Constipation is a common functional gastrointestinal disorder which can significantly affect the quality of life in those affected. It is often categorised in to three subtypes: Dyssynergic defecation (problem with the way certain nerves and muscles function in the pelvic floor), slow transit and normal transit[i]. The most common symptoms including abdominal bloating, hard consistency of stools, excessive straining, sense of incomplete evacuation, and failed attempts to defecate[ii].
Stress, low physical activity, medication and depression are all associated with constipation. Often the first-line treatment plan includes an increase in fibre and fluids, regular exercise and dietary modifications[iii]. Laxatives are commonly used to relieve constipation, however due to their potential adverse side effects, they’re used as a last resort only if symptoms have not improved through diet and exercise[iv].
Dietary modifications and supplements are often very supportive in reducing constipation. However, all recommendations are based on a thorough investigation of each individual and their own personal needs. Below are some commonly suggested recommendations, as a general guideline to support those with constipation.
Fibre - There are two types of fibre, soluble and insoluble, which both have their own unique benefits. Soluble fibre such as beans, oats, citrus fruits, apples and barley, dissolves in water and creates a gel like substance which helps stool move along the digestive tract. Whereas insoluble fibre such as whole linseeds, root vegetables, wholegrains, nuts and seeds, does not dissolve in water, and instead attracts water to your stool making it softer and easier to pass. Increasing dietary fibre to around 25-35g per day, will not only help to bulk up the stool but will also provide an array of prebiotics to stimulate and feed the protective bacteria in the gut, proving to be extremely beneficial.
Fluids – Increasing water content to a minimum of 2 litres a day will help to soften the stool and stimulate bowel movements, allowing for comfortable passing of stool[v]. It is also essential to consume adequate fluids when increasing fibre as the lack of water may increase bloating and cause more obstruction for the bowels.
Regular exercise – Sedentary lifestyle has been linked with increase likelihood of constipation. Regular exercise such as brisk walking, swimming and cycling can help to stimulate the bowels and increase overall quality of life by relieving other potential related symptoms such as depression and anxiety.
Coloclear: a carefully blended combination of fruits, leaves, roots, seed and bark to create a balanced bowel formula to help a slow colon or constipation.
Probiotics – Many strains of bacteria found within probiotics are recognised strains within the large intestines and are thought to be helpful in protecting against harmful pathogens and promoting mucosal health. Probiotics are often used to reduce the severity and duration of abdominal pain and bloating, improve bowel movements and enhance the gut microbiome to help to reduce inflammation. Viridian
Synerbio Daily High Strength Probiotic
Magnesium Citrate- Magnesium Citrate when taken in high doses has an osmotic effect which relaxes the bowels and pulls water into the intestines, relieving constipation. Magnesium is also used for reducing stress by activating the parasympathetic nervous system, whilst normalising nerve transmission by releasing nervous tension to further reduce constipation. Pure Encapsulations Magnesium Citrate
Kiki Health Psyllium Husks, Organic - Psyllium is a dietary fibre well known as a natural remedy for constipation. It is said to be of benefit via both the soluble and insoluble fibre components, although it is primarily known for its high soluble fibre content [vi].
Viridian Complete Fibre Complex With FOS - FOS, or fructooligosaccharides, are a type of prebiotic fiber that can be found in certain foods or taken as a dietary supplement. Prebiotic fibers are non-digestible carbohydrates that serve as a food source for beneficial bacteria in the gut [vii].
Cytoplan Saccharomyces boulardii - While it is often associated with its potential benefits for diarrhea, there is some evidence to suggest that Saccharomyces boulardii may also have a positive impact on constipation [viii].
Kiki Health Aloe Pure / Aloe Ferox Juice, organic (500ml) - When it comes to constipation, aloe vera has been traditionally used as a natural remedy due to its potential laxative properties. In a study, a mixture of celandine, Aloe vera, and psyllium was given to people with constipation. Those who took the mixture experienced better relief from their constipation symptoms compared to those who took a fake treatment (placebo)[viii].
If you are experiencing chronic constipation it may be worth booking a consultation with our Nutritional Therapy team to provide professional guidance, dietary interventions and potential for functional testing. We offer complete Microbiome Analysis which may be useful to ascertain if pathogenic flora are influential in symptoms and also then to look at specific antimicrobials that may be a useful part of the protocol. Gluten sensitivity or food sensitivity testing may also be a useful insight to understand whether there are any specific foods that are creating an immune response resulting in the symptoms experienced. However, it should be noted that testing is only recommended if it has potential to alter the protocol. Dietary and lifestyle modifications alone using our knowledge and experience are often enough to address symptoms and provide guidance for optimising long term health.
[i] Black CJ, Ford AC. Chronic idiopathic constipation in adults: epidemiology, pathophysiology, diagnosis and clinical management. Med J Aust. 2018;209(2):86-91. doi:10.5694/mja18.00241
[ii] Sharma A, Rao S. Constipation: Pathophysiology and Current Therapeutic Approaches. Handb Exp Pharmacol. 2017;239:59-74. doi:10.1007/164_2016_111
[iii] Bharucha AE, Wald A. Chronic Constipation. Mayo Clin Proc. 2019;94(11):2340-2357. doi:10.1016/j.mayocp.2019.01.031
[iv] Yang J, Wang HP, Zhou L, Xu CF. Effect of dietary fiber on constipation: a meta analysis. World J Gastroenterol. 2012;18(48):7378-7383. doi:10.3748/wjg.v18.i48.7378
[v] Anti M, Pignataro G, Armuzzi A, et al. Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation. Hepatogastroenterology. 1998;45(21):727-732.
[vi] Erdogan A, Rao SS, Thiruvaiyaru D, Lee YY, Coss Adame E, Valestin J, O'Banion M. Randomised clinical trial: mixed soluble/insoluble fibre vs. psyllium for chronic constipation. Aliment Pharmacol Ther. 2016 Jul;44(1):35-44.
[vii] Meksawan K, Chaotrakul C, Leeaphorn N, Gonlchanvit S, Eiam-Ong S, Kanjanabuch T. Effects of Fructo-Oligosaccharide Supplementation on Constipation in Elderly Continuous Ambulatory Peritoneal Dialysis Patients. Perit Dial Int. 2016 Jan-Feb;36(1):60-6.
[viii] Akhondi-Meybodi, M., Rahimian, M., Salmanroghani, H. (2014). Study of the Effect of Probiotic Saccharomyces Boulardii on the Treatment of Irritable Bowel Syndrome. Journal of Biology Today's World, 3(7), 152-156.
[viii] Odes HS, Madar Z. A double-blind trial of a celandin, aloevera and psyllium laxative preparation in adult patients with constipation. Digestion. 1991;49(2):65–71
Please note that the information contained within this website does not and should not replace medical advice, and is not intended to treat or diagnose. We always recommend you consult with your doctor. Our Nutritional Therapy team is highly trained and we offer one to one Nutritional Therapy Consultations, which are designed to be complementary to any medical treatment from a functional medicine approach, as well as offering a preventative & optimal health focus.