Patient Info: Better Bowel Habits

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Constipation is a frequent complaint. This can be mild (small, hard stools) to severe (no bowel movements without a laxative).

The Cause

Constipation is almost always due to insufficient fibre intake. This is because our foods are so highly refined that there is little fibre left. Our forefathers ate about 60 grams of fibre per day; we eat about 13 grams daily. Most of us need about 35 grams per day or more. One to three soft, formed stools a day is normal.

There are two types of fibre: insoluble and soluble. Soluble fibre is less helpful for constipation. The best source of insoluble fibre is cereal, but very few are truly high in fibre.

Better Bowel Habits

In order to achieve better bowel habits, we suggest the following:

1. Fibre 1 or All Bran Cereals. Please check the label to be sure the fibre content is close to 15 grams per serving. Be sure to drink a glass of water while you are eating it and another one afterwards.
   
   Fibre does not work without water. Coffee or juice does not help. If necessary, you can eat another bowl of cereal in the evening. That alone would give you 30 grams of fibre per day. Some bloating may occur but this just means that the bowel is starting to work. It should subside in time.
2. High Fibre Cookies (i.e. Bowel Buddies, etc.), breads and buns are available. Always drink a glass of water whenever you have fibre. Other foods high in insoluble fibre content include most beans, brussels sprouts, corn, peas, acorn squash, blackberries, raspberries and potatoes with the skin on.
   
   If your bowel movements tend to become too frequent or loose, decrease the amount of fibre.

Some Other Points

• Wheat Bran 1-4 tbsp. (green Quaker box) may be added to the above cereals, or put in meatloaf, etc. Remember to drink water with it!
• If you wish to lose some weight, have cereal and water ½ hour before your main meal.
• Avoid white bread and other cereals with little fibre content.
• Fibre is an invisible chemical, not a stringy material that you can see.
• Avoid supplements and laxatives with Cascara or Senna.

If you have days without a bowel movement, try this:

On arising, drink a glass of warm water, insert a glycerin suppository and then make the bed, do sit-ups, touch your toes, etc. for three minutes, to stimulate the bowel. Then sit on the toilet and push gently for two minutes. If nothing happens, leave. Do not read the paper on the toilet!

If you do this daily for three to six months, you should be able to retrain your bowel. It is important not to miss one day from this routine. Lastly, whenever you have the urge to have a bowel movement, stop whatever you are doing and go immediately.

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