How to manage constipation.

Constipation can affect up to 27% of the population. It's a common condition that affects people of all ages. It can interfere with daily living and well -being. More common in older people and as life expectancy is increasing the incidence of constipation will increase with the impact on quality of life and cost of treatment.

Signs of constipation- is when you may feel that you are not passing stools as often as you should and you are straining more than usual or unable to completely empty your bowels. Stools are unusually hard, Lumpy, large or small. "Interestingly, many individuals with fewer than three bowel movements per week do not consider themselves to be constipated, while others embrace the popular belief that ‘a bowel movement each day is necessary for good digestive health’." (Rome criteria)

1. Having a poo less than three times per week

2. Difficulty and pain when having a poo

3. Having to strain a lot to go to poo

4. Poo that is like small hard pellets

5. Feeling like you haven't been able to get all your poo out

6. You might get constipation when there is not enough water in your poo

7. Muscle contraction in the large bowel are slow and weak slowing down the transit time

   
   

Diet low in fibre, change in diet and lifestyle, lack of exercise, not drinking enough fluids being overweight or underweight, depression or anxiety and side effects of medications can increase the chances of having constipation.

There is strong evidence that eating plenty of fibre (commonly referred to as roughage) is associated with a lower risk of heart disease, stroke, type 2 diabetes and bowel cancer. Choosing foods with fibre also makes us feel fuller, while a diet rich in fibre can help digestion and prevent constipation.

Here are some ways to help you with constipation:

• Gradually increase your daily intake of high fibre foods e. g take a new 1 -2 high fibre food every week. Sudden increase can make you feel bloated

• Ensure your fluid intake is up to 8-10 cups per day 250 ml per cup .Try to drink a glass of water with every meal. Fibre is like a sponge, absorbing water making poo softer and move through your body more easily

• Introduce regular daily exercise by starting with regular walking, Recommended 30 minutes walking five times per week . This helps food and poo move through your body . Increase exercise gradually and only do what you can manage

• Relaxation exercises e. g yoga or meditation and ensure adequate sleep

• Lastly consider laxatives/ stool softeners with the advice from your local G.P/Doctor. This is a costly alternative and long term use may not be advisable

"Women were almost twice more likely than men to seek medical care for self-reported constipation."

How does fibre help?

Fibre helps the digestive system by adding bulk to your stools making it easier for your bowel to clear excess waste.

Foods rich in dietary fibre recommended 25-30 g of daily fibre per day for adults

There 2 types:

1. Insoluble which bulks the poo found in wheat bran, vegetables and wholegrains

2. Soluble which dissolves in water and slows down how food travels through the body giving you slow release energy . This is found in oats , barley, rye , fruits, veg , seeds, nuts e.g sunflower, pumpkin seeds, flaxseeds , linseeds - 1tbsp/day

• Fruit and vegetables 5 portions per day e. g a portion can be : 1 apple or 1 pear or 2 plums or 3 heaped tablespoons of cooked vegetables (from fresh or frozen) include the skin where possible, fresh or dried fruit or canned fruit in juice. fresh or dried fruit, or fruit canned in natural juice for dessert. Because dried fruit is sticky, it can increase the risk of tooth decay, so it's better if it is only eaten as part of a meal, rather than as a between-meal snack.

• Whole grain cereals - porridge, Weetabix , bran flakes

• Granary/whole meal bread

• Whole meal spaghetti or pasta

• Brown rice or Bulgar wheat

• Beans and lentils

• Potatoes with skin

• Nuts and seeds

Top tips to eat more fibre

If you are concerned about your constipation always seek the advice from a health professional

Useful references N H S choices, change 4 life, B D A fact sheets, the gut trust help line.

For specialized Diet and Nutrition advice seek the advice of a Professional Dietitian and Nutritionist Tabby kabeer