Constipation is commonly defined as difficult or infrequent passage of stool. It is one of the most common intestinal problems in western societies and all over the world. Constipation occurs when the fecal mass remains in the colon longer than the normal 24-72 hours after meal ingestion or when the person strains to defecate. In adults, normal stool weight is approximately 100-200g/day.
Primary nutrition therapy for constipation in otherwise healthy people is consumption of adequate amounts of DIETARY FIBRE both soluble and insoluble. Increased fibre increases the colonic fecal fluid, microbial mass, stool weight and frequency and rate of colonic transit. For all patients with constipation fluid intake must be at least 10 glasses.
SOURCES : Whole grains, fruits, vegetables, legumes, seeds and nuts. These are also high in PREBIOTIC substances that are not digested by humans and fuel colonic microflora.
RECOMMENDED INTAKE : 25 – 40g/day (amounts greater than 50g/day are not recommended as they increase abdominal distention)
SUPPLEMENTS : Bran and powdered fibre supplements maybe helpful in persons who cannot be able to eat sufficient amounts of fibrous foods. They can be added to juices, soups, sambar, chutneys.
DIETARY CHANGES : High fibre diet containing 6-11 serving of whole grain cereals; 5-8 serving of vegetables and fruits; at least 2 litres of fluid
NUTRITIONAL COUNCELLING :
1) Constipation can become a big deal when proper attention is not given to improve the condition.
2) Warm fluids in the mornings are specifically useful.
3) There are certain kinds of abdominal strengthening exercises that helps in maintaining regularity.
4) Some of the foods that cause constipation – refined cereals and foods, sugar, processed foods.
5) Bowel retraining programs maybe helpful which includes exercise, fibre intake, fluid consumption and setting aside 15 minutes to spend on the toilet after breakfast.
6) Regular practices help re-establish a healthy pattern.
7) In case of children, a carefull history and physical examination should be followed by parents.