Everyone suffers from constipation from time to time. But what do you do if it is a daily occurrence?

The human intestine is most comfortable when it produces feces (bowel movements) of desirable consistency and size. “A brown banana” is a good way to think of the ideal stool: not too hard, not too soft, not too big, not too small. The muscles of the colon are designed to move soft stool the size of a banana. The colon has a harder time passing hard stools, whether small or large.

Although certain diseases and many medications cause constipation, the most common culprit is a lack of fiber in the diet. Civilized man does not eat enough soluble fiber to keep the intestines well regulated. Soluble fiber is the kind that can soak up fluids to soften your stool—think dried beans. Dry, hard beans can turn into mush if they are soaked and cooked long enough to absorb enough water. Soluble fiber is not absorbed in the intestines; it passes through raw, absorbing extra water along the way, just like the gelatin in disposable diapers.

So before you get to the food, don’t forget the water. No matter what food you eat, your stool cannot soften if not enough water passes through your intestine.

Also, food cannot soften stool that has already formed; the fiber just softens the next stool down the road. Think of your intestinal tract as a conveyor belt. You want to keep a good supply of fiber moving throughout the tract to keep all of your bowel movements a good consistency. The hard stools you have now should go away in a day or two. New, higher-fiber stools can then begin to form from an improved diet. Sometimes it takes a while for the intestine to get used to this: it has to stretch out a bit and get used to working properly again. Until then, you may experience gas, bloating, cramping, or mild discomfort.

Remember the proverb, “An apple a day keeps the doctor away”? That is a good place to start. A medium apple has about 3 grams of fiber. You would have to eat 4 slices of white bread to get that much fiber (and with 4 times the calories).

Fruits and vegetables are excellent sources of fiber. In addition to apples, other fruits with a particularly high soluble fiber content are raspberries, blackberries, and pears. Don’t peel the apples and pears; Eat the skin, too, for the highest fiber content. And any fruit is a better food choice than simple carbohydrates like white bread, white rice, sweetened cereals, pasta, white flour, or sugar.

Vegetables that are high in fiber include beans, artichokes (who eats them?), peas, spinach, carrots, and broccoli. Raw vegetables are healthier than cooked ones, however they are somewhat more likely to cause bloating. But any vegetable, cooked or not, is healthier to eat than a simple carbohydrate.

Whole grains are also a reasonable source of fiber. Anything with bran is a good choice. Whole wheat or rye bread is better than white bread. Oats, shredded wheat, brown rice, and peanuts have a good amount of soluble fiber.

Try to eat at least 5 servings a day of these high-fiber foods. Again, it may take a few days or perhaps a few weeks for your colon to adjust to the increase in fiber, but it should be worth it in the long run. An added bonus: Most of these foods are low in calories but packed with vitamins and other nutrients—good for you in every way.

Copyright 2010 Cynthia J. Koelker, MD

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