As women, I think it is safe to say that we do like to consider ourselves queens, but, that doesn’t mean we like to hang out on the “throne” all day, the porcelain throne that is. Yes, ladies, I am talking about constipation.
In my field, one of the basic assessment questions I ask my patients is “Are you constipated?” Let’s face it, when you are constipated you are uncomfortable. Bloating leads to loss of appetite, and depending on how long it goes on, some people become anxious and depressed.
While it may not be the most delicate of subjects, it’s an ailment that most people have experienced at least once in their lives. Reality TV fans (of which I am one) might remember just a few weeks ago on “I’m A Celebrity, Get Me Out Of Here,” Janice Dickinson had a bout with severe constipation. She was extremely uncomfortable on account of having not had a bowel movement in over a week, and made a point of showing her extremely bloated stomach, which she said “looked like she was four months pregnant.”
So, what is constipation?
Constipation is clinically defined as having a bowel movement less than three times per week, but can also refer to straining during a bowel movement and having hard or dry stools.
Roughly 4 million people in the U.S. report constipation, and the complaint is much more common among women than men. It is also more common among older adults and pregnant women.
What causes constipation?
In Janice’s case, there were probably several factors that contributed to her problem. For one thing, it had to be awkward to attempt to go to the bathroom in the middle of the jungle, not to mention, she may not have been hydrating enough in that extreme heat (I recall all of the contestants were sweating constantly), and finally, for all intents and purposes they existed on rice and beans. While the beans have both soluble and insoluble fiber, the rice is notorious for having a binding effect on one’s gastrointestinal system.
Most commonly, a lack of adequate fiber in the diet can cause constipation. Also, not taking in enough fluids and not getting enough physical activity can contribute to constipation. It’s also very possible that simply ignoring the need to go to the bathroom will ultimately end up in constipation, so when the urge hits, its best to indulge yourself!
Constipation can also be the side effect of medications and/or supplements (i.e. iron and calcium); and some diseases can cause constipation.
How can you relieve constipation?
Ultimately, Janice had to go to the hospital to take care of her problem, but, for the average, non-celebrity/jungle bound person, there are several dietary measures you can take to avoid getting to the point of no return.
The same issues that cause constipation are the ones that will help to cure it. Since I’m a nutritionist, my advice is to focus on food, diet and exercise first. So here are the four basic rules to follow to get things moving again:
1. Make sure you are consuming adequate amounts of fiber, the minimum intake
Cabbage can help get things moving
should be ~25g/day. Consume fiber from all sorts of sources such as fresh fruits and vegetables, whole grains, nuts and legumes.
2. Consume adequate fluid. A rough estimate would be 2 liters per day, or basically enough to ensure that when you urinate it is pale yellow to clear colored. If you want a more specific estimate, the average adult under the age of 55 requires 35cc/kg of body weight (i.e. a 45 year old, 150 lb woman would require ~2.4 liters of fluid per day)
3. Move at least 30 minutes per day. Think of it in the same way you do about your daily exercise routine, except that not only are you toning your skeletal muscles and heart, you are also toning the smooth muscles of your GI system.
4. Take advantage of your body’s natural urges. If you feel the need to make a trip to the bathroom, don’t ignore it. In fact, every time you do eat a meal, this sets in motion a natural movement of the entire GI system, and generally results in the urge to go the bathroom. So, there should be at least three chances a day (depending on how many meals you eat) to make it happen.
There also some some specific foods and beverages that are thought to aid in constipation, though, not necessarily clinically proven, anecdotal evidence indicates they are worth a try:
Prunes/Prune Juice
Apricots
Raisins
Coffee
Salmon or other fatty fish
With that in mind, there are also some foods and beverages it’s best to avoid when you are experiencing constipation:
Rice
Milk
Cheese
What if none of these treatments work?
If you increase your fiber, fluid, exercise and take advantage of every urge you get, and the problem still persists, there are several other treatment options available. They range from stool softeners to emollients to laxatives. Though these are outside the scope of this particular post, the more benign of these is generally considered to be the “bulking laxatives,” which you might know better as psyllium husk (Metamucil).
Before using any of these alternate treatment options though, it’s best to check in with your health care provider to rule out any non-lifestyle or diet related causes.
This post is part of the Women’s Health Blogfest. Read more posts from Women’s Health bloggers at the following links:
Angela White at Blisstree’s Breastfeeding 1-2-3 – Helpful Skills of Breastfeeding Counselors
Angie Tillman, RD, LDN, CDE – You Are Beautiful Today
Anthony J. Sepe – Women’s Health and Migraines
Ashley Colpaart – Women’s health through women
Danielle Omar – Yoga, Mindful Eating and Food Confidence
Diane Preves M.S.,R.D – Balance for Health
Joan Sather – A Woman’s Healthy Choices Affect More Than Herself
Laura Wittke – Fibro Study Recruits Participants
Liz Marr, MS, RD – Reflecting on Family Food Ways and Women’s Work
Marjorie Geiser, MBA, RD, NSCA-CPT – Healthy Women, Healthy Business: How Your Health Impacts a Powerful Business
Marsha Hudnall – Breakfast Protein Helps Light Eaters Feel Full
Michelle Loy, MPH, MS, RD – A Nutritionista’s Super Foods for Super Skin
Monika Woolsey, MS, RD – To effectively work with PCOS is to understand a woman’s health issues throughout her life
Motherwear Breastfeeding Blog – How breastfeeding helps you, too
Rebecca Scritchfield, MA, RD, LD – Four Keys to Wellness, Just for Women
Renata Mangrum, MPH, RD – The busy busy woman
Robin Plotkin, RD, LD – Feeding the Appetites of the Culinary, Epicurious and Nutrition Worlds-One Bite at a Time
Sharon Solomon – Calories, longevity and do I care
Terri L Mozingo, RD, CDN & D. Milton Stokes, MPH, RD, CDN of One Source Nutrition, LLC – Crossing the Line: From Health to Hurt
Wendy Jo Peterson, RD – Watch Your Garden Grow
Reference List:
Higgins PD, Johanson JF. (2004) Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. Apr;99(4):750-9.
Eoff JC. (2008) Optimal treatment of chronic constipation in managed care: review and roundtable discussion. J Manag Care Pharm. Nov;14(9 Suppl A):1-15
Mahan LK, Escott-Stump S. (2004) Krause’s Food Nutrition and Diet Therapy. Philadelphia: Saunders
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). July 2007. Constipation. Retrieved July 14, 2009 from: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/
