Nutrition Series
HealthLink BC File #68l, October 2007

Managing Constipation in Adults

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

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What is constipation?

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

Should I 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 three bowel movements every day. For others, it is normal to have three bowel movements every week.

What causes constipation?

There are many causes of constipation, including:

• A low fibre diet
• Lack of fluids
• Lack of physical activity
• Depression
• Overuse of laxatives
• 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 underactive thyroid, diabetes, multiple sclerosis, kidney disease, and hemorrhoids.

When should I see a doctor?

You should see a doctor if:

• There are sudden changes in your bowel habits; or
• If you have been constipated for some time, and dietary and lifestyle changes do not seem to help.

How can my diet help 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. When you eat more high-fibre foods, remember also to drink more fluids. For example, 9 cups for women and 12 cups for men each day.

Increase fibre in your diet slowly. A sudden increase in fibre may cause cramps and/or gas.

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 protect you from cancer.

Which foods are high in fibre?

Good high-fibre food choices include:

• Whole wheat and whole grain products, such as breads, crackers, bagels, pasta, and brown rice.
• Cereals with more than 4 grams of dietary fibre per serving (check the nutrition label on the side of the box).
• Legumes, such as cooked dried peas, beans, and lentils.
• Fruits and vegetables, including dried fruits.
• Bran muffins made with unprocessed wheat bran and whole-wheat flour.

Other Tips:

• Sprinkle or mix 15-30 mL (1-2 tablespoons) of wheat bran into foods like hot cereal, meatloaf or casseroles.
• 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 1 cup prunes, 1 cup raisins, 1 cup dates. Soak overnight in a mixture of 1/2 cup orange juice and 2/3 cup prune juice. Blend in blender. 1 cup of wheat bran can be added.

Fruit lax will keep for two weeks in the fridge or 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 resort 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 bulk forming laxative with psyllium. Long-term use of other laxatives can result in having to rely on them, or other undesirable effects.

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

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