It can be a battle to obtain and maintain healthy, regular bowel movement. Fortunately, there are some simple things that can help
It is common for people with spinal cord injuries to battle with bowel movement. Often, they are constipated and require laxatives to encourage movement. While, for some, their dependence on laxatives might be a life-long requirement, there are ways for everyone to improve their bowel movement and reduce the amount of laxatives taken. Dr Virginia Wilson, during a webinar hosted by QASA in September, shared her tips for a healthy bowel.
It starts with knowing “what you produce”. Referring to the Bristol Stool Form Scale, Dr Wilson noted the various consistencies to be found from hard pebble-like stool to watery, nearly entirely liquid, faeces. The consistency of your stool indicates whether there is enough liquid and fibre in your diet.
Both pebble-like or watery faeces are on the ends of the spectrum indicating constipation. In the case of watery stool, this could indicate a blockage in the bowel that only allows liquid to pass through. Constipation for people with spinal cord injuries is dangerous as it could lead to Autonomic Dysreflexia. The ideal stool is Type 4 on the chart, which is a smooth and soft snake-like or sausage-like faeces.
Unsurprisingly, Dr Wilson highlighted diet as the key to creating a healthy bowel. First up, she advised people to eat fruit and vegetables “as much as possible, as often as possible”.
“This is critical. If you are going to look after your bowel for the rest of your life, you have got to eat plenty of vegetables,” Dr Wilson said. She added that it was important to eat a range of fruit and vegetables: “Variety is the spice of life.”
“If you can transition to a plant-based diet, that is even better,” she encouraged. Dr Wilson compared 100 grams of beef with 100 grams of beans (or plant-based protein). Both provided the same amount of protein, but the beans provided a lot more fibre to the diet. It also ranked higher in the amount of iron, calcium and magnesium provided.
Additionally, the plant-based protein is much cheaper than beef; making it a budget- friendly source of meat and fibre. It can be used in various ways. Dr Wilson suggested: “Try and include beans in your diet. You can use them cold as in salad or add them to a soup, stew or casserole.” She does caution against eating too much beans as it could result in a more water-like stool.
Another key element to a healthy diet is yogurt. It is an important provider of good bacteria for your gut, which impacts on your general health. The gut microbiome (the variety of bacteria that lives in your gut) plays a role in helping control digestion and benefits your immune system. An imbalance in the gut can contribute to weight gain, high blood sugar, high cholesterol and other disorders.
Along with yogurt, a variety of fruits and vegetables, whole grain and fermented foods can help build a healthy gut. Dr Wilson recommended eating a “brown” diet of grain including brown bread, brown rice, brown porridge, bran and “brown” potatoes, which is simply regular potatoes, but with the skin left on as the skin is the source of fibre.
“Try and have yogurt every day. Try and avoid the sweetened ones because they contain too much sugar and are not really that good,” Dr Wilson advised.
When it comes to fluids, Dr Wilson recommended at least two litres of water drunk daily. She warned against soda: “Fizzy drinks are a problem because of the gas. It can affect your bowel function. It can cause distention (enlarge) of the bowel, make you uncomfortable and make you pass more gas than is necessary.”
While these tips are a good place to start, it is highly recommended for people with spinal cord injuries to consult their doctor when making changes to their diet. With enough healthy fluids, a variety in your diets, and lots of fibre, you can win the battle for a healthy bowel.
