Constipation Diet – How to Fight It

Constipation – Causes and Diagnosis

Constipation (or constipation ) is a discomfort affecting the mechanism of defecation . It is a symptom and not a real disease, as constipation is often secondary to:

• anatomical – functional alterations of the intestine ( haemorrhoids , fissures , diverticulosis / diverticulitis , rectocele , Crohn’s disease , colitis , irritable bowel syndrome , etc.),
• other endocrine or metabolic disorders,
• pregnancy (see constipation in pregnancy )
• incorrect lifestyle and/or unbalanced diet (see diet and constipation ),
• psychological disorders/discomforts
• pharmacological treatments (see drugs that cause constipation ) etc.
  
  Constipation affects more males than females in childhood , more females than males in adulthood and more elderly than young people. In the neonatal period or in any case prior to weaning, constipation is not always linked to a concrete problem of evacuation; often, in fact, there is such a high absorption of meals (liquids), that the volume of waste is decidedly reduced.
  The diagnosis for constipation requires the recognition of at least 2 out of 5 of the following factors, for a duration of 12 weeks (even non-consecutive), to be evaluated over a period of about one year:

  • less than two evacuations per week;
  • difficulty and effort in evacuation;
  • hard consistency of stools or goat stools (segmented) or ribbon-like stools (thin and flattened);
  • feeling of blockage and/or constipation and/or incomplete bowel movement
  • need for manual assistance to complete fecal expulsion.

  Constipation is often accompanied by irascibility and asthenia , significantly compromising the quality of life of those who suffer from it. Most of the time, constipation is idiopathic (i.e. not related to a disease) and becomes chronic due to: inadequate diet, sedentary
  lifestyle , pregnancy (uterine dislocation and hormonal profile mutation ) and irritable bowel syndrome (disorder not yet well framed). If so, how can we intervene to prevent and treat constipation ? Simple, with physical activity and a healthy and correct diet ” Intestinal motility is involuntary ( peristalsis
  ), while evacuation is a voluntary act (defecation). In constipation, often, an alteration of the colonic peristalsis and a mutation of the faecal expulsion process are highlighted .

  Treatment

  Why does constipation arise? How to cure it?

  Peristalsis is a movement that affects the entire digestive tract in different ways . In the intestine, peristalsis differentiates into 2 types of contraction:

  • of segmentation or mixing: promotes the action of the intestinal bacterial flora and facilitates the absorption of vitamins , water and salts still present in the faeces
  • advancement or mass: moves the fecal mass up to the rectum , where the process of evacuation or defecation is activated.

  The mechanism of movement of the enteric contents from the descending colon to the rectum occurs thanks to the alignment between the sigmoid portion and the rectal ampulla , where the faeces are contained before expulsion. Evacuation/defecation (which, as anticipated, is a voluntary process) occurs thanks to the perception of the sensation of fullness which triggers relaxation of the pelvic floor and anal sphincter; the process can be facilitated by the increase in intra-abdominal pressure generated by the contraction of the abdominal muscles and bythe Valsalva maneuver .

  The squatted “Turkish” position (or with a stool under the feet) facilitates a physiological increase in intra-abdominal pressure, favoring defecation.
  In idiopathic constipation, the problem is often localized “upstream” of the process and generally affects daily habits and lifestyle. In many cases, people with constipation are unaware that they spend insufficient time on this important practice. Furthermore, the frenzy of daily life easily distracts attention from bodily stimuli (not only with regard to defecation, but also with regard to thirst , appetiteetc.). Upon awakening and after meals (for different reasons) defecation should be easier than for the rest of the day; needless to remember that in the morning, after breakfast and at lunch, people have less time available than at other times of the day. By correcting these habits it is therefore desirable that the frequency of evacuations increases, reducing the extent of constipation. Physical activity
  prevents and, in some cases, contributes significantly to the cure of constipation. Not only an active lifestyle, but also desirable physical activity have a positive effect on intestinal peristalsis. Sport is known to be a powerful anti – stress; it goes without saying that such activities can reduce the psychological and emotional discomfort responsible for “blocking” the evacuation. Furthermore, from an organic point of view, the vibrations (for example the impact of running on the ground ) and the abdominal muscle contractions act on the intestine like a real massage in favor of faecal progression. Not least, the release of cholinergic hormones ; these molecules interact with the digestive tract favoring its contraction. Curious to note that, in parallel, also the psychological, emotional and muscular relaxation (although diametrically opposed to the motor activity) can prevent constipation; particularly significant examples are all activities such as mental training, meditation, etc. The most effective is undoubtedly yoga which, in association, provides for the adoption of diaphragmatic breathing techniques ( pranayama ) responsible for the visceral massage (on the liver , spleen and, as anti-constipation, also on the large intestine ).
  Once it has been ascertained that constipation does not depend on the factors listed above, it is possible to analyze and possibly intervene on the food transit mechanisms. The faeces progress in the intestine thanks to peristalsis, which is activated following the pressure and nervous response of the digestive tract. Consequently, the greater the faecal volume, the more frequent and effective are the contractions. The volume of the faeces is determined by the amount of waste/residue/undigested food contained in the meals and by the presence of water; moreover, the activation of the intestinal bacterial flora is followed by the production of gases which participate in the increase in intraluminal pressure. The nutritional component that “by definition” contains waste is thedietary fiber . In summary: good amounts of dietary fiber and water in the meal, together with the right concentration of physiological bacteria in the intestine, determine hydration and fermentation (with the production of vitamins and other useful molecules, as well as shielding from harmful agents), then the swelling, of the feces. This condition triggers the peristaltic contractions of mixing (which further promote the action of the bacterial flora) and, by facilitating the advancement of the mass, speeds up the transit allowing the rectal ampoule to be filled. The soft consistency of the faeces prevents constipation and the onset of hemorrhoids, fissures ( often related to the Valsalva push maneuver) and, indirectly,intestinal neoplasms .

   

  Diet for constipation

  Let’s carefully analyze the 3 elements that boast the best “anti-constipation” function: dietary fiber, water and intestinal bacterial flora.

  Dietary fiber against constipation

  Dietary fiber is a set of NON-digestible molecules for humans, contained in vegetables and mushrooms . They can be classified as soluble and insoluble , or even better as viscous and non-viscous . Both, through different mechanisms, intervene positively against constipation. Those that produce an aqueous gel (the viscous ones) increase the volume of the faeces themselves, while those that, by fermenting, produce gas, increase the intraluminal pressure. While the former do not directly increase the speed of transit but help preserve the hydration (therefore the mass) of the faeces, the non-viscous fibers cause a muscle contraction reactionsmooth (segmentation and advancement) accelerating the overall movement. Furthermore, by acting as a substrate for bacterial fermentation, the fiber assumes the role of pre-biotic and improves the production of vitamins and other molecules useful to the body.
  The distinction between the two types of fiber is not simple and, to tell the truth, in practice it leaves its time. Vegetables , fruit , algae , cereals , legumesand mushrooms contain (in variable percentages) both types of dietary fiber and in the daily estimate it is first of all necessary to reach 30g TOT (recommended ration also for healthy adults). From here, however, it is possible to gradually increase it, while remembering that the fiber (together with other molecules contained in the foods themselves) also has an ANTI-nutritional function by chelating mineral salts (above all calcium , iron and selenium ).

  Water against constipation

  In the absence of water, even the intake of fiber could be in vain (or even counterproductive). Its function of diluting, gelling and kneading the contents of the faeces has a considerable anti-constipation action. The lack of water in the faeces does not allow the increase in volume and hinders the action of the intestinal bacterial flora, compromising peristalsis. Furthermore, the low overall body hydration increases the water absorption of the large intestine , enhancing the above-mentioned effect.

  For a diet against constipation it is therefore ESSENTIAL to introduce at least 1ml of water for every kcal taken in with the diet, without forgetting that any increase in physical activity promotes the loss of fluids. They are excellent habits to counteract constipation: bring water with you and remember to sip it from time to time during the day, drink at least 500-1000ml before, during and after physical activity (depending on losses) and consume 1 or 2 glasses at mealtimes.

  Intestinal bacterial flora

  it is now well understood that the bacterial flora favors nutritional processing, the production of useful molecules and the preservation of the integrity of the intestinal mucosa . It is genetically determined, but it is also influenced by lifestyle, medications and nutrition. For some subjects it is very useful to increase their trophism by taking prebiotics (components of dietary fiber) and/or probiotics . The latter are marketed in the form of drugs, supplements and dietetic foods . As far as food is concerned, it is not certain that they are concretely useful in preventing constipation since, undergoing the acidic action of gastric juices, a large part of the live and active bacteria contained therein perishes inexorably. On the other hand, an EFFECTIVE cure of probiotics (to be taken between meals ) by means of drugs or supplements increases the density of the intestinal bacterial flora with the advantages we have already mentioned.

  Lubrication of stool and intestines

  The walls of the digestive tract are involved in physiological mucous secretion; this protective action reduces the friction between the faecal mass and the epithelium, favoring the transit and reducing the possibility of abrasion. Food also contains some molecules that have the same physical characteristic: lipids . They grease the faeces and the walls of the intestine by simulating the action of mucus . Sometimes, boosting lubrication or keeping it from decreasing can be a key factor in preventing and treating constipation. Readers will ask, ” how can stool and bowel be lubricated? “. Simple, guaranteeing a total fat intake between 25 and 30% of thetotal calories .

  Avoid slimming diets

  We remind you that some good habits help a lot to fight constipation such as: eating a hearty breakfast (made up of solid and liquid foods), avoiding the frenzy in eating meals and assuming a sitting and comfortable position during breakfast, lunch and dinner.
  IMPORTANT! Finally, it should be remembered that certain slimming diets are harmful to the intestine , as they favor the onset of constipation. This reaction is due to several factors:

  1. Drastic reduction of fiber due to deprivation of derivatives of cereals, legumes, fruit and, in the worst case scenario, even vegetables (which provide dietary fiber)
  2. Increase in dietary protein to the detriment of fats and carbohydrates : fats, as anticipated, act as lubricants and their absence/deficiency determines an increase in mechanical friction in the digestive tract. At the same time, carbohydrates have (like fibre) a marked prebiotic function and any depletion compromises the activity of the intestinal bacterial flora; moreover, the excess protein does NOT favor the trophism of the physiological colonies and, often accompanied by ketosis, determines body dehydration with aggravation of constipation
  3. Reduction of water contained in food: a large part of the total water is provided by food; by greatly reducing the portions and not compensating with the amount drunk, the total amount of water could be insufficient and promote the onset of constipation

  Useful foods

  Then there are foods that lend themselves more than others to the constipation diet . Among these we highlight: fruits and seeds , leaves, flowers, stems and roots. More specifically, they are excellent against constipation: whole legumes, cereals and whole grain derivatives , artichokes , cabbage , Brussels sprouts , savoy cabbage, apples , pears , carrots , chicory , avocado , locust beans , chestnuts , feijoa , figs, prickly pears , guava , raspberries , macadamia , dried fruit (but in small portions), blueberries , blackberries , olives , passion flower , currants etc. They perform the anti-constipation function excellently both raw and cooked. Cooking promotes food digestibility and favors partial hydrolysis of some types of fiber, on the other hand, the process must NOT excessively deprive the food of water . The optimal combinations between the foods indicated above are mixed and cooked, i.e. soups, stews , purées,caponata etc.

  However, despite the very high fiber content , the intake of some foods is NOT considered positive against constipation. For example, the use of dehydrated fruit (NOT found in water) could have such a marked osmotic effect that it does not improve the disorder and, in some cases, risks making it worse.

  Foods not recommended

  Foods CONTRAINDICATED for constipation, on the other hand, are all those excessively processed, refined and dry; some examples are dried meat , crackers , breadsticks , taralli , fried snacks , sausages , salted meats , citrus juice (NOT whole citrus fruits), banana , etc.

  Finally, it should be specified that, in general, nervine drinks do not directly promote constipation even if, in the case of ethyl alcohol , there is a marked tendency to body dehydration, which inexorably affects the aggravation of constipation. On the contrary, in some cases, ethyl alcohol can irritate the intestine to such an extent as to cause diarrhea ; this aspect is erroneously interpreted as a relief by those suffering from constipation. On the other hand, it involves a rebound effect that arises only a few hours after the episode.

   

  Useful supplements

  As far as products able to moderate constipation are concerned, we specify from now on that no distinction will be made between drugs and supplements; for more information about it, it is advisable to read the dedicated article: Cures for constipation .
  The products considered curative for constipation, as they facilitate defecation, are many and belong to different categories.

  ATTENTION! The prolonged use of some laxatives can determine the body adaptation and the reduction of the effectiveness of the product itself; moreover, some laxatives act through chemical-physical mechanisms which are not entirely “healthy” for the intestinal mucosa and their use is recommended ONLY in case of strict necessity.

  • Fibers and lactulose : nutritional components that act by increasing volume and intraluminal pressure; can lead to excessive gas buildup
  • Osmotic : they increase the faecal volume by absorbing water from the surrounding environment (sometimes even from the intestine itself); can lead to dehydration and abdominal cramps
  • From contact : they block intestinal water absorption and can cause dehydration
  • Emollients : lubricants for stools and intestines; they can cause oily discharge from the anus .

  See an Example of Constipation Diet »