Constipation is an incredibly common problem affecting twenty percent of today’s society. However, many people feel uncomfortable talking about the subject and seek no treatment for difficulty in their bowel movements. Despite the jokes made about it, chronic constipation can severely impact the physical health, mental health, and quality of life of those suffering from it.
If you are among the millions who strain hard to get things moving along on the toilet, remedies shared in this article can liberate you from hell.
Constipation is when you only go to the bathroom fewer than three times per week and pass small, hard, and dry stools on straining. Sometimes, stools might be painful to pass, and you may have a feeling that all stool hasn’t passed yet. Some other symptoms include abdominal pain and cramps, bloating, nausea, and loss of appetite. If this situation lasts a long time, for three months or more, it is regarded as chronic constipation.
You may struggle with constipation because of your eating habits, lifestyle choices, medicines you take, or certain medical conditions you may have. A low-fibre diet, physical inactivity, dehydration, age above 60, pregnancy, inflammatory bowel syndrome, hypothyroidism, and some medications (tricyclic antidepressants, antihypertensive drugs, and opioid painkillers) are common causes of constipation.
Here are some practical solutions to relieve your chronic constipation.
Soluble Non-Fermentable Fibre
Dietary fibre is the non-digestible part of plant foods. It is abundantly found in vegetables, fruits, legumes, and whole grains. According to the Academy of Nutrition and Dietetics, individuals should eat at least 22-34 grams of fibre each day.
Not being digested, insoluble dietary fibre forms the bulk of the stool and stimulates bowel movements, promoting easier passage of stools. It also reduces the total time faecal waste stays inside the digestive tract. In fact, a 2016 study revealed that almost every four out of five people with chronic constipation benefited from fibre supplements.
Other reports suggest that increased fibre intake may only increase the frequency of stools but may not benefit stool consistency and pain. However, that depends on the type of fibre —soluble or insoluble — you include in your diet.
Insoluble fibre —found in vegetables, wheat bran, and whole grains— adds bulk to your stools and promotes its early evacuation from the digestive tract.
Soluble fibre —present in oats, nuts, legumes, and lentils— forms a gel-like paste by absorbing more water, which softens your stools and improves consistency.
Psyllium —a soluble non-fermentable fibre supplement— is the best choice for treating constipation. In fact, a 2020 study comparing the effects of wheat bran and psyllium on chronic constipation found psyllium to be 3.4 times more effective.
So, including more high fibre foods in your diet can relieve your constipation. You can also add supplementary fibre, such as psyllium, to your diet. It is recommended to consult a dietitian to help plan your meals effectively.
Drink More Water
An often neglected cause of chronic constipation is being regularly dehydrated for a long time. If there’s less water in your body to mix with stools, it gets harder in consistency, becoming difficult to pass.
Drinking more water is a vital step to treat chronic constipation. It softens your stools, making them easier to pass. This study found that drinking an extra 2L of water per day enhances the effects of high-fibre diets in increasing stool frequency.
Some studies suggest superior benefits of sparkling water (compared to tap water) at relieving constipation. The benefits were shown in people with indigestion or dyspepsia and chronic constipation. Please note that drinking carbonated soda drinks can worsen constipation.
Eat Prebiotics and Probiotics
Probiotics are living bacteria that naturally occur within your gut. These bacteria synthesise the compounds vital to healthy intestines. It has been noticed that people with constipation have disturbed probiotic profiles.
An important cause of your constipation may be an overgrowth of methane producing bacteria (methanogens) in your intestines. Studies have shown a strong correlation between methanogens and chronic constipation. They somehow interfere with the movement of stool along the intestine, reducing your stool frequency.
It is highly recommended to get your probiotic profile evaluated with . It can be done with small intestinal bacterial overgrowth test (SIBO) —a simple breath test. You just have to blow air or exhale into an analyser which will check if there’s methane present in your breath (which normally is minimal). Increased amount of methane in your breath indicates overgrowth of methanogens in your intestine.
GastroLife provides state of the art testing services all across Ireland. You can book a test appointment at our Dublin, Kildare, or Galway clinics. In case you can’t visit our clinics, just order our home testing kit and send it back to GastroLife. Once the tests are completed, you will get notified about the results.
To restore a balance in your gut bacteria, you can either eat foods -such as yoghurt, kimchi, and pickles- rich in probiotics or take probiotic supplement to improve your gut health.
A 2019 study showed that probiotics for two weeks helped treat constipation by increasing stool consistency and frequency. Another study found the production of short-chain fatty acids by these bacteria improved gut movements, making it easier to pass your stools.
Another way around is to eat prebiotics –foods that feed the growth of probiotics in your gut. These foods include nuts, legumes, bananas, berries, apples, onions, garlic, and asparagus.
OTC and Prescription Laxatives
Although effective most of the time, laxatives are not the first treatment choice for constipation. These should only be used after high fibre intake, and other lifestyle changes have failed. Moreover, laxatives are not a long-term solution to your constipation because using them too often can cause serious side effects in your body.
A laxative is a group of drugs that work via different mechanisms to stimulate bowel movements and improve stool consistency. FDA recommends consulting your doctor before opting for an optimal laxative for your condition.
Some common types of OTC (over-the-counter) laxatives used to relieve constipation include:
- Stool Softeners. (Such as docusate calcium and docusate sodium). These agents add fluids to your stools which soften the consistency. You don’t have to strain to pass softer stools during your bowel movements.
- Osmotic Laxatives. (Such as Milk of Magnesia and sorbitol). They work by pulling water from different tissues into your digestive tract, which softens your stools. However, too many laxatives can cause dehydration and electrolyte imbalance, leading to severe side effects.
- Stimulant Laxatives. (Bisacodyl). These laxatives stimulate the contraction of your intestines, moving your stools forward along the gut. They are most aggressive and only take a few hours to start working.
- Prescription Drugs. (Such as Linaclotide, lubiprostone, and Plecanatide). If OTC laxatives don’t relieve your constipation, your doctor may prescribe you more potent medicines. These work by stimulating movements in your bowel wall and increasing the amount of water in your intestines.
Get Yourself A Diagnosis
If these things aren’t working for you, the best thing you can do to relieve chronic constipation is to get diagnosed with the underlying cause of your condition. Constipation is not a disease but a symptom of many underlying diseases.
Once the root cause of your chronic constipation gets identified, treatment will become a lot easier with targeted therapy. For example, if your constipation is due to hypothyroidism, nothing will work as effectively as thyroid hormone supplements for your constipation. Similarly, if you are taking CCBs for your hypertension and have developed constipation, its best management is to switch you to another class of antihypertensive drugs.
It is highly recommended to book a consultation with your doctor. He will take a detailed history of yours to figure out the cause. He may also recommend some blood tests (such as checking your calcium and thyroid hormone levels), an X-ray (to see if there‘s any obstruction in your gut), or colonoscopy to evaluate the inside of your gut for any diseases.
Once the root cause of your constipation is diagnosed, your doctor may first prescribe you some dietary and lifestyle changes to see how your gut responds to conventional remedies. If they don’t help, he may switch you towards medical or surgical treatment according to your diagnosis.
Please note that there might not be an obvious underlying cause of your constipation, or it might not get detected, in which case, you will get diagnosed as chronic idiopathic constipation (CIC). FDA approved drugs for the treatment of CIC include linaclotide (sold under the market name Linzess), lubiprostone, and plecanatide.
High fibre diets, replenishing your body’s water demands, and maintaining a healthy profile of gut bacteria are some go-to remedies for chronic constipation. If over-the-counter laxatives aren’t also helpful, it is better to book an appointment with your doctor and get yourself diagnosed with the underlying cause of your constipation.