Constipation primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Constipation is usually easier to prevent than to treat. The relief of constipation with osmotic agents, i.e., lactulose, polyethylene glycol (PEG), or magnesium salts, should also be immediately followed by prevention using increased fiber (fruits, vegetables, and grains) and a nightly decreasing dose of osmotic laxative. Effective measures for the primary prevention of constipation include fiber supplementation, appropriate fluid intake, toilet habits, and exercise.

Primary Prevention

  • Constipation is usually easier to prevent than to treat. The relief of constipation with osmotic agents, i.e., lactulose, polyethylene glycol (PEG), or magnesium salts, should also be immediately followed by prevention using increased fiber (fruits, vegetables, and grains) and a nightly decreasing dose of osmotic laxative.
  • Effective measures for the primary prevention of constipation include fiber supplementation, appropriate fluid intake, toilet habits, and exercise.

Fiber supplementation

  • Including enough fibers in the daily diet is the most important primary prevention measure.
  • The sufficient fiber intake for general gastrointestinal health is 30 g per day, while more is better.
  • Fiber content in different foods are as the following table:[1]
Group Food Fiber contents
Beans, cereals, and breads ½ cup of beans (navy, pinto, kidney, etc.), cooked 6.2–9.6 g
½ cup of shredded wheat, ready-to-eat cereal 2.7-3.8 g
⅓ cup of 100% bran, ready-to-eat cereal 9.1 g
1 small oat bran muffin 3.0 g
1 whole-wheat English muffin  4.4 g
Fruits 1 small apple, with skin 3.6 g
1 medium pear, with skin 5.5 g
½ cup of raspberries 4.0 g
½ cup of stewed prunes 3.8 g
Vegetables ½ cup of winter squash, cooked 2.9 g
1 medium sweet potato, baked in skin 3.8 g
½ cup of green peas, cooked 3.5-4.4 g
1 small potato, baked, with skin 3.0 g
½ cup of mixed vegetables, cooked 4.0 g
½ cup of broccoli, cooked 2.6-2.8 g
½ cup of greens (spinach, collards, turnip greens), cooked 2.5-3.5 g

Fluid intake

  • Fluid intake is the key factor to maintain the body hydration status and firm consistency of stools.
  • Caffeine, alcohol, and fizzy drinks should be limited, preferably avoided completely.[2]

Toilet habits

  • Ignorance to toilet urge can lead to constipation.
  • Never delay the defecation in case of urgency.[3]

Physical exercise

References

  1. "Treatment for Constipation | NIDDK". 
  2. Arnaud MJ (2003). "Mild dehydration: a risk factor of constipation?". Eur J Clin Nutr. 57 Suppl 2: S88–95. PMID 14681719. doi:10.1038/sj.ejcn.1601907. 
  3. Wald ER, Di Lorenzo C, Cipriani L, Colborn DK, Burgers R, Wald A (2009). "Bowel habits and toilet training in a diverse population of children". J. Pediatr. Gastroenterol. Nutr. 48 (3): 294–8. PMID 19274784. 
  4. Huang R, Ho SY, Lo WS, Lam TH (2014). "Physical activity and constipation in Hong Kong adolescents.". PLoS One. 9 (2): e90193. PMC 3938666Freely accessible. PMID 24587274. doi:10.1371/journal.pone.0090193. 



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