Nutrition Series
HealthLink BC File #68l, March 2011

Managing Constipation in Adults

• What is constipation?
• Should you have a bowel movement every day?
• What causes constipation?
• When should you see a doctor?
• How can diet help constipation?
• A High Fibre Diet has Other Benefits
• Which foods are high in fibre?
• What about prunes?
• What about laxatives?

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What is constipation?

If you have constipation, you may have hard bowel movements (stools) and you may feel unable to empty your bowel completely. Constipation may cause abdominal pain and bloating in some people. In general, you are not constipated if your bowel movements are soft and pass easily without strain or discomfort.

Should you have a bowel movement every day?

It is not true that everyone must have a bowel movement daily. For some people, it is normal to have 3 bowel movements every day. For others, it is normal to have 3 bowel movements every week.

What causes constipation?

There are many causes of constipation, including:

• A low fibre diet
• Not enough fluids
• Not enough physical activity
• Depression
• Overuse of laxatives
• Not using the washroom when you feel the urge
• Travel or change in regular routine
• Side effects from certain medications, such as iron or calcium supplements, antacids with aluminum or calcium, antidepressants, antihistamines, narcotics, antispasmodics, diuretics, tranquilizers, and some heart medications.
• Health conditions that may not be diagnosed, such as irritable bowel syndrome, underactive thyroid, diabetes, multiple sclerosis, kidney disease, celiac disease, and hemorrhoids.

When should you see a doctor?

You should see a doctor:

• If there are sudden changes in your bowel movements or habits; or
• If you have been constipated for several days and dietary and lifestyle changes do not seem to help.

How can diet help constipation?

No specific foods cause constipation. Many people with constipation can benefit from a high fibre diet and lots of fluids.

High fibre foods help to hold water in the stools, keeping them soft. Slowly increase fibre in your diet. A sudden increase in fibre may cause cramps and/or gas.

When you eat more high fibre foods, remember also to drink more fluids. Women should aim to drink 9 cups/2.25 litres of fluid every day, and men should aim for 12 cups/3 litres each day.

A High Fibre Diet has Other Benefits

A high fibre diet may help control diabetes and high blood cholesterol levels. Many fibre rich foods, such as legumes, whole grains, vegetables and fruit, may help prevent certain cancers.

Which foods are high in fibre?

Good high-fibre food choices include:

• Whole grain and whole wheat products, such as breads, crackers, bagels, pasta, and brown rice.
• Cereals with more than 4 grams of dietary fibre per serving - check the Nutrition Facts table on the package. Legumes such as cooked dried peas, beans, and lentils.
• Vegetables and fruits, including dried fruit. Juice is not high in fibre.
• Bran muffins made with unprocessed wheat bran and whole wheat flour.
• Wheat bran and flax seeds are high in fibre. Sprinkle or mix 15-30 mL (1-2 tablespoons) of wheat bran into foods like hot cereal, meat loaf or casseroles. You can also add 15-30 mL (1-2 tablespoons) of ground flax seeds to cereals or baked goods.

What about prunes?

If a high-fibre, high fluid diet does not relieve your constipation, try eating prunes occasionally. Prunes are a good source of fibre, and they also contain a substance that is a natural laxative.

You may also try Fruit Lax occasionally. The recipe is as follows:

Combine:

Soak overnight in a mixture of:

Blend this in a blender.

250mL (1 cup) of wheat bran can also be added.

Fruit lax will keep for two weeks in the fridge, or it can be frozen. It can be used as a spread on toast or mixed into hot cereal or plain yogurt.

What about laxatives?

Laxatives should only be used as a last option for constipation. Try diet and lifestyle changes first. If your constipation does not get better, speak with your doctor about using a laxative. The first choice of laxative is generally a fibre supplement with psyllium – for example, Metamucil® or Benefibre™. Long-term use of other laxatives can result in relying on them or other undesirable side effects.

For more nutrition information, call 8-1-1 to speak with a registered dietitian.

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