Staying Regular Naturally
Written by Debra Kirchhof-Glazier
Constipation can be more than just uncomfortable. It can have a negative impact on our health. Staying regular is vitally important to overall well-being.
A healthy person has between two and three bowel movements a day, optimally after each meal, due to a response known as the gastrocolic reflex. When food enters the stomach and small intestine, wave-like movements are triggered in the large intestine, creating the urge to have a bowel movement. If elimination does not occur, wastes are retained and can cause a variety of problems, including indigestion, bad breath, and headaches. The longer wastes remain in the colon, the greater the potential for toxins to be absorbed, which can lead to serious problems like diverticulosis, the formation of pouches that retain wastes and can become inflamed in a condition known as diverticulitis, and even colon cancer. Since the colon absorbs water, if wastes remain in the colon for prolonged periods, stools can become hard and difficult to pass. Straining during defecation creates high pressures that can lead to hemorrhoids and even varicose veins.
Problems with constipation are widespread and so is the use of laxatives. Laxatives work in a variety of ways. Stimulants like Dulcolax, Ex-lax, or Senokot cause rhythmic contractions of the intestines. These are the harshest form of laxatives and can lead to dependence over the long term. Stool softeners like Colace moisten wastes and allow easier passage, but can lead to the imbalance of electrolytes (sodium, potassium, and chloride ions). Osmotics, such as Miralax and Sorbitol, soften stools and stimulate contraction of the intestine by pulling water into the colon. People with diabetes who take osmotic laxatives need to have a doctor carefully monitor their electrolytes. Other laxatives, such as mineral oil, function as lubricants, coating the stool with a waterproof film that enhances elimination. However, prolonged use of lubricant laxatives can interfere with the absorption of the fat-soluble vitamins A, D, E, and K. Saline enemas, such as Fleets, draw water into the colon and stimulate contraction, but overuse can lead to dependency. The safest laxatives are the fiber supplements, such as Metamucil, that add bulk to the stool. However, some people experience bloating and abdominal pain instead of relief.
The good news is that, for most people, proper diet can keep your system running smoothly without laxatives. The overall guideline is to eat a wide variety of fruits, vegetables, and whole grains and to be properly hydrated, which provides bulk and moisture to the stool and stimulates a healthy transit time. Transit time is amount of time it takes for a food to be eliminated after you eat it. Adequate fiber helps normalize transit time to the healthy range of one to three days. Red beets give the stool a distinctive color and can be used as an indicator for transit time.
How much fiber should we get? Women under the age of 50 need at least 25 grams a day, and those 50 and older need 21 grams. Men under 50 need 38 grams, whereas those 50 and older need at least 30 grams. Many people are in the habit of monitoring calories, but few people concern themselves with how much fiber they get. Nutrition labels have this information, and it is a good idea to get in the habit of checking the fiber content. In terms of whole foods that don’t come with a nutrition label, blackberries and raspberries pack a punch, with 8 grams per cup. One pear has 5 grams and an apple or an orange has 4. For the vegetables, one half cup of peas has 5 grams, a baked potato with the skin has 4 grams, and a carrot has 2. Whole wheat spaghetti has 6 grams per cup, compared to oatmeal with 4. Split peas pack a whopping 16 grams per cup, and lentils and black beans are right behind with 15. Nuts are also a good source of fiber but are high in calories so need to be eaten in moderation. As one example, one ounce of almonds (about 24) provides 4 grams of fiber and 170 calories.
In terms of proper hydration, the issue is somewhat complex. Water requirements depend on several factors, such as activity level, the humidity and temperature of the environment, and pregnancy and lactation. More water is not necessarily better for stooling, as any excess is excreted by the kidneys. As a rule of thumb, the Institute of Medicine recommends 3 liters or 13 cups of total beverages, including water, each day for men and 2.2 liters or 9 cups per day for women. Interestingly, coffee contains compounds that increase muscle contraction in the colon, contributing to regularity. In general, if you are not thirsty and produce about 6 cups of light yellow or colorless urine per day, you are probably adequately hydrated.
Additional factors that contribute to regularity- or lack of it- are exercise, supplements, medications, and food allergies or sensitivities. An active lifestyle with daily aerobic exercise is beneficial for not only cardiovascular and mental health, but for colon health as well. Some supplements, such as iron, and many medications can cause constipation. Ask your pharmacist for details. Specific foods can also affect regularity. For example, if you experience chronic constipation you may want to try eliminating milk and milk products for one week, since sensitivity to dairy products is fairly common and could be the culprit.
As with virtually every aspect of our well-being, there is no magic bullet for staying regular. However, adopting a whole food diet, staying hydrated, and making choices that reflect a healthy lifestyle are effective strategies that will pay off in both the short and long term.
The Huntingdon Health and Wellness Association makes no medical claims or recommendations. Check with your doctor about your specific health care needs.