Constipation and irregular bowel movements affect millions of Americans. “Diet plays a huge role in causing constipation,” says Dr. Hamza Aziz, MD, a gastroenterologist and internal medicine physician at Memorial Hermann Medical Group (MHMG) Cypress. “Diet, drinking water and exercise often can help prevent—and treat—constipation.”
Here are Dr. Aziz’s top tips to combat constipation and improve your digestive health.
Determine if you have a problem. “Many of us can have irregular bowel movements at times,” he says. Constipation is defined as not having a bowel movement for over three days or straining and laboring when you do go. If you’re concerned, contact your health care provider.
Choose foods that help. “You should fill at least half of your plate with green vegetables or leafy greens,” Dr. Aziz says. The rest can be legumes, fruits, barley, whole wheat, rye and meat. Fruits, avocado, chickpeas, pistachios, almonds, peanuts, raspberries, mangos and guava are great fiber sources. “Avocado is really good because it contains fiber and healthy fat.”
You also can take over-the-counter supplements containing water-soluble fiber, such as Metamucil®. “Fiber is fiber,” he says.
“The exact quantity of fiber grams needed is hard to define,” he says. “Everyone’s different, but you should choose breads with fiber added, and brown rice over white rice because they contain more fiber.”
Take it slowly. Don’t bulk up too quickly on fiber or you risk bloating, gas and cramps. “Titrate your fiber intake. As long as you’re adding fiber, you’re helping yourself,” he says. “I wouldn’t recommend consuming 3-4 servings of Metamucil®, oats, broccoli and a whole quart of strawberries.”
You may see results by adding 1 tablespoon of Metamucil® with your morning coffee or tea, along with some celery or broccoli at another meal. You can continue increasing your amount until you have bowel movements every day or every other day.
Avoid foods that cause digestive disruption. Processed, high-fat and fried foods can induce constipation, Dr. Aziz says. Ditch foods lacking fiber, such as processed or packaged snacks, sugary goods, desserts and baked goods.
Shop the perimeter of the supermarket, avoiding the packaged foods found amid the center aisles.
Study medication. “A few medications can cause constipation,” Dr. Aziz says. These can be opioids including hydrocodone and weight-loss medications, such as semaglutides. “The goal of weight loss drugs is to slow down the gut, which makes you feel full longer and eat less,” he says. “But they also can cause constipation.”
Review your prescriptions with your health care provider. They also might suggest laxatives if you have not had a bowel movement in over a week.
Drink up. Being well hydrated helps soften your stool. Generally, you should halve your weight and drink an ounce per day for each pound of that number. “Prune juice is also pretty helpful,” Dr. Aziz says. “In addition to containing fiber, prune juice has sorbitol, a complex non-absorbable sugar.”
Get moving. “Walking activates your whole body, and that includes your gut,” he says. A simple 30-minute walk 3 to4 times weekly can get your gut in gear. “I have some people say they have a morning walk and coffee.”
See a doctor: If you’ve tried the above dietary and lifestyle measures yet still are unable to have a bowel movement, “it may be time to see a gastroenterologist,” Dr. Aziz says. “You also should see a gastroenterologist, if your habits suddenly change, from going every day to now only once or twice a week.”
Your doctor will review your symptoms and diet. They also may suggest ultrasound, a CT scan or other imaging or diagnostic tests to rule out an intestinal blockage or other issue.
Notice red flags: “Rectal bleeding or black and pasty stools are concerning,” he says. “So is persistent abdominal bloating or unintentional weight loss.” Black stools aren’t always a bad sign, as the iron in some medications, such as Pepto Bismol®, can darken stools.
Make an appointment with a gastroenterologist right away if you experience these symptoms. Your doctor may want to run some tests, including a colonoscopy to make sure you have no abnormalities in your intestinal tract.
Get busy eating, drinking and exercising properly to help avoid discomfort and end constipation frustration.