Constipation & Selecting Your Laxative: Trending Now Presentation

Written by: CDHF

Updated: February 1st, 2024

This presentation was done as a part of CDHF’s 10th educational summit, “#TrendingNow: Putting the Biggest Gut Health Trends Under the Microscope“. David Armstrong MA, MB BChir, FRCPC, CAGF speaks on Constipation & Selective Your Laxative! Learn more by watching the full presentation below.

Learning Objectives

To understand what is meant by constipation
To understand the various causes of constipation
To appreciate the role of diet and lifestyle in treating constipation; and
To be aware of the different types of laxatives, how they work and when to use them

Constipation Stats and Facts

Constipation is relatively common, impacting approximately 25% of Canadians.
It can affect the young, elderly, and everyone in between.
Constipation can develop suddenly and be short-lasting or chronic.
Constipation is not usually associated with serious illness.
‘Poor intake’ constipation may improve with increased dietary fibre and liquids.
‘Slow transit’ constipation may need osmotic laxatives or newer prokinetic agents to promote gastrointestinal motility.
Successful treatment of chronic constipation requires a combination of lifestyle and dietary changes with or without other medical treatments

What is Constipation?

Constipation is defined as difficult, incomplete or infrequent evacuation of dry, hardened feces from the bowels. The ROME IV Criteria for Chronic Constipation is as follows:

Symptom onset at least 6 months prior to diagnosis
More than two of the following, in > 25% of bowel movements for the last three months:
- Straining
- Lumpy or hard stools
- Sensation of incomplete evacuation
- Sensation of anorectal obstruction/blockage
- Manual manoeuvres needed
- Under 3 bowel bowel movements per week
Loose stools rarely present without use of laxatives
Insufficient criteria for irritable bowel syndrome

What to Watch For

While typically not a cause for concern, watch out for symptoms including rectal bleeding, recent changes in bowel habits, a recent increase in abdominal pain, unintended weight loss, changes in stool calibre and anemia. Additionally, if over 50 years of age, take note of an increased occurrence of constipation. If experiencing any of the above symptoms, especially those with a family history of colon cancer, contact your primary care physician for further support.

Constipation Relief

For relief from constipation, try to eat foods with probiotics and prebiotics. These help soften stool and ease its passage through the colon. Examples include yogurt, kefir, bananas, whole-grain breads and honey.

Secondly, avoid or limit the following foods or drinks:
-Greasy, fried or high in animal fat
-Foods that contain refined sugar such as candy or rich desserts
-Drinks that contain caffeine, alcohol or artificial sweeteners

About The Speaker

Dr. David Armstrong is Professor of Medicine at McMaster University and a consultant gastroenterologist at Hamilton Health Sciences (HHS). After 2 years as a family practitioner in Labrador, he completed his clinical and research training in the UK, Switzerland and Canada.

His clinical and research interests include GERD, dyspepsia, IBD, nutrition, short bowel syndrome, colon cancer screening and quality in endoscopy with 220 peer-reviewed publications and over 100 invited articles and chapters. He has been a principal investigator for numerous clinical trials and taken part in many guideline consensus conferences.

He was President of the Canadian Association of Gastroenterology (CAG) from 2016-2018 He is Chair of the Canadian National Colon Cancer Screening Network (NCCSN), Treasurer of the International Working Group for the Classification of Oesophagitis (IWGCO), Chair of the Global Guidelines Committee for the World Gastroenterology Organization (WGO) and a Board Member of the Canadian Digestive Health Foundation (CDHF).