Definition
Constipation is defined as the abnormally slowed progression of feces through the large intestine. The stools are hard and dry and their evacuation is difficult and painful. The frequency of passing stools is variable and is not necessarily indicative of constipation. Finally, constipation can be accompanied by gas, abdominal pain and a feeling of incomplete evacuation.
Etiology
There are many causes that can be associated with constipation. The main contributors to constipation include mechanical obstructions (eg anal fissure), neurological diseases (eg depression, multiple sclerosis), metabolic diseases (eg diabetes), gastrointestinal diseases (eg. : irritable bowel syndrome) and dietary causes, such as insufficient hydration or a low fiber diet.
Goals of nutritional treatment
Nutritional treatment for constipation has three main goals: to increase stool bulk, normalize bowel movement, and decrease intraintestinal pressures.
Dietary recommendations
At the nutritional processing level, dietary recommendations may include:
- Gradually increase dietary fiber intake until you reach about double the amount usually consumed. Then, the recommended daily amount varies by age and gender. Increasing dietary fiber helps relieve the symptoms of constipation because it increases the bulk of the stool as well as its water content, which makes it easier to pass.
- Introduce fiber-rich foods, such as whole grains, fruits, dried fruit which are particularly high in fiber, vegetables, legumes, nuts and seeds.
- Consume prunes and prune juice, rich in fiber and dihydroxyphenylisatin, a substance that promotes bowel movements.
- If a dietary fiber supplement is used (e.g. psyllium), consume it in several small doses throughout the day.
- Maximize physical activity and optimize hydration by increasing fluid intake (e.g. 2 L/day). Regular physical activity and adequate hydration help prevent bloating and gas that can occur with increased dietary fiber intake.
- Re-educate intestinal transit. For example, trying to have a bowel movement at the same time each day, usually after breakfast.
- Low FODMAP Diet for Irritable Bowel Syndrome (after diagnosis)
Special problems
In the presence of certain particular problems related to constipation, dietary recommendations may vary. For example, for anorectal disorders, such as hemorrhoids and anal fissures, it is recommended to observe a diet low in fiber and high in liquid during the acute phase, then a diet high in fiber in the remission phase.
The causes of constipation can be very varied: diet, medication, diseases, etc. and they influence his treatment. In terms of diet, optimal fiber consumption and good hydration are key. Fiber notably helps regulate intestinal transit, but it also has several other health benefits. Indeed, some studies show that they can also help maintain a healthy weight and reduce the risk of heart disease and certain cancers. Optimizing your fiber intake is a win-win!
References
- Bouthillier, Lise. January 2019. Diseases of the digestive tract. NUT 2047 Clinical Nutrition 2. Montreal: University of Montreal.al.
- https://www.merckmanuals.com/en-ca/home/digestive-troubles/sympt%C3%B4my-digestive-troubles/constipation-in-adults
- https://www.merckmanuals.com/en-ca/professional/gastrointestinal-disorders/sympt%C3%B4my-of-gastrointestinal-disorders/constipationquery=Constipation%20in%20l%E2%80%99adult##
- https://www.unlockfood.ca/en/Articles/Fibre/Focus-on-food-fibre.aspxaliaspath=%2fen%2fArticles%2fFibre%2fFocus-on-Fibree
Article written by:
Marie-Noël Marsan, Nutritionist