As we age, bowel health assumes a greater importance for a number of reasons, including: increased prevalence of constipation, incontinence, bowel obstruction and other bowel disorders.
Bowel regularity varies for everyone. For some individuals, bowel motions occur daily, while for others, every second or third day is “normal” for them.
Constipation should be diagnosed based on symptoms such as pain, motion consistency, straining or difficulty in passing a motion, rather than diagnosed on motion frequency alone.
Constipation can be caused by any of the following:
Constipation in turn, can reduce appetite, causing unintentional weight loss, or in the worst-case scenario can lead to bowel obstruction and hospitalisation.
To maintain bowel health and regular bowel motions, a high fibre diet with regular fluid intake is recommended. Aim for 25-30g fibre per day.
Fibre comes in different forms and a combination of these is helpful to ensure good bowel motions and health. It is important to include a variety of soluble fibre, insoluble fibre and resistant starch in the daily diet to achieve a good balance.
A high fibre diet can be achieved by the including the following:
Texture modified diets tend to be lower in fibre, due to a reduced intake of fruit and vegetable skins, piths, seeds and nuts. Fibre in the texture modified diet can be maintained by choosing porridge, Weet-Bix, fruit juices, and texture modified fruit, legumes, vegetables or nut pastes (please check IDDSI standards).
Occasionally a low fibre diet is required when bowel surgery is necessary, or if an individual suffers from diverticulitis, irritable bowels, inflammatory bowel disease, cancer or chronic loose bowel motions.
Examples of low fibre foods include rice bubbles, corn flakes, white bread, mashed white potato, white rice and pasta, certain low fibre fruit and vegetables, including those that are stewed, pureed, strained.
It is important to get dietary advice from the Dietitian to assist with these situations.
Low fibre diets are not intended for long term use and when appropriate, fibre should be reintroduced gradually.
To manage loose bowel motions, it is important to continue including dietary fibre, particularly soluble fibre (oats, oat bran, psyllium husks, Metamucil) as this will help bind stools so that they form a gel.
Fluid intake is important in the case of both constipation (to keep bowel motions soft and easy to pass) and loose motions, due to risk of dehydration from water lost through the bowel motions. Fluids include water, juice, cordial, soft drink and high fluid food items such as yoghurt, custard, ice-cream and ice-blocks.
Note that strong tea and coffee consumed in large amounts may have a diuretic affect, and are not the best fluid for hydration.
Referral to your facility dietitian and GP for further review of constipation or loose bowels is recommended as multiple clinical conditions, medications or possible food intolerance may affect bowel motions.