By Seah Loi Shun
Constipation affects thousands of people. About 80% of Singaporeans will experience constipation at some point in their lives, and 25% suffer from chronic constipation.
In addition, constipation becomes more common as we age. It is estimated that 6 or 7 of every 10 elderly patients has constipation, and they are also more likely to suffer from complications like faecal impaction, where a large lump of dry, hard stool becomes stuck in the rectum.
Despite our fundamental understanding of constipation, many different definitions exist for this common problem. Most people define constipation as the presence of hard stools or straining, while medical doctors define it as having bowel movements less than once every three days.
In contrast, naturopathic physicians believe that bowel movements need to be much more frequent than that — at least twice a day. An infant’s frequency of defecation, which is as often as four to six times per day, has often been cited as an example. According to some naturopathic physicians, it is necessary to have one bowel movement a day for each major meal we ate the day before.
“Imagine sleeping with your faecal matter, retaining toxins in your body overnight,” said Ms Kwan Soo Chin, Holistic Health Practitioner at LOHAS WELLNESS.
Why Is It Necessary to Have Daily Bowel Movements?
The colon is not designed to store large amounts of old faecal matter. These faecal matter stores are not only breeding grounds for harmful bacteria and parasites, but the extra matter causes the colon to expand. This causes the walls of the colon to weaken and also causes the enlarged colon to make ‘rooms’ to store more faeces and toxins.
The liver, the main detoxifying organ in the body, filters and neutralises harmful drug residues and toxins from the blood, before excreting them into the bile duct and out of the body via the colon. But sluggish bowels result in the accumulation of toxic and poisonous faecal matter, which may be re-absorbed by the body, increasing the toxic loads of our body.
In addition, after absorbing nutrients from the food, the remaining food residue decomposes with prolonged periods of lying in the intestines. This can cause long-term disruption to the pH of intestinal fluids.
Autopsies have revealed some colons that have accumulated layers of encrusted, hard, black faecal material internally, such that the passage has become no wider than a pencil.
“The heavy mucus coating in the colon thickens and becomes a host of putrefaction. The blood capillaries to the colon begin to pick up the toxins, poisons and noxious debris as it seeps through the bowel wall. All tissues and organs of the body are now taking on toxic substances,” said Dr Bernard Jensen in his book, Tissue Cleansing Through Bowel Management.
If the colon is not regularly cleared, it may result in diseases such as diverticular disease, haemorrhoids, irritable bowel syndrome, ulcerative colitis, and colorectal cancer — the most common cancer amongst males in Singapore, and the second most common amongst females.
It may also contribute to other diseases like diabetes, gall stones, kidney stones, gout, hypertension, varicose veins, rheumatoid arthritis, psoriasis, and obesity.
A clean colon is essential to the detoxification process. A clogged colon is like trying to flush a toilet clogged with toilet paper — instead of clearing out smoothly, everything backs up.
In consequence, Ms Kwan advises her patients to cultivate the habit of emptying their bowels before sleep. “After a week of constant practice, most of them were able to clear their bowels twice a day, once in the morning and once before going to bed.”
Why Is Constipation Common Among the Elderly?
One possible reason is that many bodily functions, including the digestive tract, slow down with age. As the muscles of the gut become stiffer and weaker, food moves more slowly through the colon, and more water is absorbed from food waste, resulting in dry and hard stools. Moreover, due to weakened sensory feedback, they do not feel thirsty even when their body is dehydrated.
In addition, older people tend to take more medications, some of which can cause constipation.
How Can We Prevent Constipation?
1. Daily Fibre Intake: Lack of fibre in our diet will increase the incidence of constipation. The more fibre there is in the diet, the faster the transit time of waste through the intestinal tract.
Ms Kwan recommended that an adult should consume at least two servings of fruit and five servings of vegetables daily. Half a cup of cooked vegetables is considered one serving. She also recommended that the five servings of vegetables should be from five different types of vegetables, preferably in different colours.
2. Drinking Enough Water: Why do some people experience chronic constipation despite eating lots of vegetables and fruits? “Has the person been drinking enough water?” Ms Kwan questioned. Most of the constipation can be improved by increasing fluid intake.
Maintaining sufficient fluid intake and staying hydrated helps prevent constipation. But some elderly people do not feel thirsty and tend to drink less water.
In addition, some older folks take diuretics for high blood pressure or heart failure. Diuretics lower blood pressure by helping the patient lose more fluid through the urine. As a result, some people may limit their water intake, so that they don’t have to run to the bathroom as frequently.
How much fluid should one drink per day? According to Ms Kwan, a person should drink about 35ml to 40ml of water per kilogramme of body weight. For example, a person who weighs 50kg should drink two litres of water daily. Ms Kwan also recommended “drinking in small sips”, and adding some sea salt (3g of salt to 500g water) to improve the body’s absorption of fluid.
3. Probiotics: Probiotics help promote intestinal health and strengthen the immune system. Healthy intestinal flora is also vital in the prevention of constipation.
Besides increasing one’s intake of fibre, water, and probiotics, Ms Kwan cautioned against the consumption of processed foods like sausages, meatballs, canned food, tofu, and candies. In addition, she recommended avoiding foods that can worsen constipation, including glutinous rice and black rice; heaty foods like sorghum, rice wine, lychee, durian, longan, and angelica; and spicy foods like mustard and allspice.
In general, stress, smoking, drinking and an unhealthy lifestyle can also contribute to chronic constipation.
Here are some constipation remedies provided by LOHAS Wellness Holistic Health Centre: