We often ignore our constipation!

Constipation is far more common than you think. And I know from meeting many of you in my clinics that it’s a problem that is unfortunately not very high on our priority list to address.

While clients may come to me looking for help with weight loss, or for advice on starting a veggie diet, it’s only when I ask the question about “the bowels” that people start bringing up their struggles with constipation.

Constipation can affect your everyday life.

I get it – talking about pooh is definitely not high on our list of desired conversation topics… And I guess working as a dietitian for over 5 years, I have become almost too forthcoming with this topic. But in all fairness, if our bowel habits are off, it can affect so many other elements of our life. From that dull aching pain that constipation can use to distract us during important meetings, to the fear of going on holidays because constipation strikes at the most inconvenient times – I’ve heard it all guys. And I want us to stop ignoring it! 

Lets call those “sluggish” bowels and those twice weekly bowel movements by their real name – constipation. And let’s start taking charge of some of the elements such as diet and lifestyle to help relieve the discomfort and even risk that comes with constipation!

First of all, what is constipation?

Constipation can mean three main things.

Frequency and constipation

Firstly, it can mean that you are not pooing as often as your normally do, or I usually say, if you are not going at least every 3 or so days.

Difficulty moving bowels and constipation

You can also be constipated if you are having to strain more than normal, or if you feel that you cannot completely empty your bowels when you try to.

Stool consistency and constipation

And lastly, it can also mean that your poos are unusually large or small, and are lumpy or hard.

Risks of being constipated

There is a wide range in how severe constipation can be. While many people may experience constipation on and off, or only a handful of times in their life, for other people, this may be a chronic, or long-term, problem. Especially if this is a more long-term problem, people may notice a lot of pain and discomfort, or may start to experience a problem called faecal impaction (which is where your stools start to collect in your rectum), or overflow stools, which is where you may be at risk of incontinence.

While you may be able to manage your constipation with the diet and lifestyle factors we discuss today, you may also require over the counter laxatives. And if your constipation is very severe, or you are not able to manage it with diet and lifestyle changes alone, you should consult your GP about this also. I am also available for 1 to 1 consultations myself, where I can analyse your diet and bowel habits in more depth and work with you to implement diet changes that are more tailored to your needs.

So then, what causes constipation?

There are many factors that can make you more prone to constipation. These can include things such as:

• Not eating enough fibre
• A change in your normal routine
• Immobility or not exercising regularly
• Ignoring the urge to go to the toilet
• Not drinking enough liquids.
• Being over or underweight
• Mental health concerns such as trauma, anxiety or depression
• Several types of medications
• Hormonal changes, especially for women who are pregnant.
• And lastly, some medical conditions may affect your risk of constipation as well. Therefore I always recommend that you speak to your GP if you are experiencing severe constipation or your symptoms do not improve with the diet and lifestyle changes you make.

What happens in our gut when we get constipated?

Before we delve into the advice, I will quickly run us through how our guts work when it comes to constipation. Your intestines are a long tube that help us digest and absorb our food. The lining of this tube is made of muscles, which help to move the food, and eventually poos, through our gut. First of all, we need our poos to be soft enough to pass through all the way without getting stuck. However, at the same time, we need our poos to be solid and bulky enough to allow the muscles in our gut to have something to push against. And managing this balance of bulkiness and softness is something we can try to use our diet to influence.

So what can I do with my diet and lifestyle to help prevent and treat constipation?

When it comes to advising my clients on strategies to manage constipation with our diet, I often categorise the advice into three sections, each starting with the letter F. These form the angles on what I call my triangle of constipation. I’m a very visual learner myself, so love these little visualisations of complex dietary advice!

So the first F, or piece of the constipation triangle, is Fibre.

I could talk about fibre forever, but to keep this video short, I’ll give you an outline on the role of fibre in constipation. And I’ll do a video specifically on the different types of fibre in two weeks time!

When we try to make our poos more bulky, remember to help give the gut muscles something to push against, we need to include plenty of fibre. Fibre is what gives the bulk to our stools. Fibre swells up once it is in contact with water, and helps to fluff out the poos to help move them through the gut.

Many of us in Ireland do not eat enough fibre, and so I often recommend that my clients increase the amount of fibre that they eat to help relieve constipation. Good sources of fibre include wholegrains (such as brown breads, wholegrain breakfast cereals, brown pasta), and fruits, vegetables, nuts and seeds. Including fibre at different meals throughout the day will feed your gut a steady supply of fibre to help bulk out those poos.

The second F of my constipation triangle is Fluid.

Without fluid, the fibre we eat will dry out our poos a little too much. This can result in hard stools that are difficult to move through the gut. Drinking enough fluid can help to make your poos softer.

The balance of fibre and fluid can be nicely seen when it comes to Weetabix! Imagine you tried to eat a Weetabix without the milk on it. It would be a pretty tough biscuit to get through, right? But when you add your milk to your Weetabix, it swells up and becomes a lovely soft mix that is still bulky but much easier to get through. This is what happens further down in your gut too, when you drink more fluids and eat more fibre.

We recommend that you aim for at least 8 cups of fluid a day, which is about 2 litres a day. Water, tea, squash, juice – all liquids count, but water is best for your teeth!

And finally, the last F of my constipation triangle is Fitness.

Now in all fairness, I prefer the term “physical activity”, but fitness starts with an F and so fits my triangle better… But yes, we are recommended to be physically active for at least 30 minutes on 5 days of the week. Physical activity almost acts like a massage for the gut, helping you to move the food through more smoothly. Any movement is better than no movement when it comes to our gut health, and stretching, gentle walks and housework also count! And a little extra tip here – research has shown that sitting in a squat position for some time before going to the toilet can help make it easier to move your bowels afterwards!

So when you are working your way through constipation, remember my three F’s of the constipation triangle. Fibre, fluid and fitness all work together to help your gut to move that digesting food through more smoothly.

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