Though not a topic many people like to discuss, constipation, especially in women, is quite common. If it occurs just occasionally, that is relatively normal and not a major health concern. But if your constipation is chronic, it can lead to other health issues.
All sort of reasons are offered as to why women are much more likely to be constipated than men. Anatomical differences, hormonal differences, more stress, are all mentioned as factors, but the truth is that medical science really doesn’t know why.
You are diagnosed with constipation if you have experienced 2 or more of the following for at least 3 months:
1- Less than 3 bowel movements a week
2- Hard stools 25% of the time or more
3- The need to strain to complete a bowel movement 25% of the time, or more
4- Inability to completely evacuate during a movement, 25% of the time, or more
5- Swollen abdomen or abdominal pain
The following list, provided by WebMD is fairly comprehensive in listing the potential causes of constipation:
- Inadequate water intake
- Inadequate fiber in the diet
- A disruption of regular diet or routine: traveling
- Inadequate activity or exercise
- Eating large amounts of dairy products
- Resisting the urge to have a bowel movement because of painful hemorrhoids or being in a public place
- Overuse of laxatives (stool softeners) which, overtime weaken the bowel muscles
- Neurological conditions such as Parkinson’s disease or multiple sclerosis
- Antacid medicines containing calcium or aluminum
- Medicines (especially strong pain medicines, such as narcotics, antidepressants or iron pills
- Eating disorders
- Colon cancer.
There are several types of laxatives which have different mechanisms of action:
1- Bulk-forming laxatives – These laxatives are fiber sources that absorb water and form soft, bulk stools that encourage normal contraction of the intestinal muscles. Psyllium (Metamucil), Benefiber, Citrucel, Fiber Choice are all examples. These laxatives are considered to be the safest and gentlest. One has to be sure to consume plenty of water when using these bulk laxatives. If not, they can have the opposite effect.
2- Saline laxatives – These laxatives draw water into the colon from nearby tissues. Examples are: Milk of Magnesia, Miralax
4- Stool softeners – Ducolax, Correctol, Colace, Kaopectate
5- Oral Stimulant laxatives – Ex-Lax, Senokot *
6- Rectal Stimulants – Bisacodyl*
7- Combination laxatives
*Stimulant laxatives are the harshest because they cause the intestine to squeeze and contract to expel the stool.
Getting Regular Naturally
Being dependent upon any kind of laxative for other than a few days is not desirable or healthy. The goal is to get your digestive system to work efficiently and consistently on its own.
Here are some natural ways to get your system back on track without relying on drugs:
- Changes To Your Diet – Fiber, especially insoluble fiber is key to intestinal and digestive health. For dealing with bouts of constipation the use of psyllium fiber (i.e. Metamucil) along with plenty of water is a good place to start. (Remember not taking enough water when on fiber supplements can worsen your constipations). 5-7 grams of psyllium 2-3 times a day is recommended.
The fiber attracts water into the stool allowing it to pass more easily. Vegetables are especially good sources of fiber as are beans and whole grains. A major source of constipation in infants is cow milk. Removal of this from their diet often brings complete relief of constipation.
Another excellent fiber source for treating constipation is glucomannan. It works as a bulk forming laxative and 3-4 grams usually brings relief in a day or so. Yet another very healthy fiber source is ground flax seed taken in similar amounts.
The chart below provided by the Gut Foundation is helpful in identifying good food sources containing healthy fiber.
The minimum recommended fiber for normal bowel movements for adults is 30 grams a day (for children the Digestive Health Foundation recommends adding your child’s age plus five grams, for an eight-year-old that is 8 + 5 = 13 grams).
Amount of fiber
|High-fiber mixed-grain bread||1 slice||1.6 – 3g|
|Whole grain pasta||1 cup cooked||9g|
|Brown rice||1 cup cooked||2.8g|
|Kidney beans (canned)||100g||6.5g|
|Source: The Gut Foundation|
The herb senna is a stimulant laxative and can be tried if the more gentle fiber options don’t work for you. Some people find that the herb, cascara sagrada another stimulant laxative is gentler than senna.
If after a week or two your constipation does not resolve with changes in your diet and using these natural alternatives, or if you every experience blood in your stool, it is important to visit your physician to determine if something more serious is causing your constipation.
Best of Health,
Curt Hendrix, M.S., C.C.N., C.N.S.