1 Fibre intake
Fibre is important to help with digestive tract motility and to help bulk up and make stool softer and easier to pass. According to the Health Direct Australia, women should be aiming for about 25 grams of fibre per day and men, 30g per day. Currently the average Australian adult has an intake less than the recommendation (1). Fibre is mostly found in plant sources like fruit and vegetables, whole grains and beans. If your diet contains little fibre and a lot of processed food, you may want to review your intake and look to increase it. It is best to increase fibre slowly over time as suddenly ingesting a lot more fibre when you are not used to it may cause digestive discomfort and pain. Additionally, if you already have a lot of fibre in your diet and you are still constipated increasing your fibre may make things worse, with one study finding reducing fibre improved constipation (2, 3). In this case you may need to reduce your fibre and review if there are any types of fibre that you are sensitive to, however you should do this with a health professional like your GP or a dietician.
While studies so far have not shown that increasing fluid intake improves chronic constipation staying adequately hydrated in addition to other measures may help mild constipation (4). Making sure you get enough fluids through both drinking and eating (fruits, vegetables, soups etc) and factoring in things like exercise and hot weather can help to ensure you don’t become dehydrated.
3 Keep Active
Our sedentary lifestyles are not helpful for our digestive function. Sitting for long periods and just generally not been active or getting little exercise in our daily life can affect our bowel movements. Studies have shown that exercise as simple as walking can help improve constipation and also stool consistency in IBS patients (4). Exercise has also shown to improve mood disorders like anxiety and depression which can be associated with IBS (4).
5 Eating prunes
Studies have suggested prunes may be an effective remedy for constipation (5, 6). They are rich in insoluble fibre and are a good and tasty natural laxative. Recommended intake is 50g twice daily, that which has been used in studies (5, 6). It is important alongside this to have adequate amount of fluid intake as increase in fibre without enough liquids may make constipation worse.
6 Poop Stool
While it doesn’t sound glamourous, this item can help with the passing of stools. The squat position in the most natural and easiest way to have a bowel motion. This is because when we squat we change the position of what is known as the anorectal angle of the pelvic floor which helps to open our bowels (7). Western toilets don’t allow for this. So, if you are plagued by constipation either investing in a ‘poop stool’ or using something to prop up your feet that allows you to be sitting in a squat like position, such as a pile of books or magazines, may be worth trying.
7 Manage stress
Over time chronic stress can potentially affect our digestive function due to the interaction between the gut and the autonomic nervous system (8). Good digestion relies on the parasympathetic state of relaxation which is sometimes known as ‘rest and digest’. During stressful situations we will be in a sympathetic state which is known as the ‘flight of fight’ response during which our blood supply is redirected away from the guts to the periphery (our limbs) to prepare us for this ‘flight or fight’. While this is ok on occasion, if we are constantly in this state, over time it may affect our digestion and potentially lead to an array of problems including constipation.
8 Improve sleep
Sleep is one of the most important functions for overall health and well-being. Lack of sleep and poor sleep quality can affect not only our digestion but all body systems (9). Sleep is important for the body to regenerate and heal both physically and mentally. If you have a history of poor sleep this is something to consider addressing and perhaps consulting your GP or health practitioner about.
Good breathing is important for digestion. Diaphragmatic breathing can help stimulate the parasympathetic nervous system and helping to reduce stress and anxiety and therefore aiding digestion (10). Many people breathe quite shallow using only their chest, particularly when stressed or anxious, and do not utilise the diaphragm, which acts as a pump gently massaging the abdominal organs, aiding peristaltic movement, circulation and lymphatic flow. Your practitioner can help you with this as well as work on any restrictions and tightness in the diaphragm, thoracic cage and neck which may be impeding breathing.
If you still find yourself constipated even with these things addressed, then it would be worth consulting your GP to ensure there isn’t a medical reason for it. Another thing to note is that constipation can be a side effect of some medications and supplements like calcium and iron, so this is also worth reviewing with your GP.
1. Fayet-Moore, F, Cassettari T et al. Dietary Fibre Intake in Australia. Paper I: Associations with Demographic, Socio-Economic, and Anthropometric Factors. Nutrients. 2018. 10(5): 599.
2. Müller-Lissner SA, Kamm MA et al. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005. 100(1):232-42.
3. Ho. K, You Mei Tan C, et al. Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms. World J Gastroenterol. 2012. 18(33): 4593-6.
4. Mearin F, Ciriza C, et al. Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult. Rev Esp Enferm Dig (Madrid). 2016. 108(6): 332-3.
5. Attaluri A, Donahoe R, Valestin J, et al. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther. 2011. 33(7):822-8.
6. Mansouri A, Shahraki-Vahed A, Shadad H, et al. The effect of prune on the severity of constipation in elderly women. Bali Med J. 2018. 7(1): 141-5.
7. Sakakibara R, Tsunoyama, K, et al. Influence of Body Position on Defecation in Humans. LUTS. 2010. 2: 16–21.
8. Konturek PC, Brzozowski T, and Konturek SJ. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011. 62(6):591-9. (4)
9. Lichtenstein GR. The Importance of Sleep. Gastroenterol Hepatol (N Y). 2015. 11(12): 790.
10. Hopper SI, Murray SL, et al. Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review. JBI Database of Systematic Reviews and Implementation Reports. 2019. 17 (9): 1855-76.
Further Reading & Links