Preventing constipation

What you eat and how you live can make all the difference to constipation.

Diet

Normal bowel function is promoted by eating well-balanced, regularly scheduled meals.

Eat plenty of high-fibre foods:
• Increase your fibre intake gradually to allow your body to adjust and to minimise potential abdominal gas or discomfort.
• Cereals are good fibre sources if they contain 3g or more of dietary fibre per serving.
• Increase the fibre content of low-fibre foods by adding two to three tablespoons of 100% bran cereal or unprocessed wheat bran to cereal or soup. Add bran and whole grain cereals to casseroles, home-made breads and other baked goods to provide additional fibre.
• Cooked and raw vegetables and fruits are good choices. Cooking does not greatly reduce the fibre content.
• Choose fibre-containing snacks such as whole grain crackers, fresh and dried fruits (apricots, peaches, pears, raisins, figs, prunes, and dates), raw vegetables (broccoli, cauliflower), popcorn, nuts and seeds.
• Pulses (dried peas, beans and lentils) and nuts are high in fibre and protein. They may serve as high-fibre substitutes for meat, fish or poultry, which have no fibre content.
• Avoid foods that are high in fat and sugar. Constipation may worsen with diets high in fat, sugar, protein or dairy products.

Drink enough fluids:
• The fibre you eat will absorb liquid and keep your stools soft.
• Drink two to four extra glasses of water per day, especially in the morning. Try to drink at least 1.5 to 2 litres of liquids throughout the day in the form of water, juice, milk, soup or other fluids.
• Prune juice may be helpful as a mild laxative.

For babies and young children:
• Breast-feed your infant; constipation is rare in breast-fed infants.
• Make sure you add the correct amount of water to the infant's formula. For infants under six months give additional water (up to    60ml twice a day).
• From the age of six months, give your infant prune juice. Start with 2.5ml and slowly increase the amount to 60ml. From nine months, add one to three tablespoons of strained prunes per day. Alternatively, give infants from six to 12 months of age, 60 to 120ml of fruit juice, such as grape, pear, apple, or cherry, twice a day.
• Make sure your child is not eating or drinking too many dairy products, such as milk, ice cream, cheese and yoghurt. At age 12 months, a child needs four servings a day.

Exercise

Exercise more. A walking programme is a good start.

Habits
• Set aside relaxed times for having bowel movements. As urges usually occur after mealtimes, it may help to ask a constipated child to sit on the toilet after meals, especially breakfast. It may help to make this a daily routine.
• Defecate when you feel the urge. Your bowel sends you signals when you need to pass a stool. If you ignore these signals, the urge will go away and the faeces will eventually become dry and difficult to pass.
• A firm footing, perhaps with the aid of a footstool, helps children position themselves properly on the toilet.

Reviewed by Dr Saville Furman, MBChB MFGP (SA). Family Physician, Part time lecturer in family medicine and primary care at UCT, Red Cross Children’s Hospital and Groote Schuur hospital, Cape Town.

Previously reviewed by Dr P.H.S. van Zijl, MBChB. MMed (Int)