Thursday, 12 March 2015


I once struggled with constipation, during my 2nd year in medical school. As, I was always on a rice diet, it was no surprise when I started passing hard stool. I took liquid paraffin and increased my fibre intake to make passing stools easier.
I had almost forgotten this period till recently, when speaking with my friend, and he told me about his difficulty in passing stool. Not that he wasn't passing stool at all, but that it was infrequent and he was having abdominal pains as a result of it.

Constipation can easily be misinterpreted because it has different meanings to people. To some people it means difficulty in passing stools. To others, it means infrequent stools or hard stools.

According to the Rome III criteria for constipation, a patient must have experienced at least 2 of the following symptoms over the preceding 3 months:
  • Fewer than 3 bowel movements per week
  • Straining
  • Lumpy or hard stools
  • Sensation of anorectal obstruction
  • Sensation of incomplete defecation
  • Manual maneuvering required to defecate

Amidst symptoms like abdominal bloating, rectal bleeding, and pain on defecation, constipation can also cause low back pain.

Dehydration is a common cause of chronic constipation. In the large intestine, water is absorbed from digested food and if you do not drink enough water, hard stools are formed. Water also helps to soften stool and  enhances the passage of stool through the digestive system.

There are many ways to treat constipation but the dietary approach, is of utmost importance in treatment. If you are constipated, it is imperative that you increase your fibre and fluid intake and decrease the use of constipating agents, like rice. 

The table below (photo credit - Merck manuals) should be helpful in your food choices.

Foods That Often Affect Gastrointestinal Function
Foods Likely to Cause Loose Bowel Movements and/or Excessive Gas
All caffeine-containing beverages especially coffee with chicory
Fruit juices: Orange, cranberry, apple
Asparagus and cruciferous vegetables such as broccoli, cauliflower, cabbage, and Brussels sprouts
Bran cereal, whole wheat bread, and high-fiber foods
Pastry, candy, chocolate, waffle syrup, and doughnuts
Wine (more than 3 glasses in susceptible people)
Milk and milk products (in lactose-sensitive people)
Foods Likely to Cause Constipation or Help Control Loose Bowel Movements
Rice, bread, potatoes, and pasta
Meat, veal, poultry, and fish
Cooked vegetables

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