Many women are terrified of straining with constipation and worsening their prolapse problems.
Straining causes and worsens prolapse.
Stool softener foods can help avoid straining and promote recovery from common rectal problems (e.g. hemorrhoids, fissures and rectal prolapse).
Stool softener laxatives (Coloxyl or Colace) can cause unpleasant side effects including nausea, bloating, cramps and diarrhoea.
Read on now to soften your stool with:
- Best stool softener foods
- Foods that make stools hard (limit these)
- Best stool softener fluids
- Best stool softener fibre
- Bowel problems with too much fibre
- The best stool consistency for bowel movements
1. Best Stool Softener Foods
If your stool is too hard you may benefit from gradually increasing your consumption of foods known to soften the stool.
Foods that soften the stool include:
- Vegetables – green beans, spinach, red capsicum, members of the cabbage family (cabbage, broccoli, brussel sprouts which can cause increased wind/gas production)
- Fruit – fresh apricots, peaches, plums, grapes, prunes
- High Fibre Cereals – bran, multigrain breads and cereals
- Snacks – popped corn, chocolate
- Spices* – chilli, curry
- Fibre supplements – detailed below
- Additives – artificial sweeteners* Sorbitol or Mannitol
*Can cause bladder urgency
2. Foods That Firm Stool
Some foods are known to firm the stool. If you are trying to soften your stool you may wish to limit or avoid the following foods if they make your stool too hard.
Foods that firm the stool include:
- Low fibre cereals – white pasta, boiled white rice, white bread
- Mashed potato
- White Marshmallows
These foods can contribute to constipation and straining.
3. Best Stool Softener Fluids
Fluid intake is also important in ensuring your stool is the right consistency. Your fluid intake needs to be adequate to soften your stool.
If you are increasing your fibre intake, commencing a fibre supplement or taking stool softener medications it is important to increase your fluid intake.
- Prune, orange or grape juice
- Caffeine* containing drinks e.g. coffee, tea
- Alcohol* (red wine or beer)
*Note – can cause bladder urgency
How Much Fluid to Drink?
While water is the recommended fluid of choice, herbal teas and foods high in fluid also contribute to daily fluid intake.
Most healthy women can aim towards 2 litres/day of fluid to increase the effects of fibre on stool consistency however this will differ for some individuals with medical conditions that restrict fluid intake.
4. Best Stool Softener Fibre
The fibre you consume affects your stool consistency and the movement of waste through the bowel (bowel motility).
Soft stool consistency is promoted by consuming approximately 25-30 grams of fibre/day. For healthy adults 25-30 grams of daily fibre intake includes:
- 2 serves of fruit
- 5 serves of vegetables
- 4-5 serves of cereals
The fibre we consume can be grouped into two types; soluble and insoluble fibre.
Many foods contain both insoluble and soluble fibres and most healthy adults derive health benefits from consuming both types of fibre in their diet.
A. INSOLUBLE FIBRE
Insoluble fibre is the fibre that helps to soften stools. Insoluble fibre is not digestible and it increases the speed of waste movement though the body, a little like sweeping out the bowel.
You can often recognise insoluble fibres from their chewy fibrous texture for example fruit skins and vegetable peels.
Sources of insoluble fibre include:
- Wholegrain foods e.g. brown rice, wholegrain cereal, wheat bran, wholegrain bread,
- Fruits with edible skins e.g. pears, apples, stone fruit
- Vegetables e.g. corn, spinach
- Nuts and seeds
Two Problems With Too Much Insoluble Fibre
Too much insoluble fibre can cause different bowel problems for different women including constipation or diarrhoea. Eating the right amount of insoluble fibre in your diet for your body can take some trial and error to get right.
If you are increasing fibre in your diet, do this slowly to allow your bowel to become accustomed and reduce the risk of bloating and discomfort. If you are on a medically prescribed low fibre diet speak with your doctor for approval before making any changes to your fibre intake.
If you are constipated or prone to constipation avoid the mistake of consuming too much insoluble fibre (and too little fluid).
While insoluble fibre softens the stool, it is not broken down in the bowel and if too much is consumed this fibre will actually slow down bowel motility, causing gas and bloating, abdominal pain and contribute to constipation.
To help constipation women often need to ‘clear the blockage’ or hard stool first with appropriate medication before increasing fibre. Once the hard stool has been passed, insoluble fibre is then gradually introduced into the diet to reduce the likelihood of becoming constipated in the future.
Consuming too much insoluble fibre can also cause diarrhoea in some women by speeding up bowel motility. Women with faecal incontinence problems typically need to reduce their insoluble fibre intake to help firm their stool and slow down bowel motility.
B. SOLUBLE FIBRE
Soluble fibre absorbs water in the bowel forming a gel-like consistency.
Soluble fibre helps digestion and improves the absorption of nutrients. Soluble fibre can help to reduce diarrhoea if the stool is too loose.
Sources of soluble fibre include:
- Fruit (e.g. oranges, passionfruit, avocado)
- Vegetables – sweet potato, chick peas, baked beans, soy beans
C. BULKING AGENTS & FIBRE SUPPLEMENTS
Bulking agents/fibre supplements absorb water from the intestine helping to soften and gel the stool consistency e.g. Psyllium (Metamucil), Guar Gum (Benefibre), Sterculia (Normafibe). Bulking agents can help stool consistency long-term however they can cause worsening constipation of you are already constipated.
Ideally constipation should be addressed first with an appropriate laxative medication (speak with your health care provider) and then the bulking agent used as a preventative measure for long-term prevention of constipation.
5. The Best Stool Consistency for Bowel Movements
Getting your stool consistency right is very important to overcoming constipation and straining. You can check your stool consistency using the Bristol Stool Chart.
How do you rate the appearance of your regular stool using this stool chart Type (1-7)?
- Type 3-4 – soft well formed and smooth this is the ideal stool consistency that is easily passed
- Type 1-2 – hard, cracked and/or lumpy stools are difficult to pass making you more prone to constipation and straining
- Type 5-7 – not well formed and watery can cause diarrhoea and straining to empty completely
Key Points for Stool Softener Foods
Increasing your intake of these stool softener foods and fluids can help you soften your stool, reduce straining with constipation and the need for laxative medications.
- Increase insoluble fibre (and fluids) gradually over time.
- Avoid increasing your fibre intake when you are constipated which can worsen constipation and straining.
- Choosing stool softener foods and reducing your intake of foods known cause hard stools can help you reduce constipation, straining and help you protect your pelvic floor long-term.
ABOUT THE AUTHOR, Michelle Kenway
Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out.
Prolapse Exercises is a complete exercise guide for women seeking to exercise safely and protect their pelvic floor.