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Just to prove that we listen to what people say (!) this week’s blog post is in response to a comment recently received from someone we know very well. (And, to avoid any embarrassment we won’t say who it is.) 
It went along the lines of “Why haven’t you done a blog about constipation, I’m fed up with being told to drink more water and eat more fruit and veg.” 
We can’t promise that we won’t mention water, fruit and veg but can guarantee that you’ll learn lots of other things as well. So, here we go (!). 
Constipation is one of those subjects that few people discuss. And if you’d like a very English medical definition here’s one: 
“Constipation is an acute or chronic condition in which bowel movements occur less often than usual or consist of hard, dry stools that are painful or difficult to pass.” 
Contrary to popular opinion, what’s “normal” varies hugely from person to person. And it’s also a complete myth that you should go to the loo every morning before / after breakfast. Or, even worse, you should remain “enthroned” until you do. 
Some people go the loo several times a day, while others may go every three or four days. So when considering whether you may have a problem, it’s important to begin with what’s “normal” for you. 
Skipping a bowel movement occasionally isn’t constipation, nor is not going to the loo every day; as long as you’re not having to strain and force things. (And we’re not going to get too graphic here but leave it to your imagination). 
Put simply, constipation is due to stools remaining in the Large Intestine for too long. As a result, more water is absorbed from them than usual making them drier and more difficult to pass. This can lead to stomach ache, bloating, nausea, loss of appetite and, not surprisingly, irritability. 
There are many reasons why constipation can occur, depending on whether it’s an occasional problem or an ongoing one. 
If it’s an occasional problem the most likely causes are: 
Changes of routine or diet, for example, being away from home with all the complications this can bring. Often a lack of privacy or concerns about cleanliness are enough to trigger it. 
Lack of exercise or immobility, for example, being seated for long periods of time while on a long car or plane journey. 
Ignoring the need to go to the loo because it’s inconvenient or facilities aren’t easily available. 
Temporary dehydration, for example, by running a high temperature, over heating or not drinking enough fluids. 
Trauma, shock or accident where the body goes into “survival mode”; shutting down non essential functions for a short period of time while an emergency is dealt with. 
Often the exact cause can’t be pinpointed, so provided things quickly return to normal there isn’t usually anything to be concerned about. 
Where constipation is more of an ongoing issue, a different set of factors need to be considered such as: 
Diet. Yes, we know it’s always mentioned (!) but you’d be amazed how often simple changes make a huge difference. (And, as an aside, having looked into people’s trolleys in the supermarket we’re amazed that some people manage to go to the loo at all…). 
While there are always more exciting things to eat (!), our bodies are designed to function best on a wholefood diet. In other words a diet largely made up with fruit, vegetables and salad with only small amounts of protein and carbohydrates. Protein may be plant or animal based, including pulses, avocado and quinoa. Similarly carbohydrates include starchy vegetables, oats, spelt and rice. 
Which neatly leads us on to wheat which, quite simply, our digestive systems aren’t designed for and find hard to digest. A diet high in wheat – in whatever form – is the number one contributor to constipation. Not only is it abrasive against the lining of the digestive system but it’s also drying and causes lots of other problems as well. 
Dehydration. Alongside diet, making sure that plenty of water and herb teas are being drunk will help to ease things through. Caffeinated drinks in any form are dehydrating, as are many fizzy drinks and alcohol. 
Ongoing medical conditions. A number of medical conditions are associated with constipation and, often, the prescribed medication just makes matters worse. These include Parkinsons Disease, Multiple Sclerosis and Muscular Dystrophy which all affect the Nervous System, including the nerves that supply and control the Digestive System. An Underactive Thyroid slows the whole body down, including the Digestive System. And, finally, Inflammatory Bowel Disease, Bowel Cancer and Anal fissure all affect the Large Intestine directly. 
Regular use of laxatives. If you have an ongoing problem with constipation, it’s likely that you’ve resorted to laxatives; whether occasionally or on a more regular basis. While this may get things moving in the short term, unfortunately, it often makes things worse in the long term. The reason for this is twofold. 
To start with they purge the Digestive System of the “good” bacteria needed to help breakdown food. This means that food isn’t digested very efficiently and can end up fermenting lower down the system leading to constipation. Or, sometimes, diarrhoea. 
Added to this, the regular use of laxatives can make the Digestive System “lazy”, for want of a better word. If you can imagine it, the Digestive System is a long muscular tube with food going in one end and waste out of the other. Muscles in and around the tube rhythmically squeeze and relax, so forcing food through it in a process known as peristalsis. Just think of those wildlife documentaries featuring a snake swallowing a large egg and you’ll get the idea (!). 
When laxatives are taken, the contents of the Digestive System become more liquid and move through it with only a minimum of peristalsis needed to help the process along. If this happens regularly, the muscles become “lazy”, making it seem as though the constipation has got worse when laxatives aren’t taken. Or necessitating a higher dose to achieve the same effect. 
Medications generally. We’ve already mentioned laxatives, but there are many other medications that can also contribute to constipation.  
Some medications act as sedatives, reducing the speed at which the body functions overall, including peristalsis. These include antidepressants, opiate based painkillers such as codeine and morphine and antipsychotics used to treat mental health conditions. As a result, it takes longer for food to pass through the Digestive System, with more water being absorbed from it in the Large Intestine. 
Others dry out the food as it passes through the Digestive System. These include diuretics, antacids, medication containing aluminium, calcium and iron supplements. 
With it being common for many people to be on several different medications, it’s not unusual for them to have reduced peristalsis coupled with increased water absorption. The end result are small, dry and hard stools every few days. 
So what can be done to help? 
To start with, it’s useful to identify the most likely cause(s). If medication looks like playing a part, talk to your Doctor about alternatives. 
Make sure your diet includes plenty of fruit, salad and vegetables. We’ve already mentioned this above, but here are a few specific things you can do to help: 
Grated raw carrot, apple and pear are easy ways to provide additional bulk as well as increasing the amount of water in the Large Intestine. Raisins, figs and prunes can also be soaked in apple juice or boiled water – not cold tea (!) – overnight and eaten at breakfast with porridge or yoghurt. 
Sesame seeds, dry roasted in a frying pan and added to yoghurt also help to draw more water into the Digestive System. Finally, psyllium husks or aloe vera gel taken in water, can also help to provide additional fibre and bulk. 
Cutting out – or at least reducing – the amount of wheat based foods is also important. Replace wheat based cereals with oat based ones, such as porridge or an oat based muesli. Please do remember to read the labels on any pre prepared food, as wheat is added to many products you wouldn’t normally think of. 
Drink plenty of water. Yes, we know it’s boring (!), but it’s what our bodies were designed to run on. Remember that for every cup of tea or coffee, you need to drink the same amount of water to prevent dehydration. And the same comments apply to fizzy drinks and alcohol. 
If you’re drinking 4 or 5 cups of tea or coffee a day, and only a couple of glasses of water, you’re going to be very dehydrated. Having a glass of water while waiting for the kettle to boil, is the easiest way to remember to drink more water. It helps stop you getting so dehydrated, making it less likely that you’ll be reaching for the next cup of tea or coffee so soon. 
Take regular exercise, to help improve muscle function generally, helps peristalsis. A brisk daily walk has lots of health benefits and is easy to fit in to your daily schedule. If you’re up to it, taking a leaf out of the book of other cultures, doing daily squats – only as far as you comfortably can go also helps to stimulate the Digestive System. (And if you stop to think about it for a moment, squatting is the natural way to go to the loo, rather than seated as is more usual these days.) 
If you feel the urge to go, don’t delay. Holding on simply slows things down overall and won’t help you in the future. Let your body develop its own natural routine, rather than trying to force it into one. 
And, finally, a few traditional solutions for constipation. 
Baking Soda helps to neutralise acids and so alkalinise the Digestive System, aiding a smooth bowel movement. Simply add a teaspoon of baking soda to a cup or glass of warm water and take at bedtime. 
Epsom Salts. The salt helps to draw water into the Large Intestine; while the magnesium increases the peristaltic contractions. Take 2 teaspoons in a cup or glass of warm water at bedtime. 
With both Baking Soda and Epsom Salts do remember to check the packaging first, as some contain aluminium which dries things out and exacerbates the problem. 
Blackstrap molasses have a similar effect to Epsom Salts, as they’re high in magnesium. Take two teaspoons at night. However do remember that they’re high in calories and so best used only occasionally. 
Castor Oil, a very old favourite, helps stimulate the Large Intestine to contract. Take one teaspoon at bedtime. 
Olive, Sunflower or Safflower oil can all help to lubricate the Large Intestine. Take 2 to 3 teaspoons of your preferred oil each morning. 
Finally, if you have an ongoing tendency to constipation please remember that it will take time for a new routine to appear. This is quite normal and nothing to be concerned about. After all, if you’ve been constipated for years, then you’re not going to start going every day as soon as a few changes are made to your lifestyle and diet. The key is to look for small changes that take you in the right direction. 
As always, the choice is yours. 
Tagged as: Diet, Health, Lifestyle
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