Best Foods To Relieve Constipation 

Constipation is a very common condition that can affect people of all ages and can cause discomfort and many complications. Although there are many available medications to manage constipation, the first intervention the doctor might advise is to make lifestyle changes, like eating a more balanced diet that includes specific types of food. In this article, you will learn about constipation, its causes, risk factors, diagnosis, and management, and then you will learn what the best foods are that can be used to relieve constipation.

Constipation

What is constipation?

Constipation is infrequent bowel movement or difficulty in passing stools to what is normal to your usual bowel movement habits, and it could be paired with strained hard stools. The case is considered acute if constipation lasts more than three months and chronic if it lasts more than three months.¹

How common is constipation?

Constipation is one of the most common digestive system disorders, and it can affect people at any age, from infants to the elderly. The average prevalence of constipation worldwide was found to be around 15% (12.8 per 1000 people in the UK). Constipation is more prevalent in females than males, in pregnant women (almost 50% of pregnant women), and in older people (almost 34% of people aged over 60 have constipation). 

What can cause constipation?

Constipation could be caused by a dysfunction in the colon or the rectal area or without known cause; it is called primary constipation in these cases. Also, it could be caused by disorders of other organs or when certain medications are used; it is called secondary constipation in these cases.

Some of the medications that can cause constipation:

• Antidepressants
• Oral iron supplements
• Analgesics (pain killers) of the opioids family

Some of the disorders that can cause constipation:

• Neurological (multiple sclerosis)
• Psychiatric (e.g. depression)
• Metabolic (e.g. hypothyroidism)² 

What are the risk factors for constipation?

There are several risk factors that might increase your chances of having constipation:

• Lifestyle changes
• Lack of exercise
• Family history of constipation
• Depression and anxiety
• Eating disorders
• A diet low in fibre
• Dehydration
• Little physical activity
• Female sex 
• Old age

How is constipation diagnosed?

The doctor will ask about the history of your bowel habits and how they are different now. You might also request that you use a stool diary for a couple of weeks to write down your stool frequency, shape, and ease of passage. They might ask about your medications and might conduct a physical examination to rule out any underlying causes.¹ 

The doctor might use this criterion to diagnose constipation:³

When at least two of the following is present for the past three months:

1. Straining in >25% of stools.
2. Hard stool in >25% of stools.
3. Sense of incomplete evacuation in >25% of stools.
4. Less than three bowel movements/week. 

How is constipation managed?

Depending on your age, whether you are pregnant or not, and on the cause of constipation, the constipation management might be slightly different. In general, the healthcare provider might:

• Advise you to gradually increase your fibre intake, be more active, and drink more water
• Encourage you to have a regular toilet routine and immediately use the toilet when you sense the need to defecate
• Prescribe laxatives if the lifestyle change measures do not work. There are many different types of laxatives. To learn more about them, you can read here.

When to see a doctor?

• Your constipation is not getting better with treatment
• There is blood in your stools
• You are losing weight for no apparent reason
• You are constipated regularly and for long periods

If constipation lasts for long, it could lead to some complications like impaction, a case where large amounts of dry stools are stuck in the rectum.

Foods that can relieve constipation:

As a non-pharmacological intervention for constipation, the doctor might suggest changes in your diet to include foods that might help with constipation.

Fibres

What is fibre?

Fibres are a type of carbohydrate (sugars) found in plants that our bodies cannot break down, so they pass through the large intestine when eaten without being digested. Fibres have many benefits for our health; a fibre-rich diet was found to decrease the risk of diabetes type 2, heart disease, and some types of cancers.  Some studies found that patients who ate a fibre-rich diet had a higher number of stools and a better stool consistency, and a recent study has found that prune juice, which is rich in fibres, caused a decrease in hard stools in patients with constipation.^4,5 

How do fibres work to relieve constipation?

Fibres act in different ways depending on their type:

1. Insoluble fibres: like the ones found in coarse wheat bran, are the type of fibres that can act as a laxative. They are large and can irritate the walls of the gut, which reacts by producing water and mucus as a defence mechanism. In turn, this will increase the amount of water in the stools, which will soften them, making them easier to pass.
2. Soluble fibres: this type can hold onto water and, therefore, soften the stools too. However, as most of these fibres are used in the intestine by bacteria, they lose their laxative effect. One exception is psyllium, which stays intact in the gut, retains water and softens stools.⁶ 

What foods are rich in fibres?

Fibres are found in plant foods like fruits, vegetables, whole grains, nuts, seeds, beans, and pulses but cannot be found in animal sources. Insoluble fibres can be found in whole grains, nuts, and seeds, while soluble fibres can be found in fruits, vegetables, and grains (e.g. oats).

The daily recommended fibre intake is 30 g daily, and to avoid digestion problems (e.g. bloating), the intake must be increased gradually, and is better to be taken with enough fluids. In addition, the diet should include fibres of different types to get the health benefits that each type provides.

Although it is best to consume fibres from whole foods, they are available as supplements that can be added to food or mixed with drinks and as tablets. It is important to consult a doctor if you take medications, as some fibre products can affect how some drugs work and can interfere with their absorbance. 

Probiotics:

What are probiotics?

Probiotics are live, “good” bacteria that, when consumed in proper amounts, can play a role in the health of the gut and other organs in the body. Probiotics can be used to treat many digestive conditions, such as acute infectious diarrhoea, Antibiotic-associated diarrhoea, and irritable bowel syndrome in children and adults.⁷

Multiple studies have found that the use of probiotics was beneficial in constipation.^8,9 A bacteria type called Bifidobacterium lactis is one of the most studied probiotics and might be suggested to relieve constipation.

How do probiotics work?

The human gut has a substantial number of good microorganisms, known as the gut microbiota, that are important for the health of the intestine and the immune system, and probiotics are believed to positively affect the microbiota. Also, probiotics play different roles in maintaining the guts healthy. For example, they can help get rid of toxins and microorganisms that cause disease. One of the hypotheses on how they work in constipation is that they stimulate the gut to produce mucus, which could act as a lubricant and make the stools pass easily.¹⁰   

What foods contain probiotics?

Probiotics can be found in foods and dietary supplements; yoghurt is one of the foods that can contain probiotics. Also, probiotics can be added to infant formulas, milk, juice, and nutrition bars. Additionally, probiotics can be available as dietary supplements such as capsules and powders. Probiotics are generally safe across all age groups (infants, children, adults, and elderly people); however, caution must be taken in people with immune problems.¹⁰  

Summary

Constipation is a very common condition that can appear in different age groups but is more common in older age and pregnant women. It is characterised by changes in bowel movement frequency to what is normal for the patient and is usually accompanied by strained hard stools, and if it lasts for more than three months, it is considered chronic.

Many disorders and some medications can cause constipation, and in many cases, it can appear for no obvious reason. The doctor diagnoses the condition by asking the patients questions about their bowel movement and stool structure to see if it meets certain criteria; also, they might carry out some physical tests.  

This condition can be managed by lifestyle changes like being more active, staying hydrated, and introducing foods that can relieve constipation to the diet. For example, foods that are rich in fibre, like fruits, vegetables, and whole grains, in addition to foods and supplements that contain probiotics (good bacteria) like yoghurt, can help relieve constipation.