Constipation. Everyone jokes about it, but to you it’s no laughing matter. You feel sluggish, lethargic, bloated.
You know that if you could just do a poo properly you’d feel so much better. You’re sick of taking Metamucil and you’re worried about being stuck on laxatives. Constipation really gets you down! Is it really as easy as eating more fruit and vegetables, drinking more fluid and exercising more? Not necessarily.
Let’s consider top five recommendations for constipation and whether they actually work.
Eat more fruit and vegetables.
Eating more fruit works for many people, especially apples, pears, kiwifruit and passionfruit. Prunes work for some, but can also give you abdominal bloating without much action. If fruit gives you abdominal bloating, you may have a FODMAPs intolerance. Small intestinal bacterial overgrowth (SIBO) is another possibility.
Eat whole grains.
Again, works for many, and can promote good gut health and decrease risk of metabolic disease like heart disease, diabetes and vascular disease. However, not everyone tolerates grains well. Gluten-containing grains like wheat can be a problem for some, even if they don’t have coeliac disease. And coeliacs who are on a strict gluten-free diet can react to other grains like corn/maize. If you feel better on whole grains, go for it! They’ll help your bowels as well as your general health. If you don’t, see your nutritionist.
Drink more fluid.
Drinking more water only helps the bowels to a point. If you have to drink 3L of water a day to get your bowels working, something else is wrong. Drinking too much coffee can actually dehydrate you, which is not helpful for the bowels. On the other hand, sitting down and relaxing with a cup of caffeine-free herbal tea can be a wonderful way to get the bowels going.
If you are very inactive, then increasing your exercise will probably help your bowels. If you already exercise moderately several days a week, it probably won’t.
Take a fibre supplement.
Fibre supplements, like psyllium husk, could be a useful option if you already eat several cups of vegetables and fruit each day and whole grains and/or legumes. But they shouldn’t be a substitute for a diet too low in plant food. Better still is linseed meal (also known as ground flaxseed) and chia seed. Both of these actually have some nutrition.
If the top five recommendations for constipation don’t work, what can you do?
Lots, actually. Again, these tips won’t work for everyone, and it’s best to see a nutritionist with a special interest in gut health. But you might also like to try these tips.
Legumes are amazing for the bowels. They are one of the most effective ways of feeding the healthy gut bacteria that keep your bowels moving. Some lentils, chickpeas or cannellini beans every other day might be all you need to do to fix your constipation problem. If you can’t tolerate beans and lentils due to tummy pains and bloating, you may have a FODMAPs intolerance. This can be treated!
Get up earlier and stop rushing around.
Rushing around like a mad thing in the morning and racing out of the house suppresses regularity of the bowels. Taking more time in the morning helps get the “rest and digest” side of your nervous system going.
Try abdominal massage or visceral manipulation.
Some people find it helpful to massage their tummy for a few minutes a day in a clockwise direction. I also have patients who really benefit from visceral manipulation, a gentle form of abdominal massage or stretching. Consider giving this a trial run. It usually works within the first session or two. (This can’t be done during pregnancy).
Take prebiotics and probiotics.
Not all probiotics work for constipation (in fact many don’t). You need to get specific with the right strains. Prebiotics are the food for the probiotics – that is, the fertiliser that makes them grow. There are many different types, but get an evaluation with your functional nutritionist first to reduce risk of side effects like abdominal bloating.
Rule out underactive thyroid and coeliac disease.
Both of these conditions can be behind constipation. But really, so can a lot of other issues. If you’ve tried everything on the list, consider a more comprehensive approach to the problem. The functional nutrition approach we use at Equilibria is ideal to identify the underlying causes.
Try swapping regular milk for A2 milk.
Regular milk can slow the bowels because it contains casomorphines (just like the effect of real morphine). For some people, switching to A2 milk can resolve constipation.