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Let's talk constipation


Along with bloating, constipation is the digestive complaint I hear most frequently about from clients in my clinic. And with it being estimated that between 5 and 15% of the population have been diagnosed with IBS, is it any wonder that constipation is so common?


In order to understand constipation a bit better, let's first look at the two main types of constipation:


Primary constipation is when the constipation doesn't appear to have any other cause, aside from your waste disposal system just not working as well as it could. There is no clearly identifiable cause for the constipation. Functional constipation is most commonly seen in children and is also what we see in someone who has constipation predominant irritable bowel syndrome (IBS).


Secondary constipation is much more common in adults, and it occurs as the result of an underlying anatomic issue or underlying imbalance, illness or dysfunction, or as a result of medications such as opioids.


The two types of constipation are related, with a history of functional constipation in childhood being strongly associated with the development of secondary constipation in adulthood. This is because chronic constipation can result in imbalances in the gut microbiome (otherwise known as gut flora), leading to IBS symptoms or an overgrowth of bacteria in the small intestine (SIBO).


Now that we understand more about the types of constipation, let's take a look at some of the most common causes and what you can do to address them:


IBS or SIBO

A large percentage of IBS is caused by an overgrowth of bacteria in the small intestine (SIBO). In SIBO, the overgrown bacteria cause excess fermentation of methane, hydrogen or hydrogen sulphide gases, resulting in a wide array of digestive symptoms. In methane-dominant SIBO, waste products don't move forward through the intestines effectively, resulting in constipation.


Getting rid of this overgrowth and supporting the rest of the gut to heal can help to resolve chronic constipation. If you suspect you have SIBO, let's chat.


Stress

Stress slows your bowel motility, increases the tension in your pelvic floor and has a negative impact on your beneficial gut bacteria. It also contributes to leaky gut (intestinal hyperpermeability) and overall makes for an unhappy gut.


In children, going to the toilet in unfamiliar or stressful settings such as at school can result in them ignoring their urge. This results in water being absorbed back out of the stool, leading to hard stools and constipation, and ultimately a loss of the urge to have a bowel motion.


Encouraging kids (or yourself, if you're the one dealing with constipation!) to sit on the toilet at the same time every morning (after breakfast is a great time), and supporting their feet with a stool while on the toilet, can help establish regular bowel motions again. Just remember to keep the vibe relaxed because any pressure to have a bowel motion can have the opposite effect.


Low fibre diet

Fibre is food for your beneficial bacteria. They use it to produce short chain fatty acids, which play an important role in regulating your bowel function. Insoluble fibre draws water to your bowels, adding it to your stool to make it softer and and easier to pass.


Eating a diverse range of plant foods (aim for at least 30 different plants each week and 30 g of fibre a day) helps ensure you are getting enough fibre and giving your beneficial bacteria a rich variety of food, which in turn supports regular bowel motions. If you need some inspiration for ways to increase your plant food intake, I have just the thing for you.


Dehydration

This one is super common and thankfully easy to rectify. When you don't drink enough water, there isn't enough of it available to be absorbed through your large intestine and added to stool to soften it. Additionally, when you are dehydrated your body actually removes water from the stool so that it can use it for other purposes.


Aim for 35 mL of water per kilogram of body weight each day. For example, if you weigh 60 kg you will aim for 2.1 L a day.


Sedentary lifestyle

A sedentary lifestyle increases the risk of you developing chronic constipation, because when you are moving slowly so too are your bowels.


Exercise helps to make sure your food moves through your digestive tract in a timely manner. And as we just learnt, when the stool hangs around too long in the bowel water starts being reabsorbed from it back into the body, so an efficient travel time helps prevent constipation.


Having a regular daily bowel motion is one of your body's best detox mechanisms so when your bowels aren't working effectively, you can end up with a whole host of issues -- and not just digestive ones. Constipation is a very common problem, but thankfully there is a lot we can do to resolve it.


[Photo credit: Sasun Bughdaryan on Unsplash]



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