 This week I wanted to focus on constipation. This is unfortunately one of the most common gut disorders that I see in my practice. But it is also one that some people think that they have when in fact they don’t. As mentioned last week, our transit times, or the time that our bodies take to pass a meal that we have eaten can vary from 18 – 72 hours. So, if you don’t have a bowel movement everyday, it’s OK. But if you have less than 3 bowel movements per week, we need to talk. Also, we need to consider the consistency of the stool, i.e. are they soft, mushy pieces, one whole piece or small, hard and pellet-like? I linked the Bristol Stool chart to last week’s article and will do it again here, so you can get a visual and a better idea of what I am talking about. So, if your bowel movements are hard, dry and/or lumpy, we need to talk. And then we need to as if you need to force at all to pass this stool. If you are able to relax your muscles and allow the stool to pass, then this is what we are looking for. But if you feel the need to have to push and are feeling that you haven’t evacuated everything then keep reading :)
There are many possible reasons for suffering from constipation. It could be a transit time that is too slow, pelvic floor disorders causing delayed emptying or even functional gut disorders like IBS. Other causes could be certain medications or dietary supplements. A change if your life or even daily routines like travel or aging can cause it. Or even certain health and nutritional problems can be the culprit whether it could be a change in hormones or dietary intake. With all of these possible causes it’s no wonder that 1 in 61 people suffer from constipation (US data). If you are wondering if you are in fact suffering from constipation, please don’t wait, go talk to your doctor and get yourself checked out. I know it may not seem like something that would require your doctor’s attention, but let me tell you that it does. Why? They can test to see if there is an underlying condition that may be the cause of the constipation, especially if you’ve already tried some of the strategies I will list below. So, let’s focus on some things that we can actually control! Getting more fibre! Did you know that it’s recommended to get 25-31 grams of fibre per day? And that men can need up to 40? Most people do not reach the minimum of 25 g/day. Fibre can help soften the stools and can make them easier to pass. Great sources of fibre are whole grains, oats, bran, legumes, fruit likes berries, pears and apples with the skin, veggies like green peas, collards and carrots and nuts/seeds. There are some foods that are known to help with bowel movements more than others. I.e. prunes/prune juice, ground flax seeds, oats, bran and psyllium husk fibres. If you are going to add more fibre into your diet, it is recommended to do it slowly and ensure that you have adequate hydration. Meaning are you drinking enough water? The amount of water you need will depend on your age, sex and activity level. Talk to a dietitian to get help on these items. Are you getting any exercise? Being active doesn’t have to mean running marathons but it has shown that getting regular physical activity can relieve the symptoms of constipation. Consider bowel training. What’s this? Training your body to have a bowel movement at the same time daily. As an example, sitting on the toilet about 30 minutes after a meal might do the trick! Did you know that eating stimulates peristalsis (the movement of the intestinal muscles)? The trick is to make sure that you give yourself enough time to do this, in order to allow the body to relax. Also, if you have a hard time having your feet on the ground while you are on the toilet, you might want to put your feet on a footstool to be more comfortable. If it’s your muscles that are the issue with having a regular bowel movement, then it would be recommended to see your doctor and/or a pelvic floor physiotherapist. There are over the counter medicines, such as laxatives. They are generally recommended for the short term only and please consult a healthcare professional prior to choosing one. There are also medications that a doctor can prescribe if there really isn’t a solution. Don’t be afraid to talk about constipation to a healthcare provider, as you can see there are many solutions that we can try to help you with. The downside of not finding relief is being uncomfortable, in pain, bloated and frustrated. So let’s talk about your poo! What are some of your constipation prevention/relief tricks?
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 This is something I actually hope to hear from clients who have complained about irregular bowel movements; whether it is diarrhea or constipation. Or both! For the next three weeks I will be talking about bowel movements, what’s “normal”/ “abnormal” and to get you, I, and everyone to start talking about bowel movements! Why? Too often, if we have a problem, err, down there, we are too embarrassed to talk about it or assume that that’s “normal” and try to forget about it. When in fact, you are uncomfortable and embarrassed. Why not start talking about it? We all poop, so wouldn’t it be great if we could all have “normal” poo? :)
What do I mean when I say “normal”? Also, what’s with all the air quotes?? Well, it’s because we all have our own version or a normal bowel movement. How often you can have a bowel movement ranges quite a lot. Most people think that we “should” have one at least daily. Well, let me bust this myth! It can be as much as three times per day to as little as once every 3 days or more!! Also, the transit time (the time it takes your food to pass from your mouth to your anus) also varies. This can range from 18 to 72 hours. This means your supper meal tonight could stay in your system for 3 days before being excreted. Is that bad? Not necessarily. But what we do know is that a diet that’s higher in fruits, vegetables and whole grains tend to have a positive effect; meaning more frequent bowel movements and a faster transit time. Did you know that your poo generally consists of 75% water?? Most people that come into my office who complain about being constipated on average only drink about 1 litre of water per day. By reviewing the importance of adding even just half a litre (500 mL) a day of water, they can see a benefit in the frequency and consistency of their bowel movements. (Sometimes we need to add more than just 500 mL). So, if you are feeling a little constipated, take a quick look at your fluid intake and add 1-2 more cups per day (to start). We talked about the frequency, now what about color and consistency? The typical color of a bowel movement is a medium brown – not too light and not too dark. We don’t want to see other colors either, therefore no yellow, orange, silver (yes I said silver), red (unless you’ve just eaten beets) nor black. A green tinge may happen if you’ve eaten something that really didn’t agree with you. If these colors remain, consider seeking some professional help. Have you ever heard of the Bristol Stool Chart? This is the best way to see what a “normal” poo should look like. The closer you are at either end of the chart, the less “normal” your poo is. Ideally, we are aiming for a nice banana-like poo! Now, I’m not suggesting to bend down and do a full examination of your poo, just take a quick glance before you flush. There are many factors that can affect your digestion, from your probiotic makeup, psychological factors like the appearance, smell and taste of foods to our emotional state (.e. fear, stress, anxiety, worry). If you are feel that your bowel movements are a little “abnormal” and you feel that your diet is balanced and active enough, consider looking at the other factors. Consulting with a Dietitian can definitely help you along the way too! Next week, I’ll be addressing constipation and we will finish our discussion with diarrhea/loose bowel movements. If you have any questions about this topic, I would LOVE to hear them!! |