Constipation
Constipation is infrequent, hard stools passed with straining. The cure is mostly in the kitchen: fibre, fluid and activity.
At a glance
Dietary principles
| Nutrient | Recommendation | Why |
|---|---|---|
| Fibre | High: about 25-40 g a day (sources differ; ICMR-NIN 2020: 40 g per 2,000 kcal) from whole grains, pulses, vegetables, fruits; raise over 2-3 weeks | Fibre holds water and adds bulk, so stools are soft and move faster |
| Fluid | 8-10 glasses (2-2.5 litres) a day; a warm drink on waking | Fibre needs water to work; without it fibre can worsen constipation |
| Energy | Normal for the person's weight | Very low food intake means little stool |
| Fat | Normal amounts; a little oil or ghee is fine | Fat helps stools pass smoothly |
| Probiotics | Curd and buttermilk daily | Support healthy gut bacteria |
| Spastic type | Soluble fibre (isabgol, oats, fruits) rather than harsh bran; regular, relaxed meals | Older books advise a low-residue diet at first; current practice favours gentle soluble fibre |
Foods to include and avoid
| Food group | Include | Avoid or limit |
|---|---|---|
| Cereals | Whole-wheat atta with bran, broken wheat, ragi, jowar, bajra, oats, hand-pounded or brown rice | Maida, white bread, biscuits, polished rice only |
| Pulses | Whole green gram, sprouts, rajma, chana, sundal | None needed, but raise slowly if they cause gas |
| Vegetables | Green leafy vegetables, beans, carrot, drumstick, cabbage, salads | Only over-cooked, peeled vegetables |
| Fruits | Guava, papaya, orange with pulp, pear, figs (anjeer), dates, prunes, raisins soaked overnight | Strained fruit juice instead of whole fruit |
| Others | Isabgol in water, curd, buttermilk, warm water, flaxseed | Excess tea or coffee, alcohol, fried and processed snacks |
Sample one-day menu (high-fibre diet)
| Meal | Menu |
|---|---|
| Early morning | Warm water (1-2 glasses); 4-5 soaked raisins or 2 figs |
| Breakfast | Broken wheat (dalia) vegetable upma or ragi dosa with sambar |
| Mid-morning | Guava or papaya (1 cup) |
| Lunch | Whole-wheat chapati (2) with brown or hand-pounded rice, dal, keerai (greens) poriyal, carrot-cabbage salad, curd |
| Evening | Sprouted green gram sundal; buttermilk |
| Dinner | Jowar or bajra roti, mixed vegetable curry, dal |
| Bedtime | 1 teaspoon isabgol in a glass of warm water or milk |
Patients on iron or calcium tablets, bed-ridden patients and the elderly in wards often become constipated. Add fruit, greens and isabgol to their trays and push fluids unless fluid is restricted.
2 marks: “Name the types of constipation.” Atonic (weak colon muscles), spastic (irregular tight contractions) and obstructive (blockage).
5 marks: “Explain the dietary management of constipation.” High fibre (25-40 g) raised slowly, 8-10 glasses of fluid, curd, regular meals and exercise, foods to include and avoid, note on spastic type.
10 marks: “Discuss the types, causes and dietary management of constipation with a sample menu.” Define, three types, causes, symptoms, principles table, foods to include and avoid, and a high-fibre menu.
Fibre needs water. Constipation diet = 3 Fs: Fibre, Fluid, Fitness (activity).