What is constipation?

Constipation is when you have bowel movements (stools) that are hard to pass or happen less often than usual for you. You may feel like you need to have a bowel movement but are not able to. Constipation can cause belly pain and bloating (gas) and make you feel unwell.

Normal bowel movements are soft and pass easily through your body.

Do I need to have a bowel movement every day?

No, not everyone has a bowel movement every day. Some people might go 3 times per day. Others might have 2 to 3 bowel movements per week. Everyone has their own pattern.

What causes constipation?

Constipation can occur with:

• Overuse of laxatives (stool softeners
• Ignoring the urge when you have to go
• Stress
• Pregnancy hormones
• A change in regular routine or travelling
• Not eating enough fibre
• Not drinking enough fluids
• Not getting enough physical activity
• Use of medications such as antacids with aluminum or calcium, antidepressants, antihistamines, narcotics (such as codeine), antispasmodics, diuretics, tranquilizers, some heart medications
• Use of supplements such as iron and calcium
• Health conditions such as irritable bowel syndrome, colorectal cancer, eating disorders, underactive thyroid, diabetes, Parkinson’s disease, multiple sclerosis, celiac disease and depression

When should I see a health care provider?

See your health care provider if any of the following happen:

• There is a sudden change in your bowel movements without a change in your daily routine
• You have been constipated for several days and diet changes have not helped
• You have intense pain in your belly or rectum (bum)
• You have blood in your stool
• You have unexplained weight loss
• You have constipation that alternates with diarrhea

What are the possible complications?

Possible complications from constipation include:

• Hemorrhoids
• Cracks or tears in the rectum
• Weakening of the muscles and ligaments that hold the rectum in place
• Blockage of stool in the large intestine

How can my diet help with constipation?

Fibre and fluids work together to help keep your bowel movements regular. Fibre-rich foods hold liquid in your stools to keep them soft.

Aim to drink 2.2 to 3.0 litres (9 to 12 cups) of fluid every day. Water is the best choice.

Add fibre to your diet gradually over a few weeks. A sudden increase in fibre can cause cramps and gas. When you eat more fibre, remember to drink more fluids.

In general, specific foods do not cause constipation or make it worse.

Which foods have fibre?

You should eat foods that are high in fibre for overall heatlh. You can find fibre in most plant-based foods. These include:

• Vegetables and fruit, including dried fruit
• Whole grain and whole wheat products, such as breads, cereals, pasta, brown rice, oats, oat bran, barley and quinoa
• Dried beans, split peas and lentils
• Nuts and seeds

Cooking, blending, or pureeing food does not decrease the amount of fibre.

You can also boost the fibre in your diet by adding 15 to 30 mL (1 to 2 tablespoons) of chia seeds, ground flax seeds or bran (wheat, rice or oat) into hot cereal, meatloaf, casseroles or baking.

For packaged food, read the Nutrition Facts table to find out how much fibre it contains. Look for foods with a percent daily value (%DV) of 15% or more for fibre. This means the food has ‘a lot’ of fibre. Foods that have at least 4g of fibre per serving are considered high fibre.

If you are at risk for a bowel obstruction, check with your health care provider about whether a high fibre diet is right for you.

Diet changes are less likely to improve your constipation if a medication or a medical condition caused it.

Can eating prunes or drinking prune juice help constipation?

Yes. Prunes and prune juice contain sorbitol, which is a naturally occurring sugar alcohol. Prunes and prune juice are best used in combination with a diet high in fibre and fluids.

Fruit lax can also help with constipation. Try this recipe.

Fruit lax recipe

• 250 mL (1 cup) prunes
• 250 mL (1 cup) raisins
• 250 mL (1 cup) dates
• 125 mL (1/2 cup) orange juice
• 150 mL (2/3 cup) prune juice
• 250 mL (1 cup) of wheat bran (optional)

Combine and soak ingredients overnight. The next day, blend with a blender until spreadable.

You can use it on toast or mix into hot cereal or plain yogurt. Fruit lax will keep for 2 weeks in the fridge, or it can be frozen.

Can I use laxatives to help with constipation?

Laxatives are substances that can help relieve constipation. However, the long-term use of some laxatives can make your body depend on them. Talk to your health care provider about the use of laxatives to manage your constipation.

Bulk-forming laxatives, also called fibre supplements, are the gentlest on your body. They ease constipation by absorbing more fluid in the intestines. These include psyllium and methylcellulose based products.

Fibre supplements are widely available. You can find them in forms such as powders, tablets and capsules. If you have trouble eating enough fibre and want to use fibre supplements, check with your health care provider first.

If you have a medical condition or are pregnant, it is important to always talk to your health care provider before taking any new medications, including laxatives.

For more nutrition information, 8-1-1 to speak with a registered dietitian.

For More Information

For more information on fibre and your diet, see HealthLinkBC File #68h Fibre and Your Health.