What is constipation?
Constipation is one of the most common digestive complaints, and it is estimated that up to 25% of people in the developed world suffer from it, most likely due to a diet of more refined foods, inactivity and, additionally, stress.
Constipation occurs when food moves too slowly through the digestive tract and too much moisture is reabsorbed by the large intestine. When this happens, stools become dry and more difficult to pass. In this state they can be either large, or small and too compact to move easily.
There are different ways of combatting constipation when you are suffering from it. Making sure that you are sufficiently active and exercising is key – as a yoga teacher and movement specialist, I am aware of the improvements to your health and wellbeing staying fit can bring. However, it is crucial to remember that diet is important too.
How do I know if I'm constipated?
Although most of us will have experienced it at one time or another, the definition of constipation is not always clear.
Some people empty their bowels twice or three times each day, whereas for others it is no more than once a week. It can be hard to know what is “normal”. Natural health practitioners believe that you need to open your bowels at least once a day in order to stay healthy. Once after each meal would be considered ideal.
A doctor would consider you constipated if you empty your bowels fewer than three times per week, you have to strain “excessively” when you do and the stools themselves are hard, dry and pellet-like, a bit like rabbit droppings.
There are further medical criteria used to assess whether you are constipated or not. These include the feeling that the bowel is obstructed at its outlet, or a feeling that you have not finished defecating. You are also likely to be experiencing flatulence or feel bloated from trapped wind.
Often small dietary changes or committing to a more active lifestyle can make a big difference, but do check any medications that you are taking: certain medicines – prescribed and over-the-counter – can lead to constipation.
What can I do?
Diet plays a large role in the healthy function of your large intestine. Sluggish bowel habits and large (or small) dry stools can often be addressed by ensuring that you are eating lots of fruit and vegetables, plenty of fibre and drinking sufficient water (at least 1.5 to 2 litres each day). There are also herbal remedies available that can kick start your bowel movements.
A sedentary lifestyle and inactivity can often lead to problems with digestion, and constipation is a common outcome.
Exercise can combat constipation because it helps food move through the large intestine more quickly. Since one of the major symptoms and difficulties of constipation is dry stools that are difficult to pass, allowing the large intestine less time to reabsorb water from the stools into the body can help keep the stools soft.
But which exercise is best? There are two recommended approaches, which could easily be combined: aerobic exercise and stretching.
Aerobic exercise is any form of exercise that accelerates your breathing and increases your heart rate. This can help stimulate the muscles of the intestine. The efficient contraction of the intestinal walls is crucial for moving the stools easily through the digestive tract.
Twenty to thirty minutes of aerobic exercise each day is a good idea if you are suffering from constipation. (The NHS has guidelines on the recommended amount of activity for adults.) Of course there are many ways to aerobically exercise, and it is important to start with something that suits your needs and fitness level. Try choosing something that you enjoy and is fun! But if you are concerned about how much activity is appropriate for you, speak to your doctor before you begin.
Walking briskly is a great place to start. If that’s too easy, you could try hillwalking, Nordic walking (which uses the whole body) or running.
Dancing is a great way to get your heart and gut going and, again, is more likely to use and exercise your entire body. You may find belly or Latin dancing especially helpful as they encourage the kind of fluid, circular movements through your pelvis and hips that will massage your internal organs, promoting good intestinal muscular contraction.
Rebounding or trampolining is another option. Not only is this a lot of fun: by stimulating the circulation of lymphatic fluid, bouncing can provide support to the immune and digestive systems. Additionally, the alternating states of weightlessness (at the top of your bounce) and double gravity (when you land) produces a pumping action which can encourage the function of the large intestine. If you progress in trampolining enough to do some of the more complex moves that require you to go upside down, you will also get similar benefits to the inversions of yoga (see below).
When you exercise, you must always ensure that you drink enough fluids to stay hydrated. Becoming dehydrated will make your constipation worse, not better. It is also important to note that too much heavy exercise can lead to diarrhoea, so start moderately.
Yoga and stretching
Another approach to helping your constipation is yoga and stretching. You could combine some poses or stretches with your aerobic activity, using them as a warm down, as suggested in the Yoga Journal.
As a yoga teacher for over seven years, specialising in work with athletes, I am keen to demonstrate the value of a yoga practice (and stretching) when seeking to ease your constipation.
Firstly, one likely cause of constipation is stress. A yoga practice can help tackle stress and allow you to relax. The concentration on your body and the stretching and releasing of tight muscles can go a long way to ease internal tension and promote healthy digestion.
When you are stressed, the fight or flight response of the sympathetic nervous system can lead to constant and unnecessary muscular tension. This can trigger tightness or dysfunction in the psoas muscle. The psoas (which is a hip flexor, connecting the femurs to the lower spine via the pelvis) massages your organs and intestines as you breathe and walk. If it is tight and not functioning correctly, this can have an impact on your digestion. Gently stretching and releasing the psoas as part of your yoga routine can have a positive impact on your constipation.
Yoga classes often encourage deep breathing. This alternately pushes down on the intestines and releases them, stimulating their natural contractions. As a Shiatsu practitioner, I am used to using the map of the body provided by Chinese medicine. It’s worth noting here that the Lungs and the Large Intestine are paired organs, and influencing a healthy intake and discharge of air in and out of the Lungs is considered to have a beneficial effect on the function of the Large Intestine. (We capitalise the first letter of all the organs, as in “Lungs”, to mark that we are referring to the Chinese rather than the Western body map).
Other things to think about when practising yoga: backbends target the Stomach and Spleen meridians (as per Chinese medicine) on the front of the body. Stretching them can help bring relief for many kinds of digestive complaint. Inversions are great for digestive issues as you move the muscles and organs out of their usual relationship with gravity and require them to explore new ways of working: this can enhance release and relaxation as well as encouraging action in parts of you which are normally inactive. (NB please work with an experienced yoga teacher especially when learning inversions.) Twists are considered excellent for massaging the internal organs and are always used as part of “detox” sequences. Sun salutations (of any kind) alternately compress and stretch the gut as you move repeatedly through spinal flexion and extension. This supports the natural contractions of the intestines.
When should I exercise?
It is best to leave some time between eating a meal and exercising – ideally an hour – although this depends on how much you’ve eaten. When you eat, blood flow is increased to the digestive organs and the GI tract. When you exercise that blood flow is concentrated elsewhere.
The more the blood flow can be appropriately concentrated on the digestive system, the stronger the muscular contractions of the large intestine are and the less likely you are to suffer from constipation.
A great blog to have a look at is – A beginners food guide: What to eat before a 5K or 10K run – it goes into much greater detail about how much to eat and when, prior to running (but it could apply to any aerobic activity).
What to do:
- consider what factors might be influencing your constipation
- make sure you’re exercising
- try aerobic exercise, or yoga and stretching, or combine the two, using the stretching as your warm down.
What not to do:
- don’t forget to drink when you exercise
- don’t stay inactive and sedentary
- don’t exercise immediately after eating
- don’t over-exercise – too much hard exercise can lead to diarrhoea
Still need some help?
If you still feel as though you need something to kick start your bowel movements, our nutritionist Ali’s top herbal tip is Linoforce. This contains linseed, coated with senna and frangula and is a licensed herbal remedy for the relief of constipation. Chew the granules well and take with plenty of water.