People don’t talk enough about poo. Of course, we all do it, some more than others and they come in all different shapes and sizes. Ideally, we want to be having a bowel movement at least once a day, we shouldn’t have to strain, it should be smooth, well formed, like a sausage.

But why is constipation (defined as having fewer than 3 bowel movements per week and/or having hard stool that is difficult to pass) a problem? Well, as anyone that has suffered with this will know, constipation can be uncomfortable, leaving us feeling sluggish, irritable and even disrupting our sleep. Not only this but the gut is one of the major sites of detoxification and the exit route for these detox end products is via the stool. If transit time is slow these waste products can be reabsorbed and re-enter circulation causing hormone imbalances, including excess oestrogen. Yikes! More on this to come in a future blog.

But back to constipation, slow transit can create an environment where certain gut microbes are able to proliferate, leading to imbalances in the microbial community. Given how important our gut health is to our overall health, this ‘gut dysbiosis’ can impact our mood and cognition, heart health, immunity, skin, and hormones.

Ok, but how do we return to regular daily bowel movements?

Fibre

Traditional wisdom would say eat more fibre, and this can work for some people. However, it’s been shown that the absence of fibre is not the only thing that can cause constipation. If you have an imbalance of gut bacteria, adding too much fibre too quickly can cause a flare in bloating, abdominal pain, or flatulence. If your gut tends to react badly to an increase in fibre, go slowly. Focus on soluble fibre first, adding small amounts of things like, whole oats, brown rice, black beans, sweet potato, cooked carrots, chia seeds, and fruits like apples, pears and blueberries. When digested they form a gel-like consistency and help add bulk to stool. Whilst we want to be addressing the root cause of constipation, supplements with psyllium husk and/or inulin work in a similar way and can provide more immediate relief.

Low FODMAP diet

If an increase in fibre is not having the desired effect after 3-4 weeks, it may be time to try the opposite with a low or no fibre diet. Fibre feeds gut bacteria and an imbalance in gut bugs can lead to constipation. Therefore, a low FODMAP diet, which restricts certain carbohydrates, can result in symptom relief. If attempting a low FODMAP diet, it’s important once symptoms have reduced to systematically reintroduce foods and assess your reaction. The aim is to eat as diverse a diet as possible whilst minimising symptoms.

Hydration

As food moves through the small intestine water and nutrients are absorbed to be used by the body. When the leftovers reach the large intestine water is reabsorbed causing a dry mass to become soft enough for us to pass as a stool. However, if we’re not drinking enough water the digestive system will struggle to draw sufficient fluid into the large intestine leaving our stool dry and lumpy, not a pleasant consistency! This is how magnesium supplements work, drawing water back into the bowel.

Probiotics

The make-up of our gut microbiota – the community of gut bugs in our intestines – can have a significant influence on motility, meaning the speed at which digested material moves through the intestines. Whilst probiotics don’t colonise the gut, good quality, clinical grade probiotics taken in sufficient doses can change the composition of the microbiota nudging it in a positive direction as they transit through the gut. Also, as they transit, they ‘take up space’ meaning there is less room for other harmful microbes.

Avoid snacking

When we fast overnight or leave a suitable amount of time between meals our migrating motor complex (MMC), sweeps bacteria through the intestines. A strong and consistent MMC not only supports regular bowel movements but also promotes good bowel health and microbial balance. Snacking between meals interrupts the MMC and can lead to bacterial overgrowth in the small intestine.

Stress reduction

As I’ve spoken about previously there’s a strong and physical connection between the gut and the brain, via the vagus nerve. therefore, our mental state can affect our physical state (and vice versa). With stress and anxiety comes tension; in a stressed state the body diverts blood to the muscles and brain, anticipating we need to use these systems to get us out of the emergency situation. In doing so blood is diverted away from the gut and digestion is shunted down the list of priorities. In addition, when our nervous system is in this ‘flight or fight’ state our MMC is significantly reduced. Therefore, eating in a relaxed setting, preferably at a table – without the distraction of our phones or TV – can optimise our digestive function.

Summary

Constipation is not only physically unpleasant but can have negative effects on other systems in the body due to hormone end products being reabsorbed, and encouraging an imbalance in our gut bacteria. The following can support more frequent bowel movements:

• Eating a colourful, wide ranging, fibre-rich diet (increasing slowly at first if necessary),
• Drinking enough water – pay attention to your body, if you’re thirsty, drink.
• reducing snacking between meals,
• eating in relaxed environment
• taking a sufficient dose of high-quality probiotics

If you’d like personalised support overcoming your constipation, or any other gut issues, please feel free to book a free discovery call to see how we could help: Practice Better