Are you struggling with constipation? Tired of being full of poop? This article will provide you with tried and true strategies for helping to get your bowels moving.
It’s a well-known fact that dietary fiber is a critical factor in gut health. The trillions of bacteria in our gut rely upon fiber for food, and fiber also helps add bulk to stool, promotes movement of waste material through the digestive tract, and acts as a scrub brush; eliminating harmful bacteria, excess cholesterol and other waste from the GI tract.
The recommended daily intake of dietary fiber for adults is 25-38 grams, though most Americans get less than half this amount most days. Increasing fiber intake and aiming for the higher end of the range (30g+) is one powerful way to alleviate constipation.
Suggestions For Fiber Intake
- Eat at least 3-5 cups of fruit and vegetables per day
- 4-6 half-cup servings of whole grains (such as whole wheat, oats, amaranth, teff, millet, corn or brown rice) per day
- 2-3 half-cup servings of legumes (e.g. beans, lentils, peas) per day
- And 1-2 small servings of nuts and seeds daily (e.g. chia seeds, flax seeds, sunflower seeds, pumpkin seeds).
Fiber and fluid often work hand in hand in the gut, turning insoluble fiber into a gel-like substance that increases stool bulk and eases its passage through the colon. Therefore, it’s important to get enough fluid in your daily diet, including beverages, soups and hydration-packed fruits and vegetables.
The daily fluid recommendation for women is 1.5-2.0 liters and 2.0-2.5 liters for men. Drinking more water than this won’t necessarily relieve constipation, as each type of constipation may have a different cause, but drinking less than the recommendation can certainly exacerbate it.
- Note: While fiber is generally a good thing for the gut, sometimes you may be eating too much fiber and find that your constipation is actually worsening. Too much insoluble fiber can actually increase constipation for individuals with chronic idiopathic constipation, therefore it’s important to work with your dietitian to identify if this may be the case for you.
You may want to read Fiber & IBS: What You Need To Know
There are a number of probiotic supplements that have been studied for their effectiveness in relieving constipation related to IBS. The US Probiotic Guide suggests the following probiotics and probiotic-rich foods specifically for constipation:
Other probiotics tested for effectiveness with IBS include:
- VSL #3
- Genestra Brands® HMF supplements
- Good Belly® products
- GNC Ultra Probiotic Complex
- Ideal Bowel Support®
- UltraFlora® Intensive Care
There are many other brands out there, so speak with your dietitian for a personalized recommendation.
Magnesium is a natural osmotic laxative and draws water into the bowel to help soften stool. Many dietitians, including myself, recommend a daily magnesium supplement of 400-800mg daily (or 1 teaspoon – 1 tablespoon of powdered magnesium) each day to relieve constipation. Start with a lower dose and increase as needed, as too much magnesium can cause loose stools. (Magnesium citrate is easy to find and can be used, although I do not have much of a preference).
Soluble fiber supplements are also great tools for addressing occasional or chronic constipation, especially for individuals who are following the low FODMAP diet and are eating less high fiber (note: supplements are not recommended during the Elimination Phase of the diet).
Fiber supplements such as acacia fiber, partially hydrolyzed guar gum, psyllium husk or wheat dextrin can be helpful in adding bulk to stool and easing bowel movements.
Some brand names recommended by GI dietitians include:
- Heather’s Tummy Care® Fiber
- Regular Girl (which is a Monash University Certified Low FODMAP product)
- Sunfiber® (which is a Monash University Certified Low FODMAP product)
These listed above are usually gentle on the gut and won’t cause gas and bloating. The general recommendation is to start with 1 teaspoon or caplet per day at bedtime and increase as needed. Again, make sure you are drinking sufficient fluid each day.
Eat Regular Meals
Our gastrointestinal (GI) tract has a regular pattern of digestion and “housecleaning” after each meal (aka the migrating motor complex), requiring about 3-4 hours to complete the cycle. Eating too frequently can interrupt this process and lead to constipation, so avoid grazing all day.
Instead, try eating three meals per day, with an occasional snack in between. In addition, smaller or liquid-based meals may not properly trigger the gastrocolic reflex, another important GI reflex, which triggers your colon to empty once new food arrives in your GI tract (allowing you to use the toilet shortly after eating), so eating a proper solid meal can also help.
Move Your Body
Regular physical activity is important to digestive health, as movement encourages the progression of food and waste along the GI tract.
A minimum of 30 minutes of brisk activity per day is recommended for all adults for general good health. Constipation sufferers may further benefit from high intensity exercise such as running or HIIT workouts, as these increase the blood flow to the colon and cause other changes to the gut that can help encourage passage of stool.
Be sure to read our entire IBS & Yoga Series!
In addition, yoga has been found to be very effective in aiding the release trapped gas and reducing constipation.
Finally, it’s also thought that regular endurance exercise (running, cycling, etc.) can lead to favorable changes in gut bacteria, reducing inflammation and improving overall gut health.
In a nutshell, any kind of exercise is good exercise. (As always, talk to your doctor before embarking upon an exercise program).
Be Sure To Read: How to Avoid Gastrointestinal Issues During Exercise
Change the Angle
Using a small foot stool or “squatty potty” during toileting can help ensure proper posture and an optimal angle for pooping without straining. There are dozens of options for purchasing these stools online and they can also be found in most pharmacies. If you feel uncomfortable about traveling with one or taking one to work, try to sit on the toilet with your “tippy toes” on the floor and heels up to simulate the same angle.
This video illustrates why changing your angle into a squat is so important.
Sometimes you’ve tried it all and nothing seems to work. What then?
On the pharmacological front, there are a number of medications that are prescribed for IBS-C and/or other forms of chronic constipation, including:
- Amitiza (lubiprostone)
- Bentyl dicycloverine)
- Levsin (hyoscyamine)
- Linzess (linaclotide)
- Motegrity (prucalopride)
- Trulance (plecanatide)
There are also over-the-counter osmotic and stimulant laxatives such as:
A number of low dose anti-depressants are also commonly used, including:
- Prozac (fluoxetine)
- Zoloft (sertraline)
- Norpramin (desipramine).
Talk with your doctor to see if one of these may be appropriate for your specific situation.
Be sure to read: Are You Full of Sh*t? Stool Burden and the Low FODMAP Diet
Other Causes of Constipation
In addition, while IBS-C is a common diagnosis, sometimes poop troubles stem from something else altogether, and you may want to explore these with your doctor if the previously mentioned strategies are not working.
- Pelvic floor dysfunction. This is an inability to properly contract and relax the muscles in the pelvic floor and may cause straining and trapped gas and stool.
- Methane-dominant SIBO (small intestinal bacterial overgrowth). A predominance of methane-producing bacteria in the small intestine have been linked to slow intestinal transit and constipation.
- Gastroparesis. This is a scenario where the nerves and the muscles of the upper GI tract are not properly firing, creating a very sluggish digestive tract.
Each of these conditions can lead to chronic constipation and will require a slightly different treatment plan in order to resolve the core issue and eliminate symptoms. Your healthcare team will help you navigate the best approach.
You don’t have to live with constant and debilitating constipation. Sometimes it’s trial and error, but the strategies mentioned above have been scientifically and clinically shown to work for many individuals.
It’s best to start slowly and trial medications or supplements one at a time, so you can see what works and what doesn’t, and you don’t create further digestive issues by over-doing it.
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