Once in a while, nearly everyone gets constipated. It happens occasionally when we’re traveling or off our usual schedule, but some people are constipated nearly all the time. Everyone is different, some people poop several times a day while...
Once in a while, nearly everyone gets constipated. It happens occasionally when we’re traveling or off our usual schedule, but some people are constipated nearly all the time. Everyone is different, some people poop several times a day while others only have a bowel movement every couple of days. As the most common gastrointestinal (GI) complaint in the U.S., constipation is usually defined as having fewer than three bowel movements per week or having hard, dry stools that are hard to pass.
Food normally moves along via muscular waves in our GI tract that are called peristalsis. For the most part, nutrients are absorbed in the small intestine, and then peristalsis pushes it along to our large intestine, into the colon, and finally to the rectum. By the time stool arrives in the rectum, nearly all the water has been absorbed out of it by the large intestine, but if things move along too slowly to the rectum, too much water is absorbed resulting in hard dry stools or constipation.
There can be many causes of constipation but the most common one is lack of exercise. In order to have regular bowel movements, we’ve got to move! Cardio exercises that get our blood pumping are probably the simplest way to stimulate our bowels; try dancing, jogging, running, or fast walking, although even a simple walk for at least 30 minutes every day can help.
It makes sense that not drinking enough liquid is a common cause of constipation, but it can also be caused by a diet that is low in fiber. Insoluble fiber, the kind needed for constipation, does not dissolve in water. Both soluble and insoluble fiber is found in many plant-based foods, but it is insoluble fiber that attracts water into our stool, making it softer and easier to pass.
Some people “hold it in.” Holding in our stool repeatedly and for too long can be another cause of constipation. Over time muscles in the rectum stretch and the sensation of needing to empty our bowels diminishes, making it difficult to be aware that we need to go to the bathroom. Of course there are times when we have to hold it in until we have the time or a place to go, but it is never a good idea to do it habitually.
There are lifestyle changes that can help with constipation. Exercising regularly keeps things moving, and so does drinking plenty of fluids and consuming more fiber. Fiber is a kind of carbohydrate that the body cannot convert into sugar; it passes through the body undigested. The bacteria in our gut microbiome love fiber, they metabolize it in order to produce fatty acids that keep us healthy. We are told that fruits, vegetables, and whole grains contain fiber, but which ones are the best?
In general, the darker the color of a vegetable, the higher the amount of fiber. Carrots, beets, and broccoli are fiber-rich. Collard greens and Swiss chard contain 4 grams of fiber per cup, but artichokes at 10 grams are one of the highest. If you choose fresh fruits, do not peel them because the majority of the fiber is usually in the fruit’s skin. Some high-fiber fruits to choose from include raspberries, apricots, apples, plums, pears; bananas, oranges, grapes, and strawberries. We don’t eat the skins of avocados or jicamas, but they are good choices. Exotic fruits like mangos, persimmons, and guavas also contain fiber, so give them a try.
Russets, red, and sweet potatoes have a decent amount of fiber if you eat the skin. “Beans, beans the musical fruit” are packed with fiber, while navy beans and white beans have the most. Many kinds of beans are great in soups, salads, and chilies including garbanzos, black beans, and kidney beans, just to name a few. Beans of all kinds are high in protein and they are a healthy, filling substitute for red meat.
Legumes contain lots of fiber; they include peas, soybeans or edamame, and lentils. Many cereals have at least some fiber, but they are not all created equal. Any cereal with five or more grams of fiber is a good source, including some bran cereals, and old-fashioned or steel-cut oatmeal. Whole-grain bread such as seven-grain, dark rye, cracked wheat, and pumpernickel are good choices. Whole grains in general, including bulgur, brown rice, wild rice, and barley are tasty and higher in fiber than the white variety.
In the snack aisle, nuts, seeds, and dried fruits contain fiber but they are also high in calories so make a little bit of them go a long way. Popcorn and granola are other snack options, and so is roasted edamame. Although most fruit juices and dairy contain little or no fiber, new products are changing that picture so look for labels on juice, milk, and yogurt that state that fiber has been added, or that the product is “fiber fortified.”
Not only are high-fiber foods good at normalizing bowel movements, but they can also lower LDL or “bad” cholesterol, help control blood sugar, make it easier for us to achieve a healthy weight, and help reduce our risk of dying from cardiovascular disease and cancer. Fiber is necessary for normal bowel function but the caveat is to increase it gradually, over a period of several weeks because introducing too much, too quickly can cause abdominal pain, gas, bloating, and even diarrhea.
For most of us, constipation is a temporary setback that we can manage with good bowel habits, a healthy diet, increasing our fluid intake, and exercising more. For some people, however, these DIY changes will not be enough—chronic constipation can be a debilitating disorder and it deserves to be recognized and treated as such.
