Ask Dr. Etingin: Long-term effects of constipation; The “Whole30” eating plan

Can constipation cause damage to the intestines?

Occasional constipation, which is usually defined as having less than three bowel movements in a week, is unlikely to do any harm. However, frequent, chronic constipation can lead to hemorrhoids, tearing of the skin in the anus, and rectal prolapse (a protrusion of rectal tissue through the anus).

The most severe complication from chronic constipation is bowel impaction. Impaction means that the stools in the colon have hardened and become so solid and/or large that the body is not able to remove them. This can be deadly if not treated.

If you have frequent constipation, common recommendations are to increase your dietary fiber intake and make sure you’re drinking enough water. Getting adequate water is especially important if you are eating more fiber. Fiber will add bulk to your stools, and adequate fluid is necessary to keep stools moving; otherwise, increasing your fiber can actually cause constipation. Good sources of fiber include plant foods such as whole grains, beans, fruits, and vegetables; animal foods contain no fiber.

Animal-sourced foods that are high in protein and/or fat are common triggers for constipation. If you eat a lot of animal products, especially full-fat milk and milk products (cheese, yogurt, cream, cream cheese, ice cream), try cutting back or at least switching to reduced-fat products.

Some people find that getting regular exercise helps. If lifestyle changes aren’t effective, you can try over-the-counter remedies, which include high-fiber supplements and laxatives. However, laxatives should be taken for no more than a few days.

While diet is often a contributing culprit to constipation, it’s not the only possible culprit. Some medications—notably, opioid medications used to treat chronic pain—are well known for their binding effects. If you take opioids daily or several times a week, ask your prescribing physician if there’s anything you can do. There are two medications specifically targeted to reverse the effects of opioids on the intestines.

Sometimes, constipation can be a symptom of a medical condition, such as underactive thyroid function or high calcium levels in the bloodstream. Your physician can check for both of these conditions with blood tests and a physical exam.

What is the Whole30 diet, and what do nutrition experts think of it?

Whole30 gets its name from the premise that, to determine which foods are causing health problems, you need to eliminate all sugar, alcohol, grains and grain products, dairy, legumes, added sugar, and processed foods that contain additives from your diet for 30 days. After the initial 30-day period, you’ll reintroduce the foods you eliminated one at a time

Proponents of the plan describe it as a “reset” that changes your relationship with food and promotes a better understanding of how your body reacts to certain foods. They claim that, even if you don’t have any specific health issues, following this nutritional program can improve your energy level, sleep, digestion, and reduce or eliminate cravings for certain foods. They also say that it’s a nutritional program rather than a diet, and that it’s not intended for weight loss.

There’s little independent research on Whole30 and its extreme rules mean that it can be very challenging to stick with it for an entire month.

In this year’s annual diet rankings published by U.S. News & World Report, the Whole30 program ranked among the lowest in the “Best Diets for Healthy Eating” category. The rankings are determined by an expert panel of nutrition and health specialists.

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