How to get a move on: Constipation solutions that work
We know — you’d prefer not to talk about it, but constipation is a common problem. Luckily, our experts have proven tips to get things moving.
How often do your bowels move? It’s hardly a discussion you have at work, or at dinner with your friends! And that’s the problem, because it leaves people in the dark about what a normal bowel habit is and what counts as constipation.
It’s time to talk about what’s normal, and answer those questions you’re too embarrassed to ask.
A common problem
Almost one in five people over 30 has constipation at some stage during their life, according to the Gut Foundation, so it’s not a topic we can ignore.
Sometimes, people will only discover they have constipation when talking with their doctor. Up to that point they thought that having a bowel motion once a week was a normal thing and ‘just like everyone else’.
So, what is normal?
Everyone’s bowel habits are different, but ideally, your bowel will move once or twice a day, most days of the week. It should move easily without you having to strain, and the motion should be soft and bulky. See ‘What’s normal, what’s not?’ (at right) for what a normal stool — or bowel motion — should look like.
Many people often describe constipation as ’straining’ or having hard, pellet-like stools, not being able ’to go’ when they feel the need, or not going often.
But typically, chronic constipation is diagnosed when a person has bowel motions twice a week or less. There may be other symptoms, such as straining to pass a bowel motion, bloating or abdominal discomfort, or a sensation of not emptying the bowel completely.
What causes constipation?
Your stools are mostly made up of fibre, so rapid changes in the amount of fibre you eat can vary the frequency and hardness of your stools.
You may at times experience constipation just from eating more takeaway or processed food, or by diet changes such as going vegetarian or trying out a gluten-free, paleo or low-carb diet. Taking holidays and eating different foods can also cause constipation.
Fibre draws water into your bowel to soften the waste products. Increasing the fibre you eat without drinking more water can cause your stools to harden and become more difficult to pass.
Stress is also a common trigger for the condition. During times of anxiety, blood flow is redirected away from your gut, which slows down digestion and sometimes leads to constipation.
You may also become constipated by sitting for long periods, or by taking medications such as antidepressants, diuretics and anti-epileptics. Ironor calcium supplements can have this effect, too.
What’s normal, what’s not?
This guide is based on the Bristol Stool Chart, which helps show the shape and texture of different stools, so you can compare yours. Types 3 and 4 are ideal.
How to get things moving
Constipation is increasing due to our modern way of life. Here are four ways to improve your regularity.
1 Move regularly
We sit for hours at work, but a healthy gut likes activity — if you move, then your gut moves too. Studies suggest that regular activity such as walking can encourage bowel motions. Gentle, relaxing exercise like Thai Chi or yoga may also help relieve constipation.
2 Drink plenty of water
Fluid helps the fibre you eat soften and swell, creating a bulkier bowel motion. A US study found fluid was the most important determinant of constipation levels in 8000 adults.
Those who drank the most fluid were the least likely to suffer from the condition.
Most adults need about 1.5–2 litres of fluid each day — so carry a water bottle with you or keep a glass on your desk as a reminder to drink throughout the day. And keep refilling it.
3 Add high fibre foods
Eating more fibre can make the stool bigger and bulkier and speed up its transit time through the gut. A bigger, bulkier motion also makes the digestive tract muscles squeeze, which gives you the urge to go to the toilet.
Fibre is found in vegetables, grains, fruit, nuts, seeds and legumes like lentils, beans and chickpeas. Increase fibre in your diet gradually to give your gut time to get used to the change, and to avoid bloating.
4 Listen to your body
Many people ignore the need to go to the toilet when out, or at work, for example. They’re too busy, don’t like to use public toilets, or are embarrassed to make a noise or smell.
If you often don’t make time to go when the urge arises, your bowel can stop sending you the message.
Often, the best time for bowel movements is the first two hours after waking, or after breakfast. A hot drink can be enough to get you going! Allow time to respond to this urge, rather than ignoring it.
5 Ways to boost fibre
Choose grainy, high-fibre bread made with wholemeal flour (check the label for more than 5g fibre per 100g).
Snack on raw nuts, sunflower seeds or pumpkin seeds.
Leave the skin on fruit and vegetables rather than peeling them.
Sprinkle 1–2 tablespoons of bran, LSA mix, chia seeds or linseeds on cereal, or add to a smoothie.
Add canned legumes (chickpeas, lentils, kidney beans) to meals such as bolognese, curry or soups.
Help! I’m so gassy!
First of all, passing wind is normal. Gas is a natural by-product of the digestive process. According to the Gut Foundation, the average number of emissions per day for men is 12 and women seven, depending on the person and the quality of their diet.
If you notice a change in your bowel habits, along with bloating and wind, it’s worth talking to your doctor as it may be an indication of Irritable Bowel Syndrome.
But I’ve done all that… and I’m still constipated!
In some cases, adding fibre, fluid and engaging in physical exercise doesn’t improve constipation. So the next step could involve a fibre-bulking supplement, laxative or probiotic.
Fibre-bulking supplements such as Benefiber, Metamucil, Normafibe or psyllium husks are concentrated forms of plant fibre that are dried and ground up into a powder or granules.
Follow the recommended dosage on the pack and slowly build up the dose. Make sure you drink more fluid than usual.
There are a variety of laxatives. Some work by drawing water into the colon, others stimulate the colon muscles to squeeze. Speak to your GP or pharmacist about the best laxatives for you.
Probiotics are strains of healthy bacteria that help you balance out ‘good’ and ‘bad’ bacteria in your gut. One particular strain that can help constipation is found in Yakult drinks, available in supermarket fridges.
If you’re trialing a probiotic, take it for a month to see if it improves your symptoms. If it does, then continue it daily for three–to–six months.
If, despite all your efforts, constipation persists, see your GP. And if you see blood in your bowel motions (black stools) or unexpected weight loss, it’s especially important to consult your doctor.