Managing constipation with diet: Adults

What is constipation?

Constipation is when you have bowel movements (stools) that are hard to pass or that happen less often than is usual for you. You may have:

• Lumpy or hard stools
• Straining when you pass a bowel movement
• The feeling that you cannot empty your bowels completely

If you do not have a bowel movement every day, it does not mean you’re constipated. Some people might have 3 bowel movements per week. Others might go 3 times per day.

It’s more important to look for changes in the frequency and texture of your bowel movements.

What causes constipation?

Common causes of constipation include:

• Not eating enough fibre
• Not drinking enough fluids
• Not getting enough physical activity
• Ignoring the urge to poop
• Use of supplements like iron and calcium
• Use of medications such as antacids with aluminum or calcium, antidepressants, antihistamines, pain medications with codeine, muscle relaxants, diuretics, and some medications for heart conditions, seizure disorders and Parkinson’s disease
• Health conditions such as irritable bowel syndrome, colorectal cancer, eating disorders, underactive thyroid, diabetes, Parkinson’s disease, multiple sclerosis and depression
• Hormonal changes, such as during pregnancy

When should I see a health care provider?

See a health care provider if you experience constipation and have:

• Pain or swelling in your belly
• Blood in your stool or bleeding in your rectum
• Unexplained weight loss
• Vomiting
• A family history of colorectal cancer
• Not seen improvements after a week of making lifestyle changes

If you’re unsure if you should see a health care provider, call 8-1-1 to discuss your symptoms with a registered nurse.

What are the possible complications?

Complications from constipation can include:

• Hemorrhoids
• Cracks or tears in the skin of the anus
• Weakening of the muscles and ligaments that hold the rectum in place
• Diverticular disease
• Fecal impaction, where stool hardens and becomes stuck, causing a blockage 

How can my diet help with constipation?

Fibre and fluids work together to help keep your bowel movements regular and easy to pass. Fibre holds liquid in your stool to keep it soft.

If you’re not getting enough fibre in your diet, add fibre-rich foods gradually over a few weeks. A sudden increase can cause bloating and gas. 

 Remember to drink more fluids as well. Water is your best choice. Other healthy options include:

• Unsweetened coffee and tea
• Unsweetened lower-fat milk and fortified plant-based beverages such as soy, oat, almond
• Low-sodium soups

If your urine is light yellow or clear, it usually means that you’re getting enough to drink. If your urine is dark yellow and has a strong smell, you likely need more fluids.  

Which foods have fibre?

You can find fibre in plant-based foods such as:

• Vegetables and fruit, including canned, frozen and dried
• Whole grain and whole wheat products, such as bread, cereal, pasta, brown rice, oats, oat bran, barley, bulgur, millet and quinoa
• Beans, split peas, lentils and soybeans
• Nuts and seeds

To find out how much fibre a packaged food has, read the nutrition facts table. The percent daily value (% DV) shows if the food has a little or a lot of a nutrient. 5% DV or less is a little, 15% DV or more is a lot. Look for foods with a higher % DV.

Tips for boosting your fibre intake

• Leave edible skins on fruits and vegetables
• Add sliced vegetables or leafy greens like spinach and kale to casseroles, curries, omelettes, pastas, sandwiches and soups
• Add fruit or sprinkle nuts and seeds on top of oatmeal, cereal, yogurt and salad
• Replace half the animal protein in a dish with beans, peas or lentils. For example, replace half the ground beef in chili with beans
• Sprinkle chia seeds, ground flax seeds or bran (wheat or rice) into hot cereal, smoothies, or mixed into nut butters. You can also add larger amounts to meatloaves, casseroles or homemade baked goods

Can eating prunes or drinking prune juice help constipation?

Yes. Prunes and prune juice contain fibre and sorbitol, a naturally occurring sugar alcohol. Sorbitol has laxative and stool-softening effects.

Prunes can be eaten on their own or added to recipes, such as fruit lax.

Fruit lax recipe

• 250 mL (1 cup) prunes
• 250 mL (1 cup) raisins
• 250 mL (1 cup) dates
• 125 mL (1/2 cup) orange juice
• 150 mL (2/3 cup) prune juice
• 250 mL (1 cup) of wheat bran (optional)

Combine ingredients and soak overnight in the fridge. The next day, blend until smooth.

Try fruit lax on toast or crackers, or mix into hot cereal or plain yogurt. Recipe will keep for 2 weeks in the fridge. Extra portions can be stored in the freezer. 

What can I take to help with constipation?

Laxatives are medications that help with constipation. If you have a hard time managing your constipation or getting enough fibre from foods, check with a health care provider about using laxatives. There are many types of laxatives and some are more gentle than others. Some can make your body depend on them if used for a long time.

Fibre supplements are safer to use long-term, but are less likely to improve constipation caused by medications or medical conditions. Common fibre supplements include psyllium, inulin, methylcellulose and calcium polycarbophil.

It’s important to make sure you follow directions for taking fibre supplements, such as drinking plenty of fluids. If you take medications, ask a pharmacist if fibre supplements will affect any of them. 

For more information

Call 8-1-1 to speak with a registered nurse, dietitian, pharmacist or qualified exercise professional. 

HealthLinkBC File #68h Fibre and your health

HealthLinkBC File #68i Healthy snacks for adults

Canada’s food guide recipes: https://food-guide.canada.ca/en/recipes/