Managing Constipation

What is constipation? What foods have fibre? Constipation is when it’s hard to have bowel Vegetables and Fruit movements (stools). Your bowel movements may be: • all vegetables and fruit, especially those • hard and dry with skins and seeds • difficult or painful to get out Grain Products • happening less than 3 times per week • breads, cereals, noodles, pasta, and other grain Some people have a bowel movement more often products made with whole grains than others. Having fewer bowel movements • all types of barley, bran, brown rice, buckwheat, doesn’t mean you are constipated if they follow a bulgur, cracked wheat, quinoa, regular pattern and the stools are soft and easy to and oats pass. Meat Alternatives What causes constipation? • beans, chickpeas, lentils, and split peas Possible causes of constipation include: • nuts and seeds such as almonds, chia, flax, hemp seeds, peanuts, • a low fibre diet sunflower seeds, and walnuts • not drinking enough fluid Note: During pregnancy, you can eat ground • not getting enough activity every day flaxseed once in a while, but not every day. Not • ignoring the urge to have a bowel movement enough is known about its safety in pregnancy. • stress or depression • pregnancy hormones Tips for increasing your fibre intake: • certain medical conditions • Include foods with fibre at meals and snacks. • side effects from some medications or supplements • Eat 7–10 servings of vegetables and fruit each day. One serving is: o ½ cup (125 mL) fresh, frozen, or canned How do I prevent constipation? vegetables Eat enough fibre everyday o ½ cup (125 mL) cooked or 1 cup (250 mL) Fibre is the part of plant foods that our bodies raw leafy vegetables cannot fully digest. Fibre can help prevent o 1 piece or ½ cup (125 mL) fresh, frozen, or constipation by making stools bulky, soft, and canned fruit or ¼ cup (60 mL) dried fruit easier to pass. • Add 1–2 tablespoons (15–30 mL) of wheat bran or ground flax seeds How much fibre do I need? to other foods. Men Women • Enjoy a ¼ cup (60 mL) serving of nuts and Age or group (grams per day) (grams per day) seeds. • Eat beans, chickpeas, or lentils regularly. One 19–50 years 38 25 serving is ¾ cup (175 mL).

Over 50 years 30 21 • Foods with fibre can be added to casseroles, Pregnant or – 28–29 cereals, pasta sauces, salads, smoothies, yogurt, breastfeeding soups, stews, and baked items.

Developed by Registered Dietitians Nutrition Services 607891-NFS

• Prunes are a natural laxative. Eat 2–3 Tips to increase your fluid prunes or drink ½ cup (125 mL) prune juice to help manage constipation as intake: needed. • Get most of your fluid by drinking water. • Your bowels need time to get used to higher • Other fluids include milk, juice, coffee, tea, fibre foods. Increase your fibre intake slowly and broth, and soup. spread fibre-rich foods throughout the day. This • Fruit juice is low in will help prevent gas and bloating. fibre compared to • The Nutrition Facts table on food labels shows whole fruit, so limit the amount of fibre and the % Daily Value 100% juice to no more (% DV) for fibre. Read the table and choose than ½ cup (125 mL) foods with more fibre. per day.

Serving Nutrition Facts size Per 250 mL(34 g) Be active everyday Amount % Daily Value Daily activity is an important part of a healthy Calories 120 Fat 0.5 g 2 % lifestyle. It helps keep your bowels moving Saturated 0 g Trans 1 % regularly. Be active for at least 30 minutes each day, 0 g 5–7 days a week. 0 mg Cholesterol • You can start with 10 minutes at a time and Choose Sodium 210 mg 10 % Choose gradually increase the time you spend. 2 g or Carbohydrate 28 g 9 % a higher Fibre 5 g 20 % • Aim for at least 150 minutes of moderate to more % Daily fibre per Sugars 5 g Value vigorous activity each week. This type of activity Protein 4 g makes your heart beat faster. serving for fibre Vitamin A 0 % • Limiting the time you spend in front of the TV or Calcium 0 % computer may help you be more active. Iron 30 %

Drink enough fluid everyday

It’s important to drink enough fluid when you eat a higher fibre diet to help stools stay soft. The table below shows how much fluid is recommended for adults every day.

Age or group Men Women

19 years and over 12 cups 9 cups (3 litres) (2.2 litres) 10 cups Pregnant – (2.5 litres)

12 cups Breastfeeding – (3 litres)

For more information on physical activity, go to www.publichealth.gc.ca. Search for Physical Activity-Healthy Living.

Managing Constipation Page 2 of 3 607891-NFS

What about laxatives? What about probiotics? Laxatives are fibre supplements, pills, or liquids Probiotics are bacteria and yeast that may help that can help when you are constipated. These may balance the bacteria in the bowel to keep it healthy. help you if constipation doesn’t get better on a There are many different types higher fibre diet or if you can’t get enough fibre and strains of probiotics that work from food. Follow the instructions on the package in different ways, but more or those given by your healthcare provider if you research is needed in this area. use a laxative. Good food sources of probiotics Compared to other laxatives, fibre supplements are include live-culture yogurt, kefir safer for adults to use long term. Common fibre and yogurt drinks. supplements are: • inulin When to talk to your doctor • methylcellulose about constipation • psyllium Constipation can be a symptom of other health • wheat bran conditions. It can also be caused by some kinds Fibre supplements can cause gas, cramps, and of medicine. Talk to your doctor if: bloating and need enough fluid to make them work • your bowel symptoms are new or not normal for properly. Drink the amount of fluid recommended you on the package. • the problem comes and goes, but lasts for longer It’s best not to use herbal laxatives as the safety of than 3 weeks these for constipation is not known. • your constipation doesn’t get better after a few Laxatives shouldn’t be used for too long, as they weeks of eating more fibre and drinking enough can cause the bowel muscles to stop working fluid properly. This can make constipation worse. • you’re using laxatives often Note: Pregnant women should talk with their • you have alternating constipation and diarrhea healthcare provider before taking laxative medicine • there is blood in the toilet or on the toilet paper or fibre supplements to manage constipation. after having a bowel movement • you have bloating, a fever, stomach pain, or Other ideas to help manage vomiting constipation • you have less appetite or unexplained weight loss • Try to have a bowel movement when you feel the urge. If you ignore this feeling the stool can For more information: become hard and dry, making it more difficult to pass. See Steps to a Healthier You at www.healthyeatingstartshere.ca for more • The bowels are most active after eating, so eating information on fibre, fluid, and healthy eating. small meals and snacks throughout the day may help you have a bowel movement more often. Look for: • Choose Whole Grains • Write down your food and fluid intake, your activity level, • Choose Healthy Drinks and your bowel pattern. This • Eat More Vegetables and Fruit may help you find out what’s causing the constipation.

Managing Constipation Page 3 of 3 607891-NFS This is general information and should not replace the advice of your health professional. Alberta Health Services is not liable in any way for actions based on the use of this information. This handout may be reproduced without permission for non-profit education purposes. This handout may not be changed without written permission from [email protected].  Alberta Health Services (Apr 2016)