by Monica Reinagel, M.S.,L.D./N.
Today's show is for all you folks who wish you were more regular…and by that I don’t mean more normal. That’s right: We’re talking about constipation this week.
Occasional constipation is extremely common and although it’s usually not serious, it can be a real drag. Natasha asked if I’d do a show on this subject and I’m glad she suggested it. I learned some things I didn’t know while researching this episode. If you’ve already heard the conventional wisdom on this topic, I think you’ll still want to stay tuned.
How to Relieve Occasional Constipation
If you’ve ever complained to your doctor about occasional constipation, he or she will most likely have suggested that you try to eat more fiber, drink more water, and get some regular exercise. It’s not bad advice. But the truth is, doing these things might or might not help.
Take exercise, for example. It’s true that people who live very active lifestyles tend to suffer from constipation less often than those who are more sedentary. And, should you find yourself immobilized—by an accident, or surgery, for example—you might have some constipation as the result of the physical inactivity.
So it seems logical that exercise would be a good way to treat irregularity. But, actually, studies have found that when normally active people are suffering from constipation, getting more exercise doesn’t really improve things. Don’t get me wrong: exercise is still a great idea—but its reputation as a cure for constipation might be somewhat exaggerated.
Caffeine: A Double-Edged Sword
Drinking more fluids might not be as helpful as you hope, either. Dehydration can cause constipation but the fact is that most people who are constipated are not actually dehydrated. As you might recall from my episode on the dehydration myth, coffee and tea are not dehydrating and are not constipating.
In fact, you may have observed that caffeine has a stimulating effect on the bowels. But this can be a double-edged sword. Caffeine, while relatively harmless, is habituating. Suddenly withdrawing all caffeine from your diet can cause some temporary withdrawal symptoms while your body adjusts to the change. That can include sleepiness as well as some temporary constipation.
But back to fluids: there is one time that drinking more fluids really can help with constipation. When you increase the amount of fiber in your diet—as people suffering from constipation are often advised to do—you’ll get more benefit if you also increase your fluid intake.
Fluids Plus Fiber Work Better Than Either Alone
The combination of a high-fiber diet and increased fluid intake is your best shot at avoiding occasional irregularity. You can get more fiber from bran (especially wheat bran), beans and legumes, and fruits and vegetables. Eating more fruits and vegetables is particularly efficient, because they are high in both fiber and fluids.
Low-carb dieters often have quite a bit of difficulty with constipation, by the way. That’s because low-carb diets are usually low in fiber and high in protein, which tends to be dehydrating. It’s really a perfect storm. Fiber supplements can help, but it’s very important to take them with plenty of water.
Check the Medicine Cabinet
OK, so you’re getting enough fiber—at least 25 grams a day. You’re not dehydrated. And yet, things still aren’t good. It’s time to look in the medicine cabinet. There are several common medications that can cause constipation, including drugs commonly prescribed for high blood pressure, pain management, and depression. If you think one of these might be a problem, you should check with the doctor who prescribed them to see if your medication can be adjusted.
Calcium and iron supplements can also cause constipation, as can calcium-containing antacids like Tums or Rolaids. It’s important to get enough calcium but it’s also possible to overdo it. Keep in mind that most of us get about half to two-thirds of the recommended amount of calcium from foods. If you take calcium supplements, you really only need enough to make up the difference between what you get from your diet and the recommended intake.
Dairy Products: Friend or Foe?
Calcium from foods—especially dairy products—can be constipating, as well. If you eat a lot of dairy and you struggle with constipation, you might want to cut back and see if it helps. There are non-dairy milks you could try, and for advice on that check out the episode I did a few weeks back. Increasing your intake of potassium and magnesium can also help to offset the constipating effects of calcium. Potassium and magnesium are found in—you guessed it—fruits and vegetables. (What can’t they do for us?)
Finally, there is one type of dairy that you might want to get more of; yogurt contains beneficial lactobacillus bacteria that can help keep you regular. There’s no need to pay extra for the yogurt with the suggestive downward arrow on the package, though. The beneficial bacteria in regular yogurt work just as well.
Though constipation is usually not serious, it can be a sign of more serious medical issues. So if what you’re experiencing is severe, ongoing, or doesn’t respond to any of the suggestions I’ve given here, it’s time to check with the doc. He or she can rule out other causes. The House Call Doctor has an episode about bowel problems, which might be a good place to start if you think your constipation is indicative of a larger issue. There are also some pharmaceutical treatments that can help if your constipation doesn’t improve with diet and lifestyle change.
This is Monica Reinagel, reminding you that these tips are provided for your information and are not intended as medical advice. Please work with your health professional to determine what’s right for you.
If you have a suggestion for a future show topic, send an email to email@example.com or leave me a voice mail at 206-203-1438. Please include the topic of your question in the subject line of your email. You can also post comments and questions on my Nutrition Diva Facebook Page or find me on Twitter.
Have a great day and eat something good for me!
Medical Update on Constipation (Cleveland Clinic Journal of Medicine)
Episode #2 Benefits of Fiber
Episode #4: Fermented and Cultured Foods
Episode #6: The Dehydration Myth
Episode #25: Diet for Strong Bones
Episode #33: Caffeine and Health