Help me not be a constipated mess.

October 13, 2010 6:42 AM

I need some action down South, if you know what I mean! (And for those of you who don't know what I mean, I'm talking regularity and constipation.) OH YEAH!

I have a freakishly slow digestive cycle, and it's something I've struggled with my whole life. "Regular" for me is about once, maybe twice, a week. When I was in my early teens, my mom took me to see a doctor and he diagnosed me with "sluggish colon" and told me to get more fiber. The problem with his advice is that I did, and still do, have an extremely high fiber intake. Rare are the days I don't get at least 20g of fiber through my regular diet.

As a younger man, my chronic constipation wasn't that big of an issue, but as I get older I'm starting to feel more sluggish and toxic when things get backed up. I recently started drinking coffee, and was elated to find that a good strong batch usually resulted in a good strong poo, but as my body acclimated itself to my new daily coffee routine, the effect gradually wore off.

Counter-intuitively, diet seems to play little role in my colon's doings. As I mentioned earlier, I already eat a lot of fiber every day, through a diet of primarily cereals, whole grains, and lots of fresh vegetables and fruit. I eat the kind of shit-inducing stuff others can only dream of, with nary a toot to show for it! Anyhow, I've gone on too long.

What can a stopped up fellow like myself do to solve this crisis? I'd hate to turn to medicines to solve this, but I'm getting desperate. Are there any OTC laxatives or stool softeners that are safe to take on a daily basis? Do you know of any other homeopathic solutions I might try? Should I just start administering daily enemas? (That last one was sarcastic.) Please help!

posted by (bb|[^b]{2}) to health & fitness (41 answers total)

I don't know of any laxatives that are safe to take every day...they're meant for occasional bouts of constipation, and if you abuse them, you're going to be in worse shape than you are already.

Are you taking in enough water? Fiber is great, but increasing your water intake will keep the system flowing, as it were.

Exercise is also very helpful in keeping yourself regular. If you spend your days sitting for work or school (as most of us do nowadays), find a way to walk or run or bike or something. That can get your system moving.

If you continue to have discomfort, go see a gastroenterologist to make sure something more sinister isn't happening. Colonoscopies aren't a party, but neither is gastric disease.
posted by xingcat at 6:47 AM on October 13, 2010 [1 favorite]

Are you drinking enough? You sound like you're pretty conscious about what you consume, so I expect you're drinking enough fluids, but I thought I'd throw it out there. I've often found that strong coffee and extra fluid can often set things in motion. Perhaps you should try having a glass of water shortly before (or after) coffee and see if that helps.

(On preview, xingcat's suggestion of exercise, even just walking, is a good one too.)
posted by mollweide at 6:52 AM on October 13, 2010

I'm not the best at getting (non-caffeinated) liquids throughout the day. I do, however, exercise regularly, typically in the form of a 3 to 4 mile walk every evening.
posted by (bb|[^b]{2}) at 6:54 AM on October 13, 2010

Crazy wacky suggestion I know, but have you considered asking your doctor about this? I mean, more recently than the person you saw in your early teens? This is something that doctors can actually help with, and especially if you stress that you'd like to try solutions that aren't chemically-based at first they'll have plenty to suggest.

Anecdotally, I find that exercise stimulates all of my systems including the digestive ones. Are you active on a regular basis? Even just going for a regular evening walk is sometimes enough for me - it relaxes me and helps get everything in order from dinner and earlier that day.

Why would you hate to turn to medicine for this? Is this not a quality of life issue? Would you tell somebody with sensitive teeth to suck it up and not eat anything hot or cold? Would you tell someone with allergies to just stay inside and breathe filtered air instead of taking medication? Would you tell someone with diabetes to cut out that whole dependence on insulin thing? So it's your colon and not your pancreas that's a little wonky - that doesn't mean it's not something you can deal with thanks to a little science.
posted by Mizu at 6:54 AM on October 13, 2010

Probably not the best idea, but I have always found that some nicotine (cigar or cigarette) can help you relax and get things moving "down south". Though it'd probably have the same diminishing returns as the coffee after a while. Maybe smoke for two weeks, then drink coffee for two weeks, and keep alternating?
posted by Grither at 6:56 AM on October 13, 2010

I said I'd prefer not to medicate, Mizu, not that I'm completely against it. If relief can be had by swallowing an extra pill every morning, I'm all for it, but I'm always open to exploring alternatives before adding more capsules to my morning routine.
posted by (bb|[^b]{2}) at 6:57 AM on October 13, 2010

Look in the Tea section at the grocery store and find "Smooth Moves" tea. Seriously! It works. But I would make it a bit light to start. It can be pretty potent. Might take a few hours.

Also, load up on green leafy veggies today -- spinach, kale, whatever -- stirfry with some spices and olive oil, and kale becomes amazing (okay, my secret, Great Lakes Tea and Spice Organic Caribbean Jerk at GLTS.com )

I had to eliminate things like pretzels, bread, too many "waterless" foods like nuts, corn chips, and even "fiberful" cereals to keep things moving. Highly recommend that. Life is too short to be miserable.

I would really recommend another doctor visit. Things develop with age...unfortunately.
posted by sleeping beauty at 6:58 AM on October 13, 2010 [1 favorite]

I've found that for me, JUST fiber isn't enough. I need fiber, plus moisture, plus a food which leaves a lot of "residue" (in unpleasantly graphic medical terminology), plus sometimes some fat.

If you have the time and inclination, whip up a bowl of old-fashioned oatmeal mixed with 1/4 c. oat bran (it's basically like a colonic blasting cap for some people) and some finely diced prunes, plus a little whole milk or cream. I would be willing to bet, I dunno, like $5 that you'll be making a deposit at the First National Bank of Regularity within a day of that breakfast.
posted by julthumbscrew at 7:00 AM on October 13, 2010

I'm not the best at getting (non-caffeinated) liquids throughout the day.

Then that definitely needs to be your first goal! You're not going to find anything that will help you with this that isn't going to require you to up your fluid intake, anyway. Water, water, water.

I've also found that taking a green supplement like this aids digestion. I don't even take as much as suggested, I just mix a little bit with some juice.
posted by ThePinkSuperhero at 7:02 AM on October 13, 2010

Also, if you do turn to laxatives, psyllium husks as the shit (pun fully intended). More hardcore chemical laxatives can leave you crampy and miserable on the toilet at 3 AM. Psyllium may also result in tears, but only tears of joy from finally producing a quality poop.
posted by julthumbscrew at 7:03 AM on October 13, 2010 [2 favorites]

I don't have that much to suggest here, but actually 20g of fiber is not some crazy excessive amount. It's about one cup of black beans. In fact, the Mayo Clinic recommends 40g/day for men. You mentioned whole grains and veggies (which are great) but are you eating legumes regularly? Lentils and beans will get you to 40g pretty quick.

Also, you might try changing your, um, posture.
posted by en forme de poire at 7:05 AM on October 13, 2010

Look up "power pudding", a mixture of bran, applesauce and prune juice. Might be something you can work into your routine.

http://www.peoplespharmacy.com/2010/04/10/power-pudding-against-constipation/

You may want to look at taking magnesium. It relaxes the intestines and makes it easier to pass, and also attracts water, which softens the stool.

http://ibs.about.com/od/constipation/a/magnesium.htm
posted by wrnealis at 7:05 AM on October 13, 2010

This is a bit more towards the folksy home remedy area, but I make lots of fermented vegetables at home--namely pickled cucumbers, carrots and sauerkraut. I've often found the leftover brine is a good digestive tonic. The key here is fermented pickling (I use a 3% solution), not vinegar pickling. After fermentation, the resulting liquor is packed with lactobacillus along with myriad other microflora that seem to keep things in the gut moving regularly.

Also, apples and cider are beneficial. "An apple a day..."

Finally, I wonder if a nutritional yeast supplement would help you out. I seem to experience extra action when eating and drinking yeasty products.
posted by slogger at 7:09 AM on October 13, 2010

You said "adding more capsules" to your daily routine--does that mean you are already taking medications? Those could be negating your efforts with the fiber and such. If you don't mind telling, what are you taking regularly?
posted by skyl1n3 at 7:14 AM on October 13, 2010

Try eating a small handful of prunes before bed, along with a glass of water.

Also, you have to increase your water intake if you are upping your fiber. My mother says the nuns always recommended a big glass of cold water in the morning to get things moving along. Can you imagine logs floating down a dry stream bed? No pun intended. Make water your new medicine.

A lot of the dieter's teas contain psyllium and they really do work, but any fiber needs extra water to help it move along.
posted by Marie Mon Dieu at 7:16 AM on October 13, 2010

fiber stuff has never worked for me. even as a kid.

psyllium husks ... oh yes.

i don't take them everyday but every so often, i'll take 4 (as per directions) and it just helps things along.
posted by sio42 at 7:17 AM on October 13, 2010

I am not a doctor, I am not YOUR doctor.
Get thee to a gastroenterologist.
They will advise on the use of fiber, fluids, and stool softeners to get you 'going' again.
I have trouble from pain medication use. The right doctor will get you on the right track.
posted by Drasher at 7:22 AM on October 13, 2010

Excessive fiber without serious liquid intake == bowel blocked with packed up fiber. Try to drink a few pints of water spaced throughout the day, preferably downing in one go so you actually get it all in there.

I had/have a similar problem to you, though less intense. I've found the best way to manage it is to consume a little dairy each day. For some reason this "solves" the problem as I suspect I have a low level allergy to something in dairy and it counteracts the other problem. There might be a magical food that has a similar effect on you. All I know is, if I knock back a whole milkshake one day, the next day is going to be bountiful.
posted by wackybrit at 7:22 AM on October 13, 2010

Calcium/magnesium supplement. Seriously.

Sometimes probiotics help, and if you like yogurt you may be able to sidestep adding another capsule to your routine.

But yeah, nthing the idea of getting lots and lots of water.
posted by corey flood at 7:24 AM on October 13, 2010

what are you taking regularly?

Daily allergy pill and the occasional B-Complex.

I've found the best way to manage it is to consume a little dairy each day.

I'm a lactard, sadly, so that's not going to happen.
posted by (bb|[^b]{2}) at 7:26 AM on October 13, 2010

The food and liquid suggestions above are your best bet. However, OTC Miralax will help get you going. Doctors recommend it (at least they have to me) because it works differently than the old-school laxatives- it doesn't cause cramping and it's won't cause your body to become reliant on it. I wouldn't recommend it as an every day solution, but it would be fine to use it while you're changing your liquid intake and adding some of those other foods. Once things get moving better, you can quit using Miralax.
posted by Eicats at 7:27 AM on October 13, 2010

Are you drinking enough water? And do you have general issues with digestion, in that way that seems connected to being a stressed Type A individual? Just putting out possibilities...as people have mentioned, the type of fiber you're getting matters too; make sure to get a mix of soluble and insoluble. Like. Is your fiber coming from prepackaged foods like cereals primarily, and that's how you know how many grams you're getting? If so, eat fruits with pectin, drink more water, possibly take psyllium tablets provided you chase them with lots and lots of water. And how active are you routinely? I've noticed people stuck in office chairs or in their car/truck all day have more bowel issues...get some exercise first thing in the morning if you can make some time for it (even just a 10-15 minute jog would help, or some jumprope or running up and down stairs), drink water, relax, make sure you're eating slowly and chewing your food and eating small, regularly spaced out meals instead of one gigantic meal too fast or whatever, all to aid digestion. Oh, and a dill pickle for some reason helps keep things moving.
posted by ifjuly at 7:28 AM on October 13, 2010

Oh, and if it's ok for you to do so health-wise I'd recommend checking to see if you've got enough fat in your diet (at least 30%, maybe even 40% depending). Like hydration, it seems to smooth things along.
posted by ifjuly at 7:30 AM on October 13, 2010

Maybe more strenuous exercise? A 4-mile walk is great and all, but hardly strenuous. Maybe something like hill sprints or swimming laps would work.
posted by creasy boy at 7:30 AM on October 13, 2010

These are all great tips! I think I'm going to start with the power pudding to get things moving again, then work in a smoothie with that green stuff that TPS mentioned and some flaxseed and psyllium, plus start taking a magnesium pill and increasing my water intake substantially. If those measures don't get me back on track, I'll go see my friendly neighborhood GI specialist.

By all means, though, keep the suggestions coming!
posted by (bb|[^b]{2}) at 7:39 AM on October 13, 2010

Drink plenty of water and take your coffee black. It'll make things move like clockwork (well, as long as you take your coffee at the same time everyday...).
posted by chicago2penn at 7:41 AM on October 13, 2010

All of the above sounds good, and I'd add fish oil - do your research and get the higher quality capsules. Those are all that I've ever used and I haven't seen any of the side effects that I read about on the internet, same for friends and family taking it.
posted by mrs. taters at 7:49 AM on October 13, 2010

Have you had a thyroid panel? Constipation is a symptom of hypothyroidism.

Kefir, raw crunchy almond butter straight out of the jar, and vigorous exercise will work wonders.
posted by jgirl at 7:50 AM on October 13, 2010

Anything with lots of "bulgur" wheat seems to work for me. A turkish receipe called kisir is awesome and goes down well. Find some receipes that may interest you and start eating it a few days in a row. Hope it helps you as well.
posted by tsagis at 7:51 AM on October 13, 2010

People, people, PEOPLE.

There's a simple answer here.

Go to your local GNC and buy a bottle of this. Ok, that's it in pill form, but they make a powder, too. I drink the powder with juice every morning, and I swear to GOD that it is like a pooping miracle from heaven.
posted by kbanas at 7:52 AM on October 13, 2010 [1 favorite]

Miralax, docusate sodium, coffee with cream, and a cigarette.
posted by elsietheeel at 8:04 AM on October 13, 2010

Ditto Marie Mon Dieu - have a few prunes before going to bed. Drink LOTS of water all throughout the day. And a strong cup of coffee in the morning. Welcome to freedom.
posted by raztaj at 8:17 AM on October 13, 2010

My textbook - which I have bookmarked because they keep giving me all the constipated patients - says 6-12 teaspoons of unprocessed bran a day, before moving onto other things. Dear god, that seems like a lot of bran. Increase liquids. Psyllium (Metamucil) is a bulking agent and that's the next step. Drugs like docusate sodium are irritating to the muscles of the intestine and can make the muscles 'lazy' with long-term use.

From personal experience, if you can jog at least part of the way on your walk, sometimes it helps things move.

I'm also not a mutant and can't digest dairy all that well, but you may be OK with yogurt, especially the thicker Greek style ones. They're much less problematic to me.
posted by cobaltnine at 8:30 AM on October 13, 2010 [1 favorite]

If your a lactard like me, then a glass of milk will certainly move things along
posted by raccoon409 at 8:33 AM on October 13, 2010

Daily allergy pill and the occasional B-Complex.

What allergy pill? Diphenhydramine has constipation listed as a side effect, as does cetirizine, and anything with a decongestant in it could be drying you out. Maybe talk to your allergist?
posted by en forme de poire at 8:36 AM on October 13, 2010

I recently started taking chewable Acidophilus with bifidus on the recommendation of my doctor. It's those probiotics that you hear about in those designer yogurts, without the dairy or having to actually eat those awful yogurts. The pills are about the size of a TUMS and don't taste bad at all. I got the tablets at my local Health Food store.

They have helped immensely with my digestive troubles. I really cannot recommend them enough. It's a little thing that makes a huge difference.
posted by TooFewShoes at 8:55 AM on October 13, 2010

Try a magnesium supplement!
posted by The Toad at 10:20 AM on October 13, 2010

Water water water water water. Try a glass (just 6oz. if you hate it) an hour for a week or so.

Also, eat some beans. And then drink lots more water.
posted by SMPA at 11:20 AM on October 13, 2010

Activia yogurt.

And HYDRATE.
posted by St. Alia of the Bunnies at 12:12 PM on October 13, 2010

To echo a few other points that have already been made:

- Some allergy pills/antihistamines can have a constipating effect, so if that's part of what's going on in your case you'll have to either compensate for it (for example, by increasing fiber intake even more, or taking a stool softener), or perhaps find a different allergy med.

- Do get your thyroid checked. Even mild hypothyroidism (i.e., your thyroid is underactive) can result in constipation. Thyroid function in men is often overlooked, so you may have to ask explicitly for this.

- Supplemental fiber, when used to treat constipation, MUST be take with adequate fluid -- at least 8 oz. for every dose. If you take it with less, it can actually slow you down (which is why supplemental fiber plus a very small amount of water is -- seemingly counterintuitively, based on everything we're regularly told about it -- can be used to slow down diarrhea).

- A high-fiber diet really does need to be closer to 35 grams or so; 20 g is certainly better than nothing, but it's really only a moderate fiber intake. And be sure you are getting both soluble and insoluble fiber.

- Probiotics are great; you can try to get them with yogurt alone (avoid the super sugary flavored ones), or you can take a supplement. Be sure you're getting a mix and not just acidophilus alone.

OK, now for my own two cents:

MD Anderson Cancer Center in Texas has developed a series of bowel management protocols for cancer and non-cancer patients alike. One of the things they stress is that fiber capsules may not be as effective as either fiber powder (such as Metamucil or Citrucel) or fiber wafers: "By the time fiber capsules break down in the GI tract, the fiber – for example - may have lost some of the water you took in at the time you swallowed the pills and affect your GI tract in the opposite way you desired."

So if you're relying on capsules, switch to the powder in water (I know, it's gross) or the wafers (easier and tastier, though a more expensive way to go) and see if that helps. As always, make sure you're taking them with enough (non-caffeinated) fluid.

Here are some links to various handouts from MD Anderson with more details that might be helpful for you.

Bowel Management: A Guide for Patients
Nutrition Information for Relief of Constipation

For some reason I'm suddenly having problems with their website right now, but you can go there yourself you an search for two other relevant handouts: "Medicinal Fiber" and "Self-Help for Severe Constipation."
posted by scody at 12:18 PM on October 13, 2010

There's a specific intestinal-wake-up exercise you can do. sometimes we don't get enough blood to the intestines, so everything gets all slow.

lie on your back (on your bed or the floor) with your knees bent. picture that your back is like a clock (6:00 is your sacrum and 12:00 is your mid-back). starting at 12:00, press your back down into the ground. now move the pressure so that your back is in the ground at 1-2-3-4-5-6-7-8-9-10-11-12:00. you're basically making a circle in the ground with your back. the important thing is to go clockwise, not counter-clockwise. repeat these circles slowly several times. this can often be enough to get things moving down there.
posted by andreapandrea at 7:52 PM on October 13, 2010 [1 favorite]