Constipation and Diarrhoea

What is constipation?

Constipation is an abnormal infrequency or irregularity of defecation, abnormal hardening of stools that makes their passage difficult and sometimes painful, a decrease in stool volume, or retention of stool in the rectum for prolonged period often with a sense of incomplete evacuation after defecation.

What causes Constipation?

• Change in regular diet or routine; traveling
• Antacid medicines containing calcium or aluminium.
• Frequent use of laxatives (stool softeners) which, over time, weaken the bowel muscles
• Certain diseases or conditions.
• Inadequate water intake.
• Inadequate fibre in the diet.
• Resisting the urge to have a bowel movement, which may cause pain from hemorrhoids.
• Medicines ( especially strong pain medicines such as narcotics, antidepressants or iron pills).
• Inadequate activity or exercise or immobility.

Clinical Manifestations

Clinical manifestations of constipation include :

• Fewer than three bowel movements per week
• Abdominal distention
• Pain and pressure
• Decreased appetite
• Headache
• Fatigue
• Indigestion
• A sensation of incomplete evacuation
• Straining at stool
• The elimination of small-volume, lumpy, hard, dry stool

Dietary Recommendations

Foods to Avoid

• Processed and refined foods

Avoid processed and refined foods. These are foods containing white flour and white sugar, including white bread and breads containing bleached flour, cookies, pastries, cakes, white rice and white pasta. Prepared foods commonly have eliminated most or all of the original fiber, such as instant mashed potatoes, boxed potatoes and potato chips.

• High-fat foods

These include whole milk and whole milk dairy products such as cheese, ice cream and butter; high-fat meats including bacon and regular ground beef; poultry skin; fried foods; processed snacks such as chips; certain gravies, cream sauces and soups; and prepared foods such as pot pies, boxed dinners and frozen dinners.

• Fluids to Avoid

Avoid stimulants such as coffee, tea and sugary carbonated drinks. Caffeine drinks can have a dehydrating effect on the body which then can contribute to constipation.

Foods to Increase

• Whole Grains

Increasing whole grains such as brown rice, millet, buckwheat and quinoa are excellent sources of complex carbohydrates.

• Fibre

Include plenty of dietary fibre to encourage gut motility and peristalsis. Soluble fibre holds water and brings bulk to the faeces. Food rich in soluble fibre include barley, oats, oat bran, prunes, figs, vegetables, fruits (apples, pears, peaches, papaya, pineapples, bananas), seaweed, lentils and pulses.

• Fluids

Drink more water. This is particularly more important when adding more fiber to your diet. Increase your daily intake of purified water, especially in between meals. For variety drink diluted fruit juices, organic vegetable juices and herbal teas.

What is diarrhea?

Diarrhea is an increased frequency of bowel movements (more than three per day), an increased of stool (more than 200g/day), and altered consistency (ie. increased liquidity) of stool.

What causes diarrhea?

• Bacterial infections
• Viral infections
• Parasites
• Functional bowel disorders
•  Intestinal diseases
• Food intolerances and sensitivities
•  Reaction to medicines

 

Clinical manifestations

In addition to the increased frequency and fluid content of stools, other clinical manifestations include :

• Abdominal cramps
• Distention
• Intestinal rumbling (ie. Borborygmus)
• Anorexia
• Thirst
• Bleeding

Dietary Recommendations

Foods to Avoid

•  Fatty foods

Foods with a high fat content can speed up intestinal contractions and cause a reaction to a system that is already sensitized. Therefore, try not to eat anything that is greasy, fried, creamy, or covered in gravy. Hydrogenated or partially hydrogenated oils (trans fats) found in many processed foods, deep-fried foods, fast food, and junk food.

• Diary products

Diarrhea can cause a lessening of the amount of the enzyme lactase. Lactase is needed in order for the body to digest lactose, the sugar found in dairy products. If this “milk sugar” goes undigested, it can result in further symptoms of gas, bloating, nausea and diarrhea. Here are some common lactose-containing foods:

• Butter
• Soft cheese, such as ricotta or cottage cheese
• Ice cream
• Milk

• Sugar free foods

Some artificial sweeteners and sugar substitutes can have a laxative effect, as well as contribute to gas and bloating. So until you are feeling better, it is best to avoid:

• Diet soda
• Sugar-free candy
• Sugar-free gum
• Sugar substitute packets for coffee and tea

• Gas-producing foods

Certain vegetables have a well-documented reputation for increasing intestinal gas which could contribute to further diarrhea:

• Beans
• Broccoli
• Cabbage
• Cauliflower
• Onions
• Peas

• Unsafe Foods

Whether you have diarrhea or not, you should always make sure that you only eat food that has been safely washed, prepared and stored. Foods that are not safely prepared and stored put you at risk for a serious gastrointestinal illness.

• Fluids to avoid

Alcoholic beverages in excess since they hinder the functioning of the immune and digestive systems. Carbonated drinks. Excessive caffeine intake as it can disrupt the body’s system, causing insomnia and digestive irregularity (constipation or diarrhea). Sweetened fruit juices that spike blood sugar levels too rapidly.

Food to Take

BRATTY diet – Bananas, Rice, Applesauce, Toast, Tea and Yogurt.

• Bananas

Bananas have high potassium content, which is excellent for replacing lost potassium. They also have a healthy balance of starch and fruit sugars that can help firm bowel movements. Rice and white or wheat toast should be served without added spices or butter, since fats and spices may prolong frequent or watery bowel movements.

• Rice

Due to their low-fiber content, these starches are easily digested way up high in the GI tract. Eat your rice and potatoes plain. Rice and white or wheat toast should be served without added spices or butter, since fats and spices may prolong frequent or watery bowel movements.

• Apple sauce

Apples are a good source of pectin. However, the high fiber in raw apples makes them too rough for a dicey intestinal system. Therefore, by cooking the apples makes them easier on your system to digest, and allowing you to benefit from the pectin, sugar and other nutrients that lie within.

• Toasts or Crackers

When you are experiencing acute diarrhea, however, it is better to turn to processed wheat foods. The removal of the outer husk of the grains in these foods results in easier digestion. As an added bonus, the salt (sodium) in crackers will be beneficial in terms of restoring the electrolyte balance.

• Tea

Two teas in particular are especially good for quieting a diarrhea episode: peppermint and chamomile.

• Peppermint Tea: Peppermint has a soothing effect on the gastrointestinal system. It is thought to calm and relax the muscles along the intestinal tract, thus reducing spasms. Peppermint also seems to be effective in reducing intestinal gas.

• Chamomile Tea: Chamomile is a flowering herb. Chamomile tea appears to be effective in reducing intestinal inflammation and calming intestinal spasms.

• Yoghurt

Yogurt would be a good introduction as it is a calcium dense probiotic which can restore colon health.  These probiotics help to establish a healthier balance of bacteria in the digestive tract.

References :

1. 1.    Brunner and Suddarth’s Textbook of Medical-Surgical Nursing by  Lillian Sholtis Brunner, Suzanne C. Smeltzer, Brenda G. Bare, Janice L. Hinkle, Kerry H. Cheever
2. http://www.webmd.com/digestive-disorders/digestive-diseases-constipation
3. http://www.slideworld.com/slideshow.aspx/CONSTIPATION-ppt-2771906
4. http://www.thefooddoctor.com/Article-Ahealth_fst_constipation/
5. http://naturopathconnect.com/articles/constipation-dietary/
6. http://ibs.about.com/od/diarrhea/tp/DiarrheaFoodsAvoid.htm
7. http://ibs.about.com/od/diarrhea/tp/Diarrhea-and-Food.–04.htm