Open any search engine and type “foods that cure constipation”—you know, that feeling of having a gag down your sewer system—and the first results, I assure you, can sum up into one familiar line: “Eat fiber, drink water.” Low-fiber supplement consisting of milk, rice, yoghurt, ice cream and red meat is frowned upon by most nutritionists, while a diet rich in fiber and hydration is hymned as the best treatment. You’d be surprised to find that this is actually a myth. (Yes, science needs to pull itself together!)
This article was brought to you to shed light on some false truths about relieving constipation.
Myth #1: Eat fiber to increase bowel movement
While eating fiber can help regulate gut motility in the average person, for people suffering from chronic constipation or IBS, it simply aggravates the symptoms. This happens because dietary fiber is the only component of food that reaches the colon undigested. On the contrary, fat and sugar are absorbed from our system and increase the propulsion of the intestines, rendering discharge easier.
A study by the World Journal of Gastroenterology, which investigated the effect of reducing dietary fiber on patients with idiopathic constipation, proved not only that fiber deficiency does not cause constipation, but that it can actually serve as a treatment as well.
The study focused on 63 subjects with severe constipation (less than one bowel movement in three days). The age range was from 20 to 80 years, with an average of 47. The subjects were asked to follow a no-fiber diet for two weeks. From then on, they could reduce their fiber intake to a minimum they felt comfortable with.
After 6 months all patients were examined for symptoms of constipation including: difficulty in evacuation of stools, anal bleeding, abdominal bloating or abdominal pain.
Out of the 63, 41 patients persisted on a no fiber diet, 16 lived on a reduced fiber consumption, and 6 resumed their high fiber intake for religious or personal reasons.
The results were these:
The 41 patients on the no-fiber diet had increased bowel frequency from an average of once every 3.75 days to once every day.
In the 16 patients on the reduced-fiber diet, average bowel frequency leaped from an average of once every 4.19 days to once every 1.9 days.
In the 6 patients who remained on a high-fiber diet, bowel frequency was once a week initially, and it remained the same on the high-fiber diet (as expected).
The World Journal of Gastroenterology concluded:
“This study has confirmed that the previous strongly-held belief that the application of dietary fiber to help constipation is but a myth.”
But why do the social media, doctors and the majority of people around the world insist on maintaining the false notion that fiber helps move things through?
People tend to think, “Stools are made of feces. Therefore, we need feces to make them.” Indeed, fiber adds volume and size to stools, but why would anyone with constipation and a sound mind want to size up their stools?
And then there are these questions to answer:
How is it possible that breastfed babies have frequent, healthy bowel movements, when breast milk — the only food they consume — is a zero-fiber, high-fat product?
How is it that Eskimos, who basically live on a no-fiber diet, don’t get constipated?
Or, how is it possible that the Japanese, whose diet consists mostly of fish and white rice, have a longer average age of life than most Americans?
And lastly, how come people who fast and consume no solid foods for days enjoy healthy defecation?
Despite popular belief, stools aren’t solely composed of indigestible fiber. In fact, they are also made of 30% dead bacteria, 10-20% fat and cholesterol, 10-20% inorganic substances such as calcium and 2-3% protein. Cell debris, bile pigments and dead white blood cells also make it to the mix.
Still, not all fiber is the same. Insoluble fiber increases stool weight and frequency. Sources are whole-grain breads, pasta, and cereal. Soluble fiber dissolves in water and it can cause diarrhea. Beans, peas and other plant foods are known to contain it. Fiber is reported to aid in saving water in the colon and contributes in less dry and easier to evacuate stools. However, in reality, feces remain hydrated at 70%-75% regardless of fiber and water intake.
But there must be some truth to all those dietary prescriptions and web sites that promote fiber as a metabolizer, you argue.
Indeed, fiber does help conditions of sporadic constipation, but it is a nightmare for cases of chronic symptoms. A study conducted by Voderholzer et al showed that only 20% of constipated patients benefited from fiber. There are certainly subsets of patients and one person’s daily routine may be another person’s constipation.
Myth #2: Drink 8 glasses of water daily to increase stool moisture
In fact, the whole campaign about drinking 8 glasses of water a day is a big fat lie. The myth probably commenced from a 1945 Food and Nutrition Board Recommendation that stated, “A suitable allowance of water for adults is 2.5 liters daily in most instances. An ordinary standard for diverse persons is 1 milliliter for each calorie of food”. 2.5 liters of water equal 7.5 glasses (hence 8 glasses). What readers ignored from the recommendation was this line: “Most of this quantity is contained in prepared foods.”
To be more specific, only an average of 650 ml is directly acquired from drinking tap or bottled water. The rest is contained in the meals and beverages we consume regularly. Beverages like coffee, tea, wine, milk and soda hold about 85-99% of water, meats about 50-70%, and fruits along with vegetables a total of 75-96%.
The misconception about constipation is that fiber absorbs water, and since it is the main component of feces, we need to drink more water to increase stool moisture and help fiber move through our intestines. In reality, the only fiber that retains water is the psyllium seeds contained in laxatives. Furthermore, enzymatic bacteria in our intestines ferment 75% of the fiber we eat. The rest is hydrated adequately from 7 liters of digestive juices, which are emitted daily inside the alimentary canal. Last but not least, water makes fiber grow 4 or 5 times its initial size and volume, obstructing our anal sphincter. If anything, water might actually worsen constipation instead of aiding it.
So how will you know the amount of fluids you need to drink (if you can’t measure them with 8 glasses)?
The answer is as simple as it is surprising.
You feel thirsty.
Despite popular claims that “when you feel thirsty, it’s too late”, in reality, our body signals for a water refreshment exactly when it is supposed to: when the blood concentration, which is an exact evaluation of our state of hydration, has risen by less than 2%. According to most experts, dehydration kicks in at a concentration boo of at least 5%.
“There is no formal recommendation for a daily amount of water people need. That amount obviously differs by what people eat, where they live, how big they are and what they are doing,” says American pediatrician Aaron E. Carroll from Indiana University.
Mayo Clinic lists a few cases in which more water intake is actually essential. In short, people who exercise need about 400-600 ml more of the average water amount. People who engage in intense activity regularly should opt for sports drinks to replenish the sodium they lose in sweat sessions. Hot climates and indoor heat increases water loss and altitudes higher than 8500 feet (2500 meters) augments urination and breathing. Certain illnesses and health conditions, pregnancy and breast-feeding are also factors to be taken into consideration.
However, for people leading sedentary lifestyles in non-extreme temperatures, there’s no need for 8 glasses a day.
For those not convinced, here’s a related study and a man’s personal story.
Myth #3: Avoid drinking coffee, because it is dehydrating
My fellow coffee addicts, drink away! Coffee has the exact same hydrating effects as water and anyone who begs to differ needs to update their research.
Straight from Mayo Clinic: “Drinking caffeine–containing beverages as part of a normal lifestyle doesn’t cause fluid loss in excess of the volume ingested. While caffeinated drinks may have a mild diuretic effect — meaning that they may cause the need to urinate — they don’t appear to increase the risk of dehydration.”
In fact, even the rumor that caffeine increases your urine output is just that: a rumor. If you’re a regular coffee drinker (about 300 – 600 mg/day), you have no reason to worry about coffee’s diuretic effect.
A related study back in the 1928 reviewed three men over the lapse of two winters. They switched their daily coffee consumption from 4 cups a day to tea to caffeinated water, all the while having their urine volume measured regularly. The conclusion was that when the men drank caffeinated water after two months of withdrawal from both coffee and tea, their urine increased by 50%. However, when they readjusted to a regular coffee intake, they grew habituated to its diuretic effect. To add more proof, a review of 10 studies by Lawrence Armstrong from the University of Connecticut stated that caffeine is a mild diuretic at most, with 12 out of 15 cases showing that people peed the same proportion, whether they drank water or coffee.
Three isn’t a reliable statistical number, you could oppose.
A more recent study by Sophie Killer, a doctoral researcher at the University of Birmingham in the UK proved that there is no significant difference between the moistening effects of coffee and water.
To conduct the research, Killer et al measured the fluid levels of 50 healthy non-smoking men (women were excluded from the study because their menstrual cycle would cause disruptions to total water mass) who daily consumed about 3 to 6 cups of coffee (100 mg/cup). The aim was to compare the hydrating effects of coffee and water across a wide scale of hydration markers including: urination, blood-related measurements, body mass and total body water. Each participant completed two trials of the study. In one trial, they drank only coffee. In the other, they consumed the same proportions of water instead.
Sophie Killer concluded:
“Our data shows no significant differences in the hydrating properties of coffee or water across a wide range of hydration assessment indices.”
Of course, there’s a drawback, and those of you who don’t read small letters may ignore it, but for those of you with the natural gene of skepticism, this may compromise your trust. This study was funded by ISIC (Institute for Scientific Information on Coffee), whose members are coffee companies. (And now you’re nodding, thinking “They want to promote their products. Of course they wouldn’t say coffee is dehydrating.”) However, the research was published on a peer-reviewed journal and Sophie Killer confirmed that the Institute had no part in conducting the research other than financing it. Plus, with 1.6 billion cups of coffee being consumed daily across the globe, I don’t think coffee companies really need to rely on health studies to increase their sells.
That being said, here’s another study showing that coffee, among other beverages, can be counted toward the daily total of water intake.
On the other hand, coffee can actually help you poop. It’s been long discussed that caffeine can stimulate bowel movement. Scientists have provided a variety of reasons for this effect. One suggestion is that coffee activates the colonic muscles, helping them contract and relax in order to push waste through. It’s been also said that the chlorogenic acid in coffee triggers the secretion of gastric acid in our gut, speeding up digestion.
Many health sites (that should be embarrassed to use the voice of experts) cite: “Coffee can help you poop, but it can also cause dehydration and may actually worsen constipation.” I’m here to fix that statement.
Coffee can help you poop. Period.
