Constipation can happen to all of us at some point, it may be temporary as the result of stress, pregnancy, post natally, travel, or when our diets aren’t quite their normal self (Hello Christmas). However I regularly see clients who have been struggling with constipation for years, several decades sometimes. Constipation is common, believed to affect up to 1 in 7 adults, and 1 in 3 children at any given time.

I believe that most people feel their best on at least 1 daily bowel movement. Bowel movements would ideally come out without straining and not be hard, or pellet like. Any sudden change in bowel habits lasting more than 2 weeks, if you also see blood in your stool as well as becoming more constipated, please see your GP for a proper investigation as on occasion this can indicate more serious problems.

In the abscence of anything more serious, the usual rather vague advice is to “increase your fibre and water intake”? Yes these do help and form the cornerstone of my recommendations, but it’s usually much more useful to have actual specific steps and which foods to use. If you are someone who finds they are regularly constipated have a read of my top tips below, you can also get in touch for an appointment for an approach specific for you.

Use Fruit Based Laxatives – Kiwi, Mango, Papaya, Figs and Prunes. These work really well and science backs it up. These fruits increase intestinal water retention and colonic volume, resulting in increased stool frequency and softer stools. You can add them to smoothies, put them on porridge, on overnight oats, or just have them alongside any meal. Avoid juice and opt for whole fresh or dried fruit. Great for kids too, I regularly use ripe kiwi for my youngest who is weaning currently. Aim to eat 1-2 ripe kiwi’s daily.

Challenge yourself to increase your water intake by just one glass, and build up from there. You could have a glass of water before getting out of bed (keep one there ready), or have one as you run your shower, or whilst you boil the kettle for your first hot drink. Try and find a way that fits with your routine and becomes habit. You could swap one caffeinated hot drink for a warm water with a slice or squeeze of lemon. There are water bottles with measurement lines that can be quite motivating at getting you to drink a little bit more over a day if you take them with you when you’re out and about, or at work. The key is to try and find a way you like – for me swapping a coffee/tea for a herbal drink daily in the evening was an excellent start.

Gentle movement helps stimulate the bowel – aim for a 10-15 minute walk daily if you don’t already do this. Some yoga or swimming can also be really helpful.

Foods rich in soluble and insoluble fibre are crucial, try to focus on adding fibre at one meal at a time. Consider aiming to increase fibre with breakfast, and go slowly. You could make some overnight oats using jumbo oats and some ground flaxseed, top with some raspberries or blackberries and you’ve likely hit around 7g fibre. Add some fibre powder and you can easily hit 10g. Excellent food sources of soluble and insoluble fibre to include in your diet – try to add a new one each week…

Apples, pears and berries can be grated or sprinkeld into overnight oats or porridge, stewed with cinnamon and eaten with yoghurt

Soaked oats, these are nice and easy to digest and can form part of many breakfast varieties. My collagen overnight oats recipe on the blog here.

Use legumes like lentils to add some bulk and thicken soups such as this tomato, pepper and red lentil soup recipe. 

Chia seeds, ground flaxseed and psyllium can all be helpful but start low and slow. 1/2 tsp in a smoothie or added to porridge and work up to 1 tbsp. It’s fine if this takes a while, don’t be tempeted to rush in with a lot as this can lead to discomfort and bloating.

Snack on some veggies like carrot sticks with hummus or alongside a boiled egg, cucumber slices with cream cheese, pepper sticks and guacemole. A few whole nuts with a couple of squares of dark chocolate also have plenty of fibre.

Opt for wholegrains like jumbo rolled oats, wholegrain pasta, sourdough or rye bread, wholegrain couscous and rice, and opt for skin on potatoes and skin on fruits and veggies as much as possible. Eat that Jacket potato skin, and keep the skin on potatoes when mashing! Don’t peel your apples and pears!

Try some new high fibre recipes. I find it best to get a nice new recipe book, or have a browse of some online and see if you can find a couple of new dishes to try. Some of my favourites for increasing fibre are Much More Veg, 30 Plants a Week (both by Hugh Fearnley Whittingstall) and the Food For Life cookbook by Tim Spector and the Zoe team.

Fibre powders – often consisting of different types of prebiotic plant based fibre such as, flax, pysllium, oat fibre, glucommanan, cellulose, and diiferent gums. Fibre powders can be a very useful addition to your diet, just ensure you start with a very small amount and build up gradually over several weeks. It’s fine if you find you can’t tolerate a full dose, and please ensure you are already increasing your water intake. Don’t add these in if you’ve not been to the toilet for a few days, they can cause discomfort and you’ll likely need a laxative or some support to have a bowel motion first. There are a number of products available, if you need support to look at which one might be right for you, get in touch and book an appoinment.

Supplemental support.

Magnesium Citrate – this mineral chelate blend is very good at drawing water into the bowel (known as an osmotic laxative) and supporting easier and more regular bowel movements. It isn’t suitable for everyone, and those with kidney disease should avoid magnesium.

Bifido strain probiotics – did you know that it’s the bifido strains of probiotics that are involved in bowel regularity and providing bulk to the stool? Many probiotics out there contain mostly, or only, lactobacillus strains so it’s worth looking for specific bifido blends to support constipation.

Digestive Enzymes – for many people our digestive secretions are not always working optimally. When we eat on the move, don’t chew adequately, are dehydrated, low in certain nutrients, and age we secrete less. Enzymes can be very effective at helping things get moving again whilst we work on some lifestyle habits and foods to support better digestion.

Clinically I find a combination of magnesium citrate, a quality Bifido strain probiotic, and a good digestive enzyme to be a winning trio for many people. I don’t like to recommend specific brands on the blog as I believe supplements should be used with caution and require a professional, personalised approach but do get in touch if you’d like an appointment to discuss this.

References:

https://pubmed.ncbi.nlm.nih.gov/33767108/