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Reading time: 3 min The prevalence of constipation in Spain is approximately 29.5% (1), a considerably high figure that worries many people. Today, we talk about the best alternatives to avoid constipation.1. Understanding the evacuation system
The evacuation system is regulated by the Migration Motor Complex (MMC), a cyclical pattern of recurrent motility that occurs in the stomach and small intestine during fasting; and is interrupted by feeding . This complex can be subdivided into four phases, of which phase III is the most active, with a burst of contractions originating in the antrum and duodenum and migrating distally until evacuation is achieved.
Graph of migratory motor complex
The vagus nerve plays an important role in the evacuation system, however it appears to be restricted to the stomach and its absence has been associated with gastroparesis, intestinal pseudo-obstruction and small intestinal bacterial overgrowth.
1. How the evacuation cycle works
This cycle starts between two meals, as well as during sleep. When you eat, the MMC process is interrupted, so the gastrointestinal system doesn't get a chance to do its job . When we go more than two days without going to the bathroom, food and bacteria can accumulate, increasing the risk of suffering an overgrowth of the bacteria and fungi that inhabit the small and large intestines, since the food that remains in the intestines are highly fermentable by these microorganisms. For this reason, eating every 2 hours would not be recommended for people who tend to suffer from constipation, but spacing meals at least 4 hours would be interesting to ensure better intestinal motility. We have to add that, when we do not evacuate daily, fecal matter accumulates in the colon, increasing the presence of toxic products such as ammonia, indoles or nitrogenous products. As a consequence, abundant proteolytic fermentation generates a multitude of compounds that can cause inflammation and colonocyte proliferation. To improve intestinal motility, it is advisable to check that there is no type of bacterial overgrowth of methanogenic microorganisms, since these microorganisms, normally archaea, produce methane and this is related to constipation. However, bacterial overgrowths are usually the consequence and not the cause of the pathology per se, that is, the infection is caused by a poor diet, drug abuse, stress, bacterial hypodiversity from an early age or food poisoning. .2. Adequate Water Consumption
Secondly, another of the best alternatives to avoid constipation is to ensure water consumption according to energy expenditure and the person's size. Regarding fiber , current evidence reveals that although fiber increases stool frequency, it does not improve stool consistency, reduce the use of laxatives, or relieve defecation pain. Therefore, in patterns in which practically no fiber is ingested, according to the patient's tolerance, it can be tried to gradually increase its consumption. It is very important to consider the progression of fiber intake, since it can cause flatulence, bloating and abdominal discomfort.
2. What foods or supplements can help me?
If, despite eating an adequate diet and complying with all the previous steps, you do not end up having a good intestinal regularity, some foods and supplements can be another of the best alternatives to avoid constipation:- Magnesium Citrate (300mg per day): osmotic laxative and does not cause irritation in the intestine as well as classic laxatives.
- Probiotics that produce lactic and acetic acid that stimulate peristalsis present in fermented milk, sauerkraut or fermented soybeans.
- Olive oil (60ml per day): have a lubricating effect and stimulate peristalsis.
- 5-HTP : Administration of serotonin or somatostatin induces phase III activity of duodenal origin. (2)
- Ginger – Modulates serotonin signaling, supports gastric emptying, and is calming to the upper GI system. 1-2 teaspoons of powder can be used as tea in smoothies or in a motility mix.
