11 Ways to Keep Things Moving.
Irregularity is one of those things that no one likes to talk about. It's personal and, well, a little embarrassing. But if you're one of the millions of people who's ever been constipated, you know it can put a real damper on your day.
The first thing to realize when you're talking about constipation is that "regularity" is a relative term. Everyone has his or her own natural rhythm. Ask four people to define regularity, and you're likely to get at least four different answers. Normal bowel habits can span anywhere from three bowel movements a day to three a week, according to Marvin Schuster, M.D., professor of medicine with a joint appointment in psychiatry at Johns Hopkins University School of Medicine and chief of the Division of Digestive Diseases at Francis Scott Key Medical Center, both in Baltimore.
"One of the most common forms of constipation is imaginary or misconceived constipation," says Schuster. It's based on the idea that if you don't have the "magical" one bowel movement a day, then something's wrong. Constipation has a lot to do with a person's comfort level, says Peter Banks, M.D., director of Clinical Gastroenterology Service at Brigham and Women's Hospital and lecturer on medicine at Harvard Medical School, both in Boston. People who are constipated often strain a lot in the bathroom, produce unusually hard stools, and feel gassy and bloated.
Schuster calls it "constipation" if you have fewer than three bowel movements a week or if you experience a marked change in your normal bowel patterns. A sudden change in bowel habits merits a visit to your doctor to rule out any more serious underlying problems (see "Hello, Doctor?"). But for the occasional about of constipation, here are some tips to put you back on track:
Exercise seems not only to boost your fitness but to promote regularity as well. "The thinking is that lack of activity puts the bowels to rest," says Banks. That may partially explain why older people, who may be more sedentary, and those who are bedridden are prone to becoming constipated. "We encourage people to get up and be more active," says Banks. So gear up and get moving. You don't have to run a marathon; a simple walking workout doesn't take much time and can be very beneficial. When it comes to regularity, even a little exercise is better than none at all.
Raise your glass.
Drinking an adequate amount of liquids may help to alleviate constipation or prevent it from happening in the first place. The reason for this is simple. "If you dehydrate yourself or drink too little fluid, that will dry out your stool as well and make it hard to pass," says Schuster.
On the other hand, some people have the misconception that if you drink far more than you need, you can treat constipation. Schuster disagrees, saying the excess fluid will just get urinated out.
To achieve a balanced intake of liquids, a good rule of thumb is to drink eight cups of fluid a day, says Mindy Hermann, R.D., a registered dietitian and spokesperson for the American Dietetic Association. (This rule of thumb doesn't apply, however, if you have a kidney or liver problem or any other medical condition that may require restricting your intake of fluid.) Drink even more when it's hot or when you're exercising. Hermann suggests that athletes weigh themselves before and after a workout. Any weight lost during the activity reflects water loss. To replace it, they should drink two cups of liquid for every lost pound of body weight.
For those who are constipated, all liquids are not created equal. Avoid drinking a lot of coffee or other caffeinated drinks, urges Elyse Sosin, R.D., a registered dietitian and the supervisor of clinical nutrition at Mount Sinai Medical Center in New York. Caffeine acts as a diuretic, taking fluid out of your body when you want to retain it. She suggests sticking with water, seltzer, juice, or milk instead.
Don't fight the urge.
Often, because people are busy or have erratic schedules or because they don't want to use public bathrooms, they suppress the urge to have a bowel movement. "If they do this over a period of time, it can block the urge so it doesn't come," explains Schuster. If at all possible, heed the call when you feel it.
Take advantage of an inborn reflex.
As babies, we're all born with a reflex to defecate a short time after we're fed, says Schuster. With socialization, we learn to control our bladders and bowels and we inhibit this reflex. Schuster suggests that you try to revive this reflex by choosing one mealtime a day and trying to have a movement after it. "Very often, people can program the colon to respond to that meal." Schuster does point out that this works better with younger people than with the elderly.
Know your medications.
A number of prescription and over-the-counter medications can cause constipation. If you are currently taking any medication, you might want to ask your doctor or pharmacist whether it could be causing your constipation. Among the drugs that can cause constipation are calcium-channel blockers taken for high blood pressure, beta-blockers, some antidepressants, narcotics and other pain medications, antihistamines (to a lesser degree), certain decongestants. and some antacids. Antacids that contain calcium or aluminum are binding and can cause constipation. When choosing an antacid, Schuster suggests you keep in mind that the names of most of those with aluminum start with the letter "a." Those that start with the letter "in" contain magnesium, which does not constipate. If you are unsure, check the label or ask your pharmacist.
Many times, adding fiber or roughage to your diet is all that's needed to ensure regularity. Fiber, the indigestible parts of plant foods, adds mass to the stool and stimulates the colon to push things along.Fiber is found in fruits, vegetables, grains, and beans. Meats, chicken, fish, and fats come up empty-handed in the fiber category. The current recommendations for daily dietary fiber are 20 to 35 grams. "Most people eat between 10 and 15 grams," says Hermann. So there's plenty of room for improvement. Fiber supplements may be helpful, but most doctors and dietitians agree that it's preferable to get your fiber from food (see "Laxative Alert").
Add fiber slowly.
People assimilate high-fiber foods into their diet more easily if they do it gradually. "You need to add one high-fiber food at a time, start with small amounts, and wait a couple of days before adding something else so you don't throw your system into chaos," says Hermann. Sosin agrees and also stresses the need to "drink an adequate amount of fluids with the fiber."
Eat at least five servings of fruits and vegetables daily.
Select a variety of fruits and vegetables, recommends Hermann, some that are high in fiber and others that aren't so high. Potatoes (white and sweet). apples, berries, apricots, peaches, pears, oranges, prunes, corn, peas, carrots, tomatoes, broccoli, and cauliflower are all good choices.
Eat 6 to 11 servings of grain products daily.
That's in addition to the five servings of fruits and vegetables just mentioned. Grain products include cereals, breads, and starchy vegetables (such as corn, green peas, potatoes, and lima beans) "I tell people to start out the day with a high-fiber cereal because it's easy to do and it immediately knocks off a big chunk of the amount of fiber they should be getting during the day," says Hermann. Check the labels on cereal boxes; anything with more than five or six grams of fiber per serving qualifies as high fiber. If you don't like any so-called "high fiber" cereals, line up the boxes of cereal that you would be willing to eat and pick the one with the most fiber, suggests Hermann.
Read labels when choosing breads as well. "Just because a bread is brown doesn't mean it has a lot of fiber in it," says Hermann. Find a bread that has at least two grams of fiber per slice. Watch the portion size, too, when looking for high fiber foods. "Sometimes they will give you a very large size that's unrealistic for one serving," says Sosin.
Bring home the beans.
Dried beans and legumes-whether pinto, red, lima, navy, or garbanzo-are excellent sources of fiber. Many people don't like them because of the gassiness they may cause. Cooking beans properly can ease this problem considerably. Herman's technique for cooking less "explosive" dried beans: Soak the beans overnight, then dump the water out. Pour new water in, and cook the beans for about 30 minutes. Throw that water out, put in new water, and cook for another 30 minutes. Drain the water out, put new water in, and finish cooking.
Cut back on refined foods.
You can bump up your fiber intake by switching from refined foods to less-refined foods whenever possible. Switch from a highly processed cereal to a whole-grain cereal, move from heavily cooked vegetables to less-cooked vegetables, and choose whole-grain products over products made with white flour. A glass of orange juice, for instance, provides 0.1 grams of fiber, while eating an orange gives you 2.9 grams. And while a serving of potato chips has only 0.6 grams of fiber, a serving of popcorn supplies 2.5 grams. "As soon as you start juicing something or straining it or taking the pulp out, you're taking out the fiber," says Hermann.
Constipation can be a symptom of a more serious problem, such as an underactive thyroid, irritable bowel syndrome, or cancer, to name a few. See your doctor if you have any of these symptoms:
A major change in your bowel pattern
Constipation lasting for several weeks or longer
Blood in your stool
Severe pain during bowel movements
Unusual stomach distention
. Laxative Alert .
Laxatives seem like an easy solution for constipation woes, but they can cause many more problems than they solve. Indeed, these tablets, gums, powders, suppositories, and liquids can be habit forming and produce substantial side effects if used incorrectly
Laxatives work in many different ways, and "each one has its problems," says Marvin Schuster, M.D. Some lubricate, others soften the stools, some draw water into the bowel, and still others are bulk forming One real danger is that people can become dependent on them, needing ever-increasing amounts to do the job. Eventually, some types of laxatives can
damage the nerve cells of the colon until the person can't evacuate anymore. Some laxatives inhibit the absorption or effectiveness of drugs. Those with a mineral-oil base can prevent the absorption of vitamins A, D, K, and E. Still others can damage and inflame the lining of the intestine.
"I think laxatives ought to be avoided if at all possible and only used under a doctor's care," says Schuster In the long run, you'll be much better off to depend on exercise, adequate fluid intake, and a high-fiber diet to keep you regular.
FIBER FOR YOUR HEALTH
Dietary fiber or roughage is the portion of food that is not broken down by the human digestive system. The human body lacks the enzyme to break down the carbohydrate part of our food into a form which our body can absorb and use as energy. Fiber is only found in plants, fruits, vegetables, grains and beans.
Fiber can be classified into two categories namely soluble and insoluble fiber. Water-soluble fiber, as the name suggests, can be dissolved in water. These fibers can be found in fruits, vegetables, dried beans and oats. Water-soluble fibers include pectins and gums which are beneficial in lowering blood lipids (fats) and glucose. They are sticky and mix with water to form gels. Example, fruit pectins which are used in jams to hold the mixture together and give a sticky touch and taste.
Water-soluble fiber is not affected by water. This includes cellulose and hemi cellulose and lignin, and are important in the function of the gastro-intestinal tract. Most plants contain a combination of various types of fiber. These different fibers each have their own benefits and should be an important part of your food intake. It is recommended that an individual consumes about 25-30 grams of fiber a day. This recommended intake can be attained by including everyday:
4 servings of whole grain breads and cereals,
4 servings of vegetables,
2 being fresh.
Some Fibre-Rich Food
lOOgms edible portion (fibre content)
Barley - 3.4
Oats in tin -1.5
Wheat germ - 1 .8
Chickpea (Kacang kuda) - 2.6
Yellow dhal (Dal kuning) - 1 .5
Green beans (Kacang hijau) - 3.7
Soya beans (Kacang soya) - 5.5
Soya bean (fermented) (Tempeh) - 2.9
Almond (Buah badam) - 15.5
Cashew nut (Biji gajus) - 6.4
French beans (Kacang buncis) - 1 .5
String beans (Kacang panjang) - 1 .4
Guava (jambu batu) - 6.8
Source: Nutrient Composition Of Malaysian Foods
Compiled By Tee E Siong, Mohd Ismail Noor, Mohd Nasir Azudin, Khatijah Idris, Asian Food Habits Project, 1 988.
PROPERTIES OF FIBER
Fiber-rich diets stimulate chewing and increase the time required for the consumption of a meal. By chewing, food remains in the mouth longer, and the bulk created by fiber will create a feeling of fullness, which leads to a feeling of satisfaction much faster, and interrupting food intake and amount consumed earlier.
Fiber adds bulk and by absorbing water creates softer stools and increases frequency of defaecation, which is important to control constipation.
APPLICATIONS OF FIBRE REGARDING HEALTH
Fibre helps fight obesity by:
slowing down the rate at which food can be digested,
adding bulk and thus creating a feeling of fullness.
WAYS TO INCREASE YOUR FIBER INTAKE
Replace rich deserts with fresh fruits.
If your eating 1 -2 slices of fruit daily, try to increase it to 3-4 slices gradually.
Use wholegrain or wholemeal breads or products rather than refined.
Increase the use of beans, peas and nuts if possible.
Consider adding in oats or nestum to your drinks or milk if possible.
Use brown rice instead of white or wholemeal bread instead of white.
FIBER AND CONSTIPATION
Constipation can mean different things to different people, it could be infrequent defaecation, very little or hard stools. Very often, the constipated person strains to pass out the hard stools. Many factors can influence constipation namely, medication, lack of exercise and a low fiber diet.
Adding enough fiber to one's diet with plenty of water, will increase the bulk of stools and make it softer which will help an individual to pass out stools easily without straining. The stools will also help to trap undigested food and wastes and help the body to thus cleanse itself, so it actually works like an internal cleanser.
FIBER AND DIABETES
Studies do indicate that diabetic patients who consume high fiber foods have a better control of blood sugar levels, than those who do not do so.
Dietary fiber slows down the absorption of sugar through the intestinal wall. By avoiding the production of excess insulin, it stabilizes blood sugar, thereby preventing tiredness, irritability and fatigue that accompanies the ups and downs of high and low blood sugar. Studies have shown that diabetic patients who consume high fiber have a better blood glucose control and need less insulin than those who do not consume high fiber.
FIBER AND CANCER
A high fiber diet shortens the amount of time food stays in the colon, thus preventing carcinogenic substances to initiate cancer. Fiber absorbs them and flushes them out. According to the New England journal of Medicine (Vol 323, 1 990) the more fiber, the less colon cancer.
FIBER AND CHOLESTEROL
Dietary fiber has shown through research to have a cholesterol lowering effect, by excreting them out. One reason is that fiber helps in the excretion of bile and prevents its reabsorption. Bile is mainly made from cholesterol which is secreted into the small intestine to digest fats. Fiber helps by playing a role in bile acid excretion and its metabolism.
FIBER, HAEMMORRHOIDS AND VARICOSE VEINS
Fiber adds bulk and creates soft stools reducing the need to strain when passing them. When one strains due to hard stools, pressure is put on the entire abdominal region. This could in turn weaken the veins on the legs and blood vessels in the anus. This could lead to hemorrhoids and varicose veins (spider web lines on the leg or thickened veins on the leg). Dietary fiber eases constipation which reduces constipation by making stools softer and bulkier, therefore less straining is necessary, which reduces irritation to inflamed hemorrhoidal tissues.
FIBER AND DIVERTICULOSIS
This is a condition in which the intestinal wall becomes weak due to lack of stimulation. Little outpouchings (called diverticuli) may occur on the intestinal wall. When these outpouchings become inflamed, the condition is called diverticulitis. Fiber will help in additional stimulation of the intestinal wall, thus helping to treat the problem.
FIBER AND CARDIOVASCULAR DISEASE (HEART DISEASE)
Evidence indicates that soluble fibers (pectins and gums which are found in fruits, vegetables, oats and legumes) decrease serum total cholesterol. Also, it appears that soluble fiber lowers bad cholesterol (LDL) while raising the good cholesterol (HDL). The cholesterol-lowering effect and blood pressure lowering effect of diets rich in soluble fiber hold much promise for the prevention and treatment of coronary heart disease.