Chronic Constipation Back »

Written collaboratively by Megan Olesen and Patsy Catsos.


About Constipation

Most of us can agree that constipation is not the most pleasant topic to discuss. Yet, if you are one of the many who suffer from the symptoms of constipation on an ongoing basis, is very important to discuss this with your healthcare team. Successfully managing the symptoms of chronic constipation is critical because the long term effects can have a profound impact on your well-being and ability to function.

Constipation occurs when our digestive system slows down. This in turn causes hard, dry stools, less frequent bowel movements and/or the feeling that not all stool has passed after a bowel movement. Chronic, or on-going constipation occurs in about 1 in 5 people around the world and contributes to at least 8 million visits to the doctor in the U.S. every year1.

Symptoms

The two most common forms of constipation are chronic idiopathic constipation (CIC) and irritable bowel subtype constipation-predominant irritable bowel syndrome (IBS-C). Both CIC and IBS-C cause similar symptoms of gas, bloating, straining during bowel movements, and hard stools.

It is important to note the types of situations that may contribute to symptoms. Constipation commonly coincides with certain diseases and disorders including diabetes, hypothyroidism, Parkinson’s disease, spinal cord disorders, dyssynergic defecation and stroke. Dyssynergic defecation causes our body to not fully empty during a bowel movement. This is because the muscles of the rectum contract rather than relax during a bowel movement. Treatments that help with defecation disorders include biofeedback and physical therapy. Also, certain medications including calcium antagonists for high blood pressure and opioids for chronic pain can cause constipation symptoms.

Management

Tips to help those suffering from constipation:

  • Eat 3 meals a day:
    • Eating regularly stimulates gut motility.
  • Probiotics:
    • There are many different strains of probiotics. Probiotics shown to be beneficial in helping in combatting the symptoms of constipation include Bifidobacterium infantis 35624, VSL#3, and B animalis 2,3.
    • A registered dietitian nutritionist can provide you with information about which probiotic may be beneficial for you based on the symptoms you are experiencing.
  • Fiber:
    • Increasing the amount and variety of fiber you eat can bulk up your stool, speed up the amount of time it takes to pass stool and also helps to supply your digestive system with healthy probiotic bacteria. Other beneficial health effects of eating fiber include lowering cholesterol, blood sugar levels and helping you to maintain a healthy weight.
    • Everyone tolerates fiber differently. People with IBS may be more sensitive to rapid fermentation of fibers, so selecting food sources of fibers that are fermented more slowly may be better tolerated. Try regular consumption of chia seeds, oatmeal, quinoa, and brown rice. Eat more greens. Eat several portions of fruit per day, but don’t overdo it. If a fiber supplement is needed, try psyllium husk or acacia fiber.
    • Sometimes, adding too much fiber can actually make symptoms related to constipation worse so it is important to work with a registered dietitian nutritionist to help assess whether you are needing to increase or perhaps decrease the fiber in your diet to help manage your symptoms.
  • Hydrate:
    • Getting enough fluids throughout the day may improve constipation.
    • Try to drink water or other unsweetened, low-calorie beverages at every meal and while in transit to and from work, school, or other activities.
  • Regular physical activity:
    • Walking and other types of physical activity that add safe weight-bearing, jarring movements to the body may help to stimulate gut motility.
  • Low-FODMAP diet:
    • The low-FODMAP diet may help to improve stool consistency and relieve pain, gas, and bloating4.
    • ***For the safest, most effective results, work with a registered dietitian nutritionist and healthcare team on how to begin the low-FODMAP diet.

Dietary Considerations

An important reminder – modifying diet for digestive health is not a one size fits all approach! This means that some of these tips will work for some and not for others. Always work with a skilled registered dietitian nutritionist knowledgeable in digestive health conditions that can help create an individualized plan to help alleviate your chronic digestive discomfort and constipation.

Additional Resources:

  • FIND a FODMAP Dietitian Nutritionist
  • The Well Balanced FODMAPer
    Blog by Kate Scarlata, a dietitian who specializes in the low FODMAP diet and digestive health conditions including IBS, celiac disease, inflammatory bowel disease, and small intestinal bacterial overgrowth (SIBO)
  • IBS – Free at Last!
    Blog by Patsy Catsos, a medical nutrition therapist, FODMAP expert, and author whose blog consists of low FODMAP recipes and research based information and resources for IBS patients.

References:

  1. Wald A. Constipation: advances in diagnosis and treatment. JAMA. 2016;315(2):185-191.
  2. Kim SE, Choi SC, Park KS, et al. Change in fecal flora and effectiveness of the short-term VSL#3 probiotic treatment in patients with functional constipation. J Neurogastroenterol Motil. 2015;21(1):111-120.
  3. Aragon G, Graham DB, Borum M, Doman DB. Probiotic therapy for irritable bowel syndrome. Gastroenterol Hepatol (N Y). 2010;6(1):39-44.
  4. Chey WD. Food: The Main Course to Wellness and Illness in Patients with Irritable Bowel Syndrome. Am J Gastroenterol. 2016;(December 2015):1-6. doi:10.1038/ajg.2016.12.
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