Have you ever been responsible for a three to five-year-old? It’s been many years for me, but I still remember the Potty Mouth stage when just the word poo could instigate a tad of hysteria. It actually was an amusing phase. I can’t remember the subsequent phases that may have included increasingly vulgar words which weren’t so socially acceptable – or how I parented that. But I’m wondering if my blanking out on the vulgar words is linked to my not addressing the common bowel problem – constipation. Yes, I’m going to actually write about the difficulty and/or infrequency of bowel movements. Diet is definitely involved in a big way; but constipation is a rarely discussed condition.

As so often happens, I get an idea for an article when someone asks a question (in this case a neighbor, called about a grown granddaughter). Unfortunately, in this case the individual has colon cancer and pain from constipation. But the information about ending chronic constipation is the same for ordinary constipation. I don’t want to leave this paragraph without addressing the fact that constipation deserves your attention and sometimes the attention of your physician (who likely doesn’t talk about it either.) If you ignore constipation, it can progress to hemorrhoids, bleeding, diverticulosis/diverticulitis, fecal impaction, and colon perforation. The point is that ignoring constipation can lead to serious and painful complications.

The four most important issues related to avoiding constipation and its complications are the following:

• Fiber – now I’m not talking about a tablespoon of all-bran sprinkled on your Captain Crunch Cereal. What I’m trying to say is to eat and enjoy real foods containing fiber. If you restrict yourself to whole grains most of the time (think brown rice; 100% whole wheat; old fashioned or cut oats; and so on); beans, seeds and nuts; and lots of vegetables and fruit; then you’re on the right path. One publicly available database for dietary fiber is from Tufts’ Jean Mayer Research Center; or if you just want to get a quick idea of how much fiber you’re getting, you may prefer the Mayo Clinic chart. The National nutrition guidelines recommend 21 to 25 grams per day for women and 30 to 38 grams per day for men. 

It’s really best to get the fiber from real food and not from supplements, in part, because real food has many nutrients in it besides fiber and those nutrients help to keep us healthy. If you’re not eating many refined and highly processed foods, it generally means you are getting the fiber you need. The two types of fiber (water soluble and insoluble) help protect your body in two independent ways. Water soluble fiber takes on water in the intestine and increases bulk – which is great for moving things along. And water insoluble fiber adds bulk and helps speed the passing of the stool. If you’re eating a varied diet you will naturally get the two major types of fiber. Fiber, of course, is food for the gut microbiome. The fiber in food contributes to our health, not just keeping us from the ravages of constipation. The bacteria help by transforming fiber into nutrients we need.

One last word on fiber: if you’re transitioning to a higher fiber diet, it may take a little time to get where you need to be. You may need to take some psyllium fiber supplement – the kind you mix with water, for a while until you’re able to form a large, soft, bulky stool from just food. Don’t try to fix the problem with laxatives; as your body can become dependent upon them.

• Water – staying hydrated is critical to steering clear of constipation. This is not as difficult as you may think. All you have to do is to drink enough liquid to maintain light-yellow to clear urine. It’s that simple. Obviously, if there is insufficient water in our body, the fiber can’t absorb enough to bulk the stool to make it easy to pass.

• Exercise is the third factor that greatly impacts constipation. Our bodies like to move and moving our bodies on the outsides, helps the insides do its job.

• Feeling the urge – Don’t ignore it! If you put it off, the normal nerve reflex that helps you to pass stool easily is stifled. Repeated postponed bathroom trips can lead to chronic constipation.

Now having said all the above, there are medical conditions that can impact your gastrointestinal tract. So, if you’re having difficulty and it didn’t resolve with exercise, fiber and hydration, you should go to a medical doctor to rule out a medical condition. One common problem is medications and your physician will clarify in the event that medications you are taking are contributing to constipation.

While bathroom habits can seem to be an unusual subject for a site dedicated to nutrition, it’s not so funny if you’re stricken with constipation. But if all is well and you just want to enjoy a cute laugh, find a 3 to 5-year-old and just say poo.