A Closer Look
Occasional constipation is a common problem among adults that is easily treated. However, chronic constipation affects nearly 60 million Americans; especially females and individuals over age 65.
Constipation is usually the result of solid waste moving too slowly through the intestines causing dry and hard bowel movements.
Waste products are moved through the digestive system by rhythmic muscle contractions of the intestines. The large intestine, or colon, is responsible for reabsorbing water and salt from the waste material back into the body since these are essential nutrients. Most constipation is the result of a few factors:
- lack of fiber in the diet;
- lack of physical activity;
- ignoring the urge to have a bowel movement;
- changes in lifestyle or routine such as pregnancy, aging and/or travel;
- lack of adequate daily water intake
When there is not enough fluid or fiber in our diet the intestinal movement slows allowing the stool to dry and harden.
What is “normal”?
The frequency for normal bowel movements ranges from 3 per day to 3 per week. Normal does not necessarily mean having a daily bowel movement. Normal bowel movements are a soft consistency, pass from the body with little straining, leaving a sensation of complete emptying of the bowel.
What is constipation?
Constipation is defined as having a decrease in the frequency of regular (normal for you) bowel movements.
Generally this is fewer than 3 bowel movements a week, and/or bowel movements that are a hard consistency, dry or pebble like, require increased straining to empty the bowel, having a sensation of incomplete emptying of the bowel.
Constipation is considered chronic when these symptoms persist for 3 months or more.
What treatments are effective?
Occasional constipation can be treated with:
- bulk-forming agents such as psyllium (Metamucil®);
- stool softeners such as Colace®;
- laxatives such as senna, and milk of magnesia;
- dietary additions such as dried fruit and nuts.
Chronic constipation is best treated with psyllium, not other over the counter laxatives, according to recent, good evidence based studies. Psyllium improves the consistency and frequency of bowel movement in the treatment of constipation however, these supplements are often inconvenient, and many individuals dislike the taste and /or texture of liquid products. Additionally, some individuals are bothered by gas and/or bloating with fiber supplements and will discontinue use.
A healthy, natural alternative to psyllium is dried plums or apricots. Dried fruit provides a flavorful, nutritious, convenient, food-based treatment for chronic constipation. Dried fruits are a good source of fiber which adds bulk to the digestive contents, stimulating the regular rhythmic contractions of the intestines. These dried fruits should be eaten daily, not just when constipation gets worse.
Researchers compared the effectiveness of psyllium and dried plums for treating chronic constipation. All study participants had symptoms of chronic constipation for an average of 2 years. Participants were randomly assigned to a psyllium group or dried plum group. Both groups received 6 grams daily fiber in their treatment: 6 plums twice daily, or 1 tablespoon of psyllium daily.
After 3 weeks of treatment the group participants switched to the opposite treatment.
Participants kept a record of bowel movements during each treatment type.
The results showed significant improvement in bowel movements with dried plums when compared with psyllium.
Take Home Message
|Go naturally. Daily dried fruit as a part of a healthy diet will improve chronic constipation, along with increased water and exercise.|
Discuss your bowel movement patterns with your health care provider. Chronic constipation can also be a sign of other medical problems including:
- irritable bowel syndrome;
- specific diseases, such as stroke, diabetes, thyroid disease and Parkinson’s disease;
- problems with the colon and rectum, such as intestinal obstruction, diverticulosis, or cancer;
- frequent use or misuse of laxatives;
- certain medications, including pain medications, diuretics and medications used to treat high blood pressure and depression;
- injuries to the spinal cord.
Incorporate these lifestyle changes to improve and maintain healthy bowel function.
- A high-fiber diet. The American Dietetic Association recommends a diet with at least 20 to 35 grams of fiber each day (the typical American eats 5-14 grams of fiber per day). Fiber helps your body form soft, bulky bowel movements. High-fiber foods include beans, whole grains, and fresh fruits and vegetables. Adding flax seed or flax seed oil capsules, or a serving of 10-12 nuts a day will add lubrication to the bowel with helps constipation. Limit foods that have little to no fiber, such as cheese, meat, high sugar content foods, and processed foods.
- Regular exercise. Physical activity can help stimulate intestinal activity and improve the strength and function of pelvic floor muscles. Sometimes constipation is caused by poor muscle tone in the pelvic floor muscles. These muscles are used when having a bowel movement. Weak pelvic floor muscles can result in excessive straining even for a soft bowel movement.
- Adequate fluid intake. Increase water intake to at least 64-72 ounces of water daily (8-9 glasses per day).Drinking plenty of water and other fluids will help soften your stool.
- Take the time for bowel movements. Set aside sufficient time to allow undisturbed visits to the toilet. And don’t ignore the urge to have a bowel movement.
(Oh, by the way, dried plums are commonly known as prunesJ!)
For more information on chronic constipation visit the National Institute of Health website at: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/
Healthwise Knowledgebase at: www.healthwise.msu.edu – enter “constipation” into the search box.
“Recipe for Health” from MSU – check this link for a tasty high fiber oatmeal recipe: http://health4u.msu.edu/_pdfs/rfh/2011/rfhApril.pdf
More easy delicious recipes for health are available at health4u.msu.edu/ located under the “Online Health Resources” heading.