I seem to have on going discussions with people about constipation. A few years back, just writing something like that would have seemed really weird but now it’s just normal conversation.
Evidently, based on the conversations I’ve been having, constipation is a pretty common problem. That’s not good! This post isn’t really going to be me talking about constipation and how to fix it, it’s more about me sharing some interesting information that I’ve recently found.
Chris Kresser recently posted a link to a new study that points to fiber as your enemy when it comes to constipation. You can find the study here. The title of the study is Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms. WHAT?! That seems contrary to everything we’ve ever heard about constipation. After reading the study, it makes a lot of sense. I’ll quote some pieces of the study discussion section.
Constipation is often mistaken by the layman as the state of not passing stool, with the subsequent false notion that making more feces will allow easier defecation. In truth, constipation refers to the difficulty in evacuating a rectum packed with feces, and easier defecation cannot possibly be affected by increasing dietary fiber which increases bulky feces. In this paper, we looked at constipation both as the number of days before each motion as well as the ease of defecation.
It is well known that increasing dietary fiber increases fecal bulk and volume. Therefore in patients where there is already difficulty in expelling large fecal boluses through the anal sphincter, it is illogical to actually expect that bigger or more feces will ameliorate this problem. More and bulkier fecal matter can only aggravate the difficulty by making the stools even bigger and bulkier. Several reviews and a meta-analysis had already shown that dietary fiber does not improve constipation in patients with irritable bowel diseases
Makes sense, dontcha think?
Dietary fiber is also associated with increased bloatedness and abdominal discomfort. Insoluble fiber was reported to worsen the clinical outcome of abdominal pain and constipation. In our recent study, patients who followed a diet with no or less dietary fiber intake showed a significant improvement, not just in their constipation, but also in their bloatedness. Patients who completely stopped consuming dietary fiber no longer suffered from abdominal bloatedness and pain. These symptoms are caused by the fermentation of dietary fiber by colonic bacteria, which produces hydrogen, carbon dioxide and methane. Gases that are trapped by peristaltic colon exert pressure on the walls, causing the abdominal pain experienced by patients.
Stools only become well-formed in the sigmoid colon and rectum and by this time, especially in constipated subjects, more stools result in more evacuation problems.
We have shown that decreasing the bulk and volume of feces immediately enables the easier evacuation of smaller and thinner stools through the anal sphincter mechanism.
Okay, well, that was a bit graphic but I think it makes the point that if something is stuck, stuffing more in isn’t going to help. There is an analogy to cars in traffic congestion but I’ll let you go and read the full discussion if you need that example to drive the point home.
So, what to do. If you have been eating a lot of insoluble fiber but not getting any relief you might want to try cutting the amount down or even totally out for a few days and see what happens. Everyone is different so the same “fix” isn’t going to work for everyone. Some may need to eliminate certain veggies, while others may need to eliminate all.
Chris Kresser has an article titled Got digestive problems? Take it easy on the veggies., that gives a bit more information on what may help. The part of the article that I particularly like are the lists (I love lists) of veggies, those high in insoluble fiber and those high in soluble fiber.
Vegetables high in insoluble fiber (the ones you may want to avoid):
- Greens (spinach, lettuce, kale, mesclun, collards, arugula, watercress, etc…)
- Whole Peas, Snow Peas, Snap Peas, Pea Pods
- Green Beans
- Kernel Corn
- Bell Peppers
- Onions, Shallots, Leeks, Scallions, Garlic
- Cabbage, Bok Choy, Brussel Sprouts
Veggies higher in Soluble Fiber and lower in Insoluble Fiber – can be soothing to the gut so safer for people with gut issues.
- Winter Squash
- Summer Squash (especially peeled)
- Starchy Tubers (yams, sweet potatoes, potatoes)
Vegetables are good for you, they are full of nutrients. I’m sure most of you looked at the list of insoluble fiber veggies and panicked. There are some real favorites on that list. I’m sure my mother trashed this post as soon as she saw onions and garlic on the list. Take a breath. For most, the key here will be limiting the problem veggies not completely eliminating them for the rest of your life. There are people who will need to do something more but start with limiting and see how it goes.
Chris Kresser’s article also suggests additional steps to help make these potentially problematic foods more digestible when you do decide to eat them.
- Never eat insoluble fiber foods on an empty stomach. Always eat them with other foods that contain soluble fiber.
- Remove the stems and peels (i.e. from broccoli, cauliflower and winter greens) from veggies (and fruits) high in insoluble fiber.
- Dice, mash, chop, grate or blend high-insoluble fiber foods to make them easier to break down.
- Insoluble fiber foods are best eaten well-cooked: steamed thoroughly, boiled in soup, braised, etc; avoid consuming them in stir-fries and if you do eat them raw, prepare them as described in #3 above.
So there you have it. I was originally going to “share” this information on Facebook but then I thought it would be better to put it all in one place. I hope you all find it interesting and maybe even a little helpful. If you have the time follow the links and read the full articles.
Eat Well, Feel Good, Have Fun!
Amy White MS HNC
I am a holistic nutrition counselor and believe real food is the true path to wellness. If you are interested in learning more about me and how I can help you, please see my story.
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