Constipation Is Tragedy Of Nutrition - Anonymous!
Constipation is a symptom rather than a disease which results in infrequent bowel movements or strenuous passage of stools that persists for several weeks or longer. It can transpire for many reasons, such as changes in diet or routine or due to inadequate of fiber intake.
Though occasional constipation is very common, some people encounter chronic constipation that can interfere with their ability in the daily tasks due to blockage in the large intestine and such person will need urgent medical attention.
Other key features that usually define constipation include:
Stools are dry and hard.
Bowel movement is painful and stools are difficult to pass.
Have a feeling that you have not fully emptied your bowels.
Constipation can be broadly divided into 3 classes based upon the underlying physiologic cause;
1. Normal-transit constipation - In normal transit constipation the colon movements are unaltered and moves at a normal rate. But patients may experience other arduous in stool passage, for example due to harder stools
2. Slow-transit constipation - In slow-transit constipation colonic motility is decreased and bowel movements are infrequent, leading to more severe symptoms of straining and harder stools.
3. Pelvic floor dysfunction - Pelvic floor dysfunction is due to the failure of the pelvic floor muscles to relax pertinently during evacuation efforts. When this happens it makes stool passage much more difficult, regardless of whether stool transit in the colon is normal or delayed. Bottom line - The majority of persons perceived by a doctor have normal-transit constipation, followed by pelvic floor dysfunction, and slow-transit constipation. But some patients can have a combination of slow transit and pelvic floor dysfunction.
Just for knowledge Pelvic floor is the layer of muscles at the bottom of your pelvis that includes your bladder & bowel which pushes stool through your colon more easily and support to several other organs by wrapping around your pelvic bone. The pelvic organs include: The bladder (the pouch holding your urine). The uterus and vagina (in women). The prostate (in men). The rectum (the area at the end of the large intestine where your body stores solid waste). Why pelvic muscles so important ? Lets take routine example - You’re able to go to the bathroom with no problem because your body tightens and relaxes its pelvic floor muscles but this will not work efficiently in case of pelvic floor dysfunction as body keeps tightening these muscles instead of relaxing them and results into : - Trouble evacuating (releasing) a bowel movement. - An incomplete bowel movement. - Urine or stool that leaks.
Constipation usually is caused by the slow passage of digesting food through any part of the digestive system. Most of the time, however, generally slowing occurs in the colon movement of material through the colon (large bowel) and high levels of estrogen and progesterone especially during pregnancy.
Lets walk through few causes of constipation -
a. Drugs i.e medication can also cause constipation. Then its recommended to stay hydrated by increasing fiber intake in the diet or taking stool softeners. If simple measures don't work, it may be possible to substitute a less constipating medication by consulting doctor immediately.
b. Habit - Bowel movements are under our own voluntary control. This means that the normal urge you feel when you need to have one can be suppressed easily. Although occasionally it is appropriate to suppress an urge to defecate (for example, when a bathroom is not available) but doing this too habitually can lead to a disappearance of appetite and result in constipation.
c. Diet - Fiber like fruits, vegetables, whole grains are important in maintaining a soft, bulky stool. Therefore, eating foods low in fiber can cause constipation. But ensure over-eating of fibers can also cause constipation.
d. Laxatives - Laxatives helps to relieve constipation work by artificially stimulating, or irritating, the nerves in the large intestine. This stimulation makes the intestinal muscles contract and move the stool out of the body. But over- use of stimulant laxatives constipation worsen issues connected with constipation for example, senna (Senokot), castor oil, and many herbs.
However, whether the laxatives products have caused the damage or whether the damage existed prior to the use of them. Nevertheless, because of the possibility that stimulant products can damage the colon, most experts recommend that they be used as a last resort after non-stimulant products have failed.
e. Hormonal disorders: Hormonal disorders like too little thyroid hormone (hypothyroidism) and too much parathyroid hormone (by raising the calcium levels in the blood) can affect bowel movements. At the time of a woman's menstrual periods, estrogen and progesterone levels are high. However, this is rarely a prolonged condition but high levels of estrogen and progesterone during pregnancy also cause constipation.
f. Other causes - People of all ages can have an occasional bout of constipation. There are also certain people and situations that are more likely to lead to becoming more consistently constipated (“chronic constipation”). These include:
Older age people tend to be less active, have a slower metabolism and less muscle contraction strength.
Being a woman, especially while you are pregnant and after childbirth changes in a woman’s hormones make them more prone to constipation. The baby inside the womb squishes the intestines, slowing down the passage of stool. So its mandatory for the pregnant women to stay active throughout 9 months period, stay hydrated and consume fiber rich foods.
Having certain neurological (diseases of the brain and spinal cord) and digestive disorders (see causes).
Just for knowledge 1. Laxatives contain chemicals that help increase stool motility and thus relieving temporary constipation and some laxatives work on your intestine, and others work on both your stool and intestine. All laxatives are used to relieve constipation. But when misused or overused, they can cause problems, including chronic constipation. 2. Stool softeners - Stool softeners are used on a short-term basis to relieve constipation by people who should avoid straining during bowel movements because of heart conditions, hemorrhoids, and other problems. Stool softeners come as a capsule, tablet, liquid, and syrup to take by mouth and are usually taken at bedtime.
Difference between stool softeners and laxatives Laxatives are products that help people to poop by causing bowel movements. Stool softeners are a type of laxative that works by drawing water into the stool, making it softer and more comfortable to pass. Stool softeners are a type of laxative, but not all laxatives are stool softeners and choice between them may depend on how quickly a person needs relief.
Fewer than three bowel movements a week.
Stools are dry, hard and/or lumpy.
Stools are difficult or painful to pass.
Stomach ache or cramps.
Bloated and nauseous.
You feel that you haven’t completely emptied your bowels after a movement.
Feeling as though there's a blockage in your rectum that prevents bowel movements
Straining or pain during bowel movements
A feeling of fullness, even after having a bowel movement
Experiencing a rectal blockage
Lower abdominal discomfort
Increased gas (flatulence) is a common symptom and side effect of high-fiber diets. The gas occurs because the bacteria normally present within the colon are capable of digesting fiber to a small extent.
How does constipation happen?
A food normally moves through the digestive tract as nutrients are absorbed. The partially digested food waste that remains after nutrients are absorbed moves from the small intestine to the large intestine which is called as colon.
The aforementioned colon absorbs water from this waste, which creates a solid matter called stool. If you have constipation, food may move too slowly through the digestive tract. The colon’s muscles eventually propel the waste out through the rectum to be eliminated. If stool remains in the colon too long, it can become hard and difficult to pass. The stool becomes dry, hard, and difficult to push out.
Bottom line - Constipation happens because your colon absorbs too much water from waste (stool/poop), which dries out the stool making it hard in consistency and difficult to push out of the body.
Just for knowledge The colon is also known as the large bowel or large intestine. It is an organ that is part of the digestive system (also called the digestive tract) in the human body. The digestive system is the group of organs that allow us to eat and to use the food we eat to fuel our bodies.
Diagnosis and Treatment
The most dominant step by the physician in the evaluation of constipation in an individual is to obtain a complete patient history. When talking to a doctor it is really helpful if patient prepares well to describe:
the nature of the symptoms,
when symptoms started and how long they have persisted,
past medical procedures, and
any medications being taken.
After doctor's evaluation from the information provided by the patient tries to examine the exact cause of constipation like -
If the symptoms of patient include infrequent call to stool (not feeling the need to have a bowel movement) that may suggest slow-transit constipation, while the perceived need to defecate but with an inability to evacuate is more suggestive of a functional outlet obstruction.
If defecation is painful, the doctor knows to look for anal problems such as a narrowed anal sphincter or an anal fissure. If small stools are the problem, eating foods low in fiber may be the cause. If the patient is experiencing significant straining, then pelvic floor dysfunction is likely.
If patient is suffering with functional fecal retention i.e The physician should obtain a complete past medical history if their was any situation in patient's life that he/she had to hold back of stool because of fear of a painful bowel movement. Social or environmental factors, such as lack of available toilet facilities, may contribute to constipation both in children and adults and should be considered as a possible cause
If patient also suffers symptoms like rectal bleeding, a decrease in bowel movement diameter, a constant sense of the need to defecate, unexplained weight loss, nausea, and vomiting. The presence of such above symptoms, or a significant family history of colorectal cancer, mandates complete colonic evaluation, preferably by colonoscopy.
Just for knowledge Colonoscopy is a fiber optic (endoscopic) procedure in which a thin, flexible, lighted viewing tube (a colonoscope) is threaded up through the rectum for the purpose of inspecting the entire colon and rectum and, if there is an abnormality, taking a tissue sample of it (biopsy) for examination under a microscope, or removing it.
After physical examination doctor may identify root cause of constipation. And further recommend blood tests to evaluate condition in detail. More specifically, blood tests are recommended to evaluate
- Thyroid hormone (to detect hypothyroidism)
- Calcium (to uncover excess parathyroid hormone) may be helpful.
Lets walk through few general tests recommended by doctor to evaluate severity of constipation.
1. Abdominal X-ray
This is used to detect large amounts of material in the colon usually can be visualized on simple X-ray films of the abdomen, and the more severe the constipation, the more visualized on X-ray.
2. Barium enema X-ray
This studies by inserting liquid barium through the anus to fill the rectum and colon. The barium outlines the colon on the X-rays and defines the normal or abnormal anatomy of the bowel and rectum. Tumors and narrowings (strictures) are among the abnormalities that can be detected with this test
3. Colonic transit (marker) studies Colonic transit studies are simple X-ray studies that determine how long it takes for food to travel through the intestines. And procedure is as follows -
Step 1 - Individuals swallow gelatin capsules for one or more days. Capsules contains small pieces of plastic that can be seen on X-rays. The gelatin capsules dissolve and release the plastic pieces into the small intestine.
Step 2 - The pieces of plastic then travel (as would digesting food) through the small intestine and into the bowel. After 5 or 7 days, an X-ray of the abdomen is taken and the pieces of plastic in the different parts of the bowel are counted. From this count, it is possible to determine if and where there is a delay in the colon.
Final step - Then in people who are not constipated, all of the plastic pieces are eliminated and nothing remains in the colon. When pieces are spread throughout the colon, it suggests that the muscles or nerves throughout the colon are not working, which is typical of colonic inertia. When pieces accumulate in the rectum, it suggests pelvic floor dysfunction.
4. Defecography In this procedure, a thick paste of barium is inserted into the rectum of a patient through the anus. X-rays then are taken while the patient defecates the barium. The barium clearly outlines the rectum and anus and demonstrates the changes taking place in the muscles of the pelvic floor during defecation and also provides information about anatomical abnormalities.
5. Ano-rectal motility studies assist to determine if the muscles of the anus and rectum are working normally. When the function of these muscles is impaired, the flow of material through the GI tracts is obstructed, thereby causing a condition similar to pelvic floor dysfunction.
6. Magnetic resonance imaging defecography appears to be an excellent way to study defecation, but the procedure is expensive and somewhat cumbersome. As a result, it is used in only a few institutions that have a particular interest in constipation and abnormalities of defecation.
Bottom line - Numerous underlying diagnoses and treatment can prevent constipation. And its important to ensure medications being taken should be carefully reviewed for possible causative or contributory drugs.
Just for knowledge What is gelatin capsule ? This is a type of capsule that is in the form of liquid or powder, and which dissolves more quickly than any other capsules. These capsules are used for colonic transit (marker) studies.
15 best foods to eat to help relieve constipation
They have more than 10 grams of soluble and insoluble fiber per cup serving that's more than almost any other fiber source. And beans include - baked beans, black-eyed peas, garbanzo beans, lima beans, pinto beans, or kidney beans.
. 2. Kiwi
A 2013 study of adults reported in Advances in Food and Nutrition Research found that eating kiwi promotes regular bowel movements as it has 2.5 grams of fiber and lots of vitamins and nutrients. So luscious green flesh of the kiwi is best to get relief from constipation.
3. Sweet potatoes
One medium baked sweet potato with skin has 3.8 grams of fiber, and this high fiber content in sweet potatoes helps prevent and relieve constipation.
A filling 3 cups of air-popped popcorn contains 3.5 g fiber, and less than 100 calories and is really a good choice for a high-fiber snack that can help provide relief from constipation.But stay away from popcorn laden with butter as the high fat content not only contains lots of calories as the fats can cause constipation.
5. Nuts and seeds
Almonds, pecans, and walnuts have more fiber than other nuts. Just 1 ounce of almonds (about 23 nuts) contains 3.5 g fiber, 1 ounce of pecans (about 19 halves) contains 2.7 g fiber, and 1 ounce of walnuts (14 halves) has 1.9 g fiber.
On the flip side, seeds are another good fiber-filled choice for constipation relief. A scant 1 tablespoon of sesame seeds contains 1.1 g fiber, while 1 ounce of pumpkin seeds (about 85 seeds) has a whopping 5 g fiber.
But kindly note that nuts and seeds are high in calories, so keep portions small. Choose nuts and seeds that are raw or dry roasted, rather than roasted in oil.
6. Pears, plums, and apples
One large apple has more than 5 g fiber. With the skin, an average pear provides 5 to 6 grams of dietary fiber to regulate the digestive system. And its great for babies with constipation. So look for baby foods with pears as an ingredient.
Though fresh plums do not have much fiber, but dried plums i.e prunes have as many as 12 g fiber per cup and are excellent for relieving constipation.
Berries like raspberries, blackberries, blueberries and strawberries are tasty and easy to eat as all are easy to snack on and full of fiber. And eat them alone as a snack, try them on salads, or puree and freeze them for a cool summertime dessert.
Flaxseed (or flax seed) can help with constipation and is a great source of fiber, antioxidants, and omega-3 fatty acids. Just one tablespoon of both brown and golden flax seed has 2.8 g fiber, both soluble and insoluble.
Just ½ cup of cooked broccoli contains 2.8 grams of fiber to aid with constipation relief, and it's also chock full of vitamin C. It can be eaten raw as a snack with hummus or a low-fat dip.
11. Dried fruit
It is a smart choice if you're feeling constipated, as it actually contains more fiber than fresh fruit per serving. An easy snack is raisins, with 7 g fiber per cup (compared to 1 g in 1 cup of grapes) and dried fruits such as figs, raisins, and dried apricots are excellent sources of fiber. Just remember that while dried fruit has more fiber than fresh fruit, it also has more calories. So eat wisely.
12. Leafy and green vegetables
Green vegetables like spinach and even seasonal gourds have packed with nutrients including fiber, magnesium to help the colon contract, and potassium, which helps regulate fluid balance and muscle contractions.
The high fiber content in bananas can help normalize the effects of constipation. They can help you push out the waste better by making stools easier to pass.
14. Chia seeds
Chia seeds are packed with calcium and omega-3 fatty acids. They are a great source of fiber and can help stave off hunger. Add two tablespoons of chia seeds to your smoothie, yogurt, salad or oatmeal.
Oranges are packed with vitamin C and fibers, which help increase the bulk in your stool. They are also a good source of naringenin, a flavonoid that can work like a laxative.Therefore, it is best to have them whole and raw.
#B. Dos and don’ts to prevent constipation
Doctors recommend to drink plenty of fluids i.e eight glasses of water a day helps to soften your stool, making elimination easier.
Eat fresh and dried fruit like raisins,prunes,figs,bananas,apples,oranges and other dried fruits are loaded with fiber and are the foods that help relieve constipation. Along with water, fiber helps give stool the right consistency to pass easily.
Load your plate with vegetables as they are also high in fiber and can help prevent constipation. Pinto beans, legumes, salads, and raw vegetables are all high in fiber, making them great choices for constipation relief and prevention.
Fill up on whole grains for increasing intake of fiber i.e whole-grain bread, oatmeal, ground flax seed, barley, and wheat bran cereal. Your goal should be to get up to 35 grams of fiber a day, and just one ounce of wheat bran cereal gives you 10 grams. But its always recommended to discuss your fiber needs with your medical provider as increasing fiber is not the solution for everyone.
Pay attention to relaxing your pelvic floor muscles while emptying your bowels. Be sure your knees are positioned higher than your hips, use a foot stool if necessary. Leaning forward and supporting your elbows on your knees is also helpful. .
Don't suppress urges to defecate. When the urge comes, find a toilet.
Processed foods don’t have much fiber.. Eating too many of them can lead to constipation so better to go with natural foods like fruits and vegetables than to get your meals and snacks from a box or bag.
Caffeine is a stimulant so it can cause you to have a bowel movement. But it can also cause dehydration, which can have the opposite effect and lead to constipation, Avoid coffee or caffeinated drinks all day.
Dairy on its own may not lead to constipation, but the lactose in dairy can produce gas and make you uncomfortable if you’re backed up already,. Also, foods that are loaded with cheese aren’t usually part of a balanced diet, so be sure to get the three recommended daily servings of dairy from healthy, low-fat sources, such as nonfat milk and yogurt.
Avoid to drink too much alcohol. Like caffeine, alcohol can dehydrate you and cause constipation. Limiting your alcohol intake can help relieve constipation.
Eating late dinner is also not good as chowing down too close to bedtime, whether a meal or a snack, can increase your feelings of heartburn through the night. That's because the food in your stomach can get pushed back up into your esophagus more easily when you’re lying flat. Stop eating at least 2 to 3 hours before you plan to go to bed.
Supersizing your meals is also important as eating or drinking too much at a single sitting leads to unpleasant fullness, reflux, and bloating. Therefore have smaller meals.
Resists gulping down too many beverages like water,coke etc with dinner not a good habit too as more liquid can have the same bloating side effect as too much food. It also contributes to reflux symptoms by flushing overfull stomach contents up into your esophagus.
Adding fiber too fast is really bad idea. Eating fiber from fruits, vegetables, and other foods is really important. But add it to your diet slowly. Too much fiber too quickly can give you painful bloating and gas.
Frequently asked questions
1. How much fiber should be there in my diet? How much should I add at a time?
The recommended amount is between 25-35 grams of fiber a day. Besides, to find out how much fiber you are eating, read the nutrition label of your foods and add the grams of fiber together. But avoid adding fiber too fast in diet as it might lead to bloating and gas so start eating fiber with minimal quantity.
2. Is it normal to be constipated during my periods?
Periods have a number of side-effects, which may differ from person to person. Apart from cramping and bloating, constipation may also pop up during that time of the month. Good news as you are not alone. Many ladies face constipation during periods so stay hydrated and avoid over consumption of caffeine.
Pregnancy is meant to be a happy phase for every lady but constipation do occur in up to half of all pregnant women. So pregnant ladies should be moderately active and avoid sedentary lifestyle.
4. What are home remedies for constipation?
Drink a glass of lukewarm water every morning after you wake up. Squeeze in some fresh lemon juice and add few tablespoons of honey in lukewarm water.
You may even consume triphala powder before going to bed. Triphala is an ayurvedic medicine for indigestion and consists of amla powder, beheda powder and hirda powder.
Increase fiber intake as it helps in regulating bowel movements; thereby keeping colon clean. But, it is one of the most important component of balanced diet as it helps in excreting waste products from body by regulating bowel movements.
Grease your intestines by adequate consumption of oil and ghee. Ghee activates production of hydrochloric acid (HCL) in stomach and aids in digestion. On flip side oils help in moisturizing digestive tract and helps in absorption of vitamins and minerals into bloodstream.
Baking soda can come to your rescue in terms of constipation. So make a drink with squeezed lemon and pinch of soda to accelerate bowel movement and also helps in cleaning colon.
Increase your fluid intake and if you get bored of consuming normal water, you can add some taste or flavor to it by infusing some lemon juice, ginger juice, mint leaves, basil leaves etc. Sugarcane juice, coconut water, cold milk, butter milk, fruit and vegetable juices are good options to keep your body hydrated.
Green tea or any herbal tea is another option that will help you to cleanse your system. Regular consumption of green tea will not only help in constipation, but also increase metabolic rate.
5. Which yoga poses help in digestion?
.Practice of yoga should not be restricted to few days, but it should be metamorphose into lifestyle. Below are the yoga poses to help to boost digestion process:
Adho Mukha Svanasana
Most cases of constipation are mild and easily treated with transpose in diet and exercise. But if the constipation is a frequent problem then it’s better to see a doctor sooner rather than later. Besides, these days doctors in lieu of prescribing medicines recommends patient to change their eating habits and uplift to circumvent sedentary lifestyle.
In simple words, every individual should consider constipation as " It shouldn't come as a surprise that what you put in your body has a lot to do with the way it comes out"