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Constipation and Its Remedies

Constipation is common. In the general population, incidence of constipation varies from 2 to 30%[1].

What's Constipation?

Constipation is best known as infrequent bowel movements (typically three times or fewer per week).   The number of bowel movements generally decreases with age.  Ideally,  you want to have one bowel movement a day,


Constipation is a symptom with many causes.  In the elderly, causes can be[1-3,9,13-14,16-17]:

  • Insufficient dietary fiber intake
  • Inadequate fluid intake
  • Decreased physical activity
  • Side effects of medications[9]
    • Many medications, especially opioids (painkillers), can cause constipation[14].
    • Among the drugs that can cause constipation are calcium-channel blockers taken for high blood pressure, beta blockers, some antidepressants, narcotics and other pain medications, antihistamines (to a lesser degree), certain decongestants and some antacids.[16]
  • Hypothyroidism[18]
  • Colorectal cancer
    • Growths in the colon can cause a narrowing or blockage, leading to the constipation.
    • Other warning signs of colon cancer: seeing blood in the stool, very long and thin stool, weight loss, stomach pain, or nausea and bloating.
    • Also notice whether the constipation persists even after making adjustments to diet (consuming more liquids and fiber).
  • Parkinson’s disease[2,3]
    • Constipation may represent one of the earliest signs of Parkinson’s disease, preceding the onset of motor symptoms by two decades or more.
  • Back pain[13]
    • In some cases, it’s simple- the lower back muscles spasm and interfere with the autonomic nerves responsible for the intestinal action that cause bowel movements.
  • Magnesium deficiency[17]
    • Magnesium is needed for normal muscle function, including intestinal muscles. One recent study examined the intake of magnesium with constipation in 3835 women. Low magnesium intake was associated with constipation.

Consequences of Constipation

The holding back of fecal matter in the lower parts of the intestinal tract can lead to

  • A toxic environment in the colon and, if the situation is not resolved, in the the entire body
  • Cellulite because it causes waste and toxins to remain in the body rather than being eliminated
  • Bloating, rectal bleeding, abdominal pain and cramps, nausea and vomiting

Remedies

You should avoid laxatives[15-16] and try the following natural remedies (if Magnesium is counted as natural too) first.   Laxatives can become habit-forming to the point that they damage your colon. Some laxatives inhibit the effectiveness of medications you're already taking, and there are laxatives that cause inflammation to the lining of the intestine.
  • Healthy Diets[6-7,16]
    • Facts
      • Fiber is the part of fruits, vegetables and grains that the body cannot digest. 
        • Both soluble and insoluble fiber help to make your bowel movements softer and easier to pass.
        • Fiber can help prevent constipation, especially in conjunction with adequate fluid intake.
      • Apples
        • Eat an hour after a meal to prevent constipation. 
      • Apple juice and apple cider. 
        • These are natural laxatives for many people. Drink up and enjoy! 
      • Bananas. 
        • These may relieve constipation. Try eating two ripe bananas between meals. Avoid green bananas, because they'll actually make your problem worse. 
        • However, as discussed in [24]
          • At the end of the day, we’re all different. A food that relieves constipation for you may have the opposite effect on someone else.
      • Raisins. 
        • Eat a handful daily, an hour after a meal. 
      • Rhubarb
        • This is a natural laxative. Cook it and eat it sweetened with honey, or bake it in a pie. Or, create a drink with cooked, pureed rhubarb, apple juice and honey.
      • Flaxseeds
        • Sprinkle one teaspoon of ground flaxseeds over any meal.
      • Prunes and figs
        • Can be added to breakfast or eaten as a snack.
    • Precautions
      • Increase fiber gradually. 
        • Your stomach and intestines need time to adjust to this change. Too much, too fast can cause gas, cramps and diarrhea; and can discourage your healthy changes.
      • Be sure to drink enough water otherwise fiber can have the opposite effect and be constipating.
  • Warm bath
    • Facts
      • Warm water relaxes your body muscles and reduces the stress.
      • Take sitz bath if you don't have much time
    • Precautions
      • The higher the temperature, the more effective it is.  However, don't burn yourself.
  • Prune juice
    • Facts
      • Prunes act as a natural laxative and they contain fiber so including prunes or prune juice in your diet may help to manage constipation. 
    • Precautions
      • Too much of prune juice can cause watery stools.
      • Everyone responds to dietary changes differently so you may need to experiment with how much you need to get relief.
  • Magnesium[4,5]
    • Facts
      • Accepted as standard care for constipation
        • Having a normalizing influence in promoting regular bowel function
      • When you take supplemental calcium, Dr. Oz recommends you to take magnesium with it
      • Food sources of magnesium include green leafy vegetables, nuts, legumes, and whole grains.
      • Are less likely to cause side effects such as diarrhea, nausea and abdominal cramps when taken with food
    • Precautions 
      • Avoid high dosage
        • Although it is safe in selected patients at appropriate dosages, magnesium may cause adverse effects or death at high dosages. 
      • Should be avoided by patients with kidney disease
        •  Because magnesium is excreted renally, it should be used with caution in patients with kidney disease.
      • Avoid giving babies milk of magnesia (or magnesium hydroxide) for two reasons:
        • They should not learn to depend on a laxative[15]
        • Milk of magnesia hinders their body's utilization of calcium
  • Psyllium[6,7]
    • Facts
      • Used as a source of dietary fiber to relieve constipation and maintain a healthy digestive tract. 
        • The husk of psyllium seed contains large amounts of soluble fiber; when wet, it becomes slippery and mucilaginous and expands to 10 times its size as it absorbs water
        • Recommended by both herbal and conventional medical practitioners
        • Provides 71g of soluble fiber for every 100g
        • Can speed up the time that it takes for food to travel through the digestive tract when taken over a period of weeks
      • Has been found effective in treating mild to moderate cases of inflammatory bowel disease, irritable bowel syndrome, hemorrhoids, and other intestinal problems.
      • Appears to effectively lower blood cholesterol levels, particularly low-density lipoprotein (LDL), or "bad," cholesterol, when added to a low-fat, low-cholesterol diet.
      • Interestingly, psyllium is also effective for the treatment of diarrhea and even can be particularly useful for those with irritable bowel syndrome who experience periods of constipation interspersed with periods of diarrhea. 
    • Precautions
      • Can reduce the absorption of certain drugs, so drugs should be taken either 1 hour before or several hours after psyllium is taken.
      • Obstruction of the gastrointestinal tract has happened in people taking psyllium fiber, particularly if they had undergone previous bowel surgery or when psyllium was taken with inadequate amounts of water.
  • Probiotics
    • Facts
      • Lactic acid bacteria may be an effective and safe means of countering constipation in a senior population as reported[10].
        • These benefits, attributed to the probiotic intervention, clearly offer an advantage over the traditional management of constipation which often utilizes stimulant laxatives. Such medications can lead to dependence and long term bowel dysfunction[11].
        • The concentration of healthy bacteria also grew and a decline in two harmful enzyme activities (tryptophanase and urease) were noted.
      • Probiotics are naturally found in aged cheeses, cultured milk and yogurt and may be purchased in supplement form.
    • Precautions
      • Most probiotics (including supplements) contain milk proteins, which can trigger an allergic reaction if you have a milk allergy
      • If you develop hives after taking probiotics, along with facial, lip, tongue or mouth swelling and shortness of breath, you need to call 911.
  • Honey[16]
    • Facts
      • Honey is a very mild laxative. Try taking 1 tablespoon three times a day, either by itself or mixed into warm water. 
    • Precautions
      • Honey is high in calories, so use it as an occasional laxative, not a daily preventative.
      • Avoid fake honey from the market.[25]

References

  1. Constipation (Wikipedia)
  2. Is constipation a sign of early Parkinson’s disease?
  3. Medical records documentation of constipation preceding Parkinson disease: A case-control studyNeurology November 24, 2009 73:1752-1758
  4. Hypercalcemia due to Hypervitaminosis D: Report of Seven Patients
  5. Therapeutic uses of magnesium
  6. National Geographic Guide to Medicinal Herbs
  7. Psyllium Seed from Metamucil or Konsyl
  8. Constipation on MedicineNet.com
  9. Medications that cause constipation
  10. February edition of the Nutrition Journal
  11. Laxatives: OTC Products for Constipation
  12. The health benefits of dried apricots
  13. Are Constipation and Back Pain Related?
  14. Ohtori S, Inoue G, Orita S, Eguchi Y, Ochiai N, Kishida S, Takaso M, Aoki Y, Kuniyoshi K, Nakamura J, Ishikawa T, Arai G, Miyagi M, Kamoda H, Suzuki M, Toyone T, Takahashi K. Transdermal fentanyl for chronic low back pain
  15. Are Laxatives Safe?
  16. 15 Home Remedies for Constipation
  17. Remedies for Constipation Relief
  18. Can Drugs Cause Hypothyroidism?
  19. How honey kills bacteria
  20. High-fiber foods (Mayo Clinic)
  21. Scrutiny for Laxatives as a Childhood Remedy
  22. 老年人的 便秘困扰 (in Chinese)
    • 一些簡單的食療如紅薯小米粥可以補氣健脾養胃,幫助潤腸通便。如果你的大便乾澀,可喝些蜂蜜茶(若有糖尿病就不適合),或在食物中加入麻油來潤滑腸道,幫助排便。若可以結合一些針灸、穴位按摩(如:中脘、大橫、氣海、關元穴)或腹部按摩促進腸道蠕動,常常能收到意想不到的療效。
  23. The perceived effect of various foods and beverages on stool consistency
    • When the three groups were asked which foods or beverages caused constipation, only chocolate and white bread were named more often
  24. Do Bananas Cause or Relieve Constipation?
  25. How to Differentiate Real Honey From The Fake Ones
  26. Top 12 Causes of Constipation & Natural Remedies

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