How to make the intestine work without using laxatives – 05/26/2023 – Equilibrium
Is there a way to cure constipation without taking laxatives or prescription drugs every day?
This is one of the most common questions I am asked as a gastroenterologist, and I understand why.
Intestinal constipation, also called “constipation”, generally defined as less than three bowel movements per week, is the most frequent gastrointestinal complaint. And many people don’t want to take medicine every day, or fear becoming dependent on laxatives (even though this is a common misconception).
Here are some of the more “natural” ways to improve constipation that are also backed by science.
Increase your fiber intake
Most adults should aim for between 21 and 38 grams of fiber a day, according to the National Academy of Medicine.
Prioritizing fiber-rich foods such as fruits, greens, nuts, seeds, legumes, and whole grain products not only increases your fiber intake, it can also prevent constipation by making your stools bulkier, softer, and easier to pass.
Experts also recommend taking psyllium, a soluble fiber supplement, every day.
Water and other hydrating foods and liquids naturally soften stool, preventing it from becoming hard and dry.
To stay hydrated, try to keep a large, full reusable water bottle nearby throughout the day. Or consume hydrating foods and drinks, such as milk, juice, tea or coffee (which can also stimulate the urge to have a bowel movement), as well as fresh fruit, such as melon or grapes.
Researchers have found that exercise can improve gut health in a variety of ways, such as bolstering the microbiome, reducing risks of colorectal cancer and constipation. Just 15 minutes of light to moderate exercise — like walking or raking leaves in the backyard — can cause changes in blood flow and hormones that can stimulate the bowel to move its contents out.
Use food as a natural laxative
Michael Camilleri, an intestinal motility expert at the Mayo Clinic, says that certain foods like prunes and kiwis can help with constipation.
In a small study published in 2011, for example, researchers found that consuming 50 g of prunes (about five or six berries) twice a day is more effective in improving stool frequency and consistency than eating 11 g. of psyllium twice a day. Drinking prune juice has also been shown to be beneficial.
A 2021 clinical trial finds that eating two kiwis a day is just as powerful as prunes in increasing stool frequency and reducing straining — and has the added benefit of helping with bloating.
The sugar, fiber, and other nutrients in kiwis can produce a laxative effect, increasing the water content and bulk of the stool, says Camilleri. “It makes the consistency of bowel movements smoother and easier to expel.”
Use a stool in the bathroom
Darren Brenner, a gastroenterologist at Northwestern Medicine, says that using a stool in the bathroom to support your feet, positioning your knees above your waist, can be a low-cost, low-risk solution to overcoming constipation.
“You can use anything — a stool, an old phone book. Just lift your knees above your hips,” says Brenner.
Try Pelvic Floor Physical Therapy
More than 20% of people with chronic constipation have a dysfunction of the pelvic floor muscles (called pelvic floor dyssynergia), which causes them to contract in such a way as to block the passage of stool.
Brenner says that if bowel cleansing methods like enemas don’t help, or if you find even loose stools difficult to pass, talk to a doctor about this condition.
Small but solid studies have found that a special type of physical therapy with biofeedback, which involves working with a physical therapist to coordinate muscles during defecation, can help about 80% of people with pelvic floor dysfunction.
Experts are yet to come to a conclusion about several other so-called “natural” remedies.
“People always ask about things like probiotics or fecal transplants,” says Brenner. “These may be plausible treatments in the future, but current data are not robust enough to recommend them against constipation.”
If you have a sudden new constipation, discuss the problem with your doctor, as further investigation, including a colonoscopy, may be required.
Sometimes “natural” or lifestyle interventions do not resolve severe cases. Just as you need to take medication for other health problems like high blood pressure or diabetes, some medicine to manage chronic constipation may also be necessary.
Translated by Luiz Roberto M. Gonçalves