How to deal with constipation?

The colon’s role in digestion and constipation

The colon, also called the large intestine, is around 1.50 m long. Located between the small intestine and the rectum, it forms part of the digestive tract and plays a vital role in it: it completes the assimilation of nutrients from digestion, and absorbs water to contribute to the body's water balance and ensure the consistency of the stools that are then expelled. It plays an essential role in getting rid of the body’s waste.

The waste moves through the colon thanks to a series of muscular contractions. Just like other organs in the digestive system, the large intestine is surrounded by smooth muscles, which contract independently: this phenomenon is called peristalsis and is responsible for digestive transit. Efficient waste elimination is reliant on good transit!

The colon is also home to millions of good bacteria which make up the intestinal microbiota. Involved in digestion and regulating immunity, this microbiota is a vital player in our health. Less known is that the colon also harbours a collection of neurons forming the enteric nervous system, which is why it is sometimes called the second brain. These nerve cells ensure communication between the brain and the intestines, but also with the microbiota.

With 200 million neurons, billions of bacteria and a key role in the assimilation of nutrients and the elimination of waste, it’s easy to understand why it is so important to maintain a healthy colon and smooth transit!

Source: SNFGE – Société Nationale Française de Gastro-Entérologie

Transient or chronic constipation in adults

Intestinal transit disruption is extremely frequent. Especially constipation which affects 20% of the world’s population! It is defined as fewer than 3 bowel movements per week, and/or hard, difficult stools. When one is constipated, transit is slow, the stools no longer progress through the colon, which continues to absorb water. The stools become harder and more difficult to pass…

By their very nature, women are greatly more affected by constipation than men. Pregnant women are particularly susceptible. The elderly also seem to suffer more with transit problems due to changes in lifestyle: less physical activity, sedentary or even bed-ridden which makes it difficult to pass stools, a diet that is less varied and not rich in fibre, chewing problems etc.

Whilst generally transient and benign, constipation in adults can cause discomfort (bloating, gas, cramps etc) which affect quality of life.

Taking laxatives: is it the right way to stimulate the intestines?

In the event of slow intestinal transit, the reflex is often to take a laxative treatment to accelerate stool frequency. There are 4 types: bulking laxatives, osmotic laxatives, lubricant laxatives and stimulant laxatives. Amongst these, there are some called mild laxatives which are based on natural mucilages.

Be careful, taking laxatives is not harmless, especially when taking stimulant laxatives! They should be taken for short periods only, as long-term use or use for every occasional bout of constipation can lead to gastrointestinal problems or problems with the absorption of certain nutrients, and can also lead to dependency.

The role of dietary fibre in constipation prevention

Did you know that a diet low in dietary fibre is the principal cause of constipation? Fibre is a well-known plant-based substance beneficial to healthy transit. There are two types:

• Soluble dietary fibre ,generally derived from plant pulp, takes on the appearance of a viscous gel when in contact with liquids, which is gentle on the intestines, making it easier for stools to pass through the colon.
• Insoluble dietary fibre, derived from the walls and coatings of plants, remains suspended in the intestine where it swells on contact with water, increasing the volume of stools (this is known as the bulking laxative effect). They can also stimulate the colon directly.

Furthermore, some fibres are broken down by the intestinal microbiota bacteria, which use them as nutrition. In this way, they encourage the growth of good intestinal bacteria which are beneficial for good digestion: these are known as pre-biotic fibres.
A healthy balanced diet rich in fibre, can free you from transit problems!

Increase your dietary fibre and avoid constipation!

But do so gradually to avoid the bloating and abdominal pain associated with their fermentation by the microbiota: 

• at least 5 portions of fruit and vegetables a day, favouring green vegetables (spinach, watercress, chard, etc.) and fresh fruit, which are rich in fibre (e.g. 3 vegetables and 2 fruit or vice versa).
• think about introducing more pulses in your diet, they are also a good source of fibre: split peas, lentils, chick peas, beans etc.
• replace starchy foods with whole grain cereals: wholemeal bread, wholemeal pasta, wheat, buckwheat, wholemeal rice, quinoa, oatbran etc.
• For your snacks, avoid sugary products and think about dried fruits (raisins, figs, dried apricots, prunes, dates) and seeds and nuts ( a handful of walnuts, hazelnuts, almonds, linseeds etc) all sources of fibre.