Everyone has dealt with constipation at some point in the life. It accounts for over 2.5 million annual physician visits a year and over affects 1-30% of children worldwide! (1,2) All the straining can lead to anal fissures,  hemorrhoids which can all be secondary problems. There are a couple things you want to rule out before you dismiss your decreased bowel movements to constipation especially if you are dealing with this long term. These include a thyroid condition, celiac or gluten sensitivity, or Irritable Bowel syndrome. Be sure to tell your doctor if you are on any medications, because some medications contribute to constipation.  Here are few tips to help keep you regulated!

1. When you got go, just go

Children aren’t the only ones that’s have anxiety and an aversion to going to the bathroom in public or at home. When you feel the urge to go, don’t hold it in, this perpetuates the constipation situation.

2. Schedule a date with yourself.

Your body likes routine.  Make a date with yourself to go at the same time every day. Wake up 20min earlier in the morning and try to sit on the toilet. Eventually something will happen. Training your mind will also help train the body. Biofeedback, as well as journaling are also both effective methods to help keep you regular. (1,2)

3.Hydration cubed

Ensure your fluid intake is adequate. Drink at least 9 glasses of  8oz water a day for females and up to 13 glasses for men. Just increasing your water consumption will help your bowels move. Often just fixing this problem will help you go!

4.  Get your Fiber Fix on.

Make sure you are getting enough fiber. You need to get at least 30-35g/fiber day. This can be a problem for many people. Eat plenty of fiber rich foods especially from fresh vegetables, fruits, and grains. Mom always said, “Eat an apple a day, keeps the doctor away”, and it keeps your regular. Eating fresh fiber rich fruits like apples, prunes and berries will help you go. Eating lentils, beans and nuts are also rich in fiber and you can eat less of them and also stay full not to mention the added benefit of protein you are getting.

5. Try supplementing your diet

Adding things like Chia seeds, which has 15g/fiber per serving and flax seeds, 13gper serving, to your oatmeal, yogurt, and the foods you cook with will also help you go. Metamucil, fiber con and other psyillium based supplements are also helpful. They don’t always taste great but they keep you going. My secret when I feel like I’m getting backed up is mixed 1 table spoon of chia seeds in water and drink that throughout the day. Within a day I’m back to normal. Adding probiotics is also a good option, however at this time there are limited studies.(1) I recommend a good quality probiotic at least once a day.  Not only will it help regulate your GI system but also your strength your immune system.

6. Exercise gets the bowls moving.

Someone with a sedentary lifestyle is more likely to complain of constipation. Exercise two to six times per week is associated with a 35 percent lower risk of constipation.(1) At this time, there is no consistent evidence that exercise relieves constipation fully. (1)  In one Study done in Hong Kong in 2006-2007 among adolescents constipation was associated with insufficient physical activity and excessive sedentary behaviors. (3)

7. Massage it out

There is an osteopathic manipulation I learned and I like to recommend to my patients which includes massaging your abdomen. In a circular motion, starting from your small intestines move upward, radiating up your transverse colon and then down your large intestines. Doing this at least 3x for a couple minutes each time at least 1-2x/day will help stimulate your bowels. This is also a great technique to use in babies and young children. Just be sure to discuss this with your provider as over stimulating in certain cases can cause diarrhea.

8.Green tea it!

Having a couple cups of green tea a day stimulates the bowels. Anything more than 4 cups/day can lead to the opposite and contribute to constipation while acting as a diuretic and dehydrating you. The best time is to do this early in the morning. There are numerous polyphenols in green tea which are also an added benefit.

9. Relax

Lastly, just learn to relax and remain care free. This will help stimulate your bowel when you are more as ease. The more uptight you are, the more likely you will be constipated. Learn to get things go and just flow with the way of life!

10. Talk to your Primary Care Provider.

There are many different pharmacological alternatives your doctor can recommend. There are many different Laxative and Stool softeners on the market that may work for you. Other alternatives include suppositories, Enema, herbal teas, colonic treatment and as extreme as surgery if need be, so please discuss these options with your doctor to see which is best suited for you.

References:

1.Nurko, Samuel, MD. Zimmerman, Lori, A, MD. Evaluation and Treatment of Constipation in Children and Adolescents. Am Fam Physician. 2014; July 15:90(2): 82-89

2. Hsieh, Christine M.D.,Treatment of constipation in Older Adults.  Am Fam Physician. 2005 Dec 1;72(11):2277-2284

3. Huang R, Ho SY, Lo WS, Lam TH. Physical activity and constipation in Hong Kong adolescents. 2014 Feb 28;9(2):e90193. doi: 10.1371/journal.pone.0090193. eCollection 2014.