Constipation is an abnormal delay in the evacuation of stools or an obstacle to their elimination. The normal frequency of bowel movements varies from person to person between three times a day to three times a week. Medically, we speak of constipation when we have less than 3 bowel movements per week, over a period of several weeks or months.

Constipation is very often also accompanied by difficulty in defecating

Statistics indicate that nearly 20% of the French population (particularly women) suffer from constipation to varying degrees.

There are several reasons for constipation, including lack of exercise, a diet that is deficient in fiber, a fecal bowl that is too low in water, too high in refined carbohydrates, or has insufficient volume, or taking certain medications.

This transit disorder leads to a series of inconveniences such as heaviness or abdominal bloating up to real intestinal pain. The accumulation of stool in the rectum also promotes the development of hemorrhoids. In addition, very hard stools that are difficult to expel can lead to anal fissures. More rarely, but especially in bedridden elderly people, constipation can cause intestinal obstructions.

Constipation: also a disease of civilization

This pathology is closely linked to our overly sedentary lifestyle and to two major dietary errors: too little fiber intake and insufficient hydration.

Drinking plenty of fluids combined with foods such as fruits and vegetables, which are very high in fiber, can soften the stool and increase its volume. Vegetable fibers are essential as they are like sponges. In fact, they are the ones that absorb and retain the water that permeates the fecal bowl. The more liquid fecal matter then passes more easily and quickly through the colon.

Fiber is found mainly in whole grains (bread, pasta, rice, etc.) as well as in fruits and vegetables. Therefore, put more emphasis on unrefined grain products, legumes, fruits rich in pectin (such as apples, apricots, quince) and to a lesser extent other fruits and vegetables.

Five servings of fruits and vegetables a day is ideal for a healthy diet, but becomes essential for people with constipation. This corresponds to a consumption of about 400 grams (calculated on the edible part) of fruits and vegetables per day.

But beware, eating a lot of dietary fiber is strictly useless if you don't drink enough.
So it is essential to have good hydration. Ideally, your day should begin by drinking
a large glass of water on an empty stomach, it will act as a starter by reflex cholagogue effect, which will promote transit.

Many people (often due to lack of time!) do not consume the 2 liters of fluids necessary for a healthy colon. Most beverages are useful at this level (water, coffee, tea, fruit juices and soups), but it is especially important to drink mainly with high-fiber meals.

Some forms of calcium and all foods that contain it (milk, cheese, etc.) can have a constipating action in some people, in others it will be the taking of medications that will have these constipating effects. This is the case with iron or aluminum-based drugs, many painkillers, antidepressants and antihypertensives. This last cause is often forgotten.

However, constipation does not always result solely from inadequate nutrition. Physical causes or an underlying disease may also be the source.

In all cases, the regular practice of large evacuation enemas is also recommended.

Constipation: caution with laxatives

The use of laxatives, a legacy of our grandmothers who purged once a week, remains strongly embedded in our habits. However, many scientific studies question their systematic use. In studies conducted for up to 4 weeks, laxatives show efficacy on stool frequency and weight, but the difference from placebo is negligible (1 additional stool per week). But for studies of 5 to 12 weeks duration, these differences, already minimal, become almost zero.

Not to mention that many of them have non-negligible side effects.

The laxatives can be irritating (Dulcolax®, Contalax®, Tamarine®, Pursennide®, Sénokot®) and over time cause inflammation of the colon wall. This is called "laxative disease", in which case the colon loses its spasticity and can no longer contract without them, resulting in alternating diarrhea and constipation. It is therefore best to avoid them.

Some emollient laxatives (Lansoÿl®, Magnesia Lubentyl®, Laxamalt®) with a kerosene oil base soften stools. Their chronic use leads to malabsorption of certain fat-soluble vitamins (vitamins A, D, E and K).

Osmotic laxatives (Duphalac®, Importal®, Sorbitol Delalande®) are made up of sugars that are not digestible by the gut. They reach the colon intact where their ultimate degradation leads to the production of water, but also of carbon dioxide, which induces frequent bloating.

And finally, mucilages, considered the least harmful (Normacol®, Parapsyllium®, Spagulax®, Transilane®) since they are derived from wheat bran, ispaghula, sterculia and methylcellulose. Their mode of action is identical to that of fibers (increasing the weight and volume of stools). However, as with dietary fiber enrichment, the effects are variable and sometimes disappointing. They often cause bloating and flatulence.

In summary, even though laxatives are available without a prescription, their use should remain very occasional.

Constipation: to be done practically at the dietary level .

Take advantage of natural laxatives such as fibers that nature has generously put at our disposal. They are particularly present in whole grain foods such as whole wheat bread and whole grain cereals (organic), which contain bran, the laxative of laxatives!

Natural laxatives, such as bran, increase fecal mass and are a much safer and gentler treatment than the medications provided for this purpose.

To start, try a high bran or high fibre whole wheat cereal at one-third to one-half cup per day, gradually increasing the amount as needed. Also choose very dense whole grain bread. Another quick and easy solution is to add raw, unrefined wheat bran to your favorite cereal or other foods.

For most people, one tablespoon of unrefined wheat bran per day is enough to cause easy bowel movements, while others need less or more. You have to test it!

Rice bran has long been known to Asians. It is an extremely energetic laxative like oat bran.

At the beginning of the treatment, it is possible to feel some discomfort, flatulence and gas, because the fibers occupy a more important place. These pains usually disappear after two to three weeks. It is therefore important to go gradually over the first 4 to 6 weeks, respecting individual needs. It is also essential to drink a lot to soak up the fiber; this emollient action facilitates the passage of fecal matter into the intestine.

Constipation: foods that are very helpful for constipation

• Legumes (peas, dried beans) and nuts
• Dried fruits and berries
• Tubers, including potatoes and carrots
• Leafy vegetables: such as spinach, chard
• Fruits (importance of a large variety).
• Prunes cooked in boiling water or soaked in water overnight, give the liquid its laxative properties. We have then a pleasant purgative decoction, slightly sweetened and effective.

 MISE EN GARDE !

It is best not to add unrefined wheat bran or rice bran to children's menus. If your child is constipated, you should give him or her fruits and vegetables, whole-wheat bread and whole-grain cereals, which are high in fiber, and always remember to give plenty of fluids.

• Probiotics to the rescue.

Taking probiotics alone for 4 weeks generally reduces constipation by 50%.

• Natural laxatives

In addition to these classic hygienic measures (total cessation of laxatives, abdominal gymnastics) and adequate dietary corrections, certain known or lesser-known plants can be combined to promote the work of the colon in a very effective manner.

Thus, bitter orange, magnolia, Chinese rhubarb and mirabelle facilitate the peristaltic movements of the colon. Ophiopogon japonicus and apricot seeds lubricate the colon walls, while paeonia lactiflora has an antispasmodic action.

Constipation: natural protocol against constipation

Recommended product tip

Composition Laxative, depending on the extent of constipation: 2 capsules 1 to 4 times daily, 30 minutes before meals and before bed.

For children, the capsules can be opened and the contents mixed with water or fruit juice.

In case of flatulence or bloating :

PROBIOTICS: 3 capsules per day 1/4 hour before each meal (morning - noon - evening).