Constipation is the bane of many people’s existence. Everyone defines constipation differently. Some will go every 2-3 days and feel totally fine whereas others will go every day; and if they don’t go for 2 days, they feel extremely constipated. So, the definition of constipation varies for everyone. However, once we start getting to that 5-day mark, constipation is real.
Fiber helps with constipation because fiber increases stool bulk and absorbs water to soften the stool. Experts recommend at least 25 to 30 grams of fiber a day. For perspective, an orange only has about 4 grams of fiber. Given that most Americans are barely eating 5 servings of fruits/vegetables a day, most Americans are not consuming enough fiber. Sometimes a little fiber supplementation may be necessary. But you gotta be careful because some over the counter fiber supplements may contain small amounts of sodium (in case you’re watching your salt intake).
But fiber does not solve all cases of constipation. Another cause of constipation is side effects of medications. Medications that may induce constipation include narcotics, oral iron supplements, diuretics, and certain anxiety/depression medications. Endocrine disorders such as hypothyroidism or neurologic disorders such as strokes and spinal cord injuries may also contribute to constipation. And some people do just have a slower colon. All of these people may benefit from more chronic laxative usage including the usage of prescription strength laxatives.
Still others suffer from IBS-Constipation (irritable bowel syndrome-constipation). IBS is a gut-brain interaction disorder that can oftentimes be triggered not just by mental stressors but also physical stressors. IBS causes our digestive tracts to be more sensitive; and in some of these cases lead to constipation.
Another subset of constipation evolves around mechanical issues. Although colon cancer can cause obstruction with subsequent constipation, it’s rarely the cause of constipation. Some people have pelvic floor dyssynergia. When we are trying to defecate, our rectum needs to mount a pressure in order to push the stool out. Simultaneously our anal sphincters should be relaxing to allow easier passage of the stool. When things aren’t in sync or the forces just aren’t right, we get pelvic floor dyssynergia. Biofeedback pelvic floor therapy can help with dyssynergia.
So, there are lots of causes of constipation. I generally say more fiber and adequate water intake constitute a good place to start. More exercise also tones our muscles and promotes gut motility. Obviously if things aren’t improving or get a lot worse, it’s time to consult your doctor.