CONSTIPATION DIETARY GUIDELINES

Constipation refers to the incomplete (small stools) or infrequent (fecal mass remains in colon longer than the normal 24-72 hours after meal ingestion) passage of stools, as well as difficulty passing stools. The condition can be acute or chronic. Most people experience constipation from time to time, but usually lifestyle changes and improved dietary habits can help relieve the symptoms and prevent recurrences. There is no standard for frequency of bowel movements, but most physicians recommend 1-2 bowel movements daily (based upon the frequency that is generally observed among healthy people who eat a high-fiber diet).

There are four categories of constipation:
• Functional constipation: Caused by insufficient dietary fiber and water, inadequate exercise, etc.
• Neurogenic or “spastic” constipation: Increased narrowing of the colon with small, ribbon-like stools caused or exacerbated by obstruction, stress, nervousness or anxiety (as in cases of cold, pain, grief, fear, etc.). It can also result from a repeated voluntary resistance of the urge to move the bowels. There may be some food allergies, as to milk or wheat, associated with this type of constipation. Drugs and some medical conditions can also decrease the natural peristaltic motion of the gut smooth muscle and increase the tendency for constipation. Low back pain, exacerbated by straining, may contribute.
• Atonic constipation (“lazy bowel”): This is a muscular weakness in the rectum and sigmoid colon, caused most often by laxative abuse. Other medical conditions such as hypothyroidism, pregnancy, emphysema and electrolyte imbalances (in the blood that supplies the muscles of the rectum) may also result in this type of constipation.
• Mechanical or “obstructive” constipation: Can be caused by fecal impaction, lesions that obstruct the bowel (tumor, pregnant uterus), inflammation (irritable bowel disease) or spasm from pain in the colon, rectum or anus.

Constipation can give rise to many different ailments, including appendicitis, halitosis (bad breath), body odor, coated tongue, depression, diverticulitis, fatigue, gas, headaches, hemorrhoids, hernia, indigestion, insomnia, malabsorption, obesity, varicose veins and the development of intestinal cancer. Regular bowel movements are important in the body’s detoxification process, as the colon serves as a holding tank for waste matter. Antigens and toxins from an unbalanced gut flora population may play a role in the development of many types of chronic disease.

Note: Your naturopathic treatment for constipation will vary according to the type of constipation you have. The dietary recommendations and guidelines below contain foods to which some individuals may have allergies, intolerances and sensitivities. In those cases, those foods should be avoided. Dietary choices should be modified to meet your personal dietary needs. Consult your physician/clinician for further information regarding nutrition and your individual medical condition.

Dietary Recommendations and Considerations

• In general, eat a high-fiber whole foods diet that includes vegetables, fruits, whole grains, legumes, nuts and seeds. The most efficient colon movers contain a combination of soluble and insoluble fiber. Soluble fiber dissolves in water, forming a gel that coats the intestinal wall. Insoluble fiber does not dissolve in water, but rather soaks water up like a sponge as it passes through the intestine, helping to prevent constipation.
• Foods highest in soluble fiber include adzuki beans, barley, dried beans and peas, beets, cabbage, carrots, oats, okra and some fruits, especially apples, apricots, bananas, blackberries, blueberries, citrus, cranberries, figs, grapes, melons, peaches, pears and prunes. Psyllium, slippery elm (Ulmus Fulva) and marshmallow (Althaea Officinalis) are also high in soluble fiber.
• Foods highest in insoluble fiber include cereals and whole grains, brans, seeds (like ground flax or psyllium seed), and the skins or peels of many fruits and vegetables.
• Avoid dairy products, soft drinks, meat, refined carbohydrates, sugar and processed foods, salt, alcohol and coffee.
• Drink more water. This is particularly more important when adding more fiber to your diet. Drink at least 64 ounces daily. Rule-of-thumb for water consumption: one third of your body weight in ounces plus 8 ounces for each cup of coffee or tea (diuretics), plus 8 ounces for each one half hour of exercise daily.

Mango, Peach, and Grape Nectar: Blend together 1 peeled and sliced mango, 2 peeled and sliced peaches, 4 ounces white grapes, 1-1/4 cups soy milk/rice milk or nut milk, ½ teaspoon ground cinnamon.
Beet and Carrot Cleanser: Juice together 3 large carrots and 2 beets. Garnish with chopped fresh cilantro.
Can’t Beet It: ¼ cup raw grated beet, ¾ cup carrot juice, ¾ cup apple juice, 1-1/2 cups frozen diced papaya, 2 teaspoons fresh lime juice, ¼ teaspoon grated fresh ginger. Blend until smooth.
Almond Regulator: Blend together 2 ripe bananas, ½ cup ground almonds (almond butter), 2/3 cup fresh orange juice, 2/3 cup plain yogurt, and 1 Tablespoon honey. Serve sprinkled with nutmeg.
Fiber Burst: Blend together ½ cup maple yogurt, 2/3 cup buttermilk, 1/3 cup pitted chopped dates, 2 sliced frozen bananas, 2 Tablespoons bran, 2-3 crushed ice cubes.

Resources
Balch, Phyllis and James. Prescriptions for Nutritional Healing, 3rd edition. 2000. Avery.
Barber, Mary C. and Whiteford, Sara C. Super Smoothies. 2000. Chronicle Books.
Escott-Stump, Sylvia. Nutrition and Diagnosis-Related Care, 4th edition. 1998. Williams and Wilkins.
McIntyre, Anne. Drink To Your Health: Delicious Juices, Teas, Soups and Smoothies That Help You Look and Feel Great. 2000. Gaia Books Ltd.

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