But it shouldn’t be. And this month, our Sussex health expert gets to grips with constipation. Constipation is one of the most common presenting ailments and is characterised by a difficulty passing stools or an absence of the urge to eliminate the bowel. Stools, when passed, tend to be hard, knotted and dark. Other symptoms that accompany constipation include bloating, appetite loss and mild nausea or indigestion. Repeated straining to defecate eventually leads to haemorrhoids.
Chronic constipation has constitutional implications because toxins are formed and absorbed when waste remains in the intestines for excessive periods. Headaches, bad breath and skin problems can result and increase the susceptibility for intestinal cancer. Waste should be eliminated through the bowels on a regular basis, usually once or more per day. If you experience constipation along with other abnormalities, including blood in the stool, weight loss or pain, always consult your medical practitioner for further diagnostic evaluation.
Causes
- Constipation occurs when waste passes through the intestines too slowly. A healthy colon eliminates waste in 6-18 hours. The underlying cause is often as simple as a low-fibre, high-sugar diet, which causes the muscles in the gut to become sluggish. Too much refined flour, rice and pasta – which have been stripped of their fibre and nutrients – can cause constipation. The consumption of cow’s milk is a common cause of hard, dry stools, especially in children. High stress levels also contribute to constipation. Also, inadequate intake of liquids, especially water, will slow the movement of waste through the gut.
- Laxatives compound the problem because the constant stimulation of the bowels interferes with the body’s natural functions. An imbalance of intestinal flora in the bowels is also a contributing factor.
- Magnesium deficiency will also lead to constipation. Magnesium is the central element of chlorophyll and is found in all greens.
- Likewise, a deficiency of folic acid may lead to chronic constipation. Folic acid is also abundant in green leafy vegetables.
- Lack of physical activity also plays a role. Physical fitness optimises circulation to the bowel as well as other vital organs.
- A number of medications cause constipation, including iron pills, antacids, diuretics, painkillers and antidepressants. Many pregnant women must combat constipation, which can be further aggravated by iron supplements.
- Short-term bouts of constipation are particularly common among tourists, who change their eating habits and routines when visiting a foreign place.
- Other factors to consider are underactivity of the thyroid gland, which slows the metabolic rate, and liver problems that restrict bile needed for proper digestion.
- Chronic constipation may be due to certain parasitic infections. People can easily pick these infestations up from buffet food bars, communal / community centres and household pets.
Dietary modification
Fibre, particularly insoluble fibre, can help prevent chronic constipation. Insoluble fibre from food acts like a sponge, pulling water into the stool and making it easier to pass. Insoluble fibre comes mostly from vegetables, beans, brown rice, whole wheat, rye, and other whole grains. Switching from white bread and white rice to whole wheat bread and brown rice often helps relieve constipation. It is important to drink lots of fluid along with the fibre – at least 450ml per serving of fibre – otherwise, the fibre may actually exacerbate the constipation.
Intake of fibre can also be increased in the form of fresh fruits and vegetables. In addition, wheat bran may be added to the diet. Recommended intake is 60g or more per day of wheat bran along with fluid. An easy way to add wheat bran to the diet is to put it in breakfast cereal or switch to high-bran cereals. Studies have shown that chronic constipation among infants was triggered by intolerance to cows’ milk in two-thirds of the infants studied. Symptoms disappeared in most infants when cows’ milk was removed from their diet.
Certain fruits and vegetables are excellent mild, natural laxatives:
- A glass of hot water with a little lemon taken first thing in the morning helps promote normal bowel function
- Sauerkraut contains choline, which stimulates the inherent contractions in the gut
- Artichokes relieve constipation that is caused by a sluggish liver, by stimulating bile production
- Foods rich in magnesium such as dark green, leafy vegetables and figs draw water into the stools, increasing their volume and softness
- Papayas have a stimulating effect on the bowels and are mild enough to be fed to infants
- Prunes are a time-tested effective remedy. Soak five to ten prunes overnight and eat them in the morning, along with the water they have been soaked in
- Even more effective is a mousse made from two-thirds prunes and one-third figs: press the soaked fruits through a sieve and take a teaspoon every half hour
- Ripe gooseberries have a cleansing and laxative effect on the bowels because of their high cellulose and mucilage content
- Sorrel, added to a green salad, stimulates intestinal activity
- Chronic constipation can often be alleviated simply and naturally by eating a cucumber salad dressed with lemon, onion and unrefined, cold-pressed flax seed oil. Flax seeds are an excellent source of mucilaginous fibre. They absorb up to eight times their weight in water, thereby softening stools and making them easier to pass.
Lifestyle modification
Regular exercise like walking, swimming or cycling increases the muscular contractions of the intestine, promoting elimination. Walking is the best bowel regulator. When walking, the calf muscles, which are indirectly related to the digestive tract, are activated.
Diaphragm exercises are excellent to stimulate peristalsis (the inherent constriction and relaxation of the gut muscles). It is important to have a routine that allows evacuation of the bowels whenever the urge is felt. The digestive tract is at its peak performance during the early morning hours between 5 am and 7 am. Suppressing the urge to eliminate the bowels is a large factor in chronic constipation.
Nutritional supplement treatment options
Glucomannan is a water-soluble dietary fibre that is derived from konjac root. Like other sources of fibre, such as psyllium and fenugreek, glucomannan is considered a bulk-forming laxative and will generally help produce a bowel movement within 12 to 24 hours.
Chlorophyll, the substance responsible for the green colour in plants, may be useful for a number of gastrointestinal problems, including chronic constipation. Chlorophyll can be obtained from Chlorella or Spirulina supplements, as well as wheat grass.
Magnesium can be used to rectify short-term constipation caused by a temporary change in environment and / or daily routine. Vitamin C can be used in the same way as it has a natural laxative effect.
Botanical treatment options
The laxatives most frequently used worldwide come from plants. Herbal laxatives are either bulk-forming or stimulating. Avoid them during pregnancy or whilst breastfeeding, with the exception of psyllium seeds, which are safe to take during pregnancy.
Psyllium, flaxseed, and fenugreek – these bulk-forming laxatives have a high fibre and mucilage content that expands when they come into contact with water. As the volume in the bowel increases, a reflex muscular contraction occurs, stimulating a bowel movement.
Basil (Ocimum basilicum) seed has been found to relieve constipation by acting as a bulk-forming laxative.
Alginic acid, one of the major constituents in bladderwrack (Fucus vesiculosus), is a type of dietary fibre that may be used to relieve constipation.
Stimulant laxatives are high in anthraquinone glycosides, which stimulate bowel muscle contraction. The most frequently used stimulant laxatives are senna leaves, cascara bark, and aloe latex. While senna is the most popular, cascara has a somewhat milder action. Aloe juice is a very potent substance that heals and aids in colon functioning. It can be too aggressive for people with irritable bowel.
Other stimulant laxatives include buckthorn, alder buckthorn (Rhamnus frangula), and rhubarb (Rheum officinale, R. palmatum).
Castor oil is a potent laxative and should be used for extreme cases only and not over a long-term period.
Slippery elm helps to heal the lower intestinal tract.
Camomile or comfrey root enemas help remove bacterial toxins when other remedies are unsuccessful.
Licorice tea soothes intestinal walls and is especially indicated for chronic constipation.
If you found this post helpful, you may also be interested in:
Sussex Health: Heartburn & Acid Reflux
The Nutritional Advantages and Disadvantages of Vegetarian or Vegan Diets
Sussex Health: What Causes Anaemia?
Article contributed by Dr Tracy S Gates, DO, DIBAK, L.C.P.H., Consultant, Pure Bio Ltd. Copyright © Pure Bio Ltd 2023. All rights reserved.
Pure Bio Ltd are a leading UK supplier of the highest quality PURE nutritional supplements, based in Horsham, West Sussex. Proud Winners of Southern Enterprise Awards, Best Nationwide Hypoallergenic Nutritional Supplements Distributor 2022. Visit www.purebio.co.uk for all your nutritional supplement needs
