Constipation refers to the inability to defecate. Hard, small and difficult-to-pass stools are the most frequent complaint. The frequency of defecation and the consistency and volume of stools vary so greatly from individual to individual that it is difficult to determine what is normal. In general, most nutritionally oriented physicians recommend at least one bowel movement a day.
What Causes Constipation?
There are a number of possible causes of constipation, but the most common is a low-fiber diet. Other common causes include inadequate fluid intake; lack of physical activity; medications such as anesthetics, antacids and diuretics; low thyroid function; and irritable bowel syndrome.
What Dietary Factors are Important in Constipation?
A high-fiber diet, plentiful fluid consumption and exercise is an effective prescription in most cases of constipation. High levels of dietary fiber increase both the frequency and quantity of bowel movements, decrease the transit time of stools and the absorption of toxins from the stool, and appear to be a preventive factor in several diseases. I recommend 25 to 35 grams of fiber from food per day.
Two foods that are particularly effective in relieving constipation are bran and prunes. The typical recommendation for bran is 1/2 cup of bran cereal, increasing to 1 1/2 cups over several weeks. When eating bran, make sure to drink at least six to eight glasses of water per day. Whole prunes as well as prune juice also possess good laxative effects. Eight ounces is usually an effective dose.
Cow’s milk was determined to be the cause in roughly two-thirds of children with constipation, according to studies published in the prestigious New England Journal of Medicine. Presumably, the same significance holds true for adults as well.
Which Nutritional Supplements Should I Take for Constipation?
Foundation Supplements. High potency multiple vitamin and mineral formula; Vitamin D3 2,000-5,000 IU/day; Fish oil, EPA+DHA 1,000 to 3,000 mg/day.
Psyllium-containing bulk laxatives are the most popular fiber formulas used to relieve constipation. Other fiber formulas are composed of natural plant fibers derived from kelp, agar, pectin and plant gums such as karaya and guar; or purified polysaccharides such as methyl-cellulose and carboxymethyl cellulose sodium. These bulking agents are the laxatives that approximate most closely the natural mechanism that promotes a bowel movement.
Barley malt extract is an especially effective bulk laxative for infants and small children. Follow label directions based upon age and size of child.
Senna (Cassia senna) is the most gentle of the stimulant laxatives. Cascara sagrada (Rhamnus purshiana) and aloin (from aloe vera) are more likely to produce severe cramping, electrolyte and fluid deficiencies, and malabsorption of nutrients. Stimulant laxatives should never be used as an initial treatment of constipation, and they should be discontinued as soon as normal bowel function is restored. Follow label directions when using senna and other stimulant laxatives.
Artichoke leaf extract (Cynara scolymus) is often quite helpful in chronic constipation. It works by increasing the output of bile, which attracts water to the feces and acts as a mild laxative. Take 150 to 300 mg daily.
How Do I Know if the Recommendations are Working?
Relief of constipation and the easy passage of normal, well-formed stools are clear signs the program is working.