Fiber intake is recommended for some patients with constipation but this does not always alleviate constipation. Fiber intake is very effective in patients with constipation despite no problem with the transit time of food through the large intestine, while it is not effective in patients with constipation whose intestinal transit time is long due to intestinal hypomotility. The presence/absence of such intestinal problems must be checked. Eating soybeans is recommended for patients in whom fiber intake is effective against constipation. Natto (fermented soybeans) and soymilk are also effective. Raw vegetables are not a main source of fiber. For patients with separate, hard lumpy stools, a magnesium preparation should be administered to soften stools. Such patients must also pay attention to how to drink adequate fluid. If a lot of cold water is drunk at once, most of it will soon be excreted in urine or sweat. It is therefore recommended that an extra 500 mL or more of room temperature water be drunk over the period of one day.
It is generally accepted that fluid intake is important. Since 80% to 90% of stool content is water, inadequate fluid intake may soon lead to hard stools and difficult defecation. Another essential material is dietary fiber. Since dietary fiber is excreted almost indigested, it increases fecal volume and activates bowel functions. This is particularly effective for patients who are on a diet with reduced food intake. Dietary fiber is also good for the intestinal environment because it feeds/increases probiotics. In addition, oil is also important to make stools smooth. Animal fats raise the possibility of constipation because they increase harmful bacteria. It is recommended to ingest oil from blue fish or olive oil if possible.
Food-containing dietary fiber is very good for bowel movements because it increases the bulk of stools. However, a dietary imbalance is not good. It is important to take a balanced diet. Even if dietary fiber is good for the intestines, excessive eating or drinking of foods or beverages containing dietary fiber is not recommended. In addition, there are some elderly patients who are concerned about constipation due to a decrease in fecal volume or in frequency of bowel movements; however, this may not be a cause for worry. Although many elderly persons think that they are taking a balanced diet as with that when they were young, they eat less with age and thus it is natural that they have less feces. They may also have less frequent bowel movements. For elderly patients who show no abnormality on colorectal examinations but are concerned that they have constipation despite a balanced diet, I advise them that "this is not constipation but is a normal body condition of patients your age." Such advice is also important for patients.
Fiber intake is important, but a dietary imbalance is not good. There are two types of dietary fibers: water-soluble fibers and insoluble fibers. These fibers are good for constipation; however, persons who keep eating green vegetables only may be constipated. In addition, necessary amounts of fibers cannot be taken from raw vegetables only, so it is recommended to eat cooked vegetables. Food ingredients not to be taken after treatment include irritants such as wasabi (Japanese horseradish), red pepper, and garlic. Garlic is also an irritant although this is not widely known, so pay attention to the amount of food you eat which may contain garlic, e.g., gyoza (Chinese dumplings). Among fruits, kaki (Japanese persimmon) is not good for constipation. Tannin contained in kaki is an ingredient of antidiarrheal drugs and is likely to cause constipation. Furthermore, milk and yogurt are not good for some people. Milk and yogurt are effective for people whose stools are hard. Some people have diarrhea after ingesting milk or yogurt, so they should avoid these ingredients.
To prevent persistent constipation or diarrhea, it is fundamental to eat dietary fibers and a well-balanced diet. Furthermore, attention should be paid to alcohol intake. It is said that hemorrhoids (piles) can worsen with alcohol intake. Some people drink alcohol, saying that alcohol softens stools, allowing them to smoothly pass through the anus. In my opinion, some moderate alcohol intake for smooth defecation is acceptable. It is the same for milk. Some people experience diarrhea after drinking milk; however, for people in whom milk encourages bowel movements, drinking milk is recommended. It is important not to quit drinking alcohol or milk suddenly, and to eat a balanced diet. The frequency of bowel movements and the consistency of stools are indices of regular bowel habits. Keep in mind that the recommended ideal stool consistency is from a toothpaste for loose ones to a banana for hard ones. It is also important to control your bowel movements, checking your stool condition in addition to bowel movement frequency.
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Question to a doctor “About the control of bowel movement ”
