Does exercise help relieve constipation?

“Many people believe daily defecation is necessary. They complain of constipation if stools occur less frequently. Others are concerned with the appearance (size, shape, color) or consistency of stools. Sometimes the major complaint is dissatisfaction with the act of defecation. Some get a sense of incomplete evacuation after defecation. Constipation is blamed for many complaints.” [1]   
 
Do any of these down-under complaints sound familiar to you? If so, read on about the relationship between exercise (or lack of it) and constipation.
The Mayo Clinic says, “Simple lifestyle changes, such as getting more exercise, drinking more fluids and eating a high-fiber diet, can go a long way toward alleviating constipation.”[2]  This guide is influential. It is widely believed exercise helps relieve constipation.[3] The advice was obviously followed by the following person who recently wrote:[4]
“My father had slow transit constipation.  It led to his developing bowel cancer. I also developed the problem during my teens. I did EVERYTHING to hasten passage. It included taking fluids, a high fibre diet including prunes, and, yes, exercise. All helped. My body moves things along readily now. You do need the bulk and mucus membrane-friendly foods to help everything slide along. I think my body has learned what to do and I crave fruit if things ever build up”
Exercise can help prevent diabetes, arthritis, anxiety and depression.  But whether it helps relieve constipation depends on what type of constipation you have, says Professor Terry Bolin, a gastroenterologist and Associate Professor of Medicine at the University of NSW.[5]

There are two types of constipation, viz simple constipation and slow transit constipation.

Simple constipation is what most people have experienced at some time of their life. Changes to our daily routine can result in this type of constipation. This normally happens when we eat different foods than those we normally do. Likewise, it appears when we are going on holidays.  Inadequate fluid intake or dehydration can also be a cause.

It could also be a symptom of diseases such as stroke, diabetes, thyroid disease and Parkinson's disease.[6]

With older adults, simple sonstipation is an issue. It is said to affect up to 50% of the elderly.[7] Lack of physical activity (a sedentary life-style generally) is a well-known cause. A wider picture is given by merckmanuals.com:

“Constipation is common among elderly people because of low-fiber diets, lack of exercise, coexisting medical conditions, and use of constipating drugs. Many elderly people have misconceptions about normal bowel habits and use laxatives regularly. Other changes that predispose the elderly to constipation include increased rectal compliance and impaired rectal sensation (such that larger rectal volumes are needed to elicit the desire to defecate)”.[8]

Exercise usually helps this type of constipation. “Exercise helps relieve constipation because it stimulates the nervous system and helps the muscles and nerves in the gut to work better, particularly because it often goes hand-in-hand with a better diet. There is not any particular exercise that helps more than others. It doesn't matter as long as you're doing something”, says Professor Bolin.
For oldies, doing tai chi is a great form of exercise. Apart from helping the bowels to move, it strengthens their legs and maintains a good sense of balance. It also reduces risks of falls.
Taking a walk is also a great way to stimulate a bowel movement.
 
Slow transit (long-standing) constipation
Slow transit (long-standing) constipation is a genetic condition. It affects mostly women. It tends to develop during childhood and teenage years. Sometimes, it occurs in newborn babies.
Girls and young women, in particular, can suffer this type of severe constipation. Sometimes, they may not pass a motion for one to two weeks. And yet they're slim-looking and look well. They may also exercise, drink water and have a good diet. Yet they remain badly constipated. It may show up in their facial expression. That could be the origin of the expression ‘uptight arse’ or ‘anal retentive’.[9]

Exercise does nothing to help this type of constipation.

What’s the explanation for this type of constipation? Professor Bolin says, “Usually during the digestion process, food moves along your large intestine by muscular contractions, which are caused by the stimulation of nerves in the intestine wall. Those with slow transit constipation are thought to have a problem with the nervous system that controls these nerves. The young women with really severe constipation often have a problem with their unconscious nervous system, and that is reflected by the fact they suffer with quite severe cold hands and feet, because the same nervous system that controls the circulation controls the gut. They have a physical cause for their constipation because the nerves and muscles in the bowel don't work as well as they should".
Should we take more fiber for our constipation? For people with slow transit constipation, eating a high fibre diet can be a problem. The more fibre they eat, the more gas they produce, and the more bloated they can become. Bolen says they should only gradually increase fibre intake until taking enough to control the constipation. Bulking agents that increase the amount of fibre in your diet, along with laxatives, can be beneficial in those with simple and slow-transit constipation. Simple laxatives stimulate your bowel muscles, and osmotic laxatives help increase the amount the water in the bowel. You need to take enough laxatives to change the shape of your motion so it is easier to pass, Professor Bolin says.
 
How one person tries to get rid of his constipation Different people have different beliefs on how to handle their personal constipation problem. Here’s a guy whose strategy to remove his faecal materials could attract millions of curious viewers if we could somehow capture it on video camera and post it in the internet:
 “My technique is to sit on my toilet and ‘do the twist’. The theory is that the stuff coming down the colon and walls of the colon grip each other in such a loving embrace that the stuff can't move. By twisting the hips while sitting on the seat, with one knee-cap moving forward while the other comes back, the walls of the colon are moved horizontally and vertically in relation to the stuff coming down and are dragged loose from it. Gentle pushing is then all that is needed.”
Do you think this (anonymous) person is dead serious?
Can we say he needs a dummy’s guide to the human physiology and anatomy?
 
Gim Teh/Thursday, 26 July 2012
 
Sources:
 
1.      http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/ .[ Constipation. National Digestive Diseases Clearinghouse.  
 

[1]   ‘CONSTIPATION’ in http://www.merckmanuals.com/ [Good detailed article with treatment perspective]
 
[3] What is constipation? Constipation is infrequent bowel movements or difficult passage of stools. You're probably experiencing constipation if you pass fewer than three stools a week, and your stools are hard and dry: http://www.mayoclinic.com/health/constipation/DS00063  . ‘It's not unusual to get bloating and abdominal discomfort when you are constipated’, Professor Terry Bolin.
[6]  http://www.mayoclinic.com/health/constipation/DS00063/DSECTION=causes [See this for a long list of possible causes]
 
[9]   This reminds me of a well-known Aussie saying about people who are very ‘tight’. They’re said to be ‘as tight as the arse of a fish swimming upstream tail-first’.