While it is a topic not many people like to talk about, constipation certainly effects many people (and it makes people grumpy). Constipation is one of the most common gastrointestinal complaints in North America.

How does constipation occur?

When bowel movements are hard and difficult to pass constipation occurs causing abdominal pain, bloating and a feeling that your bowels may not have emptied fully. As part of normal digestion of food your body uses peristalsis (mini muscle contractions) to move waste products through the digestive tract. When the waste moves to the large intestine (colon), fluids and electrolytes are removed and water is absorbed. The waste is then moved to the rectum where it is passed out as a bowel movement.

If the large intestine does not contract quick enough or strongly enough waste material lingers too long causing too much water absorption leaving the stool hard and dry and potentially difficult to pass.

What is considered “normal” when it comes to bowel movements?

Contrary to popular belief you may or may not have one bowel movement per day. Bowel habits are highly variable and normal is considered anywhere between three times per day or three times per week. If you only have a bowel movement every few days this is not considered constipation as long as it is soft, pain free and follows your usual pattern.

Who is most likely to suffer with constipation?

Children, women, pregnant women and adults over the age of 65 years are the most common groups that struggle with constipation. Constipation also commonly occurs in sedentary individuals, those that are bedridden and as a side effect to surgery, chemotherapy and when taking certain medications such as painkillers or iron or calcium supplements.

Changes in your usual routine such as travelling, stress, activity and sleep along with a poor fibre or fluid intake can also greatly influence your bowel habits and lead to constipation.

In our practice we also see a large number of clients suffering with constipation because of a medical issue such as an eating disorder or restrictive eating pattern that has removed grains or other healthy sources of fibre from their diet.

What can you do to help constipation?

1. Your digestive system likes routine. What this means is that the more your eating, sleeping, physical activity and patterns are consistent, the better your bowel habits will be.
2. Stress management is one of the single most effective ways for ensuring you have healthy bowel movements. As I like to say the brain and gut are very connected (a stressed out brain leads to a stressed out gut).
3. Keep physically active. Aim for 150 minutes per week of moderate to vigorous activity such as walking, biking, swimming or other activities.
4. Boost your intake of fluids.   Drink 2-3 Litres of fluids (water and other healthy beverages per day)
5. Increase your fibre intake.   According to the Dietary Reference Intake’s adult women under 50 years need approximately 25 grams of fibre per day and those over 50 years need approximately 21 grams of fibre per day. Adult men under 50 years need about 38 grams of fibre per day and those over 50 years need approximately 30 grams of fibre per day.

What are the best fibre rich foods I should include in my diet?

Here are 5 ways to increase fibre in your diet include:

1. Bran based cereals, homemade bran muffins, whole grains and whole grain flours.
2. A variety of fresh, frozen and dried fruit chosen at least 3 times per day with meals, as a snack or built into a smoothieA variety of fresh or frozen vegetables (boost your intake by using what I call the 2 by
3. 2 rule (have at least 2 different types of vegetables twice daily)
4. Salads, soups and chili that contain legumes such as lentils, chick peas, black beans or baked beans
5. Nuts and seeds as a snack or added to baked goods or on salads or try ground flax seeds, chia seeds or hemp hearts added to cereal, oatmeal or yogurt

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