In the last article on constipation, we talked about what it is and what are the most common causes. In this material, we understand why, with constipation, you should not immediately take laxatives, but it is better to pay attention to your diet.

Often the problem is not a lazy bowel that needs to be "pushed". We decided to talk about useful products that help you go to the toilet in a natural way.

Be sure to see a doctor if constipation lasts for weeks or is accompanied by pain, blood and mucus in the stool, and other uncomfortable symptoms.

Contents

• 1. Why do we need different types of fiber
• 2. Soups: more water and fiber
• 3. Fermented probiotic dairy products
• 4. Stone fruits for constipation
• 5. Whole grains and bran
• 6. Legumes in the fight against constipation
• 7. Seeds for regular digestion
• 8. How to eat fiber properly
• 9. Important note

Why different types of fiber are needed

Fiber helps regularize stools and feeds beneficial gut bacteria. It comes in soluble and insoluble forms, and both types are equally important for healthy digestion.

Soluble fiber absorbs liquid and forms a gel-like substance that facilitates the passage of stool through the digestive tract. It also creates a feeling of fullness.

Insoluble fiber adds bulk to the stool and stimulates intestinal receptors to speed up stool elimination. Insoluble dietary fiber also retains water and prevents feces from turning into a dry, lumpy mass.

Soups: more water and fiber

Vegetable soups solve two problems at once, because they contain the necessary dietary fiber and liquid. You can start with puree soups - they are easier to digest and contain more nutrients, and they also just taste better.

To make the broth rich, cook the soup for a long time and on low heat. The main thing is to boil the vegetables, but not to digest them, so as not to destroy the fiber they contain.

Milk and cream soups can cause bloating and only make you feel worse. For a thicker, more textured soup without any GI side effects, opt for recipes with potatoes. The starch it contains does an excellent job of giving the soup that creaminess.

Probiotic fermented foods

Fermented foods are rich in beneficial lactic acid bacteria Lactobacillus and Bifidobacterium. In the intestines, such bacteria resist dysbacteriosis and produce short-chain fatty acids that maintain mucosal health and normal peristalsis.

Fermented foods contain little or no lactose, so you don't have to worry about stomach discomfort. If a slight seething after their use nevertheless appeared, the reason is more likely in the probiotic effect than in intolerance.

If the sour taste and smell of kefir puts you off, try other fermented dairy products:

• Greek yogurt;
• sheep's or goat's milk yoghurt;
• matsoni;
• airan;
• tan;
• fermented baked milk;
• acidophilus;
• narine.

Vegan probiotics also exist, such as kombucha, kimchi, sauerkraut and other fermented vegetables, miso paste, cashew or soy based yogurt.

Take the Atlas Microbiota Test to check your gut bacteria composition and find out which prebiotics and probiotics are right for you.

Anti-Constipation Stone Fruit

These fruits are juicy and fibrous and will help you digest naturally quickly. Some stone fruits also contain sorbitol, which has a mild laxative effect.

These fruits are considered the most effective against constipation:

• apricots;
• plums;
• peaches;
• nectarines.

If the fresh fruit season is over, you can limit yourself to prunes and dried apricots. It is important to always drink dried fruits with water - if you gnaw them dry on the go, this will only worsen the condition.

Whole grains and bran

Unprocessed grain retains the outer shell, endosperm and germ. Such grains contain a maximum of nutrients and fiber, so for chronic constipation, whole grains and bran (separated grain shells) should be included in the diet.

This could be:

• whole grain toast for breakfast;
• bran porridge;
• blasted whole grain breads as a snack;
• brown rice as a side dish.

If you don't like the taste of brown rice, you can buy a mixture of regular brown rice. As for flax crackers, such a snack is not suitable for everyone - dense raw grains may not be digested at all.

Legumes for constipation

Lentils, chickpeas and beans are high in fiber, which is what causes flatulence in many people. For this fiber to benefit, you need to eat legumes in small portions and focus on your well-being. In any case, gas is rather a positive sign that intestinal bacteria have something to eat.

It is recommended to soak beans in cold water for several hours before cooking. Canned chickpeas and beans are easier to digest because some of the "gas-forming" substances go into a liquid that can be drained.

You can also buy bean sprouts or make your own - they are also less problematic to digest. The spice asafoetida, according to some studies, can reduce bloating after legumes.

Want to learn more about stomach health?

Download the free microbiome book from the Atlas experts!

Seeds for regular digestion

We have described foods rich in insoluble fiber. Now it's time to talk about sources of soluble fiber.

Psyllium husk is sold dry as a natural remedy for constipation. It has a neutral taste and smells almost nothing. When diluted with water, the husk forms mucus, which is necessary for the formation of healthy stools.

Chia seeds are another trending source of soluble fiber. They also need to be diluted with water and added to cereals or smoothies. Chia pudding or chia yogurt is a light breakfast or dessert option that will help keep the moisture in your stool and add the viscosity you need.

More affordable soluble fiber - flax seeds. They are recommended for irritable bowel syndrome, chronic constipation and type 2 diabetes. Seeds need to be soaked in water overnight to get that gel-like texture. If you don’t want to wait, you can buy flaxseed porridge in the form of an instant mix.

How to eat fiber properly

Insoluble fiber must be chewed carefully and for a long time, otherwise the coarse particles will irritate the esophagus and intestines. If you spend much more time on a salad than on a main course, this is absolutely normal. The better you chew, the better this food will be absorbed and digested.

It is important to drink plenty of fluids. If fiber has nowhere to absorb water, it won't work as a natural laxative.

If you've never eaten a lot of fruits and vegetables, start small and give your microbiome time to adjust to the new diet.

There are several signs that you may be eating too much fiber. These are:

• bloating of the lower abdomen, distension and flatulence;
• Loose, unformed stools with clearly visible undigested fibers.

Highlights

1. A proper diet that includes soups, fermented and whole grains, and various types of fiber can help you improve your bowel movements.
2. It is important to remember to drink plenty of water throughout the day. Sugary drinks and coffee do not replace water.
3. You can find out which nutrients and dietary fiber your bacteria are lacking with the Atlas Microbiota Test. You will receive personalized and understandable recommendations that will help improve the functioning of the microbiota and improve digestion.

More fiber articles on the Atlas blog:

• Everything you need to know about fiber
• What foods contain fiber
• How to take care of your gut bacteria

• National Health Service, Constipation, Causes of constipation 9014
• National Health Service, Constipation, About constipation, 2020
• Min Chen et al., Modulatory Effects of Gut Microbiota on Constipation: The Commercial Beverage Yakult Shapes Stool Consistency, 2019
• Compound Interest, The Chemistry of Plums & Prunes: Constipation & Chewing Gum, 2015
• Harvard School of Public Health, Food features
• U.S. National Institute of Health, Graham DY et al, The effect of bran on bowel function in constipation, 1982
• Gastrojournal, R. S. Fisher, M.D., Bran as therapy in constipation, 1983
• International Foundation for Functional Gastrointestinal Disorders
• R&D Centre, Aurea Biolabs Pvt Ltd, Kolenchery, Cochin, India, Augustine Amalraj and Sreeraj Gopi, Biological activities and medicinal properties of Asafoetida: A review, 2017
• Noureddin Soltanian and Mohsen Janghorbani, A randomized trial of the effects of flaxseed to manage constipation, weight, glycemia, and lipids in constipated patients with type 2 diabetes, 2018

How to get rid of constipation at home, remedies for adults

What is constipation

Constipation is considered to be retention of stool for more than two days. This condition is also characterized by incomplete emptying of the intestines, accompanied by discomfort, changes in the consistency of feces and the need for excessive straining during bowel movements.

People who neglect the rules of healthy eating and lead a sedentary lifestyle most often suffer from constipation. Constipation is classified according to two criteria: etiology (cause) and pathogenesis (development mechanism).

According to the etiology, constipation is divided into:

• Primary. Occur as a result of congenital or acquired pathologies of the colon.
• Secondary. They are the result of another disease, injury, as well as side effects of pharmacological drugs.
• Idiopathic. Behind this definition lies the inability to find out the exact cause of the disruption of the intestines. Constipation with an unknown etiology is also called cryptogenic.

Classification by pathogenesis:

• Alimentary. It develops with a violation of the diet and a decrease in water consumption.
• Mechanical. Caused by neoplasms in the large intestine. They can be both tumors and polyps or clots of lymph nodes, as well as adhesions or kinks.
• Dyskinetic. It occurs due to a violation of intestinal motility, which became the result of nervous tension. This type of constipation is also called neurogenic.

Symptoms of constipation

Strictly speaking, constipation itself is a symptom or a side effect. At least, modern medicine does not consider it as an independent disease, although constipation is formally included in the list of diseases according to ICD-10. If we talk about concomitant manifestations (not to be confused with the criteria), then they include:

• feeling of heaviness and discomfort in the lower abdomen and rectum;
• decreased appetite;
• prostration, irritability, depression;
• bloating, flatulence;
• sensation of incomplete emptying of the bowels.

When to see a doctor?

Episodic constipation should not cause undue concern. Often the reason lies in malnutrition, stress or a change of scenery (moving, business trips, etc.), and the elimination of provoking factors solves the problem. However, if constipation continues regularly, this may indicate a health problem, so in such a situation, a visit to a gastroenterologist should not be postponed.

Particular attention should be paid to this problem for pregnant women, since excessive straining is contraindicated for them. In addition, constipation is fraught with the development of intoxication of the body, which is also completely useless for a pregnant woman.

People who are prone to gastrointestinal diseases should also consider increasing constipation as a signal from the body that the course of the disease is aggravating. Therefore, one should not expect that the problem will be solved by itself - in such situations, the help of a doctor is necessary.

Where constipation comes from

Stool retention occurs periodically in all people, regardless of age, gender and political views. Constipation can occur for a variety of reasons. Let's consider them in more detail.

Stress

Any situations associated with nervous tension can cause stool retention, since the nervous system regulates all vital processes in the body, including intestinal motility. Stress can have an unpredictable effect on digestive function, since the human gut contains an extensive network of neurons that communicate with the central nervous system.

This is why situations of emotional discomfort, whether it be a minor domestic conflict or chronic work-related stress, can lead to constipation. We should also mention the change of scenery: very often problems of this kind arise when moving to a new place of residence or in field conditions.

Pregnancy

In pregnant women, constipation occurs quite often for several reasons:

• In the first half of pregnancy, a change in the hormonal background occurs, as a result of which the synthesis of progesterone increases. This hormone reduces the tone of the uterus and helps to avoid premature birth. However, it also weakens the tone of smooth muscles, thereby worsening intestinal motility.
• Around the end of the second trimester, the ever-increasing uterus puts pressure on the rectum, which also impedes peristalsis and leads to regular stool retention.
• Influence of drugs. Many women during pregnancy are prescribed antispasmodics, as well as iron and calcium supplements. One of the side effects of these medicines is hardening of the feces and weakening of intestinal motility.

Here you can add a decrease in motor activity, stress and severe toxicosis.

Sedentary lifestyle

Despite the fact that the skeletal muscles are of the striated type, and the intestinal muscles are of the smooth type, there is a close relationship between their activity. In other words, the less a person moves, the greater the risk of developing constipation. Sedentary work and low physical activity are almost guaranteed to lead to stool retention.

Lack of fluids

In people who consume insufficient amounts of water, the production of digestive juices decreases. In addition, the feces become too dry and hard, which makes it difficult for them to move through the intestines.

Unbalanced diet

Constipation can be provoked not only by a lack of fruits and vegetables in the diet, but also by the use of muffins, large amounts of meat, rice, smoked and fatty foods. In addition, the lack of the habit of eating at the same time, evenly distributing the amount of food for each meal, also contributes to impaired intestinal motility.

Treatment of constipation

When choosing methods of treating constipation, the doctor first of all focuses on eliminating the causes that caused this condition. Treatment should be complex, but regardless of its main course, all patients should increase physical activity, adjust the diet and consume at least one and a half to two liters of water per day. Treatment methods can be grouped into groups, which we will discuss below.

Physiotherapy

In the treatment of constipation, physiotherapy methods are used as adjunctive therapy. It should be noted that the expediency of using some of them is the subject of controversy and discussion in science. Far from all modern medical recommendations can find such information.

• Abdominal massage. It is assumed that this method helps to improve intestinal motility and relieve spasm. Predominantly sparing pressing and stroking movements are used, which are performed strictly clockwise.
• Electrical impulse therapy. Due to the use of electrical impulses, the contractile function of the smooth muscles of the intestine improves, which is especially important for atonic constipation.
• Inductothermy. It is usually used for spastic neurogenic constipation, as well as for inflammatory processes in the intestines that provoke stool retention. The essence of the method is the application of a high-frequency electromagnetic field.
• Electrophoresis with novocaine. Gauze tissue moistened with novocaine solution is placed on the patient's lumbar region. Due to the impact of direct or pulsed electric current, the drug enters through the skin to the lumbar nerve plexuses. The procedure is relatively painless - the patient feels only a slight tingling sensation.

Special mention should be made of such methods as acupressure (shiatsu), acupuncture (acupuncture), aromatherapy and other branches of Far Eastern folk medicine. At the end of the last century, these techniques were widely advertised by various medical charlatans as a universal remedy for almost any disease. Currently, their popularity is gradually fading away, and so far there has been no evidence of the effectiveness of such techniques.

It is important to understand that from the point of view of modern medicine, stimulation and piercing of various points on the body, supposedly responsible for improving bowel function, have no proven clinical effectiveness. At best, the patient can expect a placebo effect.

Phytotherapy

As an alternative to pharmacological preparations, herbal remedies with a laxative effect can be used. However, it is not recommended to choose them on your own, because if used incorrectly or unjustified, they will do more harm than good.

Some herbs have antispasmodic, others irritate the nerve endings of the intestines. The use of such effects should be related to the cause of constipation, and only the attending physician can understand it. Among the most common herbal remedies for constipation are licorice root, senna, buckthorn and oregano - decoctions are prepared from them. In addition, pharmacies sell ready-made laxatives. It should also be remembered that any laxatives with prolonged use (2 weeks or more) are addictive.

Medications

If we disassemble laxatives aimed directly at eliminating constipation, they can be divided into several groups.

Prebiotics

This group of drugs does not give a quick laxative effect, since it is aimed at normalizing the composition of the intestinal microflora - this requires a certain time. In essence, prebiotics are a breeding ground for lacto- and bifidobacteria, without which the intestines cannot function normally. The main active ingredients of prebiotics are inulin and lactulose. They are poorly digested, and therefore reach the intestines almost unchanged, contributing to the growth of beneficial microflora.

Osmotic laxatives

These drugs provide quick relief from constipation, but are recommended for acute stool retention. Osmotic laxatives may also be given to the patient to cleanse the bowel prior to diagnostic procedures. The drugs of this group contribute to the accumulation of fluid in the intestine, which creates the osmotic pressure necessary for normal defecation. Osmotic laxatives are made on the basis of macrogol, lactitol and magnesium sulfate.

Prokinetics

Preparations of this group improve peristalsis by improving the excitability of intestinal receptors. As a result, propulsive activity and motility of the gastrointestinal tract improves. It is not recommended to take such drugs on your own, as they can disrupt the heart rhythm. The active components of the prokinetics are itopride hydrochloride, domperidone and metoclopramide.

Lubricants

The laxative effect of this group of drugs is achieved due to the lubricating effect: the feces soften and their passage through the intestines improves. Lubricants are available both for oral administration (linseed and mineral oil) and for rectal administration in the form of suppositories (with glycerin or sodium docusate).

Stimulant laxatives

Preparations based on bisacodyl and sodium picosulfate improve peristalsis due to irritant action. They are considered second-line drugs because they cause rapid addiction, contributing to the development of the so-called lazy bowel syndrome. In addition, the irritant effect is associated with side effects such as cramping abdominal pain or diarrhea.

Antispasmodics

Used only for spastic constipation. Most often, preparations based on drotaverine and bendazole are used, which relieve spasm of the smooth muscles of the intestine and contribute to its relaxation. In other forms of constipation, these drugs can cause the opposite effect.

Correction of nutrition and lifestyle

It is necessary to learn how to eat not only correctly, but also in a timely manner. The intervals between meals should be approximately equal. The same applies to the distribution of its volume throughout the day. What does it look like in practice?

Since the middle of the last century, many people in Russia have been accustomed to have breakfast in a hurry, and during the lunch break with a dry sandwich to interrupt their appetite. At the same time, during dinner, “compensate” for malnutrition during the day with an abundance of food, consuming the first, second and dessert at one time. Unfortunately, this is not the healthiest eating style.

Another suggestion is to prohibit eating after a certain time of day. However, the secret to maintaining a healthy weight lies not at all in evening fasting, but in the correct distribution of the balance of nutrients throughout the day, as well as in physical activity.

Overeating at night is really bad, especially when it comes to food rich in complex carbohydrates. However, there is no need to torture yourself with hunger: lean meat in combination with whole grain bread and vegetables or cottage cheese with kefir not only stimulate normal digestion, but also help maintain normal weight.

To ensure normal intestinal motility, you should eat at least three times a day, and preferably at the same time. If possible, it is better to eat fractionally, in small portions, about 4-5 times a day. To do this, you can either take a lunch box with you to work or study, or have lunch in the dining room.

It is important to ensure at least minimal physical activity. The work of a large number of modern people is associated with a long stay in a sitting position. This negatively affects intestinal motility. But you can find some time for physical activity. For example, you can replace taking the elevator with walking up the stairs, and public transport with walking. Perhaps this will slightly increase the travel time, but the result is worth it - in addition to intestinal motility, walking improves sleep and overall well-being.

It is very useful to perform physical exercises, working out the legs, shoulder girdle and abdominal muscles. This is best done in the gym, but there are plenty of exercises that are easy to do at home. It is more effective to spend an extra hour exercising or walking than to spend the same time every day agonizing in the toilet.

You should also develop the habit of emptying the bowels at the same time of day and not create the need to regularly suppress the urge to defecate that appears at the wrong time.

Regular suppression of the urge to empty the bowels reduces the reflexes of the rectum, ensuring a normal bowel movement.

We should also mention the bad habit of eating dry food, which affects not only students, but also office workers who are embarrassed to take lunch boxes with them or go to the canteen. You can also add more liquid foods, such as soups, to your diet.

Folk remedies

Most of the folk methods aimed at the treatment of constipation, one way or another associated with the intake of any products or decoctions. Below we have outlined a range of foods that can help relieve the symptoms of constipation and support its prevention.

What to eat for constipation

When constipation occurs, there is no need to rush to buy a laxative. The first thing to do is to rethink your diet. Is there enough fiber in the diet? Fiber is the part of plant foods that the body cannot break down. When eating fiber-rich foods, the extra mass of dietary fiber helps keep stools soft and speeds up digestion.

All plant foods, including fruits, vegetables, whole grains, and beans, contain fiber. Dietician recommends consuming 25 grams of fiber per day for women and up to 38 grams for men. After 50 years, its amount can be reduced to 21 grams for women and 30 grams for men. The percentage of fiber content is indicated in table No. 1.

Table No. 1. The percentage of fiber in various products.

Wheat bran	43.5	Oatmeal	6.0
Flax seeds	27.2	Carrot	3.2
Sprouted wheat	17.0	Broccoli	3.0
Almond	15.0	Cabbage	2.9
Green peas	12.0	Apples	2.0
Prunes	9.5	White potatoes	1.8
Hazelnut	9.0	White rice	0.8
Beans	7. 0	Grapefruit	0.5

If during the day you can not get the required amount of fiber from fruits and vegetables, you can compensate for its lack by eating granulated bran: 40-50 grams per day will be enough. At the same time, it is important to drink them with a sufficient amount of water, because otherwise they will enter the intestines in the form of dry food boluses. The author of The Charming Gut, Julia Enders, recommends drinking at least 2.5 liters of water a day, but you need to focus primarily on your own thirst. For some people, one and a half liters of purified water per day is enough (which, by the way, is also not so little), while others are able to drink all three. At the same time, of course, it must be remembered that the diet is only part of the treatment program prescribed by the doctor. What foods should be consumed?

Prunes

We all heard from childhood that prunes help with constipation. The laxative effect is due to the fact that prunes have a moderate choleretic effect, and also suppresses the activity of opportunistic intestinal microflora, thereby normalizing the intestinal biocenosis. It is used both in the form of dried fruits and for the preparation of decoctions.

Plums and plum juice

As in the case of prunes, the laxative effect of plums and plum juice is due to their choleretic and antibacterial properties. When they enter the intestines, they retain moisture and increase osmotic pressure, which stimulates peristalsis.

Kefir

Kefir improves the balance of intestinal microflora due to the high content of lacto- and bifidobacteria. However, it should be borne in mind that with a tendency to constipation, you should drink only fresh kefir - it is he who has a laxative effect. Two-or three-day kefir gives the opposite effect.

Olive oil

The mechanism of action of olive oil in constipation is simple: it envelops the intestinal wall and softens the stool, thereby improving peristalsis. As we already know, such products are lubricants. Usually one spoon on an empty stomach is enough to eliminate stool retention.

Baked apples

Apples contain digestion-friendly ingredients such as pectin, sorbitol, lactulose and cellulose. For constipation, it is advisable to eat apples both raw and baked, but remember that more is not better. Eating more than 3 apples a day can cause bloating, which can backfire and aggravate constipation. Baked apples cause less gas formation, so this option is considered more gentle.

Red beetroot

Beetroot contains a large amount of hemicellulose, which is poorly digested, but is completely eliminated from the body. Due to the slight irritating effect of undigested fibers, intestinal motility improves. In addition, polysaccharides in dietary fiber act as a prebiotic, being a nutrient medium for beneficial intestinal microflora.

Lemon juice and warm water

In some sources, you can find recommendations to use lemon juice diluted in warm water for constipation. However, no one has yet provided a convincing justification for its effectiveness in stool retention: supporters of the use of this recipe operate with general phrases from the series "effectively stimulates digestion" or "quickly eliminates congestion in the intestines. "

Lemon juice does have a number of health benefits, but academic and nutritional literature does not mention the benefits of lemon for constipation. In addition, it should be remembered that in a number of inflammatory diseases of the gastrointestinal tract, lemon is contraindicated. Of course, you can try to agree on the appropriateness of using this prescription with your doctor, but the gastroenterologist will almost certainly not approve of this idea.

Flax seeds

Since flax seeds contain a large amount of dietary fiber, and they themselves, with sufficient water intake, increase in volume and stimulate intestinal motility, their use for constipation is quite common. It is important to know the nature of stool retention, since such a prescription is contraindicated with mechanical constipation.

Figs

Figs contain a large amount of dietary fiber that stimulates peristalsis. Pectin softens feces, due to which a mild laxative effect is achieved.

Water

Constipation really often occurs due to insufficient water intake - with its lack in the body, the feces become excessively hard and dense, and this significantly complicates their movement through the intestines. Taking one and a half to three liters of water per day (it is advisable to agree on the exact amount with your doctor) improves intestinal motility and the production of gastric juice.

Save yourself a leaflet with products that help with constipation.

Prevention

To prevent constipation, you should adhere to the following recommendations:

• Consult a doctor in a timely manner in case of digestive disorders - constipation is often the result of various diseases of the gastrointestinal tract.
• Do not eat dry food and chew food thoroughly.
• Provide sufficient physical activity - at least half an hour of walking a day, exercise, working out the muscles of the press. All this improves intestinal motility.

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