Going, Going, Gone–Prevention and Treatment of Constipation
added 05/10/11
by Mary Saucier Choate, M.S., R.D., L.D.
Dietitian and Co-op Food and Nutrition Educator
A frequent question I get is about the topic of constipation. It is apparently a very common problem that many people struggle with. In fact, more than 4 million Americans have frequent constipation. Women and adults ages 65 and older are most often affected. Pregnant women may have constipation, and it is a common problem following childbirth or surgery. There is a surprising lack of research on which are effective foods, activities, and supplements to prevent and treat it.
Let’s define what constipation is and then discuss some foods and supplements that may be helpful to try until solid research can show which are superior to others. These suggestions should be discussed with your doctor or pharmacist, as some foods and supplements may interfere with prescription and over the counter medicines and with other supplements you may be taking.
According to the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, constipation means having a bowel movement fewer than three times per week with hard, dry, small, and difficult to pass stools. Sometimes it can be painful to have a bowel movement and people who are constipated may experience straining, bloating, and the sensation of a full bowel. While some people think they are constipated if they don’t have a bowel movement every day, “normal” can mean three times a day or three times a week, depending on the person.
Increase Fluids
Getting enough fluids can offer relief to some people. Water is fine, but beverages such as flavored club soda, tea, coffee, and juice, as well as juicy fruits like apples and oranges will all add fluids to your diet.
Increase Fiber
The recommended amount of fiber for overall health is 25 grams a day for women and 38 grams a day for men. Foods that add fiber to your diet are: all vegetables, especially dry beans, such as garbanzos, black, and pinto beans; fruits, including those with edible skins; whole grains such as oatmeal and 100% whole wheat breads and cereals; and nuts and seeds.
Increase Physical Activity
Taking a daily walk or walks, or doing other activities that use the lower body and legs may be helpful.
Check for Constipating Medications
Medications that can cause constipation include: narcotics, aluminum and calcium-containing antacids, calcium channel blockers to treat high blood pressure, anti-Parkinson drugs, antispasmodics, antidepressants, iron supplements, diuretics, and anticonvulsants. If you have constipation and are on any of the medicines listed, ask your doctor if there is a non-constipating substitute. If not, the treatments discussed may still be useful.
Dietary Supplements That May Be Helpful
The following list of dietary supplements is from the Natural Medicines Comprehensive Database, one of the most comprehensive, science-based, and practical natural medicines databases.
They rate natural medicines on a scale ranging from “Effective” to “Ineffective” as well as noting those with insufficient reliable evidence to give them a rating. If you are on other medicines or supplements, please discuss these constipation treatments with your doctor or pharmacist to avoid potentially serious interactions. Read and follow package directions carefully.
Highest Effectiveness Rating:
PSYLLIUM
Taken orally works as a bulk laxative and reduces constipation.
The FDA requires that psyllium be labeled: “WARNING: Taking this product without adequate fluid may cause it to swell and block your throat or esophagus and may cause choking. Do not take this product if you have difficulty in swallowing. If you experience chest pain, vomiting, or difficulty in swallowing or breathing after taking this product, seek immediate medical attention”.
MAGNESIUM
Taking magnesium orally is helpful as a laxative for constipation. Magnesium citrate, sulfate, and hydroxide salts are typically used. The magnesium sulfate salt is the most potent.
Rated as Likely Effective:
CASCARA
Taking cascara orally has laxative effects and helps for treating constipation.
EUROPEAN BUCKTHORN
Taking European buckthorn orally is effective as a stimulant laxative for constipation and is comparable to the gentle, laxative effects of cascara.
OLIVE OIL
Taking olive oil orally is effective as a mild laxative for reducing constipation.
SENNA
Taking senna orally is effective as for a short-term treatment of constipation. Senna is an FDA-approved nonprescription drug for adults and children ages 2 years and older.
Rated As Possibly Effective:
ALDER BUCKTHORN
Taking alder buckthorn orally seems to relieve constipation. Alder buckthorn has laxative effects comparable to cascara.
ALOE LATEX
Taking aloe latex orally as a stimulant laxative seems to relieve constipation.
CASTOR OIL
Taking castor oil orally is effective as a stimulant laxative for reducing constipation.
GUAR GUM
Taking guar gum orally seems to relieve constipation due to its bulk laxative effects.
INULIN
Taking inulin orally seems to increase the number of stools from 1-2 per week to 8-9 per week in elderly patients.
WHEAT BRAN
Taking wheat bran orally seems to be effective for treating mild constipation and restoring normal bowel function.
XANTHAN GUM
Taking xanthan gum orally as a bulk-forming laxative seems to decrease constipation.
For More Information:
National Digestive Diseases Information Clearinghouse
nddic@info.niddk.nih.gov
Best Practice 12(7) 2008 JBI Management of constipation in older adults. http://connect.jbiconnectplus.org/ViewSourceFile.aspx?0=453
Natural Medicines Comprehensive Database
http://s.coop/nmcd
