This article was co-authored by Roy Nattiv, MD. Dr. Roy Nattiv is a Board-Certified Pediatric Gastroenterologist in Los Angeles, California. With over 20 years of experience he specializes in a broad range of pediatric gastrointestinal and nutritional illnesses such as constipation, diarrhea, reflux, food allergies, poor weight gain, SIBO, IBD, and IBS. He completed his pediatric residency at the Children’s Hospital at Montefiore, Albert Einstein College of Medicine in New York, and his fellowship at the University of California, San Francisco (UCSF). While at UCSF, he was a California Institute of Regenerative Medicine (CIRM) fellowship trainee and was awarded the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Fellow to Faculty Award in Pediatric IBD Research. Dr. Nattiv received his undergrad degree from the University of California, Berkeley, and his medical degree (MD) from the Sackler School of Medicine in Tel Aviv, Israel.
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Constipation is very common and causes irregular bowel movements. However, not having a bowel movement every day is not considered constipation. Everyone is different and some people have more frequent and regular bowel movements than others. Medically, constipation is defined as fewer than three bowel movements in a week, and the condition is considered chronic if it lasts for more than six months. Those experiencing constipation also report that stool is dry, hardened, small, and frequently painful or difficult to pass without straining.[1] Constipation affects as much as 15 percent of the population in the U.S.[2] However, changes to diet and exercise habits, as well as over-the-counter medicines for acute cases, can help regulate bowel movements.
Steps
Changing Your Diet
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1Eat more foods rich in dietary fiber. Dietary fiber is a portion of plant-based foods that your body can neither digest nor absorb. Fiber helps move material through your digestive tract and also adds bulk to your bowel movements, but of which can help regulate your bowels.[3] Though your diet should include a solid mix of both, dietary fiber comes in two forms—soluble and insoluble.
- Soluble dietary fiber means that the fiber is water-soluble, the mix of which creates a gel-like substance that can help promote the movement of material through your bowels. Since this fiber absorbs water, it also cuts down on runny stools by solidifying them. Foods rich in soluble fiber include oats, peas, beans (navy, pinto, black, kidney), apples, citrus fruits, carrots, barley, and psyllium.
- Insoluble fiber is not water-soluble, so it helps add bulk to stool, which helps maintain regular movement of your bowels. Foods rich in insoluble fiber include whole wheat flour, wheat bran, nuts (pecans, almonds, Brazil nuts), beans, and vegetables (such as cauliflower, green beans, leafy greens, and potatoes).
- Your suggested amount of daily fiber depends on your sex and age. Men and women age 50 and under should aim for 38 and 25 grams per day, respectively. Men and women over age 50 should consume 30 and 21 grams per day, respectively.
- A high-fiber diet can help you fight constipation-predominant IBS. With this type of diet, you might eat 3-5 servings of fruits and veggies a day, and switch over to whole grains.[4]
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2Cut back on foods low in fiber. Many common foods are very low in fiber. Relying on a diet too heavy in these foods can lead to irregularity, so you should always balance them with high-fiber options. Foods low in dietary fiber include:[5]
- Cheese (and other dairy such as ice cream)
- Meat
- Processed foods such as fast food, hot dogs, or microwave dinners
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3Discuss any dietary restrictions with your doctor. If you have any dietary restrictions due to a medical condition, then it is important to discuss these with your doctor. You may require a nutritional consult to ensure that you are following a balanced diet and to help keep you regular.
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4Drink plenty of fluids. You should aim to drink two to three liters of fluid each day.[6] While most of your fluid should come from water, you can also include fruit and vegetable juices, as well as clear soup broths to meet your daily requirements.[7]
- Some medical conditions (such as congestive heart failure) will require you to restrict your fluid intake.[8] Consult your doctor regarding your acceptable level of fluid intake before making any changes if you have a condition where you fluids have been restricted.
- Dehydration is also associated with a condition known as “retentive constipation,” especially in children.[9] With this condition, initial constipation due to dry, hardened stool is worsened by stagnating in the colon/rectum where additional water is drawn out, hardening it even further. This can lead to a vicious cycle of irregularity.
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5Eat more yogurt. The lactic-acid producing bacteria (LAB) found in yogurt has been shown in studies to assist with regularity for some gastrointestinal conditions, including constipation and some diarrheal diseases.[10] The most commonly studied strains of LAB are Lactobacillus and Streptococcus.[11] Check the label on the brand of yogurt for the presence of these LAB strains.
- You can also try a low residue diet if you're suffering from diarrhea. With this diet, you eat a lot of starchy carbs, like bread and grains, and fewer raw fruits and veggies, which speed up your bowel movements.[12]
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6
Addressing Other Causes of Irregularity
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1Check any medications you’re taking. Narcotic pain medications, some antidepressants, some anticonvulsants, aluminum-containing antacids, and some blood pressure medications are just a few examples of medications that commonly lead to constipation and irregularity. You should always consult your doctor before making any changes to a prescription regimen, but in some cases your doctor may be able to switch you to a drug without constipation as a side effect.
- If you currently take narcotic pain relievers, then getting plenty of fluids and moving around frequently can help to promote peristalsis. Peristalsis is the wave like motions of your colon that helps to move waste through your body and promote bowel movements.
- If you have recently has surgery and are taking narcotic pain relievers, then you may be encouraged by your surgical care team to take a stool softener along with the pain medication to reduce your chance of becoming constipated.
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2Try over-the-counter laxatives or stool softeners. Several varieties of laxatives and stool softeners are available over the counter. You doctor will likely recommend one of these options if a necessary medication has caused your irregularity. However, you can also use these options as directed even when a medication is not the cause. Just be sure to check with your doctor first if you have a chronic GI condition. OTC options include:[15]
- Osmotic agents - These options (such as Milk of Magnesia and Miralax) help stool retain fluid usually absorbed by the digestive tract, easing the passage of bowel movements.
- Stool softeners - These products (including Colace and Docusate) mix fluid with your stool to soften them and ease passage. Doctors especially recommend these options for those who strain during bowel movements or for women who suffer from constipation after childbirth.
- Lubricants - Lubricants (such as Fleet and Zymenol) coat stool, helping it to retain fluid and move more easily down the lower digestive tract.
- Stimulants - These options (which include Dulcolax and Correctol) contract the intestines, causing them to move stool more quickly through your intestinal tract. Though available over the counter, you should reserve stimulants as a last resort for severe cases, and you should avoid stimulants containing phenolphthalein.[16]
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3Ask about prescription options. If OTC options have proven ineffective, you can also see your doctor and ask about prescription options. Chloride channel activators (such as Amitiza) increase the amount of fluid in your gastrointestinal tract to help with the passage of stool.[17]
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4Exercise regularly. Inactivity is one of the major lifestyle causes associated with irregularity. Studies have shown increased activity leads to a faster, more effective metabolism. Thirty minutes of aerobic exercise (that gets your heart rate up) three times a week is recommended. Jogging, swimming, biking, and power-walking are all good forms of exercise. However, even fifteen to twenty minutes of walking a day can help with bowel motility.[18]
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5Manage your stress. Stress may also contribute to constipation, so it is important to do things to keep your stress under control.[19] Try to set aside at least 15 minutes for yourself every day. During this time, use a relaxation technique to help reduce your stress. Some things you can try include:
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6Consider taking probiotics. Probiotics have not been proven to help with constipation, but there is some evidence that they may help to ease it. Probiotics may also be especially helpful for combatting digestive changes caused by antibiotics because probiotics can replenish the good gut bacteria that antibiotics kill along with bad bacteria.[20]
- You can get probiotics just by eating yogurt once per day, or you can take a probiotic supplement. Talk to your doctor for recommendations and before starting any probiotic supplements.
- A daily probiotic can help you recover faster from diarrhea.[21]
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7Improve the tone of your pelvic floor muscles. Especially for women who have been through multiple pregnancies, weakened pelvic floor muscles can lead to irregularity and even an overactive bladder. You can strengthen these muscles with different exercises either standing or laying down.[22]
- While standing, assume a squat position and pull in the muscles of your glutes.
- While laying in your back, elevate your pelvis in the air with your knees flexed at 90° angles. Thrust your pelvis off the ground while clenching your buttocks.
- For either exercise, do ten repetitions while holding each for five to ten seconds. Perform three sets daily.
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8Consult your doctor about underlying conditions. Irregularity is often a symptom of an underlying disease or condition. If basic lifestyle changes haven’t proven effective, then see your doctor to rule out other causes. These may include:[23]
- Irritable bowel syndrome
- Anorexia
- Diabetes
- Hypothyroidism
- Multiple sclerosis
- Parkinson’s disease
- Spinal cord injury
- Stroke
- Colon or rectal cancer
- Bowel obstructions
Expert Q&A
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QuestionI sometimes experience an urgent need to have a bowel movement, which can cause problems when I am not at home. What can I do?Carlotta Butler, RN, MPHCarlotta Butler is a Registered Nurse in Arizona. Carlotta is a member of the American Medical Writers Association. She received her Masters of Public Health from the Northern Illinois University in 2004 and her Masters in Nursing from the University of St. Francis in 2017.
Registered NurseIf you suffer from bowel urgency, then you might want to try simply developing a bowel schedule. Bowel urgency is a sudden, uncontrollable need to have a bowel movement. Bowel training could help you resolve the issue of urgency while doing activities. Adjusting your diet can also help aid in bowel urgency. There are certain foods and drinks that are bowel irritants, such as spices and caffeine. If all fails, you need to seek medication attention as there may be an underlying medical condition, such as Irritable Bowel Syndrome.
Warnings
- Consult a doctor before attempting any dietary changes or new exercise routines.⧼thumbs_response⧽
References
- ↑ https://my.clevelandclinic.org/health/diseases/4059-constipation
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388525/
- ↑ https://www.ncbi.nlm.nih.gov/books/NBK218764/
- ↑ Roy Nattiv, MD. Board Certified Gastroenterologist. Expert Interview. 18 December 2020.
- ↑ https://www.cancer.org/treatment/survivorship-during-and-after-treatment/coping/nutrition/low-fiber-foods.html
- ↑ https://www.nlm.nih.gov/medlineplus/ency/article/003971.htm
- ↑ https://www.health.harvard.edu/aging/easy-ways-to-stay-regular
- ↑ https://www.nlm.nih.gov/medlineplus/ency/article/003971.htm
- ↑ Shaman Rajindrajith MD, Manjuri Devanarayayana MD, Constipation in Children: Novel Insights into Epidemiology, Pathophysiology and Management, Journal of Neurogastroenterology Motility 2011. Jan 19 (1) 35-47.
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/15277142
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/15277142
- ↑ Roy Nattiv, MD. Board Certified Gastroenterologist. Expert Interview. 18 December 2020.
- ↑ https://www.nlm.nih.gov/medlineplus/ency/article/003971.htm
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676347/
- ↑ https://www.nhs.uk/conditions/laxatives/
- ↑ http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/constipation/Documents/Constipation_508.pdf
- ↑ http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/constipation/Documents/Constipation_508.pdf
- ↑ https://my.clevelandclinic.org/health/diseases/4059-constipation
- ↑ http://kidshealth.org/en/parents/constipation.html
- ↑ http://www.health.harvard.edu/blog/probiotics-may-ease-constipation-201408217377
- ↑ Roy Nattiv, MD. Board Certified Gastroenterologist. Expert Interview. 18 December 2020.
- ↑ https://medlineplus.gov/ency/article/003975.htm
- ↑ https://my.clevelandclinic.org/health/diseases/4059-constipation
Medical Disclaimer
The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.
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