A dietitian’s guide to the best nutrition strategies and foods for constipation

If you’re struggling with constipation, good nutrition can help get things moving. I’m a gut health dietitian with over 15 years of experience helping people fix their digestive issues, and I know that constipation is complicated….so I want to share I’ve learned about good foods for constipation, when more fiber is NOT the right approach, non-nutrition constipation fixes and when you might need a little extra help. So let’s do this!

If you’re constipated, you know how miserable it can feel. And you’re not alone. According to the GI Society of Canada, chronic constipation affects as many as 30% of us in Canada. In the US, it’s thought that up to 20% of Americans are chronically constipated. That’s a lot of unhappy bellies, and one of the reasons I wrote an entire cookbook on gut health nutrition.

And you should also know, it’s totally normal to get constipated every once in a while. Perhaps a stressful week with too many take out dinners. Or, when you travel (ugh, how the bowels love to seize up when you go away!) Constipation happens in a normal healthy life, but if constipation is your normal, and has been for a while, it’s time to fix it.

Sooooooo…what can you actually do about it? If you are constipated, and it’s not accompanied by any other notable symptoms like pain, blood in the stool or serious fatigue or joint issues, you are likely safe to tackle it on your own for a month or so. I’m gonna assume you’ve already checked things out with your doctor (ahem, always see your doctor!) and know you’re constipated, so now we can talk nutrition.

Constipation is complicated…and you don’t have to figure this out alone. If you’re in BC, Alberta or Ontario, get one-on-one help from one of our experienced dietitians.

First, we’ve got to understand WHY we get constipated before we understand the best nutrition strategies to use

• Not enough water: if you’re dehydrated, you probably expect that you might pee less. However, the body also has a failsafe that grabs fluid from the bowels, making poops drier, lumpier and harder to pass.
• Low Fibre: So boring. I know. But, um, we still aren’t eating enough! Women need at least 25 grams of fibre daily and men need 38 grams. Less fibre means less hydrated, lower volume, slower moving poops.
• Activity Levels: Your gut is essentially a muscle. If you move, it moves…gravity is your friend. If you are inactive, your bowels will be sluggish. Full stop.
• Medications: Several medications and supplements can constipate you; these include antidepressants, calcium channel blockers for blood pressure, calcium, iron pills and opiates. If you suspect medications and not lifestyle, talk to your doctor.
• Diseases: Your gut movement is governed by the enteric nervous system (hello gut-brain), which can be dysregulated in many conditions such as multiple sclerosis, diabetes and diverticulitis. However, serious and hard to treat long term constipation should always be investigated by a physician because of the potential for tumors or intestinal strictures causing the issues.
• Learned behaviour: It’s possible that your nervous system has dysregulated to the point that it no longer smoothly navigates defecation. This has happened to clients who have avoided pooping due to embarrassment during travel, work or school commitments.

The best foods for constipation aren’t always high fiber

I’m gonna say something that might surprise you: but if you’ve got chronic constipation, eating a bunch of fiber might make things way worse. Why? Well, if your gut is already moving super slow, or you’re not used to eating high fiber foods, or you don’t drink a lot of water, loading up on fiber is gonna slow down your gut even more and lead to a bunch of gas and bloating.

So the first, and most important, nutrition strategy before you do anything else is to ensure you’re drinking a ton of water so dehydration isn’t an issue. I’d really love if you can front load your water intake a little bit, trying to drink a 500mL (a pint) of water pretty soon after waking up.

Eating, and drinking liquids, when you wake up helps activate the gastro-colic reflex that encourages the colon to move things on out…I see you breakfast skippers!! Skipped meals are a skipped opportunity to move your bowels.

Best motility-promoting foods for getting your bowels moving

If you’re chronically constipated, before you go just eat more fiber, you actually want to choose foods that help get the bowels moving. Yes, these foods often have a little fiber, but it’s actually other naturally occurring compounds that are thought to really get the gut moving.

• Kiwis: 2 kiwis a day is my favourite evidence-based food for constipation relief. In addition to some low bloat fiber, they contain a compound called actinidin that helps the bowels move, as effectively as psyllium, but with less bloating (and they taste way better!).
• Prunes: yes, grandma’s fave snack. But I actually really like them! Typical recommendation is 5-6 prunes a day so start there, but the research study above used 100g a day (about 10). Prunes contain sorbitol, a sugar alcohol that helps you go, as well as chlorogenic acid.
• Papaya: soluble fiber is soooo good for helping you go, and papaya contains an enzyme called papain that might help encourage things. Try 1 cup a day.
• Chia Seeds: chia seeds are rich in soluble fiber and hold a LOT of water. For constipation, a chia seed pudding makes a great snack. Try 1-2 tablespoons of chia seeds a day, in your smoothie or oatmeal or even just stirred into a drink, chia fresca style. Just ensure they’re well hydrated before eating so they help add water to your stool, not soak it up.
• Coffee: you’re welcome, ha. Warm liquids are great for the bowels, and the caffeine and chlorogenic acid in coffee help encourage movement…for some. Try drinking first thing on an empty stomach, as long as your nervous system tolerates it.

Give these foods 2-4 weeks to see if they get things moving. If they don’t, are you drinking enough water? You might also want to consider magnesium citrate with your doc or dietitian…or something stronger to get that movement going BEFORE you try adding extra fiber.

Best low bloat, high fiber foods for constipation

Once things are starting to move again, you can start slowly increasing your fiber intake so that you keep things moving. The goal is 25 grams a day for smaller, less active bodies and 38 grams a day for larger, more active bodies.

BUT!! You need to train your gut to tolerate fiber the same way you tolerate your legs to tolerate running. Slowly and consistently…so I want to you increase your fiber by 3-5 grams at a time only. Yes, really.

What that looks like is adding 1 food with 3-5 grams of fiber to your daily diet and waiting until you tolerate it without additional gas, bloating, or slowing your gut down again. That might be a few days for some. That might be a few weeks for others! Do not rush the process, patience will really pay off. Be sure to drink even more water. Fiber needs water to do its job properly or it can make you MORE constipated. Actually.

Here are some of my top picks to get you started easily…and I’ve got more low bloat fiber sources when you’re ready.

• 1 cup blueberries (4g fiber)
• 1/2 cup rolled oats // 1 cup cooked oatmeal (5 g fiber)
• 1/2 cup raspberries (4g fiber)
• 1 medium orange (4g fiber)
• 1 cup cooked carrots (4g fiber)

What about psyllium, you ask? I love it! It’s a great soluble fiber supplement if you’d rather go that way instead of food. I’ve got a blog post with everything you need to know to get started with psyllium.

Other helpful lifestyle strategies to relieve constipation

In addition to the nutrition basics, there are other really helpful factors that can help you poop more consistently that I routinely recommend in practice.

• Watch your fat intake. A really high fat diet – lots of red meat, cheese, fast food, fried food etc – can seriously slow down the bowels. You don’t have to go low fat, but less fried food, more simple home cooked meals and leaner proteins will help.
• Move your body daily. Even if it’s a 15 minute after dinner walk, you need to increase your activity to help nature do its work. If you are chained to a desk, get up once per hour even if it is just to do a few toe raises and a stretch. Decompressing the abdomen assists with movement.
• Try a squatty potty. These simple stools help elevate your knees into the correct anatomical position for pooping. If you’re constipated, this is a must have!
• Create a poop routine. Your body loves routine. If you want to encourage morning elimination, try getting up at the same time. Have your water, tea or coffee. Then, take 10 minutes to just sit on the toilet without expectation or anxiety (because your bowels get stage fright!) over whether you’ll go. When 10 minutes are up, get up even if you haven’t pooped. Try doing this every day to create an automatic poop routine.

If the basics don’t work for you, here is what to consider next:

Sometimes, constipation happens because our bodies have difficulty actually releasing the poop. It’s more of a gut-brain thing and pelvic floor physiotherapy can be really helpful for this!

You might also have deeper issues with motility, which is the way the gut moves, talk to your doc about a motility study or if you’ve got an overgrowth of methane-producing microbes, known as intestinal methanogen overgrowth (IMO) that requires antibiotics.

For folks with IBS-C, gut-directed hypnotherapy might help! Try Nerva, which is an evidence-based app we recommend to our clients…NOT a sponsored link, just a useful tool!

Constipation is super common, but it can actually get better. I hope that some of these strategies will work wonders for you and help you feel your vibrant best. And remember, always get yourself checked out by a doc!! You never know what underlying medical causes can be fixed to get you moving again.