Constipation, fiber, peristalsis and stool softener...POO!

Factual Questions
1

Yes, a poo thread.

When you stop giggling, perhaps you can enlighten me about the nature of constipation and what cures it.

Does fiber actually trigger and enhance peristalsis? (The contractions of the gut that push the food through the intestine, then the waste out the end.)

Constipation has been an issue for me a few times in recent years, and the issue seems to be inadequate peristalsis…probably in combination with hard stool. But hard stool is no problem if my guts are undulating well.

WARNING TMI TMI TMI TMI TMI!!!

The most horrendous experience I’ve had, and I’ve had it twice, is when the waste just…stops at the exit. Won’t retreat, wont’ exit. Just stops. For anyone who hasn’t had this awful experience…it’s fucking awful. You can’t really get up and go do something else and come back later. You’re stuck in this kind of painful toilet trap. That’s a combo situation of very hard stool and very wimpy peristalsis, and the worst of the two times it happened found me lying on the bathroom floor in tears. Funny to think or talk about, way not funny to experience.

So I want to know how this all works and particularly the role of fiber and if it actually improves peristalsis itself.

2

By the way, can anyone who participates do me the kindness of using polite terms for the subject at hand? Referring to bowel movements and the product thereof using nasty slang just squicks me out and I’m asking nicely. Please.

3

Fiber forms bulk and retains water, giving the gut some mass to process and keeping the mass soft.

I don’t think fiber stimulates peristalsis, although excess gas (sometimes a side effect of fiber) may be an intestinal stimulant in some small way (perhaps as an irritant?).

4

Not a doctor, but I don’t think fiber causes your bowels to move, it just gives you more “bulk.” If you have a problem with hard stools, I’d try drinking more water. If it’s a constant problem, you obviously should talk to a doctor. Or at the very least, a pharmacist.

5

Fiber doesn’t trigger peristalsis. It improves peristalsis in the sense that fiber helps keep stool soft and therefore easier for the intestines and colon to keep it moving. You might not mind hard stool per se, but hard stool is not normal. I would think you would want to improve your diet to make for healthier-for-your-gut stools. Here’s a WebMd article you may find useful.

Magnesium stimulates peristalsis. Taking that on a low-dose (milk of magnesia) basis may help, but you really should be seeking to eat more digestible, higher fiber foods, rather than just trying to make your digestive tract work hard enough to move hard stools. Also, magnesium interacts with a list of other medications.

IANAD, etc, etc.

I hope you find relief. I can’t imagine how uncomfortable you must be!

6

Well, the most common cause of constipation is low fiber in the diet; without normal bulk, peristalsis is not fully stimulated in the first place, so in that sense you could say that fiber stimulates peristalsis. If your gut is capable of doing the job in the first place, then fiber is all the laxative one needs. If the gut has low motility, then fiber may help retain water and keep the stool softer longer, but the only way to increase peristalsis would be to flog the colon with stimulants like Correctol or Ex-Lax.

7

I’m generally fine so long as I make sure to take in enough liquid and make it a POINT to increase the fiber in my diet. (LENTILS… )

We tend to take for granted the marvelous feeling of having fully evacuated one’s bowels… having been through the wars once or twice I now appreciate the marvel of my body and its systems!

8

Indeed.

-The guy who’s been miserably, frustratingly, persistently constipated for six years now (!!)

9

[quote=“Indistinguishable, post:8, topic:553364”]

Holy god! I assume you’ve seen a doctor? This is not good! Lentils. Lentils and beans. And water. Loads of water, lentils, beans.

Yipes.

10

Yes, I’ve been seeing doctors, albeit with sadly little progress on fixing me or even figuring out what the hell the problem is. (Of course, I’m not completely stopped up all the time, but, yeah. It’s been and continues to be pretty miserable). When I reflect on how long it’s been going on and how completely fucked up the whole thing’s gotten, it’s insane.

11

Actually, the whole “Oh, you’re constipated? Eat more fiber, drink more water” thing really annoys me*, since for a long time, that was the only thing doctors ever said to me, which was frustrating in its not really taking my problem seriously (plus, with my vegetarian diet, I was hardly lacking in fiber to begin with). But, of course, it’s probably foolish to judge its sensibility as general advice based on its not addressing whatever is going on in my particular case.

*: Not from you just above, since I know that’s just empathetic, but as medical advice which has often been offered to me well past the point when it was clear my problems were deeper than could be so glibly addressed.

12

Many people find that having that first or second hot cup of coffee or tea in the morning helps get things moving. Even if it’s caffeine free, it seems to help. I, personally, find that I have far fewer problems if I just make sure to have a high fiber cereal (shredded wheat or Cheerios) with half a cup of frozen blueberries for breakfast. I don’t bother to defrost the blueberries, they defrost almost instantly.

Getting enough fiber will help prevent a recurrence of that horrendous experience, by the way. And if you’re regularly constipated, I’ve had good luck with sugarfree Metamucil. Oddly enough, fiber therapy powders are good for diarrhea, too, as they sop up any extra moisture.

13

Pick up some flax seed at the health-food store. Also pick up a coffee bean grinder ($15) at Wal-Mart if you don’t own one. Use a tlbs. or two ground up on your food and you will be leaving the kids off at the pool right on schedule. The flax has many other health benefits as well.

14

I would also recommend walking to stimulate the colon, and making sure to drink enough water.

15

Fiber is good…except when it isn’t. :wink: Bulk fiber supplements like Metamucil can actually increase constipation in some people, and people with IBD should absolutely not be on a high fiber diet. (They should actually be on a low residue diet, which is low in what we think of as fiber and also low in “ash”, which comes from things like milk.) Some (but not all) people with diverticuloses or a history of diverticulitis are put on low fiber diets to reduce the risk of complications from bits of food getting stuck in pouches in their intestines.

But, assuming you’re a “normal” person, fiber works in two ways, because there are two different things we call fiber.

Insoluble fiber is what you’ll find in things like bean and lentil skins, corn skins and other things that come out of you looking much like they did when they went in, as well as whole wheat, bran and brown rice. These are indigestible carbohydrates, so they’re not broken down (much) by digestion, leaving them with gently sharpened bits and corners. They help scrape the walls of your colon clean like a bottle brush. They also form “bulk”, which is just what is sounds like. Bulk increases the size of the stuff in your intestines, which makes it easier for your peristaltic waves to push along. Think of a nice new, fully filled toothpaste tube. It’s so easy to get toothpaste out of it that often it starts oozing out just when you open the cap! Now think of an old, mostly empty toothpaste tube. Takes a lot more work to get the toothpaste out, doesn’t it? Your intestines are much the same - “bulk” makes it easier to move fecal matter along and out.

The other kind of fiber is soluble fiber. These are carbohydrates which love water. They will hold a bunch of the water from your stomach and not let your intestines reabsorb it as the feces passes through. This has the effect of softening the stool, again making it easier to pass. Insoluble fiber is found in foods like oats, peas, beans, apples, citrus fruits, carrots and barley.

So, to get the most benefit, you need *both *kinds of fiber - soluble and insoluble - and lots of water in your diet. And Cub Mistress is right - walking promotes peristalsis and can aid in elimination.

Caffeine and tobacco also increase peristalsis, but we’re not supposed to recommend those. :wink:

16

I’ve been taking liquid probiotics twice a day and I’ve been having the most pleasant and satisfying bathroom visits of my life. I buy it in the refrigerated section of my health food store. It tastes a bit like tart yogurt, not bad.

I started taking it after a course of antibiotics for a sinus infection left me completely wrecked (diarrhea AND a yeast infection, joy! I would rather have had the sinus infection). After 2 days of the probiotics I was better than normal. I kept taking it and I think it’s great stuff.

I read the labels and try to buy the type that delivers the most active cultures per serving, sorry, I can’t think of the current brand off the top of my head!

17

If constipation is longstanding there will be no quick fix.
Childhood constipation is often due to the child “holding it in” on purpose.
This is either because they’ve had a painful BM and wish to avoid a repeat performance or because the bathrooms at school freak them out, or even because they are too busy having fun when the urge comes to stop and visit the lavatory.

This results in their rectum remaining full, and the stretching that usually signals evacuation is continually ignored. The end result is that the rectum no longer efficiently signals when it needs to be emptied and the remains full of faeces until the volume is so great that it has to empty. This is delightfully termed faecal loading, and when the situation deteriorates further, faecal impaction.

The way to overcome this situation is twofold.
Firstly, stool softening and/or bulk forming laxatives (like Macrogols or lactulose) to give the bowel something to move and prevent the stool being hard and painful to pass.
Secondly, and more importantly, bowel re-training. That means twice daily toilet visits- whether felt to be needed or not- as well as encouragement to open the bowels as soon as they feel the need to do so. This gradually re-trains the rectum to recognise and respond to being full.

18

I can’t help but think about that old King of the Hill episode, when poor Hank couldn’t go and spent hours on the throne. Doubly miserable because his friends were hanging out, outside, and he wanted to be out there with them, not stuck in the bathroom.

19

I think this is a large part of my problem. I’m TERRIBLE about failing to immediately respond to my urges…“later, in a minute, when it gets stronger, I’m busy…” then the urge goes away. Until later, when I often ignore it again.

I must stop doing this.

My mother was actually incapable of having a bowel movement anywhere except her own home (I’m not incapable, but it’s certainly my vastly preferred location). She was hospitalized during one of her pregnancies and this resulted in her having impacted bowels, and evidently the only way to deal with it was to have nurses actually dig it out of her. I’m not sure if they have a special tool for that, but hey… one more reason I’m glad I didn’t go into nursing. Or have kids.

20

Nor am I, but I can imagine