Nutrition Science and Everyday Application - beta v 0.1

156 ALICE CALLAHAN, PHD, HEATHER LEONARD, MED, RDN, AND TAMBERLY POWELL, MS, RDN
they block the production of an enzyme that protects the stomach lining, so using these
medications frequently and chronically can increase the risk of developing a stomach ulcer.
To treat an ulcer caused by NSAIDs, doctors recommend stopping or reducing the use of
NSAIDs. They may also prescribe an acid-reducing medication to allow the tissue to heal. 3
DIARRHEA AND CONSTIPATION
Both diarrhea and constipation can occur if the normal function and rhythm of the GI tract
is disrupted. If waste matter moves too quickly through the large intestine, not enough
water is absorbed, resulting in the loose, watery stools characteristic of diarrhea. This is
most commonly caused by ingesting food or water contaminated with bacteria (e.g., E. coli,
Salmonella), viruses (e.g., norovirus, rotavirus), or parasites (e.g., Cryptosporidium enteritis,
Giardia lamblia). Dietary allergies and intolerances can also cause diarrhea, as we’ll discuss
on the next page. Complications of diarrhea include dehydration and malabsorption of
nutrients. 4
On the other end of the spectrum is constipation, characterized by infrequent bowel
movements (less than 3 times per week) with stools that are hard, dry, or lumpy, and often
painful to pass. Sometimes, constipation is caused by holding stool and delaying defecation.
That gives the colon and rectum additional time to absorb water, making the feces too hard
and dry. Delaying defecation is common in children or others who may fear that it will hurt
to pass a stool, but of course, holding it only worsens the problem. Constipation can also
occur due to other disruptions in daily rhythms, such as changing what or how much you
eat, travel, or medication changes. Constipation is common in pregnancy due to hormonal
changes. It also becomes more common with age, which may be due to decreased physical
activity, medication use, or weakness in the smooth muscle of the intestine. Constipation can
be a sign of another medical problem, so chronic constipation should be checked out by a
doctor.
Constipation can often be addressed by dietary changes, including eating more highfiber
foods (whole grains, legumes, fruits, vegetables, nuts, etc.) and drinking more water. It
can also be helpful to attempt a bowel movement after meals, when the intestine is more
active, and to make that a habit to try to establish more regularity in bowel movements. A
caffeinated beverage with breakfast can help, as can increasing physical activity.
Fiber supplements such as Metamucil, Citrucel, or Benefiber can be helpful for increasing
fiber intake and addressing constipation, at least in the short term. However, it’s preferable
to transition to dietary sources of fiber, as they come packaged with many other valuable
nutrients.
Laxatives may also be helpful to address constipation in the short-term but are usually not
a good long-term solution. It’s possible to become dependent on some types of laxatives for
bowel movements, meaning that the colon doesn’t contract normally on its own. In these
cases, a doctor can help make a plan to gradually reduce laxative use and find other ways to
improve bowel regularity. 4