When Constipation is the Enemy
Americans are notorious for spending outrageous amounts on laxatives and other remedies in their battle against chronic constipation. Product producers estimated that at least $725 million is expended yearly on the problem that plagues so many people. Women are two to three times more likely than men to encounter more problems with constipation because we have a slower transit time through our digestive system. Our intestinal tract is also longer. And there seems to be a hormonal correlation because women who are pregnant or post-menopausal report more problems than others. Apparently, estrogen helps with regulation, but this is not scientifically verified. Regardless of what’s been tried, the most effective answers lie in behavioral strategies - activity and foods. Let’s just review the foods that work and the ones that remain largely unproven.
The most important answer is to build a higher percentage of one’s daily intake of food from plant foods like whole grains, beans, vegetables, nuts, and fruits. The closer to a natural, unprocessed source, the more effective these food groups can be. Opt for non-ground wheat bran. And eat it as cereal, not in sugary muffins. The kinds of beans you should eat are black beans, split peas, kidney beans, lentils, chickpeas, and pinto beans. A single, half-cup serving of each carries 6- 8 grams of fiber. Fresh vegetables are good too but lower in fiber, more like 2-5 grams per half-cup serving. Don’t be fooled by thinking lettuce is high in fiber. It’s 95% water. Those highest in fiber are peas, sweet potatoes with skin, and broccoli. Whole wheat pasta (one cup cooked) is packed with 6 grams, but brown rice has half as much. Blackberries are wonderfully rich in fiber, with 8 grams in a cup. A pear has 5 grams. Because of its bulking properties, insoluble fiber such as in beans is promoted over soluble fiber such as in oat bran, but both are considered helpful.
How many grams a day do you need? At least 25 grams, and this increases as you age. As we grow older, we typically are less active physically and we are less active sexually, both helping to “move” our bowels. And we tend to drink fewer liquids. While we don’t need extra water if we’re constipated, we do need to be hydrated sufficiently especially if we’re adding fiber to the diet. The point is to avoid becoming severely constipated because then the preventive measures of a high-fiber diet don’t work, and the impaction of stool has to first be addressed before getting back on track.
Be cautious about foods that actually ferment in the gut and cause intestinal gas and even diarrhea. Examples are onions, garlic, artichokes, leeks, and asparagus. They will just create new problems. Try to avoid the harshest of commercial laxatives because they induce contractions in the intestines in an effort to move stool through. This can create spasms, cramping, and sudden fecal urgency. And don’t become overly reliant on stool softeners. These are helpful for people who should be careful about straining, such as pregnant women with hemorrhoids or older women with pelvic organ prolapse. But extended use can result in an electrolyte imbalance, affecting our potassium, sodium, and chloride levels. Even prolonged use of saline-based laxatives such as Fleet Enema or Milk of Magnesia can result in such imbalances, leading to dizziness, weakness, and falls.
Constipation makes us feel heavy, sluggish, irritable and downright lousy. It can even be painful. And it exacerbates symptoms of overactive bladder, even mimicking symptoms of OAB when stool is pressing on the bladder. Reexamine your diet and your medicine cabinet. Get moving
Nancy wrote for HealthCentral as a patient expert for Incontinence.