Myths and truths about constipation and gas

Myth: I should have a bowel movement at least once a day.

Truth? Not necessarily says Ted Xenodemetropoulos. “There’s this idea that one well-formed, easy to pass, rather soft bowel motion is what we’d define as a normal bowel habit but the reality is there’s quite a bit of variation,” says Dr. Xenodemetropoulos, assistant professor in the division of gastroenterology at McMaster University. He says healthy movements aren’t just about quantity. But er, the quality of them as well. “That means whether you’re straining to evacuate your bowel, whether the stools are lumpy or hard to pass, whether you’re feeling completely empty after your bowel movement and then the idea or sensation about whether you have a blockage in your bottom and more,” he says. But if you are having less than three bowel movements a week, that indicates something else might be going on such as chronic constipation and it’s something to discuss with your doctor or even local pharmacist.

Myth: I shouldn’t strain on the toilet because it causes hemorrhoids.

Truth? Straining or pushing on the throne certainly can contribute to hemorrhoids. But the thinking seems to be changing as to what exactly hemorrhoids are. “For many years, scientists thought they were caused by large varicose veins in the anal area. But a lot of that thought has fallen out of common acceptance,” says Dr. Xenodemetropoulos. Instead, today’s researchers and scientists believe that hemorrhoids are actually a breakdown of the supporting tissues and anal cushions in the rectal region. “And over time it results in the enlargement of regional veins,” he says. When the walls of those veins and surrounding tissue become inflamed, the painful and sometimes itchy hemmeroids form. Straining does however help with the formation of hemorrhoids so as mom may have warned you, don’t push if it’s not ready to come out.

Myth: I should eat more fibre if I’ve got chronic constipation.

Truth? Yes and no. “Fibre is basically an organic complex carbohydrate which increase stool weight and improve consistency by retaining fluid within the stool,” says Dr. Xenodemetropoulos. However there’s a difference in the type of fibre-soluble (found in some vegetables and fruits and beans and peas) and insoluble (found in the bran portion of whole grains and fruit and vegetable skins). “Soluble fibres attract water and form sort of a gel matrix which has a lot of different properties including bulking of the stool,” Dr. Xenodemetropoulos adds. While it’s good to have a mix of these types of fibres, it’s the soluble kind that should predominate. “I tell patients that we should have 25-30 g. of fibre per day,” he says. (One medium red apple with skin has about 0.9-1g. of soluble fibre for example.) “And predominantly soluble fibre that’s increasing very gradually over a period of a few weeks because your gastrointestinal tract needs to acclimatize.”

Myth: I can have too much gas.

Truth? Perhaps. Although excessive flatulence can simply indicate you’ve ramped up your fibre intake too fast and your GI system hasn’t gotten used to all that fibre yet.  However, too much gas can point to a food tolerance. “With excessive gas and bloating, we do consider whether there’s a carbohydrate malabsorption going on,” says Dr. Xenodemetropoulos. “So for example, lactose tolerance is more common in some populations. Some have acquired lactose intolerance and that contributes to gas and bloating. But there’s also fructose intolerance, which is less commonly known.”

If gas and bloating is a concern for you, track your symptoms in a food journal for a few days before discussing it with your physician. And remember that symptoms are subjective. “There really isn’t a clear definition of how much is too much,” says Dr. Xenodemetropoulos. “There are patients who feel like they’re passing an excessive amount of gas or have too much bloating when relatively speaking may not be the case.”

Related:
• 9 tips for eating when you have IBS
• 7 ways to relieve constipation
• What to eat for a healthy gut