GI Docs Swear by This Simple Hack To Prevent Constipation
Constipation is crappy. Prevent it with GI doctor-recommended tip.
Constipation isn't the world's sexiest comment. In fact, it's anything but.
However, the stigma around it can lead to embarrassment and send people down a Google rabbit hole (maybe that's why you're here). Dr. David Purow, MD, talks about constipation all day, every day. Nothing fazes him. While he doesn't think everyone needs to make constipation their number one topic of conversation, he recommends speaking up if you're backed up.
"A lot of people don’t want to talk about it," admits Dr. Purow, Northwell Health's eastern regional director for gastrointestinal endoscopy. "There are very easy things to help treat it. If there is a change in bowel habits for someone who doesn’t normally have constipation, it could be indicative of other health issues."
There's no need to spiral further down the rabbit hole. Dr. Purow and a GI doctor from Cleveland Clinic discussed the causes of constipation, easy ways to reduce your risk for it and what to do if the condition becomes chronic.
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What Causes Constipation?
Before getting into constipation prevention tips, experts say it's important to understand how constipation starts in the first place. "When constipation actually happens, we talk about colonic inertia, which means the colon isn’t moving well," Dr. Purow says. "It’s considered slow transit."
Or, it could be something called dyssynergic constipation. "When people are having bowel movements, there’s a certain coordination of muscles [in the pelvic floor and abdomen] that needs to occur," Dr. Purow explains. "Sometimes, that can get disordered."
Research shows that about half of people with chronic constipation have dyssynergic constipation.
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Common Symptoms of Constipation
Dr. Purow says that people often focus on the frequency of bowel movements. But a constipation diagnosis hinges on more than the number of times you poop.
"It’s not just the frequency you’re going but whether you are straining or struggling," Dr. Purow says. "Some people aren’t going as much as they would like, but they are probably not considered constipated."
Dr. Christine Lee, MD, a gastroenterologist at Cleveland Clinic, says telltale signs of constipation include:
Feeling like you didn't clear everything out after pooping
The size, shape and texture of your poop also matter. Dr. Purow says that doctors use something called the Bristol Stool Chart, which basically grades your poop on a scale of 1 to 7—seriously. But, unlike a math test, you aren't aiming for the highest score. And, unlike golf, you aren't shooting for the lowest. Instead, you want to be at a 3 or a 4. Dr. Purow says these types of poops are sausage-like with some form. Hard, small, lumpy feces are a flag for severe constipation.
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The No. 1 Way To Prevent Constipation
If none of the above sounds fun, GI doctors suggest evaluating your diet to ensure you're getting adequate fiber and fluids.
"A high-fiber diet can assist in bulk and creating a higher water content within the lumen of the intestines, creating easier elimination out of the body," says Dr. Lee.
Dr. Purow agrees. He suggests getting 25 to 30 grams of fiber per day, which aligns with American Heart Association (AHA) recommendations. However, he says some people may require more and advises people to start on the low end and increase their fiber intake as needed. Generally, people can get enough fiber through diet. Dr. Purow says that good sources of fiber include:
But a constipation-fighting diet doesn't stop with what's on your plate. "Because fiber can add bulk to the stool, taking in too much fiber without fluid can increase bloated feelings if we’re not accompanying that by increasing our fluid intake," Dr. Purow says.
Dr. Purow recommends getting two to three liters of water each day.
“Keep a water bottle with you throughout the day if your job or what you are doing allows you to do so," Dr. Purow suggests.
Other Constipation-Fighting Habits
As with many aspects of health, experts suggest pairing diet with exercise. "Exercise strengthens muscles, improves circulation and stimulates motility, or intestinal tract movement," Dr. Lee says.
Dr. Lee suggests getting 30 to 45 minutes of exercise three to four times per week.
"Focus on resistance training and strengthening of the core muscles," says Dr. Lee.
Dr. Purow and Dr. Lee agree that, generally, people can consume adequate fiber through diet. But if diet alone isn't enough, over-the-counter options may reduce constipation risk. "When diet is lacking in fiber, psyllium husk fiber supplements or similar products over the counter may help," says Dr. Lee.
When To See a Doctor—and What They'll Do for Constipation
Constipation is treatable. But it can cause other issues if left untreated, including ulcers and inflammation, says Dr. Purow. Plus, it's just plain uncomfortable, and you deserve to feel good.
Dr. Purow says that people generally have at least one bowel movement per day, but it's not necessarily a problem if that's not normal for you. If you are experiencing a deviation from your version of normal, it's a flag you may be constipated.
He and Dr. Lee suggest discussing constipation symptoms with your doctor. They can perform bloodwork and imaging tests like X-Rays.
"Seek medical attention to rule out treatable causes such as hypothyroidism [or] mechanical abnormalities such as strictures, stenosis [and] neoplastic process," Dr. Lee says.
Dr. Lee says that a doctor can also help you with non-over-the-counter or lifestyle remedies for your constipation, such as prescription medication.
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Dr. David Purow, MD, Northwell Health's eastern regional director for gastrointestinal endoscopy
Dr. Christine Lee, MD, a gastroenterologist at Cleveland Clinic