Updated: Oct 5, 2022
If your bathroom breaks require straining, or if you can finish one of my long-winded blog posts before you've finished doing your thing, you might be one of the 20% (1) of us experiencing constipation this year.
So what's keeping so many of us from being regular? Not eating enough fibre is a major component here - most of us are getting less than half of the recommended amount (2)! But lack of fibre isn't the only thing that can slow things down. If you're trying to get to the bottom of why you're constipated (come on, I had to include at least one constipation joke or my Dad would have been disappointed), remember that your hydration levels, your stress levels, and your overall health can also contribute to how regular you are (or are not). Now, depending on your health history, the Canadian Digestive Health Foundation (14) recommends checking in with your doctor if you've been experiencing significant constipation symptoms for more than two weeks.
If constipation is a regular occurrence (okay, bad choice of words there), you can often eliminate it (I can't stop) through some lifestyle and nutritional adjustments. And the best way to determine where to start is to consider what your bathroom experiences are usually like, and what your stool looks like. Are you ready? Things are about to get, well, descriptive.
I think most of us *know* when we're constipated. But, for clarity's sake, I'll be using the Bristol Stool Chart as a reference. If you're not familiar with this chart, it provides rather detailed drawings of seven different types of poop. I've added it to the bottom of the article to use for your reference. So, according to the Bristol Stool Chart, if your stool is pellet-like, hard, or lumpy (drawing #1 and #2, if you're referencing the chart), you might be experiencing some constipation (3).
Eat More Plant-Based Foods You Already Enjoy
Depending on how much fibre you're currently consuming, work towards increasing it slowly by a few grams per day. Experts recommend between 25 and 38 grams of fibre per day, with at least 6 grams of that being soluble fibre (4). Legumes, fruits, veggies, whole grains, nuts, and seeds contain varying amounts of both soluble and insoluble, so choosing a selection of each is recommended.
Start by adding high fibre foods to your existing meals or snacks rather than making full on food swaps (such as replacing white bread with whole grain bread). A lot of times, there is a significant change in flavour and texture in your replacement choice. So while that whole grain choice might have more fibre, if you hate the flavour, you're probably not going to stick with that change.
Give it a Try: if you're a cereal person, try topping it with your favourite fruit or raw nuts. If you're planning on pasta one night, maybe you'd enjoy some cut up (or pureed) veggies in your sauce. The next time you make a chili, try serving it with some quinoa or barley.
Dehydration is one of the most common causes of constipation (5), which means increasing your water intake is my number two (yep) choice. Without adequate hydration, stool will become hard and difficult to pass, which means even if you're eating enough fibre, you'll still experience constipation. If you're seeing stool like drawing #1 or #2 and you're already eating a lot of fibre, or if your stool is lumpy but cracked (drawing #3), you might need to up your hydration game.
How to Start
As a general rule, we need around 3L of fluid each day (6). Usually, around 1L of that can be obtained from "wet" foods that we eat, such as fruits, veggies, legumes, cooked oats, etc. That leaves us with a 2L baseline goal, with additional requirements when considering factors such as exercise, climate, eating habits, alcohol use, and level of thirst.
Try to spread your intake out over the day by sipping on some of your favourite beverages, and this can include coffee and tea! Contrary to popular belief, caffeine is not as dehydrating as some may think. If you're a regular tea or coffee drinker, studies show that consuming caffeine does not lead to an excess of fluid loss (ie is not more dehydrating than any other fluid), nor is it associated with poor hydration status (7). That said, caffeine is still a stimulant, and while there are some possible benefits to consuming caffeine, it interacts with our hormones as well as our brains, and experts recommend staying within 8 to 24 oz of coffee per day (8).
Give it a Try: If you don't normally drink very much throughout the day, 2L may seem a bit overwhelming. Start by increasing your fluid intake by just 1 glass at first, and then slowly add more every few days as you feel ready. Remember that you don't have to drink only water!
While there isn't a definitive answer as to *why* it helps, studies indicate that Qigong, walking, physical movement, and aerobic exercise all have a positive impact on constipation symptoms (9). That said, intense exercise (over-training, or very intense training sessions) can also have an impact on our digestive tract. That's because chronic over-training can lead to an increase in stress, which (coincidently) can also lead to constipation issues. Conversely, some training - particularly endurance based training, can sometimes lead to other GI issues, like loose or watery stool (#6 or #7 if you're referencing the chart).
How to Start
If you are currently experiencing constipation symptoms and you exercise regularly, evaluate your current program. How often are you exercising per week? For how long? At what intensity? Does your program include rest days? (hint: it absolutely should!) What are your energy levels like after a workout? If your workouts are super intense, super long, or scheduled on most days, with little to no recovery built into your program, your workouts may be contributing to your constipation symptoms.
If you are currently experiencing constipation symptoms and you're not exercising very regularly, consider adding some intentional movement into your day. This can be anything from a walk, to a kitchen dance party, to playing with your kids.
Give it a Try: Since blood is diverted from the gut to working limbs during exercise, avoid exercising right after a meal to minimize cramping or other GI symptoms. Depending on your current exercise habits, consider walking, try out a fitness class, or turn on some music and dance it out. Aim for a minimum of 10 minutes to gain some heart health benefits, too.
Research continually points to a deep connection between the brain and the gut (10). There's enough information there to write several more posts, so I'll save that for a different day and just share with you that based on it's influence on the autonomic nervous system, stress can create disturbances in our digestive tract, leading to constipation symptoms or loose or watery stool. If you've been noticing your stool is trending more towards drawings 1, 2, 6 or 7, take some time to evaluate the stress in your life. Given everything we've been living with over the past 2 years, it's reasonable to assume our stress levels are high. And while we can't necessarily do much to change our current situations, we can make some changes to how we're coping with that stress. Find some stress relieving techniques that work for you such as meditation, physical activity, visits with friends, reading, or making time for your favourite hobbies. (For more information on how to support yourself during stressful periods, check out this article).
How to Start
If you suspect stress is contributing to your current constipation symptoms, determine whether there are things you can adjust within your schedule to reduce your stress load. Consider creating stronger boundaries between work/home life, removing non-urgent things from your to-do list, or asking family members for additional help with tasks. Then, try out some coping techniques and figure out what things work best for you. Try to come up with things that can help you out in the moment (ie breathing techniques), systems that can reduce the impact of future stress (such as meal planning, or not taking on additional responsibilities), as well as things that create joy.
Give it a Try: This week, prioritize your mental health by planning a joyful activity, and set aside some time to plan out a weekly menu. Your joyful activity can be whatever you’d like – big or small – just be sure to put your phone away to avoid the temptation of responding to emails or scrolling social media. When it comes to meal planning, I try to make leftover heavy meals over the weekend so that I have a few days of leftovers during the weekdays. If I’m really on the ball, I end up cooking only one or two meals on weeknights!
Become Besties with Bacteria
Our gut is home to all kinds of friendly bacteria that help with digestion. When the delicate balance of bacteria is disrupted, it can lead to digestive problems, such as symptoms of constipation, or even diarrhea. Enter: pre- and probiotics! Prebiotics are found in starches such as whole grains, fruits and veggies, and legumes. They feed the friendlies already present in our gut (11). Probiotics *may* help add more friendly bacteria into the mix; however research is mixed on specific benefits. Probiotics tend to be “strain-specific and population-specific”, meaning only certain strains are beneficial for specific health issues, and they don’t always work the same for every person (12). It does, however, appear that supplementing with specific probiotic strains can be beneficial for people with IBS, or people experiencing diarrhea from antibiotics or from travelling.
How to Start
To increase your prebiotic intake, take stock of what fruits, veggies, whole grains, and legumes you already enjoy, and choose one or two to add to your meals or snacks. Food sources of probiotics include yogurt, kefir, sauerkraut, kimchi, and kombucha. If you’re thinking to increase your probiotic intake, I’d recommend consuming more food-based sources rather than choosing a supplement (unless specifically recommended by your doctor, in which case, be sure to confirm the strain they are recommending!). Probiotic supplements are often expensive, and since the strains you choose must match the symptom you’re trying to improve, and they might not even work for you, you could be quite literally flushing your money down the toilet.
Give it a Try: Personally, I don’t supplement with pre- or probiotics, but I do consume plenty of plant-based foods, and consume yogurt, kefir, and other fermented foods somewhat regularly. If you choose to supplement with probiotics, research suggests consuming between 1 million to 1 billion colony-forming units (CFUs) (13). Be sure to consume them before their expiry date to ensure you are getting the dosage you think you’re getting. Monitor your symptoms to determine if they are working for you. If they aren’t giving you any marked improvements within a month, it might not be worth continuing them (15). Lastly, as with any supplementation, it is best to speak with your doctor or pharmacist prior to starting something new. There are some cases where probiotics may not be beneficial, and in some cases, may not be advised at all.
Digestive issues such as constipation can be a pain in the butt, but they aren’t impossible to crack (last ones, I promise). Touch base with your doctor if these symptoms are new for you, or if it’s been going on for more than 2 weeks. Implementing one of these changes might help, but give it about 2 weeks or so before trying another one so that you can determine what changes are im-poo-ving (sorry) your symptoms.
Cheering You On,
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