the bloodstream (hypercalcemia). Dr. Abramowitz says your physician should check for both conditions with blood tests and physical examinations.
“You also need to be on the lookout for alarm signs or symptoms of possible colon cancer that may masquerade as constipation; these include unintentional weight loss, rectal bleeding, and anemia,” explains Dr. Abramowitz.