Constipation is characterised by hard stools that can be painful to pass. This happens when food moves too slowly through the digestive system, meaning that your stool is dry by the time it reaches the colon. It is normally harmless, despite being uncomfortable and irritating. Constipation is usually a result of diet and lifestyle factors. For example, inactivity, not drinking enough water, and a low-fibre diet are some of the leading causes of constipation. However, it can also be caused by some common medicines such as antidepressants, opiates and blood pressure tablets and even stress or anxiety can have an effect on your gut.
What helps constipation
Psyllium Husks - Help to bulk out your stools and absorb water, making them softer and easier to pass. Psyllium husks are preferable to stimulant laxatives (which cannot be used long-term), as they most closely mimic the natural mechanisms that promote bowel movements.
Exercise - Constipation is often exacerbated by low physical activity and a sedentary lifestyle. With many people having desk-jobs, this is a common problem. Exercising for 20 minutes a day may help stimulate peristalsis - muscle contractions associated with digestion. Even just going for a brisk walk or doing some yoga stretches may help get things moving and it also has other added health benefits. If increasing your physical activity remember to stay well hydrated, as this will help to soften the stools, making them easier to pass.
Apple Cider Vinegar
- acts as a natural laxative
- contains pectin, a water-soluble fibre that can help improve your overall digestion
- contains digestion-friendly malic acid and acetic acid
- contains small amounts of magnesium that helps promote regular bowel movements.
Kiwis - Are high in fibre but also contain a digestive enzyme that speeds up the digestive process.
Chia seeds - Add a tablespoon of these to your diet, decreasing or increasing (up to two tablespoons), depending on your digestive symptoms. Chia seeds need to be consumed with lots of liquid, and soaking them for as little as five minutes, but as long as overnight, is helpful. You can add them to cooked porridge or overnight oats or make a chia pudding.
Papaya - Is naturally rich in digestive enzymes. It also has soothing effects on the stomach and digestive tract. Eat after a meal or include it in a daily smoothie.
Oats - Oats contain soluble fibre which dissolves in water and forms a thick gel in the gut which softens stools. Oats are rich in soluble fibre, so try overnight oats for breakfast; and roast some root vegetables such as carrots, parsnips and celeriac to have at dinner.
Beans - Adding fibre-rich tins of beans (such as cannellini, haricot or kidney) to salads and soups or dishes such as cottage or shepherd’s pie will bulk your stools, which, in turn, applies pressure to the walls of the gut, stimulating peristalsis.
Apples - Consume one stewed apple a day. Stewed apples (cooked with a little water, until soft) are very supportive for gut motility and reducing inflammation. You can eat on them on their own or stirred through chia pudding or cooked oats.
Flaxseed - Eat flaxseed also known as linseed when you have chronic constipation. Choose the ground version, as it’s gentler on the tummy than the whole seeds. Start with one teaspoon a day and build up to a tablespoon. This gel-forming soluble fibre can take a while to work, so stick with it for a few months and make sure you drink an extra glass of water each day to help the process along.
Onions and garlic - Increase your intake of prebiotic fibres from foods such as onions, garlic, leeks, slightly under-ripe bananas, Jerusalem artichokes and asparagus as prebiotics help to feed beneficial species of bacteria in the gut.
Edamame beans - These are high in fibre to support friendly bacteria and soften stools, both of which support regular bowel movement.
Magnesium rich food - Sources include leafy greens such as spinach and kale , pumpkin seeds, almonds, avocado, kefir, and dark chocolate (at least 85% cacao).
Dandelion - Bitter tasting herbs such as dandelion root increase the production and flow of bile, which is a natural laxative. Take care, however, if you are pregnant or breastfeeding.
Chamomile Tea - Chamomile is a wonderful herb for the digestive tract because it helps to calm and soothe the nervous system. Use chamomile teabags or the dried flowers can be infused in water or milk to make an herbal beverage. Use one teaspoon of dried, or two teaspoons of fresh, flowers per mug.
Lemon balm - Herbs like Lemon balm work on the gut-brain axis, so are great for when constipation is linked to stress and anxiety.
Toilet Position - There is a little muscle that circles the colon like a lasso. Squatting relaxes this muscle and allows the colon to straighten, and the stool becomes easier to release. Putting your feet on a small stool so that your knees are above your hips will help optimise this position.
Gut Health - Look after your gut bacteria. Studies have shown there to be an imbalance of the intestinal microflora of those with constipation, compared to those without.
Fermented Foods - Fermented foods such as sauerkraut, kimchi, miso, live yoghurt, kefir, kombucha and pickled vegetables into your diet on a daily basis to support a healthy microbial balance.
Water Intake - Maintaining fluid intake is important to keep stools soft and easy to pass. Aim to drink around two litres of water a day (more if exercising). An easy way to tell if you are drinking enough is the colour of your urine, which should be a light straw colour. Flavouring water with fruits such as sliced lemon, lime or orange, or herbs, including mint or basil, can make it more interesting to drink. Herbal teas can also be counted towards your water intake.
Eating Slowly - Make time to chew, slow down and relax. When we eat in a stressed state our digestion can slow, we often do not chew properly, and we rush our food. This can lead to large particles of food being swallowed, and the body not being in the right 'state' for digestion, which can impact on stool motility and lead to constipation. Try to switch off from the outside world when eating – remove your phone or screen from the table, for example – and chew thoroughly.
Stress - Many constipation sufferers see a worsening of digestive symptoms when they are unhealthily stressed. This is perhaps no surprise given that stress essentially shuts down the digestive system, instead re-directing energy to systems and organs of the body that are useful in fighting or fleeing from a perceived threat. Try taking steps each day to reduce stress.
Low thyroid function, certain medications, hidden food intolerances, low stomach acid and digestive enzyme production or an over-growth of methane-producing bacteria in the small intestine (SIBO) can all contribute to constipation.
Online Therapy - If, after taking the above steps, you do not see an improvement in your symptoms, then it’s a good idea to investigate any other underlying causes.