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Constipation
- By Sharon Erdrich
- Digestive Health
What do you think of when you hear the word constipation? The symptoms are a lot broader than you may think. It’s not always struggling to pass a bowel movement, or spending a long time sitting on the toilet! Constipation can also mean infrequent bowel movements. What are the common causes of constipation? And which are possibly causing your issues?
Read on to find out what may be causing your toilet troubles and how to help them.
Symptoms of Constipation
The symptoms for constipation may be a lot broader than you think. Here are the most common symptoms you may experience.
- Abdominal discomfort, pain and bloating. Your clothes are not fitting as well as usual (beyond body fat issues!). You possibly feel better after passing stool or gas.
- Rectal discomfort. Do you get bleeding from pushing too hard? Or pain or a burning sensation in the anal area?
- Infrequent bowel movements. Ideally you should have a bowel motion every day. Less than this suggests a possible problem.*
- Hard stools – see the Bristol Stool Chart to grade your stool. Number 4 is considered the “perfect poop”. If you’re routinely number 1-3, this indicates sluggish digestion.
- Sensory dysfunction. This means not having the urge to go or a sense of incomplete evacuation.
- Flatulence
- Overly noisy or unsociably smelly gas.
- Diarrhoea/loose stool (number 5-6 on the Bristol Stool Chart). While this seems to suggest the opposite problem, it can indicate what’s known as “retention” (severe constipation) with overflow. That happens when loose faecal material slips around the edges of hard stool.
- Faecal incontinence or uncontrolled leakage
Could Lack of Fibre be my Problem?
Eating more fibre is often the advice given to constipation sufferers. This is because fibre adds bulk to your stool and is fermented by bacteria in your colon. There are two types of fibre, commonly called Soluble and Insoluble. Soluble fibre absorbs liquid and forms a gel that keeps poo from breaking apart in pieces. On the other hand, the insoluble sort acts as roughage, stimIf you are getting enough fibre in your diet your stool will be soft and come out easily. If you are not, your stool may be difficult to pass, hard and small.
Soluble fibre comes from oats, nuts, beans/legumes, apples, ground flaxseed, chia seeds and blueberries. Both flax and chia seeds are an excellent source of soluble fibre, but they need to be soaked before eating (and ground if you want to get the benefit of their omega-3 content).
Insoluble fibre is high in wholegrains (think wheat bran), but also in brown rice and the skins of fruits and vegetables.
In our clinic we often see people who’s symptoms have worsened when they increased the fibre in their diet. If this has happened to you, it is a major clue that you may have small intestinal bacterial overgrowth (SIBO).
Drink your Fluids
Have you been paying attention to how much water and fluids you are getting every day? Your stool form is directly influenced by how much water you drink, as water and fibre work together to make stool easy to pass. The main job of the large intestine (colon) is to reabsorb water – this is a mechanism that helps protect against dehydration, so keep yourself well hydrated (1.5-2L, or 6-8 glasses of water daily) to ensure your body has enough fluid.
But fluids don’t necessarily mean drinking gallons of water as you do get some water from other sources like fruit, vegetables and soups. To optimise the
health benefits of the water you are drinking you can make your own hydrogen water at home using a hydrogen generator. Learn more about the benefits of hydrogen water here.
Medications
Some medications can cause constipation. If you are on any of the following then they could be playing a part in your problem:
- Antacids (acid blockers)
- Antidepressants
- Calcium channel blockers (for blood pressure)
- Diuretics (for blood pressure – sometimes called “water pills”)
- Iron supplements
- Some pain medications, such as Tramadol, Panadeine, Codeine, and others.
- Parkinson’s disease medication
Lifestyle
Is your lifestyle somewhat sedentary? Sitting for long periods can cause constipation. Spending hours at your desk hunched over your keyboard can also slow down the digestive process. Try to get up and move around at least every hour at work. Get out during breaks and take a brisk walk. If you can switch to “active transport” to get yourself to and from work and other places, this will be of enormous benefit.
Not obeying the call of nature can worsen constipation. It is very important to make time to go to the bathroom when you feel the urge. Don’t ignore what your body is trying to do!
Certain Health Conditions
Although symptoms related to constipation are often due to a lack of fibre or fluids, in some cases it can be associated with other health challenges. Some conditions that can cause constipation are:
- Depression
- Hypothyroidism
- Inflammatory bowel disease
- Metabolic syndrome and Diabetes
- Irritable bowel syndrome (IBS)
- Neurological conditions, such as stroke, Multiple sclerosis, Parkinson’s disease
- Uterine fibroids
- Pregnancy
- Bowel cancer
- SIBO, or simply a high growth of methane-producing bacteria in the gut. (We measure methane when you do a breath test)
- Hypermobility disorders
Nutrition & a Natural Medicines Approach to Help Constipation
Make an appointment to see one of our clinicians if you are experiencing chronic constipation. At the initial appointment, we’ll gather a full history regarding your health, lifestyle, digestive function and diet to inform a customised approach to address underlying factors and get you moving again.
If you are experiencing symptoms of constipation please get in touch with one of our team.
* While in medical circles, pooping once every third day is considered adequate, it is certainly not optimal. The longer faecal material sits in the intestines, the more likely you are to have other problems.
Chronic constipation. A review of literature. Medicine 97(20):p e10631, May 2018.
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References
- Pare P, et al. An epidemiological survey of constipation in Canada: definitions, rates, demographics, and predictors of health care seeking. Am J Gastroenterol. 2001 Nov;96(11):3130-7. PMID: 11721760.
- Constipation in children and young people: diagnosis and management. London: National Institute for Health and Care Excellence (NICE); 2017 Jul. PMID: 32200591.
- Talley NJ, Lasch KL, Baum CL. A gap in our understanding: chronic constipation and its comorbid conditions. Clin Gastroenterol Hepatol. 2009 Jan;7(1):9-19. doi: 10.1016/j.cgh.2008.07.005.
- What are the symptoms of constipation? (2018) https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/symptoms-causes
- Takakura W, Pimentel M. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome – An Update. Front Psychiatry. 2020 Jul 10;11:664. PMID: 32754068
- Johanson JF, Sonnenberg A, Koch TR. Clinical epidemiology of chronic constipation. J Clin Gastroenterol. 1989 Oct;11(5):525-36. PMID: 2551954
- Rao SSC, Brenner DM. Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review. Am J Gastroenterol. 2021 Jun 1;116(6):1156-1181. PMID: 33767108
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