Introduction to Constipation
Constipation is reduced bowel movements, meaning less than 3 per week. Building a constipation care plan can make a HUGE difference in someones quality of life.
Working on a constipation care plan though involves understanding causes of constipation and getting to the root cause, so it’s not a chronic issue!
So what EXACTLY does constipation include?
Straining while pooping
A sense of incomplete evacuation of the bowels
Failed or lengthy attempts to poop
Use of digital manoeuvres to evacuate bowels
Abdominal bloating
Hard consistency of poop
Dealing with chronic constipation can have a serious negative impact on quality of life. This is why education on foods to reduce constipation needs to be evaluated.
By adding in high fibre foods you can reduce both the incidence of constipation as well as the risk of.
Common Causes of Constipation
Constipation incidence increases with age.
In 65 years and older occurrences are 26% in women and 16% in men. As we look to 85 years and older occurrences are 34% in women and 26% in men.
These numbers are also expected to be underreported, as a significant portion of people that deal with constipation may not report it to an official source such as a Doctor.
We do see some frequent causes that can be associated with constipation. These include:
Less physical activity
Reduced overall movement daily
Medication addition or change
Stress
Slowed gastrointestinal system related to ageing
Significant weight loss
Older age
Hormone changes (Hypothyroidism, Diabetes)
Neurologic diseases (Dementia)
Chronic Kidney Disease
Cancer (and related treatments)
Metabolic issues (Hyper/hypo – calcemia, kalemia, magnesemia, uremia)
Diet related constipation causes include:
Low fruit and vegetable intake
Low water intake
Low whole grains in diet
High processed food diet
High deep fried diet
Low fluid intake overall
What Medications Increase Constipation?
There is an extensive list of medications that can increase the risk of constipation. Here I will give you common medications that I see increasing the risk.
Analgesics (NSAIDs, opioids)
Antipsychotic drugs
Anti-Parkinson’s drugs
Anticonvulsants
Antidepressants
Antidiarrheal drugs
Antiemetic drugs
Antihistamines
Antihypertensive drugs
Chemotherapy drugs
When evaluating constipation causes, it’s important to look at:
The time frame when constipation began to occur
If there were any medications added
If there were any medication dosage adjustments made
If it is chronic constipation, is there a medication that can be adjusted/reduced?
If you want to see a full list of medications that can cause constipation, click here.
Current Fibre Recommendations
In order to meet the recommended fibre daily allowance, we need to know what they are.
The current fibre recommendations are:
Women → 21-25 grams per day
Men → 30-38 grams per day
These recommendations are for adults (not kids – if you want these numbers, check out paediatric research).
When adding fibre to your diet, it’s REALLY important that we also increase fluid intake as well.
If you simply add fibre without adding in fluids (think water), this can lead to some pretty uncomfortable gas and bloating. You need both to have great and frequent bowel movements.
How is Having More Fibre Beneficial?
Increasing fibre in the diet leads to SO many good things health wise.
Research shows that having a high fibre diet can lead to:
Better gut microbiota and gut health
Better insulin sensitivity
Better blood glucose control (Hello Better Diabetes levels!)
Better colon health
Better gut motility
Improved metabolic factors
Improved cardiovascular health
Better regulation of appetite
There is also some research that suggests that a high fibre diet could be related to decreased risk of colon cancer.
If we look at all these factors, they can and do lead to improved quality of life. So it’s important that we don’t overlook constipation.
Reducing constipation occurrence and risk can lead to better overall health.
Food or Medications: What Should I Choose First?
Research actually does support taking a food first approach to treating constipation! Woo Hoo!
Medications should be a close to last resort when treating constipation. Even in long term care homes where we see very high rates of constipation, medications are not the first route.
Medications may be able to temporarily relieve constipation discomfort, but they do not get to the root cause.
Getting to the root cause which can typically be helped with high fibre foods, can help to reduce risk of future incidence.
Medications act as a bandaid to treating constipation, one that needs to constantly be reapplied – and doesn’t treat the underlying skin issue.
So we need to take a look at foods that treat constipation!
Looking at taking a food first approach means increasing the amount of fruits, vegetables, and whole grains that are in the diet.
Foods and Constipation
There are many myths surrounding foods that will instantly relieve constipation, so I wanted to take some time here to dispel myths.
Does Celery Juice Make You Poop?
One cup of celery has 5 grams of fibre. This is a decent amount of fibre for a ‘serving’. But imagine sitting down and eating a full cup of just celery?
No thanks.
That sounds awful.
And the gas that would be associated with having a full cup of celery… Yikes.
Celery juice would involve pureeing the celery, so you would likely have more than 1 cup of fibre in a cup of celery juice. Many people resort to celery juice because the calories in it are so low.
But we need to think about practicality when talking about fibre. Practically speaking, I would never recommend eating a full cup of celery to improve constipation.
Though celery may aid in reducing constipation and help you poop, I’m not sure that the pros outweigh the cons.
Does Oats Cause Constipation?
Oats are a fantastic source of fibre, and it’s a realistic food that can be incorporated in the diet. Having a cup of oats in the form of oatmeal for breakfast (a very real serving size) can provide 7.5 grams of fibre.
You can also add in other sources of fibre to a morning cup of oatmeal such as chia seeds, ground flax seeds, berries, and more to add flavour.
It’s a great way to start the day.
So no, oats do not cause constipation. They can actually provide some relief from constipation.
Does Peanut Butter Make You Constipated?
A regular serving of peanut butter is a couple tablespoons, maybe more for some people. So you might get about 2 grams of fibre in a serving of peanut butter.
Not a huge amount, but you need to look at consistent sources of fibre, so peanut butter may be a great addition to add fibre.
Many people will ask, does peanut butter make you constipated?
Not necessarily. Some people may feel constipated due to an overall lack of fibre in the diet. Not because of one food item, such as peanut butter.
Having a high sugar peanut butter may cause some people to have constipation symptoms. But peanut butter by itself will not cause constipation.
If you want to reduce the amount of sugar in the overall diet, choosing an all natural peanut butter source will do that.
Foods High in Fibre
Fruits
Vegetables
Whole Grain Foods
Nuts and Seeds
Foods may not always work, so what else is there to do when dealing with constipation?
What Else Can I Do To Reduce Constipation?
Move it move it!
Moving the body is a fantastic way without any other interventions to relieve constipation. It can help to reduce bloating, gas, and discomfort to help food digest faster.
If someone has difficulty moving due to mobility issues, any type of movement can help.
This can include simple arm exercises, leg lifts, moving the trunk, every little bit can add up.
Increasing fluid intake can also help. So increasing the amount of water taken in daily can help with reducing incidence of constipation.
Try to get at least 8 cups of fluids a day, you can add more as you are able to handle it.
Sometimes people do not want to increase their fluids because getting up to pee is not easy. This can also present a problem with people who have mobility issues and use incontinence products.
They may not want to take in more fluids due to restrictions on getting assistance with changing their products.
You can increase the amount of fluid rich fruits and vegetables to reduce the occurrence of peeing so often. Think about melons, berries, celery, etc.
There may be a time though where no matter how much fibre is added to the diet, and movement, fluids, are added, and constipation still isn’t ‘cured’.
This does happen, and as we age and go through various health conditions, we need help with constipation by medications.
There is nothing wrong with medicating constipation, it just shouldn’t be the first resort.
If medications are needed there are some common ones we see are:
Colace
Senokot
PEG
Metamucil
None have too harsh of side effects that I’ve seen, especially in the elderly. Typically the benefits will outweigh many side effects.
So there is no shame in adding a medication to aid in constipation prevention, but it should be used in conjunction with a high fibre diet.
Constipation Care Plan
For Clinical Dietitians specifically, we have to build a nutrition care plan around constipation. So what does that look like?
Nutrition Problem:
Inadequate fibre intake.
Nutrition Goals:
Increased bowel movements to a minimum of 4 times weekly.
Increased bowel movement comfort as reported by patient.
Nutrition Intervention:
Add bran flakes daily to breakfast tray (¾ cup)
Add ground flaxseed daily to breakfast cereal (1 tbsp)
Provide a minimum of 2000 mL daily of fluids (as chosen by patient)
Preferences to be accommodated
Nutrition Monitoring/Evaluation:
Bowel movement frequency will be tracked by health care aides beginning in 2 weeks from implementation of high fibre diet. Bowel movements will be tracked for 2 weeks.
Constipation Diet Plan PDF: Download Your Free Copy!
If you want a sample copy of what a constipation diet plan can look like, download your copy here!
Are you still looking for more great food ideas for high protein, preventing weight loss, and building healthy foods?? Click here to read more!
