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Constipation increases your risk of a heart attack, new study finds – and not just on the toilet

<p><em><a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and <a href="https://www.pbs.org/newshour/health/elvis-addiction-was-the-perfect-prescription-for-an-early-death">it’s believed</a> he was straining very hard to poo, which then led to a fatal heart attack.</p> <p>We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many.</p> <p>But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack.</p> <p>This includes a recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">study</a> led by Australian researchers involving data from thousands of people.</p> <h2>Are constipation and heart attacks linked?</h2> <p>Large <a href="https://www.nature.com/articles/s41598-023-38068-y">population</a> <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">studies</a> show constipation is linked to an increased risk of heart attacks.</p> <p>For example, an <a href="https://www.nature.com/articles/s41598-023-38068-y">Australian study</a> involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">Danish study</a> of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes.</p> <p>It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital.</p> <p>These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated.</p> <h2>How about this new study?</h2> <p>The recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">international study</a> led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population.</p> <p>The researchers analysed data from the <a href="https://www.ukbiobank.ac.uk">UK Biobank</a>, a database of health-related information from about half a million people in the United Kingdom.</p> <p>The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation.</p> <p>People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation.</p> <p>The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34% increased risk of a major heart event compared to those with just hypertension.</p> <p>The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/26812003/">Japanese study</a> looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day.</p> <h2>How might constipation cause a heart attack?</h2> <p>Chronic constipation can lead to straining when passing a stool. This can result in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">laboured breathing</a> and can lead to a rise in blood pressure.</p> <p>In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">one Japanese study</a> including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">One theory</a> is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels.</p> <p>As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease <a href="https://pubmed.ncbi.nlm.nih.gov/12493255/">doubles</a> when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure).</p> <p>The systolic blood pressure rise with straining in passing a stool has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">reported to be</a> as high as 70 mmHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/22256893/">Some people</a> with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing.</p> <p>This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure.</p> <p>Another intriguing avenue of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399019/">research</a> examines the imbalance in gut bacteria in people with <a href="https://pubmed.ncbi.nlm.nih.gov/3596341/">constipation</a>.</p> <p>This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack.</p> <p>This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease.</p> <h2>What can we do about this?</h2> <p>Constipation affects around <a href="https://pubmed.ncbi.nlm.nih.gov/36826591/">19% of the global population</a> aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health.</p> <p>Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237209/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/vincent-ho-141549"><em>Vincent Ho</em></a><em>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/constipation-increases-your-risk-of-a-heart-attack-new-study-finds-and-not-just-on-the-toilet-237209">original article</a>.</em></p>

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11 surprising home remedies for constipation relief

<p><strong>Constipation remedy: Sesame seeds</strong></p> <p>Sesame seeds make great home remedies for constipation, according to a study published in the International Journal for Research in Applied Science and Engineering Technology. The oily composition of sesame seeds works to moisturise the intestines, which can help if dry stools are a problem and provide constipation relief.</p> <p>Add the seeds to cereals or salads for crunch, or pulverise them in a coffee grinder and sprinkle on food like a seasoning.</p> <p><strong>Constipation remedy: Molasses</strong></p> <p>One tablespoon of blackstrap molasses before bed should help ease your constipation by morning. The ingredient was studied by the Journal of Ethnopharmacology in 2019 on paediatric constipation with successful results.</p> <p>Blackstrap molasses is boiled and concentrated three times, so it has significant vitamins and minerals; magnesium, in particular, will help you achieve constipation relief.</p> <p><strong>Constipation remedy: Fibre</strong></p> <p>Fibre acts like a pipe cleaner, scrubbing food and waste particles from your digestive tract and soaking up water. It adds bulk to your stool, giving the muscles of your GI tract something to grab on to, so they can keep food moving along. </p> <p>The Mayo Clinic suggests aiming for 20 to 35 grams of fibre a day to stay regular. Foods particularly high in fibre include bran cereals, beans, lentils, oats, almonds, barley, many vegetables, and fresh and dried fruits. All of these things can be home remedies for constipation. If you’re constipated and taking in additional fibre, be sure to drink more water than usual to keep your stool soft and easy to pass.</p> <p><strong>Constipation remedy: Mint or ginger tea</strong></p> <p>Mint and ginger are both proven home remedies to help alleviate a slew of digestive problems. Peppermint contains menthol, which has an antispasmodic effect that relaxes the muscles of the digestive tract. Ginger is a ‘warming’ herb that causes the inside of the body to generate more heat; herbalists say this can help speed up sluggish digestion.</p> <p>Dr Stephen Sinatra recommends ginger in either capsule or tea form. In tea, the hot water will also stimulate digestion and provide constipation relief. Dandelion tea is also a gentle laxative and detoxifier.</p> <p><strong>Constipation remedy: Healthy fats</strong></p> <p>Olive oil, nuts and avocados all contain healthy fats, which can help lubricate your intestines and ease constipation, according to the experts at Harvard Medical School. A salad with fibre-rich leafy greens and a simple olive oil dressing, a small handful of nuts, or a tablespoon of natural nut butter on fruit or toast are good options.</p> <p>Even if you’re watching your weight, healthy fats are necessary for basic body functions; they are very satiating to keep you satisfied with less.</p> <p><strong>Constipation remedy: Lemon water</strong></p> <p>The citric acid in lemon juice acts as a stimulant to your digestive system and can help flush toxins from your body, providing constipation relief. Squeeze fresh lemon juice into a glass of water every morning, or add lemon to tea; you may find that the refreshingly tart water not only acts as a natural remedy to your constipation but also it helps you drink more water each day, which will improve your long-term digestion.</p> <p>And don’t be afraid to warm it up, says the American Cancer Society, sharing that warm or hot fluids can also be a helpful treatment.</p> <p><strong>Constipation remedy: Coffee</strong></p> <p>Coffee can stimulate your colon and speed up your trip to the bathroom. Other hot drinks work as home remedies for constipation too: herbal tea or a cup of hot water with a little lemon juice (a natural laxative) or honey may stimulate your colon as well. </p> <p>Coffee is also a diuretic, however, so make sure to keep drinking water or your constipation could become worse, according to Harvard Medical School experts.</p> <p><strong>Constipation remedy: Raisins</strong></p> <p>High in fibre, raisins also contain tartaric acid, according to Stanford Children’s Health, which has a laxative effect. Cherries and apricots are also rich in fibre and can help kick your constipation. </p> <p>Eat these fruits with a bowl of yoghurt for the added benefits of gut-soothing probiotics.</p> <p><strong>Constipation remedy: Prunes</strong></p> <p>This fibre-rich fruit is a go-to home remedy for getting your digestion back on track. Three prunes have 3 grams of fibre, and contain a phenolic compound that triggers the intestinal contraction that makes you want to go. </p> <p>Another great dried fruit choice is figs, which may not cause as much bloating as prunes.</p> <p><strong>Constipation remedy: Castor oil</strong></p> <p>This home remedy for constipation has been handed down for generations. One of the primary uses for castor oil is as a laxative, according to Cleveland Clinic; take one to two teaspoons on an empty stomach and you should see results in about eight hours.</p> <p>Why? A component in the oil breaks down into a substance that stimulates your large and small intestines.</p> <p><strong>Constipation remedy: Exercise</strong></p> <p>The Mayo Clinic promotes exercise as a way to increase muscle activity in your intestines. Even a daily 15-minute walk can help move food through your bowel more quickly. If you feel sleepy after a heavy meal, try to move around instead of lying down. </p> <p>Jump-starting the digestive process can help you avoid that painfully full feeling that often follows a large meal.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/11-surprising-home-remedies-for-constipation-relief-2?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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Heartbreaking reason for two-year-old's constipation

<p>A two-year-old boy in the UK has been diagnosed with stomach cancer after suffering from constipation for over a week.</p> <p>Kodie-Joe was rushed to hospital on February 15th in the UK after suffering from constipation for eight days.</p> <p>Multiple tests were conducted as well as a biopsy which revealed that the little boy had a "high grade" neuroblastoma in his stomach.</p> <p>Cancer had spread quickly into his bone marrow and the two-year-old Kodie-Joe not begins an intensive round of treatment which includes radiotherapy, immunotherapy, chemotherapy and stem cell therapy.</p> <p>He is also undergoing surgery as well as multiple blood transfusions.</p> <p>His aunt, Shae Robson, has shared the story on a<span> </span><a rel="noopener" href="https://au.gofundme.com/f/kodiejoes-cancer-journey" target="_blank">GoFundMe page</a><span> </span>for the family as they struggle to cover the costs of his treatment as well as plan to go on a holiday this year.</p> <p>The diagnosis is a "worst nightmare" scenario for the family as it only gives Kodie-Joe a 50-50 chance of survival.</p> <p>“We’ve been told he has a 50 per cent chance of survival and if he survives then there’s a 50 per cent chance it’ll come back,” Ms Robson wrote.</p> <p>“We are absolutely devastated.”</p> <p>“I’d like to raise as much money as possible, half of the total to help out with the costs of travelling to and from the hospital every day, the costs of staying in hospital for multiple weeks as well as caring for their baby at home to take as much financial stress away from us as a family at this already awful time,” Ms Robson wrote.</p> <p>“The other half of the total raised will go towards paying off their caravan holiday they have booked for September so that they have something to look forward to without the worry of paying it off and to give us all a well-deserved break.”</p> <p>The GoFundMe page has currently hit its goal.</p>

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4 things to help treat constipation

<p>Chronic constipation is incredibly common. Around <a href="https://www.ncbi.nlm.nih.gov/pubmed/30364088">one in four people</a> worldwide report symptoms, while in Australia and New Zealand, it’s around <a href="https://www.ncbi.nlm.nih.gov/pubmed/18269746">one in seven</a>.</p> <p>Lots of things can trigger <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation">constipation</a>: being out of your usual routine (think holidays, illness or injury), <a href="https://www.ncbi.nlm.nih.gov/pubmed/31292358">having a low fibre intake, not drinking enough water</a> and <a href="https://www.health.harvard.edu/diseases-and-conditions/common-causes-of-constipation">inactivity</a>.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pubmed/29382180">Certain medications</a> can also cause constipation including iron supplements, painkillers, diuretics (to help you get rid of sodium and water), and other drugs to treat heart disease, mental health conditions and allergies.</p> <p>Constipation is more common in <a href="https://www.ncbi.nlm.nih.gov/pubmed/16342852">older adults</a> and in <a href="https://www.ncbi.nlm.nih.gov/pubmed/10805262">women</a>, due to hormonal changes that slow bowel motility – the time it takes for your body to digest food and expel the waste products (stools or bowel motions). <a href="https://www.ncbi.nlm.nih.gov/pubmed/25803402">Pregnant</a> women are particularly prone to constipation.</p> <p><strong>How do you know you’re constipated?</strong></p> <p>Symptoms include:</p> <ol> <li><a href="https://www.continence.org.au/pages/bristol-stool-chart.html">lumpy or hard stools</a></li> <li>feeling that your bowels haven’t emptied completely or your <a href="https://www.webmd.com/digestive-disorders/picture-of-the-anus#1">anus</a> is blocked</li> <li>straining to pass a bowel motion</li> <li>manipulating your body position to try and pass a bowel motion</li> <li>having fewer than three bowel motions per week.</li> </ol> <p>If over a three-month period you answer yes to <a href="https://www.ncbi.nlm.nih.gov/pubmed/30364088">two or more of these symptoms</a> most weeks, then you have “constipation”.</p> <p>The good news is it can be treated and then prevented.</p> <p>If your bowels are so packed you can’t pass any bowel motions at all, see your GP. You may need treatment with specific laxatives to clear your bowels before you can start on a prevention plan.</p> <p>Here are four things that research shows improve bowel function, which refers to the time it takes for food to move through your digestive system and be expelled as a bowel motion (called gut transit time), the frequency and volume of bowel motions, and stool consistency.</p> <p><strong>1. High-fibre foods</strong></p> <p>Dietary fibres are <a href="https://www.ncbi.nlm.nih.gov/pubmed/28676135">complex carbohydrates that aren’t digested or absorbed</a> in the gut.</p> <p>Different types of dietary fibres improve bowel function through the following processes:</p> <ul> <li> <p>the fermentation of fibre in the colon produces water and other molecules. These make stools <a href="https://www.ncbi.nlm.nih.gov/pubmed/27170558">softer and easier to pass</a></p> </li> <li> <p>absorption of water into stools stimulates the gut to contract and makes bowel motions softer</p> </li> <li> <p>a higher fibre intake creates bigger stools, which pass more quickly, resulting in more regular bowel motions.</p> </li> </ul> <p>A good source of fibre is psyllium. It forms a viscous gel, which gets fermented in the colon, leading to softer bowel motions. Psyllium is the main ingredient in Metamucil, which is commonly used to treat constipation.</p> <p>A review <a href="https://www.ncbi.nlm.nih.gov/pubmed/31764399">comparing the effect of psyllium to wheat bran</a> in people with chronic constipation found psyllium was 3.4 times more effective at increasing the amount of stool passed.</p> <p>This is important because having a bigger bowel motion waiting in the colon to be passed sends signals to your gut that it’s time to expel the stool – and it helps the gut contract to do just that.</p> <p>The review found <a href="https://www.ncbi.nlm.nih.gov/pubmed/31764399">both psyllium and coarse wheat bran had a stool-softening effect</a>, but finely ground wheat bran had a stool-hardening effect.</p> <p>Other foods rich in fermentable carbohydrates include dark rye bread and <a href="https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/food-and-food-products/legumes-what-are-they-and-how-can-i-use-them/">legumes</a> (chickpeas, lentils, four-bean mix, red kidney beans, baked beans); while <a href="https://nomoneynotime.com.au/hacks-myths-faqs/how-much-fibre-should-i-be-eating">wholemeal and wholegrain breads</a> and cereals are high in different types of dietary fibres.</p> <p><strong>2. Kiwi fruit</strong></p> <p><a href="https://www.ncbi.nlm.nih.gov/pubmed/30706488">Kiwi fruit fibre</a> absorbs about three times its weight in water. This means it helps make stools softer and boosts volume by increasing the amount of water retained in bowel motions. This stimulates the gut to contract and moves the bowel motions along the gut to the anus.</p> <p>In a <a href="https://www.ncbi.nlm.nih.gov/pubmed/12074185">study of 38 healthy older adults</a>, researchers found adding two to three kiwi fruit per day to their diets for three weeks resulted in participants passing bowel motions more often. It also increased the size of their stools and made them softer and easier to pass.</p> <p>Kiwi fruit are also <a href="https://www.ncbi.nlm.nih.gov/pubmed/30706488">rich in the complex carbohydrate inulin</a> a type of <a href="https://en.wikipedia.org/wiki/Fructan">fructan</a>. Fructans are a <em>prebiotic</em> fibre, meaning they encourage growth of healthy bacteria in the colon.</p> <p>But fructans can also <a href="https://www.monashfodmap.com/ibs-central/i-have-ibs/">aggravate symptoms in some people with irritable bowel syndrome</a> (IBS). If you have IBS and constipation, check in with your GP before upping your fructan intake.</p> <p>If you don’t like kiwi fruit, other <a href="https://www.ncbi.nlm.nih.gov/pubmed/17625872">vegetables and fruit high in fructans</a> include spring onion, artichoke, shallots, leek, onion (brown, white and Spanish), beetroot, Brussels sprouts, white peaches, watermelon, honeydew melon and nectarines.</p> <p><strong>3. Prunes</strong></p> <p><a href="https://en.wikipedia.org/wiki/Prune">Prunes</a> are dried plums. They contain a large amount of sorbitol, a complex carbohydrate that passes undigested into the colon where bacteria ferment it. This produces gas and water, which triggers an increase in bowel movements.</p> <p>Eating prunes is even more effective than psyllium in improving stool frequency and consistency.</p> <p>One study of adults with constipation compared <a href="https://www.ncbi.nlm.nih.gov/pubmed/25109788">eating 100 grams (about ten) prunes</a> a day for three weeks to those who ate psyllium. The prune group passed an average of 3.5 separate bowel motions per week compared to 2.8 in the psyllium group.</p> <p>The prune group’s stools were also softer. They rated, on average, 3.2 on the <a href="https://en.wikipedia.org/wiki/Bristol_stool_scale">Bristol stool chart</a> compared to 2.8 for the psyllium group, meaning their bowel motions were more toward smooth to cracked sausage-shaped motions rather than lumpy ones.</p> <p><img src="https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /> <span class="caption"></span> <span class="attribution"><span class="source">The Conversation</span>, <a href="http://creativecommons.org/licenses/by-nd/4.0/" class="license">CC BY-ND</a></span></p> <p>If you don’t like prunes, <a href="https://www.ncbi.nlm.nih.gov/pubmed/19765364">other foods that contain sorbitol</a> include apples, pears, cherries, apricots, plums and “sugar-free” chewing gum and “sugar-free” lollies.</p> <p><strong>4. Water</strong></p> <p>Not drinking enough water is the <a href="https://www.ncbi.nlm.nih.gov/pubmed/27933718">strongest predictor of constipation</a>. When your body is a bit dehydrated, there’s less water for the fibre in your colon to absorb, meaning your bowel motions also become dehydrated and harder to pass.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pubmed/27933718">Aim for</a> around 1.5 to two litres of fluid per day, which can include liquids such as tea, coffee, soup, juice, and even jelly and the liquid from stewed fruit.</p> <p><strong>Putting it all together</strong></p> <p>Start by increasing the amount of water or other liquids you drink. You should be drinking enough that your urine is the colour of straw.</p> <p>Next, add in psyllium. Start with a tablespoon once a day with breakfast cereal.</p> <p>Psyllium forms a gel as soon as it comes into contact with liquids so to make psyllium more palatable, mix it with a small amount of stewed fruit or yoghurt and eat it straight away. If needed, increase psyllium to twice a day.</p> <p>At least once a day, have some prunes (either dried or canned) or kiwi fruit and a variety of other foods high in fibre, fructans, sorbitol and fermentable carbohydrate.</p> <p>If your bowel habits don’t improve, see your GP.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/123364/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p><em>This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/had-constipation-here-are-4-things-to-help-treat-it-123364">original article</a>.</em></p>

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Health check: What causes constipation?

<p>Most people have experienced being blocked up from time to time, whether it’s while travelling, after taking painkillers, or when you’ve let your diet go.</p> <p>But some people will experience constipation more often, and for longer periods. <a href="https://www.ncbi.nlm.nih.gov/pubmed/17464377">Chronic constipation</a> is generally defined as a problem that has persisted for six months or more. It can mean you have hard or lumpy stools that you’re straining to pass, or are passing fewer than three stools per week – or both.</p> <p>Constipation is sometimes related to the rate at which food moves through the colon in order to be expelled as poo. This process is known as <a href="https://link.springer.com/article/10.1007%2Fs11894-015-0471-z#CR20">colonic transit</a>.</p> <p>Some people have normal colonic transit, but become constipated because of other factors, such as harder stools. This is called functional constipation.</p> <p>Others have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170709/">conditions of the rectum</a>, such as narrowing or tearing or an inability to relax the anal sphincter, that make it difficult to evacuate the waste.</p> <p><strong>What is the ideal poo form?</strong></p> <p>Poo should ideally be in a sausage form with cracks, or a smooth sausage form. Using the Bristol stool chart, this is type three or four.</p> <p>But if this doesn’t describe your usual poo, don’t worry: a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379343/">good proportion of people</a> don’t pass these stool types regularly and are perfectly healthy.</p> <p>In terms of how easy it should be to pass, the goal is to prevent undue straining. Passing stools in the <a href="https://theconversation.com/whats-the-best-way-to-go-to-the-toilet-squatting-or-sitting-63991">squatting position</a> or with an elevated foot rest may make it easier.</p> <p>At the extreme end of the spectrum, some people with rectal evacuation disorders find it so difficult to empty their bowels, they often need to resort to digital manual evacuation. This <a href="https://www.health.qld.gov.au/__data/assets/pdf_file/0034/429586/lmn-bowel-management.pdf">involves</a> using a gloved, lubricated finger to remove the stool.</p> <p>So what are the key factors that affect the consistency of our stools?</p> <p><strong>Water</strong></p> <p>Our stools are made up of around <a href="https://theconversation.com/your-poo-is-mostly-alive-heres-whats-in-it-102848">75% water</a>. Once the water content <a href="https://www.ncbi.nlm.nih.gov/pubmed/9558028">falls below 75%</a>, any slight decrease in water content can lead to quite a large increase in the thickness of that stool. And the thicker the stool, the more difficult it will be to pass.</p> <p>An experiment in pigs found a decrease in the water content of stools by just 20% resulted in a <a href="https://www.ncbi.nlm.nih.gov/pubmed/9558028">240-fold increased thickness</a> of that stool.</p> <p>The amount of water in our stool, however, is regulated by the gut. An average person consumes around one to two litres of fluid a day. But this represents <a href="http://pathwaymedicine.org/gi-water-and-electrolyte-absorption">a small fraction</a> of the daily volume of fluid handled by the gut. Most fluid is reabsorbed by the small intestine and colon, resulting in an average stool fluid volume of <a href="https://www.nature.com/articles/1601907">around 100mls</a>.</p> <p>It’s important to drink more water when you’re <a href="https://www.ncbi.nlm.nih.gov/pubmed/15654804">dehydrated</a> – and this will reduce constipation. But drinking additional water when you’re already well hydrated <a href="https://www.ncbi.nlm.nih.gov/pubmed/9916661">doesn’t improve</a> the consistency of your stools.</p> <p>Be mindful of how frequently we can become mildly dehydrated. When travelling, for example, you might drink more coffee and alcohol than usual, which can lead to dehydration and constipation.</p> <p><strong>Fibre</strong></p> <p>Fibre can hold onto water and is therefore able to soften stools that are too hard.</p> <p>A high-fibre diet leads to a <a href="https://www.ncbi.nlm.nih.gov/pubmed/6269944">quicker colon transit time</a> – the time it takes to digest food and poo out the waste – while a poor-fibre diet is associated with constipation.</p> <p>A high-fibre diet is helpful for patients with normal colonic transit. But people with slow transit constipation generally find their symptoms <a href="https://www.ncbi.nlm.nih.gov/pubmed/8995945">aren’t improved</a> with dietary fibre.</p> <p>Excessive fibre consumption doesn’t change colonic transit and can <a href="https://www.ncbi.nlm.nih.gov/pubmed/7912305">even worsen symptoms</a>.</p> <p>But for most of us, there’s certainly room to improve our daily fibre intake. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986479/">recent Australian population survey</a> found more than one in two children and more than seven in 10 adults didn’t consume enough fibre.</p> <p><strong>Exercise</strong></p> <p>People who don’t get enough physical activity are <a href="https://www.ncbi.nlm.nih.gov/pubmed/23977327">more likely</a> to have problems with constipation.</p> <p>On the flipside, <a href="https://www.ncbi.nlm.nih.gov/pubmed/30843436">one review</a> found that exercise, and particularly aerobic exercise, was helpful for constipation. Although the authors acknowledge more research needs to be done in this area.</p> <p>But interestingly, <a href="https://www.ncbi.nlm.nih.gov/pubmed/30642148">a study</a> evaluating Youtube exercise videos marketed as improving bowel problems found they were not all that good at improving constipation.</p> <p><strong>Ageing, pregnancy and periods</strong></p> <p>Constipation is <a href="https://www.aafp.org/afp/2015/0915/p500.html">far more common</a> in older people, often <a href="https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-015-0366-3">due to</a> low-fibre diets, dehydration, lack of adequate physical activity, major medical conditions and the use of medications.</p> <p>Constipation occurs <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206560/">more often</a> in women than in men. Women often report constipation just before and during their periods, which <a href="https://www.ncbi.nlm.nih.gov/pubmed/11227952">may be due</a> to the effects of the hormone progesterone.</p> <p>Young women in particular are more likely to experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1433176/">slow transit constipation</a>, where there’s a delay in digested food passing through the body and being expelled. Symptoms often present around puberty but can develop at any age. People with this condition often have very infrequent bowel motions and rarely feel the urge to poo, even if weeks have gone by without a bowel motion.</p> <p>And constipation is a common problem during pregnancy. A <a href="https://www.ncbi.nlm.nih.gov/pubmed/8047482">British study</a> of more than 1,500 women found 39% of pregnant women reported constipation at 14 weeks.</p> <p>This is due, in part, to a surge in progesterone, which slows the body’s ability to digest food and expel the waste. During pregnancy, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418980/">water absorption from the gut increases</a>, which can make stools drier. In late pregnancy, an <a href="https://www.ncbi.nlm.nih.gov/pubmed/17889809">enlarging uterus</a> can also slow the forward movement of poo.</p> <p><em>Written by Vincent Ho. Republished with permission of </em><a href="https://theconversation.com/health-check-what-causes-constipation-114290"><em>The Conversation</em></a><em>.</em></p>

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6 foods to eat if you are constipated

<p>If you’ve experienced the discomfort of constipation, you’ll know how important it is to eat the right foods to keep things moving.</p> <p>The modern diet has long been attributed to this common digestive issue. Overeating red meat, fried foods, sweets and a general lack of fibre has been the main cause of many people’s blocked system.</p> <p>If you are already in the depths of constipation, here are the best meals and snacks that can help provide relief.</p> <p><strong>1. Start the day with porridge</strong></p> <p>A simple bowl of porridge with some berries gives you two hits of fibre (plus antioxidants from the berries) that are going to act like an intestinal broom to sweep things out.</p> <p><strong>2. A smoothie for breakfast or lunch</strong></p> <p>Make yourself a fruit smoothie with overripe banana, cucumber, baby spinach, and a teaspoon of flax seeds. Blend with some coconut water or almond milk until smooth.</p> <p><strong>3. Water and caffeine</strong></p> <p>Water is an essential element of the waste system in our bodies. Without enough water, it simply won’t be able to flush out the waste. Try adding sliced lemon or lime to entice the taste buds to drink more.</p> <p>Caffeine from coffee or tea can help stimulate the bowel, causing a laxative effect that can provide some relief.</p> <p><strong>4. Bulk up meals with legumes</strong></p> <p>Whether you’re making soup, salad, stir fry, casserole, curry or Bolognese – add some legumes for fibre and protein. Think chickpeas, kidney beans, black beans or lentils. Enjoy hummus (chickpea dip) on your sandwiches or as a snack with carrot sticks (more fibre!).</p> <p><strong>5. Snack on apples and pears with nut butter</strong></p> <p>Instead of snacking on processed food like crackers or chips, go natural instead. Slices of fruit with 100% nut butter (think almond or peanut butter) is a sweet and satisfying snack that gives you the one-two punch of fibre and protein. Keep the skin on your apple for extra fibre benefits.</p> <p><strong>6. Make a trail mix</strong></p> <p>If you’re heading out and about, make your own tubs of trail mix to take with you. A mixture of air popped popcorn, walnuts, cashews, pumpkin seeds, dried apricots and raisins is a healthy choice that is absolutely packed with fibre and protein.</p> <p>How do you find relief from constipation? We would love to hear your tips in the comments.</p>

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