Come clean. It's not potty talk to acknowledge your difficulty going.
Maybe you don't poop for days at a time -- when you used to go regularly every day -- or when you do go, your stool is hard, dry and small, which can make going a strain and perhaps painful.
Constipation is defined in different ways, just as individual experiences vary, but it often involves both these uncomfortable stool changes and less frequent bowel movements. Ultimately, you know your "regular." So if you haven't been feeling at your colonic best, experts say, take heed to find relief.
Consider medical and medication-related causes.
Sudden onset constipation that's not associated with changes to your diet can be a sign of something serious, so if you're not taking any medications or have any known predisposing medical conditions, it's a good idea to see a gastrointestinal doctor for more investigation.
Conditions that can have sudden onset constipation as a symptom include:
-- Colon cancer.
-- Severe depression.
Talk to your doctor about treating underlying health issues, or whether it's safe to switch or stop taking medications that cause constipation.
Exercise: To get things moving, get moving.
"It's a bit controversial, but there seems to be some role for regular exercise in maintaining regular bowel habits," Quigley says, according to research. That could include walking 10 to 15 minutes a day or engaging several times weekly in another aerobic activity, such as jogging or swimming.
"Exercises help the intestines squeeze and relax and act more normally," says Dr. Amy Foxx-Orenstein, a gastroenterologist at Mayo Clinic in Phoenix, Arizona. For those with limited mobility, she adds, Pilates done lying on the floor or tai chi can also assist in stimulating blood flow and intestinal activity, which may help get things going.
Fiber is still king and queen of the throne.
Molly Kimball, a registered dietitian with Ochsner Health System in New Orleans, says everyone should get at least 20 to 35 grams of fiber per day, depending on their caloric intake. She encourages gradually increasing fiber intake, but to aim for the higher side of that range -- or above. To do this, eat foods richer in both soluble and insoluble fiber.
Soluble fiber absorbs water, and can be found in oatmeal, apples, melons, squash, avocados, carrots and beets. Foods richer in insoluble fiber, which doesn't absorb water, include leafy greens, nuts, seeds, popcorn, 100% whole-wheat bread and fruit skins. They can help your body create stool that's larger, softer and easier to pass.
Stay properly hydrated.
"If you're truly dehydrated, you'll be more constipated," Foxx-Orenstein says. Patients frequently pile on the fiber while taking in little fluids, experts say, and end up more constipated as result. So you need to be well hydrated.
But there's no need to over do it -- a normal level of hydration suffices. "One of the things that has been recommended a lot in the past to people is (to) increase your fluid intake (to) relieve your constipation," Quigley says. "There's really no evidence for that."
Dried plums -- aka prunes -- are still the dietary standard in regularity.
Despite marketing efforts to give wrinkly, dried plums a face-lift -- calling them dried plums instead of prunes, for one -- the strong, indelicate association with relieving constipation remains, says Anne Dubner, a registered dietitian in Houston who sees some of Quigley's patients. That's because they really work to do just that, experts say; but eating other dried fruits, like apricots, can also help a person go, Dubner notes.
While prunes have a lengthy history of being known as the go-to food for going, more recently kiwi fruit has earned similar and perhaps even better accolades for relieving constipation. According to research presented at ACG 2020 Virtual, the annual scientific meeting of the American College of Gastroenterology, consuming two peeled kiwis per day improved chronic constipation while being better tolerated than other traditional natural remedies.
Dinner and a supplement
However, with Americans on average eating only about half the daily recommended fiber, many struggle to get enough from their diet alone. Foxx-Orenstein says taking a fiber supplement can be a great way to make up the difference. She recommends those who choose to do so take it around dinner time to save any potential side effects, like bloating, for later in the day.
Start off the day with a hot drink -- and a quick dash to the bathroom.
Waking up and going in the morning after eating is a routine for some. If you're stopped up, don't skip breakfast. Instead, grab a bite to eat and a hot drink such as coffee or tea, Foxx-Orenstein says. The heat, eating and caffeine -- if you're able to take your drink caffeinated (it's OK if you can't) -- all stimulate colonic activity to get your day started with some movement.
In particular, coffee, even decaf coffee, contains chlorogenic acid, which can stimulate the bowels. It's more effective than tea or plain water, so a daily cup of joe might help keep you more regular.
Be strategic about caffeine.
Though it can help relieve constipation, prodigious amounts of caffeine can make it harder to go. "Too much caffeine can have a bit of a dehydrating effect, but caffeinated beverages are actually gastric stimulants," Kimball says. "So having that cup of coffee or having that cup of tea can actually help with that GI motility, which basically means it gets you going."
However, if you don't typically drink caffeine -- or if you're averse or have a health reason not to -- it's not recommended you start. Instead, try decaf coffee for its chlorogenic acid content, which is a great option for caffeine-sensitive people who want the bowel stimulation of coffee.
Go easy on deprivation diets.
Though foods affect different people in different ways, gastrointestinal and dietary experts say a high-protein/low- or no-carb diet and extremely low-fat, no-fat diets can all potentially increase constipation.
"I have found that so many of my patients become very constipated when they go on a completely no-fat or extremely low-fat diet," Dubner says. "You need some lubrication."
At the other end of the spectrum, high-fat low-carb diets can be constipating because they remove all sources of dietary soluble fiber, such as grains, fruits and legumes.
To go regularly, Dubner instead recommends eating foods that contain healthy fats like avocado and olive oil; experts also say it's important to eat a mix of healthy fare -- like whole grains -- in all food groups. The key to staying in balance in the bathroom sometimes comes down to being in balance in the kitchen too.
Answer nature's call as soon as you can.
When you do get the urge to go, heed it. When your colon calls, Foxx-Orenstein says, make like a baby and answer it. Poop. The longer you wait, the harder it gets. That goes for you -- more straining -- and the poop itself.
Get in the proper position.
Skip the bathroom reading. With proper form, it shouldn't take longer than around three minutes to go, Foxx-Orenstein says: "It's excellent to have your knees up," ala your ancestors popping a squat on the open plain -- by placing your feet on a short stool or a small trash can turned on its side for leverage -- and not the 90-degree position modern toilets have you sitting.
Take in a deep breath. "It increases your intra-abdominal and intrarectal pressure and that's oft times what needs to happen to make you evacuate easier," she says. Breathe out slowly and go.
'Regular' you could have 'Hollywood stool.'
Forget going No. 2. Aim for No. 4 on the Bristol Stool Scale, which essentially sizes up the quality and consistency of poop.
Fiber will help you get to No. 4, Foxx-Orenstein says, "which is what I refer to sort of as the 'Hollywood stool' -- not that Hollywood is by any means perfect, but ... you don't want to have No. 1" -- hard pellets like a deer might drop -- "you don't want to have No. 7" -- so watery it's almost pee-ish. The goal: stool that's bulkier, softer and easier to pass. "Like that torpedo," she says, which, ultimately, could relieve you from having to talk about poop again any time soon.
Ways to relieve constipation:
-- Consider medical and medication-related causes.
-- Gradually increase your dietary fiber intake; take a supplement if needed.
-- Eat prunes or other dried fruit and kiwis.
-- Have a hot drink, like coffee or tea, with breakfast.
-- Be strategic about caffeine consumption -- switching to decaf could make a difference.
-- Go easy on deprivation diets.
-- Don't wait to go.
-- Get in proper pooping position.
-- Size up your stool. Know what's normal and what's not.