We tend to get used to things. But just because we get used to something, doesn’t mean it’s normal. Lately, it seems that no matter who comes into my office and no matter why they are coming to consult with me, I always hear, “Oh, and I seem to always be constipated.” I hear it from clients and friends and family members, not just from older people.
Constipation is uncomfortable. It is one of the most common digestive problems in the United States, affecting around 2.5 million people. It’s defined as having hard, dry bowel movements, or going fewer than three times a week. It can also mean having the sensation of not emptying. In older adults, it tends to be more common with up to 50% of them suffering from it.
The great Jewish philosopher Maimonides thought of constipation as a precursor to serious illness, emphasizing the importance of regular and soft bowel movements. He recommended dietary and lifestyle adjustments to achieve this, such as eating laxative fruits like grapes and figs, along with exercise. He may have lived more than 850 years ago, but most of what he said seems to have been proven in modern science.
Constipation is not only uncomfortable – it is a health hazard. If you are not going regularly, and by regularly I mean at least once a day, something is wrong. It can cause hemorrhoids, anal fissures, and you can actually get fecal impaction which is quite serious. But just as important, you are probably not get nearly enough fiber in your diet, which also means your gut microbiome is in an unhealthy state and you may also not be consuming enough water, and are possibly chronically dehydrated.
What’s causing your inability to be regular? I once heard a Harvard gastroenterologist quoted as saying that the big three culprits are lack of fiber, lack of movement and lack of hydration. Let’s take a closer look.
Fiber
Fiber occurs naturally in fruits, vegetables, legumes, lentils and whole grains. The key word here is whole foods. Refined foods, processed foods, and animal proteins have almost no fiber or only very low amounts of it. The average American is only getting about 13-14 grams of fiber per day. Adults need more than 35 grams per day with 50 being even better. Eating a wide variety of foods from plants, not animal proteins or ultra-processed foods, will give you all the fiber you need.
Exercise and activity
Exercise and activity in general are also vital to keep your stools soft and flowing. Dr. Judy Nee, a gastroenterologist at Harvard’s Beth Israel Deaconess Medical Center says, “Movement on the outside increases movement on the inside.” Although a 30 minute brisk walk daily will help increase your peristalsis, (the involuntary constriction and relaxation of the muscles of the intestine that brings your stool forward and help you eliminate), activity of any kind, even in short spurts helps.
Hydration
Last but not least, drinking enough fluid is also vital for preventing constipation. Water is definitely the name of the game. The water which is not absorbed in the small intestine and colon acts as a lubricant in the bottom of the digestive tract. So strive to drink about eight cups of water per day, or at least six plus some green or black tea.
Foods to stay away from
Although following this advice on what to eat to reduce the chances of getting constipation is important, just as important is what not to eat. Among constipating foods are all junk and fast food, refined foods like white bread and other refined grains, alcohol, all animal proteins including fish, dairy and eggs, and certainly all fried foods. We basically want to keep consumption of these foods to a minimum, while increasing the fiber rich foods we spoke about earlier.
In a study done in 2012 and presented at the conference of the American College of Gastroenterology, it was found that people who suffered from constipation after age 18, meaning who had at least two diagnoses of being constipated, had nearly double the instance of colon cancer than people who weren’t constipated. This is worrisome and is just another reason why diets that are keto/paleo in nature may be hazardous to your health. Although there have been subsequent studies showing no connection, it would still be best to err on the side of caution.
What can I do right now?
As far as specific foods to help someone when they are already constipated, Dr. Will Bulsiewicz has mentioned newer research showing that eating kiwi fruit can be quite effective. A newer client of mine who has been constipated for a very long time took my advice and made a smoothie with flax, hemp and chia seeds, cruciferous vegetables, water, ginger, and a little bit of frozen fruit. Within 24 hours, he was moving his bowels every 10-12 hours with no extra effort.
Although laxatives can help in the very short term, long-term use can cause dehydration, electrolyte imbalances and potential long-term damage to the kidneys, heart, and digestive system. If you have been having a chronic problem, aside from the lifestyle changes suggested, you may want to get natural psyllium seed husks and take them every day for a month to add a lot of fiber into your diet. A nice side effect can also be a lowering of cholesterol.
Even when you begin to be more regular, continue taking it until your gut has completely undergone the necessary changes. Taking care of constipation will not only make you feel better, it will put you in a good mood, help you function better and “add hours to your days, days to your years, and years to your lives.”
The writer is a wellness coach and personal trainer with more than 25 years of professional experience. He is a member of the International Council of the True Health Initiative and of the board of Kosher Plant Based, as well as the director of The Wellness Clinic. alan@alanfitness.com