close

Constipation

Uncategorized

DIVERTICULITIS AND DIVERTICULOSIS

DIVERTICULOSIS refers to the presence of small out-pouching(called diverticula) or sacs that can develop in the wall of the gastrointestinal tract.
• While diverticula can be present anywhere in the intestines, they are most common on the left side of the large intestine, the area known as the Descending and Sigmoid Colon.
When one or more of these pouches become inflamed or infected, the condition is called DIVERTICULITIS.

EPIDEMIOLOGY OF DIVERTICULAR DISEASES
• Diverticulosis is a common disorder, especially in older people.
• The condition is uncommon in people under the age of 30 years of age, and is most common in those over 60.
• Diverticulosis may be somewhat more common in men than in women.

CAUSES/PATOPHYSIOLOGY OF DIVERTICULAR DISEASE 
• No one knows for certain why diverticulosis develops; however, a few theories have been suggested;
• Some experts believe that abnormal intermittent high pressure in the colon due to muscle spasm or straining with stool may cause diverticula to form at weak spots in the colon wall.
• Historically, low-fibre diets were felt to play a ,major role in the development of diverticulosis. However, recent studies suggest that this is not only the case.

There also appears to be a genetic predisposition to diverticulosis; that is, if your parent or sibling has diverticulosis, you may be more likely to develop it than someone who does not have a family member with diverticulitis.

SYMPTOMS OF DIVERTICULAR DISEASES
• Most patients with diverticulosis have no symptoms or complications, and will never know they have the condition.
• But when symptoms occur they are usually mild and includes; Pain in the belly (abdomen), Bloating, Constipation (less often, diarrhoea) and Cramping.
• This symptoms are not specific to diverticulosis only they can be general to all diseases of the digestive tract.
Unless it is discovered during an endoscopic or radiographic (X-ray) examination, some people with diverticulosis become aware of the condition only when acute diverticulitis occurs.
• Diverticulitis is a more serious condition and causes symptoms in most people with the condition that include:
• Pain in the abdomen, usually in the lower left side
• Bleeding, bright red or maroon blood may appear in the stool, (a symptom of rectal bleeding). Bleeding is often mild and usually stops by itself; however, it can become severe.
• Fever
• Nausea
• Vomiting
• Chills
Constipation (less often, diarrhoea). d

DIAGNOSIS OF DIVERTICULAR DISEASES
• Diverticular disease is generally discovered through one of the following examinations:
• Barium enema: This x-ray test involves putting liquid material into the colon through a tube placed in the rectum. The x-ray image shows the outline of the colon, and can identify if diverticula, large polyps or growths are present.
• Colonoscopy: This test uses a thin, flexible tube with a light and camera to view the inside of the colon. Diverticula as well as polyps and other abnormalities can be seen with this instrument.
CT scan: This radiology test takes multiple cross-sectional pictures of the body. It is not generally performed to make a diagnosis of diverticulosis, but this type of exam, when done for other reasons, may identify diverticular.

MANAGEMENT OF DIVERTICIULAR DISEASES
• The best way to treat diverticulosis is to avoid constipation.
• Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fibre (25 – 38g/day).For patients with diarrhoea as symptoms a low fibre of 10-15g/day is prescribed for few days then gradually increased to RDA
• Drink plenty of fluids, because fluids and fibre work together.
• Get some exercise every day.
• Take a fibre supplement, such as Citrucel or Metamucil, every day if needed.
Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when you are having a bowel movement.

read more
Diet Therapy of DiseasesGeneral Research

LOW CARB DIET AND DIARRHEA

Lowering your carb intake might give you an edge on weight loss — at least in the beginning. But first, you have to get over the hurdles that such a big diet change can throw in your path. Low-carb diet side effects, including diarrhea, can be bothersome as your body adapts to the diet.

DIET CHANGES AND DIGESTION

Once you make a change to your eating habits BOOM! you risk disrupting your digestive system’s homeostasis — or balance. Taking away foods and nutrients your body is used to relying on or adding new ones can throw your gastrointestinal, or GI, system into a dilemma  — and it may let you know in more ways than one 😁.

Suddenly cutting your carb intake is bound to have at least some effect on your digestion. It may improve your digestion if you used to eat a lot of refined grains and sugary junk foods or if you’re one of those people who are sensitive or intolerant to certain types of carbs.

If that’s not you, then rest assured you are not alone. Most people who cut carbs experience some low-carb diet side effects — and those who cut carbs drastically experience more.

A common result of eating fewer carbs is constipation. Carbs are a rich source of dietary fiber, which adds bulk to stool and softens it so it’s easier to pass. Eating less fiber will have the opposite effect. Diarrhea is also a common side effect of low-carb diets. This is likely due to the foods you have added to your diet to replace the carbs you have cut.

KETO DIARRHOEA FROM FAT INTAKE.

The ketogenic diet is an extreme low-carb diet that cuts carbs to a maximum of 50 grams daily, but often much less than that. In addition, fat intake is increased to as much as 90 percent of calories. That is a whole lot of fat for your digestive system to have to deal with suddenly.

Even in normal amounts, fat is harder for the body to digest than protein, starches or sugars. Of the three macronutrients, fat takes the longest to digest, which can put more stress on your GI system and cause diarrhea, gas, bloating and other uncomfortable symptoms. People with digestive disorders are often encouraged to lower their fat intake because of this.

A high-fat diet can probably disrupt the microbiome — the population of beneficial bacteria in your gut that regulates digestive health. This is especially true of increased ingestion of saturated fats from meat and dairy products. Also, a  link between high fat intake and digestive disorders such as Crohn’s disease and ulcerative colitis exists.

Last, some people have more trouble than others digesting fat. When your body can’t digest and absorb fats normally, they are broken down in the colon into fatty acids. This causes the colon to secrete fluids, which can trigger diarrhea.

PROBLEMS WITH PROTEIN AND DAIRY

An increase in protein can also cause digestive disruptions for some people. The keto diet keeps protein intake at a moderate levels, about 35%.

However, if you are choosing to follow a low-carb, high protein and low- to moderate-fat diet, rather than a high-fat keto diet, a large increase in protein can be problematic, causing either constipation on diarrhea. Like fat, protein is also harder for the body to digest; it has to work harder to break down the macronutrient into its constituent amino acids.

A high-protein or high-fat diet may also include increased amounts of dairy. For people who have trouble digesting the milk sugar lactose, this can cause a host of problems, including diarrhea. Using a protein supplement can be a good way to boost your protein intake; however, you may be sensitive to some types of protein more than others. Whey protein is a common culprit because it contains lactose.

EFFECTS OF SUGAR SUBSTITUTES

Having a sweet tooth on a low-carb diet can be excruciating. This causes many people to turn to sugar substitutes, such as erythritol, xylitol, sucralose and stevia. These sweeteners have no calories and no effect on blood sugar, and many people go overboard because of this.

Some may find sugar substitutes cause no problems — whether or not they are actually good for them is another story. For other people, these sweeteners can have a laxative effect, especially when consumed in large amounts. This can leave you running for the bathroom right after indulging in your favorite treat, which isn’t so sweet.😂🤣

IS IT JUST TEMPORARY?

The good news is that diarrhea and other low-carb diet side effects are often fleeting. They may last for a week or so while your body adjusts to the change. After that, you may find that your digestive system normalizes. But whenever you are making a diet change, it helps to do so gradually, so your body can take more time to adjust. This may prevent low-carb diet diarrhea altogether.

In other cases, for example, for those who are lactose intolerant, the diarrhea may persist. If you find that your new diet continues to cause digestive problems, it just may not be a good fit for you. Diarrhea that lasts longer than a few days is not only uncomfortable, but can also lead to dehydration and nutrient malabsorption. In this case, it’s best to go back to your regular diet immediately and check in with your doctor

You should consult a registered dietitian whenever you consider going through with this type of diets if you must. Cutting out a particular food group from your diet isnt too healthy, so you probably shouldn’t.

SOURCES:

Fields H, et al. Are low-carbohydrate diets safe and effective? Journal of the American Osteopathic Association. 2016;116:788.

Sackner-Bernstein J, et al. Dietary intervention for overweight and obese adults: Comparison of low-carbohydrate and low-fat diets. PLOS One. 2015;10:1.

Raynor HA, et al. Position of the Academy of Nutrition and Dietetics: Interventions for the treatment of overweight and obesity in adults. Journal of the Academy of Nutrition and Dietetics. 2016;116:129.

read more
Diet Therapy of DiseasesWomen’s Health

CONSTIPATION IN EXCLUSIVELY BREASTFED KIDS

As a first time mother and a health practitioner, on being pregnant, I had already decided to exclusively breastfeed my baby for 6 months and continue thereafter with alongside complementary feeding because I was a nutritionist right? I had to ensure I practiced what I preached. Many experiences and drama trailed my journey to motherhood. My very first battle was with constipation.

Knowing that I was exclusively breastfeeding I became even more worried because there was little or nothing I could do to help my bundle of joy because she was to be on breast milk only for the next 6 months. Nope, maternal instinct kicked in and I knew I had to do something! Below is what I gathered from the experience.

constipation

What is Constipation?

Constipation could mean various things to different people. For some people, it means infrequent passage of stool (feces), to others; it means hard stools, difficulty in passing stool, or a sense of incomplete emptying after a bowel movement. According to the National Institute of Diabetes and Digestive and Kidney Diseases, constipation is one of the most common digestive problems in the United States, affecting around 42 million Americans and is not uncommon among infants.  Constipation is a common problem that affects both all ages irrespective of race.

Causes of Constipation        

Often when a child is constipating, there is infrequent bowel movement and most times the stool is hard, dry and painful to pass.

Causes of constipation in infants include:

  • Withholding stool: This happens when a child is trying to hold his bowel movement in, due to some reasons such as stress about potty training, or not wanting to use the rest rooms in certain places (like in school), or pains while stooling.
  • A low fiber diet.
  • Side effects of certain medications.

 

Signs and Symptoms

Understanding the signs of constipation can help you detect a potential issue before it becomes a big problem.

  • Infrequent bowel movements: The number of bowel movement of a child will reduce as to the normal frequency during constipation, sometimes during the period of trying new foods which the body seems to find different from the “usual”, sometimes may cause constipation
  • Blood in the stool: If you notice streaks of bright red blood in your child’s stool, it is likely a sign that the child is pushing too hard to have a bowel movement. Pushing and passing out a hard stool may cause tiny tears around the anal walls, which can result in blood in the stool.
  • Refusing to eat: Child may feel full quickly or refuse to eat while constipating.

What Can You Do?

If you notice signs of constipation, you can try several strategies to offer your baby relief. These strategies include:

A high-fiber diet: Your child’s plate should be teeming with fresh fruits and vegetables, high fiber cereals, whole grain breads and a variety of beans and other legumes can be very helpful. Foods containing probiotics like yogurt can also promote good digestive health. If your child does not like fresh fruits much, you could try pureeing/blending it or adding them to certain meals to encourage acceptance. Besides, adding fruits and vegetables to your child’s diet early in life helps build healthy eating habits later in life.

Switch up the milk: If your baby is breastfed, you can try adjusting YOUR diet. Baby may be sensitive to something you are eating, which could be causing the constipation, though this is uncommon. Bottle-fed babies may benefit from a different type of formula (which are rich in fiber), at least until the constipation clears. Sensitivity to certain ingredients can cause constipation.

Use solid foods: Although certain solid foods can cause constipation, but others could improve it. If you recently started feeding your baby solid foods, try adding a few high fiber alternatives, such as: broccoli, pears, prunes, peaches, skinless apple. Instead of refined cereals or puffed rice, offer cooked grains, such as barely or brown rice. Whole grain breads, crackers and bran cereals also add a lot of bulk to stool, which may help clear the constipation. Beans and other legumes provide soluble fiber which cause stool to move through the body faster.

Use pureed or mashed foods: if your baby is over 6 months and has not made the transition to solid foods yet, try some of the foods listed above in their pureed form. Keep in mind that fruits and vegetables have a lot of natural fiber that will add bulk to your child’s stool. Some are better than others at helping stimulate a bowel movement.

Up the fluids:  Proper hydration is essential for regular bowel movement. While focusing on fiber, don’t forget fluids. Water is great for keeping your baby hydrated. If your child is eating plenty of high fiber food but not getting enough fluid to help flush it through the digestive tract, it could make matters worse. There should liberal intake of water, soda and sugary drinks should be limited. Usually breastfed babies get enough fluid from the breast milk. However, infants from 7-12 months need about 0.8 L/day of fluid and children of ages 1-3 require 1.3L/day.

Encourage exercise: Movement speeds up digestion, which can help move things through the body more quickly. If your child is not walking yet, bicycles and play dates would be helpful.

Massage: Gentle stomach and lower-abdominal massage stimulate the bowel to pass a bowel movement. Do several massages throughout the day, until your child has a bowel movement.

Regular Toilet Time: Encourage your growing child to use the toilet first thing in the morning. Particularly for a younger child, you may get better results by telling, not asking. Instead of suggesting, “Do you need to go to the bathroom?” Simply say, “Time to go to the bathroom”.

Conclusion

Because breast milk is quite nutritious, sometimes a baby’s body absorbs almost all of it, leaving little or nothing to move through the digestive tract. Your baby may poop only once in a while—it is perfectly normal for breastfed infants to have a bowel movement once a week. Other infants just have a slower (but completely normal) gut, so they don’t go very often. But if your baby seems to be in pain, or you have any complain, call your doctor or dietitian. In rare cases, a medical problem could cause lasting, severe constipation. For kids that have progressed to eating solid foods very well, encourage them to consume more of high fiber foods and to take enough water.

 

read more