Struggling with Bloating and Constipation: Seeking Effective Solutions

Abdominal bloating and constipation?

Hello doctor, I have been experiencing constipation since I was young, and it has not improved as I grew up.
I have tried various methods without much effect.
When I visited a gastroenterologist, they only prescribed medication for me.
However, I can't rely on medication indefinitely to solve this issue.
I asked the doctor, and they advised me to drink more water and eat more fruits, suggesting that I should drink at least 1800cc of water daily and consume three servings of fruit a day.
I have been following this advice, but aside from causing me to retain water and urinate excessively, there hasn't been much improvement.
I also tried doing sit-ups for a month to strengthen my abdominal muscles, but it was ineffective as well.
Recently, I felt very bloated and couldn't resist taking a laxative.
Unfortunately, after being unable to have a bowel movement for over a week, it became even more painful.
I ended up going to the emergency room, where I received an enema that relieved me a bit.
I have also tried probiotics and yogurt, but they haven't worked either.
I don't know how to improve my situation.

riskwu, 30~39 year old female. Ask Date: 2017/04/22

Dr. Hong Yuanbin reply Internal Medicine

Constipation is indeed a common concern for many women.
Medications may only provide temporary relief, addressing the symptoms rather than the root cause.
Here are several recommendations:
1.
It is essential to consume a large amount of vegetables.
Try to avoid replacing vegetables with fruits, as only vegetables contain a significant amount of fiber that aids in bowel movements.

2.
Establish a regular bathroom routine.
Aim to sit on the toilet at the same time every day, preferably after meals.
This could be after breakfast or dinner, as the urge to defecate is usually stronger during these times.

3.
It is crucial to develop a habit of exercising.
Aim for at least three times a week, with each session lasting at least 30 minutes of moderate-intensity exercise that raises your heart rate and induces sweating.
This is the most important factor, as most people experience constipation due to a lack of physical activity.

Wishing you a swift return to regular bowel movements.
Thank you for your question.

Reply Date: 2017/04/22

More Info

Dealing with bloating and constipation can be a frustrating and uncomfortable experience. It sounds like you've been proactive in seeking solutions, but unfortunately, many common approaches have not provided the relief you need. Let's explore some effective strategies that may help alleviate your symptoms.

First, it's important to understand that constipation can have various underlying causes, including dietary habits, lifestyle factors, and even certain medical conditions. Since you've already consulted a gastroenterologist and tried medications, it may be beneficial to consider a more holistic approach that encompasses diet, exercise, and possibly behavioral changes.

Dietary Adjustments
1. Fiber Intake: While you mentioned that you are consuming fruits, it’s crucial to ensure you are getting enough dietary fiber. The recommended daily intake for adults is about 25-30 grams. Incorporate a variety of fiber sources, including whole grains (like oats and brown rice), legumes (beans and lentils), and vegetables (broccoli, carrots, and leafy greens). Gradually increase your fiber intake to avoid gas and bloating.

2. Hydration: You mentioned drinking around 1800cc of water daily, which is a good start. However, if you are consuming a high-fiber diet, you may need to increase your water intake further to help the fiber work effectively in your digestive system. Aim for at least 2-3 liters of water daily, especially if you are increasing fiber intake.

3. Probiotics: While you have tried probiotics, consider varying the types you consume. Different strains of probiotics can have different effects on gut health. Foods like yogurt, kefir, sauerkraut, and kimchi are excellent sources of probiotics. You might also consider a high-quality probiotic supplement that contains multiple strains.

4. Avoid Trigger Foods: Some foods can exacerbate bloating and constipation. Common culprits include dairy products (if lactose intolerant), high-fat foods, and certain artificial sweeteners. Keeping a food diary may help identify any specific foods that trigger your symptoms.

Lifestyle Modifications
1. Regular Exercise: While you have attempted sit-ups, consider incorporating a broader range of physical activities. Regular aerobic exercise, such as walking, jogging, or cycling, can stimulate bowel movements. Aim for at least 150 minutes of moderate aerobic activity each week.

2. Mindful Eating: Eating too quickly can lead to swallowing air, which contributes to bloating. Practice mindful eating by chewing your food thoroughly and taking your time during meals. This can also help you recognize when you are full, preventing overeating.

3. Stress Management: Stress can significantly impact your digestive health. Techniques such as yoga, meditation, or deep-breathing exercises can help reduce stress levels and improve gut function.

Behavioral Strategies
1. Establish a Routine: Try to set a regular time each day for bowel movements, ideally after meals when the gastrocolic reflex is strongest. This can help train your body to have more regular bowel movements.

2. Avoid Overuse of Laxatives: While laxatives can provide immediate relief, over-reliance can lead to dependency and worsen constipation in the long run. It’s best to use them sparingly and under the guidance of a healthcare provider.

3. Consult a Dietitian: If you continue to struggle, consider consulting a registered dietitian who specializes in gastrointestinal health. They can provide personalized dietary advice and help you develop a comprehensive plan tailored to your needs.

When to Seek Further Help
If your symptoms persist despite these changes, it may be necessary to revisit your healthcare provider. They may consider further investigations to rule out conditions such as irritable bowel syndrome (IBS), hypothyroidism, or other gastrointestinal disorders.

In conclusion, managing bloating and constipation often requires a multifaceted approach that includes dietary changes, lifestyle modifications, and behavioral strategies. By taking a proactive stance and exploring various options, you can work towards finding a solution that provides lasting relief. Remember, patience is key, as it may take time to see significant improvements.

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