Lifestyle Modifications for Constipation By Leslie Rusch-Bayer, RD, LDN, CPT

Constipation is a dysfunction of digestion, encompassing both slow bowel motility (decreased frequency) and difficulty passing stool. It is the most common gastrointestinal complaint, affecting individuals of all ages, ethnicities, and varying degrees of health, often for diverse reasons. Constipation becomes uncomfortable and can lead to symptoms such as abdominal pain, bloating, weight changes, fatigue, and lack of motivation. If left untreated, constipation can progress, potentially requiring medical treatment or surgical intervention by a gastroenterologist.

Diagnosing constipation can be challenging. Different people eliminate at different rates. Most medical professionals define constipation as the elimination of stool less than three times weekly. Medications, chronic diseases, surgical history, and various medical conditions can lead to constipation, with dietary factors being the most common primary cause. As diets increasingly consist of highly refined and processed foods, constipation complaints appear to rise in prevalence.

Lifestyle modifications have proven helpful in relieving constipation by improving transit time and frequency of stool elimination. Given that constipation often has multiple contributing factors, implementing several lifestyle changes may be necessary. The gastrointestinal system functions optimally with a regular routine, so it’s important to maintain and allow for 4-6 weeks of lifestyle modifications before making additional changes.

Here are a few lifestyle modifications that can help improve stool frequency or ease of elimination:

Food and Fiber

Diet plays a crucial role. Research indicates that an ultra-processed, low-fiber diet is positively correlated with constipation. Low-cost, shelf-stable, convenient, highly marketed refined foods promote constipation.  A whole-food diet rich in naturally fibrous materials like raw vegetables, fruits, beans, seeds, and unprocessed whole grains encourages healthy transit time and elimination. Many whole foods such as Jerusalem artichokes, leeks, chicory root, artichokes, onions, and garlic also act as prebiotics, fostering a healthy gut microbiome. Refined sugars, sugar alternatives, and many processed additives not only promote constipation but also negatively alter the gut microbiome.

The current daily recommended value (RDV) for women is 25g of fiber; for men, it’s 38g. Children should consume their age plus 5 grams of dietary fiber. Fiber adds bulk to stool, lubricates the colon, increases transit time, and stimulates peristalsis (muscular movement of the colon). Fibrous foods contain phytonutrients with powerful compounds that prevent disease and enrich the digestive tract environment through fermentation. Increased fiber intake correlates positively with stool frequency, transit time, and weight. Refined foods, especially refined carbohydrates, decrease transit time. Aim to increase raw, roughage intake by consuming at least four cups combined of whole fruits and vegetables daily.

Water

Water is essential for hydration. Fiber requires water to create bulk and stimulate movement. Consider drinking 24-32 ounces of water each morning before consuming coffee or food or engaging in morning activities. This amount of water can help push stool through the colon. Maintain adequate water intake throughout the day.

Exercise

Though challenging to research, regular exercise likely promotes healthy elimination. Consider starting repetitive, weight-bearing cardiovascular exercises such as walking, light jogging, hiking, jumping, or calisthenics. These exercises involve light impacts that encourage stool movement.

Supplementation

Supplementation options for constipation range from simple whole foods to complex laxatives. Supplements and foods that could positively affect constipation include apples, prunes, psyllium, flaxseed, prebiotics, probiotics, magnesium citrate, and cape aloe. Due to their complexity and potential outcomes, patients should discuss supplementation options with a medical provider. Attempt lifestyle modifications first and rule out more complex digestive problems before considering supplementation.

Stress

Unhealthy stress can negatively impact digestion and motility. Stress affects food choices, dietary patterns, and intake speed. Instead of preparing whole-food meals, individuals may opt for fast food or convenience meals. Meal times may vary day-to-day, and intake of refined sugar, caffeine, and alcohol may increase. Stress can disrupt exercise routines and regular, consistent sleep. A healthy stress management routine is necessary to maintain digestive regularity.

Food Intolerances

Food intolerances also impact digestion, and they may develop at different stages of life depending on dietary habits. Food sensitivity testing should be conducted using a serum blood specimen. Interpreting results can be complex, so it’s important to work with a health professional experienced in food sensitivity testing. A comprehensive analysis should include the patient’s medical history, dietary habits, symptoms, and food sensitivity results to make informed recommendations.

Body Positioning

Depending on individual body structure and pelvic floor muscle strength, a change of positioning could help promote easier elimination. Pregnancy, childbirth, obesity, constipation, and a sedentary lifestyle could all weaken pelvic floor muscles. A medical study reports that the greater the hip flexion achieved by squatting, the easier the elimination. Consider implementing a squatting stool or seeking a physical therapist specializing in pelvic floor therapy.

Constipation is frustrating. It literally and figuratively weighs a person down. Lifestyle changes have the potential to positively influence transit time, ease of elimination, and elimination frequency. A comprehensive program like TLC: Total Lifestyle by Couri will provide personalized laboratory explanations, dietary supplementation, and exercise recommendations that could help relieve constipation. A free consultation to discuss program options is easily scheduled by calling the Couri Center at 309-692-6838.

Leslie, Registered Dietitian

Sources:

Guilliams, T. G., Ph.D. (2016). Functional Strategies for the Management of Gastrointestinal Disorders: Principles and Protocols for Healthcare Professionals. Point Institute.

Modi RM, Hinton A, Pinkhas D, Groce R, Meyer MM, Balasubramanian G, Levine E, Stanich PP. Implementation of a Defecation Posture Modification Device: Impact on Bowel Movement Patterns in Healthy Subjects. J Clin Gastroenterol. 2019 Mar;53(3):216-219. doi: 10.1097/MCG.0000000000001143. PMID: 30346317; PMCID: PMC6382038.

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