Don’t you just hate it when things get backed up? You can feel bloated, uncomfortable and trying to move things out can be downright painful!

Constipation is a common problem for a lot of people and for a lot of different reasons. In fact, constipation affects approximately 16% of adults worldwide (1). But you don’t need to struggle with this! We are here to help provide you with strategies to help “unclog the pipes”.

Constipation is characterized by the following symptoms (3):

• fewer than three bowel movements per week
• hard, dry, or lumpy stools
• difficulty or pain when passing stools
• a feeling that not all stool has passed

There are many reasons people experience constipation.

• Almost half of pregnant women report having constipation as a result of higher levels of progesterone.
• Women can also experience constipation as part of their menstrual cycle.
• Not consuming enough fibre and water can contribute to constipation.
• Taking medications such as pain meds can really impact bowel motions.
• Lack of exercise can also contribute to constipation as movement with the body helps with passage of the stool through the intestine.
• If a person often “holds it in” to avoid going, this can also cause stools to get backed up and contribute to constipation. This can be a common problem with kids.

What Can I Do To Help Stop Constipation?

Top 7 Nutrition Strategies To Help Relieve Your Constipation:

1. Consume Adequate Fibre To Bulk Things Up

There are two types of dietary fiber, soluble and insoluble. Both types of fiber have a role in treating and preventing constipation. Both types of fiber are also essential for keeping your intestinal system running smoothly. Soluble fiber draws water and therefore retains more water within in your stool, making waste larger and softer, resulting in easier to pass bowel movements. Insoluble fiber adds bulk to your fecal material, speeding up the transit time through your gut and preventing that heavy constipated feeling.

Fruits and vegetables, whole grains and legumes are all healthy sources of fiber. If you still feel you struggle to get enough fibre from food, fiber supplements are also available. In fact, one 2016 review found that 77% of people with chronic constipation benefited from supplementing with fiber (4).

Remember, when increasing fiber intake, do so slowly. Increasing fibre intake too quickly, might overwhelm the digestive tract and make constipation or abdominal pain worse.

Canadian guidelines for minimum fiber intake is as follows:

2. Drink Water To Get Things Flowing:

To help your stools move through your digestive tract, taking in an adequate amount of fluid is very important. Often, we are just not drinking enough! Nearly ¾ North Americans are chronically dehydrated despite the vast majority of us having easy access to safe drinking water on demand.

Health Canada recommends on average 2.7 liters for women a day and 3.7 liters for males a day. However, if you are a larger person, live an active lifestyle, or are pregnant or breastfeeding, you are likely to need even more than this.

If you don’t like water, try infusing it with fruit, vegetables, or herbs. Freshly squeezed lemon juice can be great to help stimulate digestive processes. Plus, using a water bottle is helpful as you can carry this with you, and because it can hold more water it means less trips to the fridge to fill it up.

Increasing water intake when increasing fiber intake is critical, as both work closely together to help get the bowels working optimally.

3. Drink Herbal Teas To Help Ease Constipation Symptoms

Certain herbal teas can not only help make it easier to consume adequate water intake, but may also help to aid in some of those uncomfortable feelings that come with constipation and digestion problems. Soothing teas include peppermint tea, fennel tea, ginger and green tea. Dandelion tea, as well, may help with mild digestive symptoms such as bloating or occasional constipation. In fact, dandelion can stimulate the liver to produce bile, which can indirectly help with constipation.

4. Your Morning Coffee Can Help Promote A Regular Morning Bowel Movement 

You will be pleased to know that coffee can have a great effect on your bowel routine. One reason is that coffee contains small amounts of soluble fibers that help prevent constipation. But the real powerhouse component is the caffeine. Caffeine is a stimulant and so it causes the intestinal muscles to begin contractions called peristalsis, which is a sort of pulsing, squeezing action that moves fecal matter through the intestines.

One study found that caffeinated coffee can stimulate a bowel motion. This effect was 60% stronger than drinking water and 23% stronger than drinking decaffeinated coffee (5).

5. Fermented Foods Feed Good Bacteria

Our gut is basically a huge ecosystem of living organisms known as our microflora or microbiome. The good bacteria in our gut is crucial for ensuring bowel regularity. Fermented foods include yoghurt, kefir, miso, kombucha, sauerkraut and kimchi. If you don’t like fermented foods, then taking a probiotic with over 10 billion cultures can be another way to get your good bacteria levels up in your body.

One study in 150 people with IBS revealed that supplementing with probiotics for 60 days helped improve bowel regularity and stool consistency (2). A 2019 review found that taking probiotics for 2 weeks can help treat constipation, increasing stool frequency and stool consistency (6).

6. Eat Small, More Regular Meals Throughout The Day

We all have the gastrocolic reflex which is stimulated every time we eat. Its role is to help move food and fecal matter through our intestines. If we eat regularly this reflex gets activated more regularly and therefore more movement is occurring in our intestines to help push fecal matter through our systems.

7. The Low-FODMAP Diet Can Help To Relieve Constipation And Other Digestive Problems

The low-FODMAP diet is a diet that was developed in Australia, specifically for people with IBS. It has been shown to help with numerous IBS-like symptoms including bloating, abdominal pains, nausea and constipation (7).

The low-FODMAP diet is focused on reducing intake of specific types of carbohydrates, so involves restricting a lot of otherwise healthy fruits, vegetables, grain and legumes. But, FODMAPs can be hard for the digestive system to breakdown, which causes fermentation in the gut, and with that multiple digestive problems can follow for sensitive individuals.

For more information on the low-FODMAP diet, please check out our recent article or download our 1-Week Low-FODMAP Meal Plan.

Summary
Remember, there can be a number of reasons why you might be experiencing constipation. Try drinking more water, herbal teas and coffee, and incorporating fermented foods into your diet, along with regular exercise, and consuming more fruits and vegetables. These can all be great ways to help receive your constipation!

If these don’t work, please check with your health professional to determine if there are other underlying health conditions or diseases, or to discuss if implementing the low-FODMAP diet is an option for you.

And as always, we’re here to help! Book a session today and let us help you on helping your pipes run smoothly and regularly.

References
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976340/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993960/
3. The National Institute of Diabetes, Digestive and kidney Diseases
4. https://onlinelibrary.wiley.com/doi/full/10.1111/apt.13662
5. https://pubmed.ncbi.nlm.nih.gov/9581985/
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379309/
7. https://onlinelibrary.wiley.com/doi/full/10.1111/jhn.12385
8. https://pubmed.ncbi.nlm.nih.gov/24090144/
9. https://onlinelibrary.wiley.com/doi/full/10.1111/apt.12913

Digestive health challenges are extremely common in Canada, and Irritable Bowel Syndrome (IBS) is the most common diagnosis given for those digestive challenges. IBS affects the intestine both by causing issues with motility (the way foods moves through your intestines) and sensitivity (the way the signals from the intestines are interpreted by the brain). IBS symptoms can range from irritating and annoying to disruptive, embarrassing, or even debilitating – leading to lost time at work or at school for nearly half of reported sufferers. (1)

Could You Have Undiagnosed IBS?

If you have:

• abdominal pain at least once a week in the last several months
• change in number of times per day or week you have a bowel movement
• constipation, diarrhea, or a combination of both (2)

a consultation may be helpful!

IBS symptoms can occur outside the digestive tract as well and may include insomnia, fibromyalgia, interstitial cystitis, chronic pelvic pain, temporomandibular joint (TMJ) disorder, back pain, migraine headaches, or mood disorders. (2)

How Common Is Digestive Upset & IBS?

More than half of the Canadian population report uncomfortable or inconvenient digestive symptoms on a weekly basis. (1) 18 – 20% of Canadians are dealing with some form of IBS, with twice as many women as men affected. These statistics of IBS sufferers put us well above the global average of 10-11%, and among the highest rates in the world. Sadly, only 40% of those with IBS symptoms seek help with their condition. (3)

For those who do seek support, the current first-line treatment suggestion is often to try a low-FODMAP diet. This approach is well-backed by studies that show 75%-86% of people who follow this type of diet plan report improved symptoms. (4, 5)

What Is The Low-FODMAP Diet?

A low-FODMAP diet is meant to minimize (not eliminate) specific fermentable forms of carbohydrates for a short time, typically 3-8 weeks, then systematically reintroduce them in larger quantities while monitoring for symptoms. Not everyone reacts to all possible trigger foods.

What Are FODMAPs?

FODMAP stands for “Fermentable Oligo-, Di-, Mono-Saccarides and Polyols”. These are specific short-chain forms of carbohydrates and sugar alcohols that are not digestible. (2)

Why Can FODMAPs Cause Digestive Upset?

Because FODMAPs are not digestible, they end up being fermented and digested by your gut bacteria. The end product of that is hydrogen gas, which can cause digestive symptoms such as bloating, flatulence and abdominal pain.

FODMAPs also tend to pull more water into the intestines contributing to diarrhea and urgency.

Monash University Low-FODMAP Explanation

Monash University originally developed the Low-FODMAP diet, and have done extensive research improving this dietary strategy. We love this simple, 3-minute video they produced explaining the Low-FODMAP diet and how it relates to IBS symptoms.

Common FODMAPs Include:

• Fructose: sugar found in fruits, refined corn sweeteners such as high fructose corn syrup
• Lactose: natural sugar found in dairy products
• Fructans: wheat products, onions and garlic, cruciferous vegetables such as broccoli and cabbage (1)
• Galactans: soy-based products, beans/legumes, and lentils
• Polyols: stone fruits such as peaches and plums, additive in sugar-free products such as gum and soda

High-FODMAP Foods, To Be Avoided On A Low-FODMAP Diet:

Vegetables: onions, garlic, artichoke, cabbage, broccoli, cauliflower, Brussels sprouts, asparagus, celery, beetroot, mushrooms

Fruit: apples, avocado, banana (ripe), peach, apricot, plum, nectarine, mango, pear, watermelon, cherries, blackberries

Grains: wheat foods (cereal, bread and baked goods, bran, couscous), rye, barley

Protein sources: processed meats, most legumes/lentils, cashews, pistachios

Dairy: Milk (cow, goat, sheep, soy), yogurt, cheese (ricotta, cream cheese)

Sweeteners: High Fructose Corn Syrup (HFCS), agave, honey, inulin, maltitol, xylitol, erythritol

Low FODMAP Foods, Generally Well Tolerated In Appropriate Servings Sizes Include:

Vegetables: Green beans, bell peppers, bok choy, carrot, cucumber, lettuce, tomato, zucchini, potato

Fruits: Cantaloupe, grapes, kiwi, banana (green tipped), blueberries, papaya, rhubarb, strawberries, pineapple

Grains (whole, gluten free): buckwheat, millet, oats, quinoa, brown rice, corn/maize

Protein Sources: meat (beef, pork, lamb), poultry (chicken, turkey), fish (tuna, salmon, prawns), eggs, macadamia nuts, pumpkin seeds, walnuts

Dairy and dairy alternatives: almond milk, brie, camembert, feta cheese, hard cheese, lactose-free milk

Sweeteners: maple syrup, molasses, rice malt syrup (4)

Pros & Cons Of The Low-FODMAP Diet

Pros

• 70-86% of those following a low FODMAP diet for IBS report improvement of their symptoms and overall wellbeing.
• Fewer sick days
• It’s a short-term commitment – while one may have to remain FODMAP aware for some time, the initial elimination phase is short, with the goal being reintroduction of as wide a diet as tolerated.

Cons

• Lots of Low-FODMAP lists that don’t agree, mixed messages.
• 14-30% of people following a low-FODMAP diet see little or no improvements.
• May initially eliminate or limit foods you are not reacting to, making the diet unnecessarily restrictive.

If you are concerned you may be reacting to gluten-containing grains, you may wish to have a blood test to rule out celiac BEFORE eliminating wheat and glutinous grains from your diet.

In Summary

Like most things, IBS and digestive challenges are best managed with a whole life approach including managing stress; physical activity levels; a healthy, whole-foods diet; and having a strong support system. All these factors contribute to overall health and well-being, and are important in resolving IBS symptoms. Taking that into consideration, a Low-FODMAP diet is still the current gold-standard to begin investigating the root cause of IBS symptoms due to the extremely high success rate.

If you’re considering taking steps to address digestive health concerns, Koru Nutrition would be happy to support you in reaching your health goals. Our skilled team of naturopathic doctors, nutritionists, and dietitians are here to help! You can book an appointment online now if you’re ready to take that step toward healing.

Alternatively, we’ve created a 7-Day Nutritionist-Designed, Digestion-Supportive, Low-FODMAP Meal-Plan that can help guide you in implementing a low-FODMAP diet. With 30+ simple but delicious Low-FODMAP recipes, getting started on a Low-FODMAP diet has never been easier! Check it out the downloadable PDF today, you deserve to feel better! 

References:

https://www.ibsdiets.org/fodmap-diet/fodmap-diet-chart/
https://pubmed.ncbi.nlm.nih.gov/22426087/
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1746.2009.06149.x
https://badgut.org/wp-content/uploads/IBS-Survey-Results-2016.pdf
https://www.monashfodmap.com/ibs-central/
https://pubmed.ncbi.nlm.nih.gov/15932367/
https://badgut.org/wp-content/uploads/IBS-Survey-Results-2016.pdf
https://www.monashfodmap.com/ibs-central/
https://pubmed.ncbi.nlm.nih.gov/22426087/
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1746.2009.06149.x
https://pubmed.ncbi.nlm.nih.gov/15932367/
https://www.ibsdiets.org/fodmap-diet/fodmap-diet-chart/