Dietary Recommendations for Constipation and a Sample Recipe

Patients with cancer experience varying degrees of constipation depending on their main cancer treatments, additional medications, coexisting diseases, tumor location and previous bowel habits. In our previous article , we examined the causes and treatment approaches for constipation in patients with cancer in detail and emphasized that it is often overlooked. However, eating habits are very important in treating constipation.

What is the role of nutrition in treating constipation?

Foods containing soluble and insoluble fiber are the most important in constipation treatment. Daily fiber intake should be between 25-30 gr. Soluble fiber absorbs water in food, forming a gelatinous structure. It is found in oats, barley, apples, legumes, peas and many vegetables and fruits. Insoluble fiber works by increasing bulk; its main sources are fruit skins, wheat, corn and nuts. Both types accelerate food passage through the large intestine (colon) and stimulate colon movement. To increase dietary fiber, eat 5 portions of fresh vegetables and fruit with their skins daily, legumes at least 2 times weekly, and 6-11 portions daily of unrefined grains such as bran and whole wheat. Cooking meat dishes with vegetables can increase their fiber content.

Our dietary recommendations for treating constipation:

1. Try to eat at the same time every day,
2. Set aside time for using the toilet at the same time every day, 
3. Drink warm beverages in addition to 8-10 glasses of water daily,
4. With the knowledge of the doctors managing your treatment, you may eat high-fiber foods such as oats, wheat germ, prunes, pears, citrus fruits, peaches, apples, apricots, broccoli, corn, peas, tomatoes, squash, pineapple, cherries, turnips, beets, broccoli, cauliflower , carrots, almonds, lentils, onions, hazelnuts, walnuts and similar foods,
5. Combining hot drinks and high-fiber foods at breakfast is helpful in managing constipation, 
6. Hot lemon water may be consumed between meals, 
7. Eat small amounts frequently,
8. Every day, try to do exercise, even if light . Those unable to exercise may perform exercises in bed aimed at working the abdominal muscles, 
9. Foods containing rice flour should not be consumed, 
10. If the bowel is obstructed for any reason, your doctor will not recommend a high-fiber diet; hospitalization and temporarily stopping eating may even be necessary
11. Drink warm or hot beverages about 1 hour before meals, 
12. Consume fruit compotes, 
13. Nuts also act as prebiotics because of their resistant starch content and increase bowel movement; therefore, consume the amount required daily. 
14. Adding wheat germ or oat bran to soups can increase their fiber content, 
15. A packaged product label indicating 5gr/serving of fiber means it is high in fiber.

A Recipe Against Constipation: VEGETABLE LASAGNA

INGREDIENTS (serves 4)

• 1 tablespoon olive oil
• 2 garlic cloves, crushed
• 1 onion, finely chopped
• ½ fresh basil, chopped
• 1 hot red pepper
• 3 celery stalks
• 4 carrots, grated
• 10 mushrooms, chopped
• 1 bunch spinach, chopped
• 3 tablespoons tomato paste
• 6 tomatoes, chopped
• 1 box lasagna
• 2 slices of kaşar cheese, grated.

Preparation

Before preparing the ingredients, preheat the oven to 180 degrees. Sauté garlic, onion, celery, basil, pepper and carrots for approximately 5 minutes and add olive oil. Add spinach and mushrooms and cook for about 1 minute. Add tomatoes and tomato paste and bring to a boil over medium heat. Cook for approximately 10 minutes until the vegetables soften, adding 1 teaspoon salt shortly before removing from the heat. Distribute the mixture over the prepared lasagna and continue to make 2 layers. Top with grated kaşar cheese and place in the oven. Bake for approximately 50 minutes.

Constipation and Prebiotics

Prebiotics are a group of short-chain carbohydrates that cannot be digested by intestinal digestive enzymes and increase the number and activity of beneficial bacteria in the microbiota, also known as intestinal flora. Prebiotic foods are fermented by intestinal bacteria, producing short-chain fatty acids. They also lower the pH, increasing acidity and thereby calcium and magnesium absorption. They increase the numbers and effects of probiotic bacteria and help eliminate harmful bacteria from the body. Because they increase fluid absorption in the colon, they can be used for constipation. In particular, inulin (artichokes, garlic, leeks, onions, rye, wheat bran) and oligofructose (artichokes, garlic, leeks, onions, rye, wheat bran) are preferred for constipation. In addition, pectin in legumes and fruit and vegetables with their skins increases bowel movements in constipated individuals while softening stool consistency. Likewise, resistant starch in legumes and whole grains facilitates defecation through fermentation only in the large bowel by beneficial digestive bacteria called bifidobacteria. Prebiotics belong to the functional food group. Functional foods naturally contain bioactive components such as fiber, antioxidants and prebiotics and are consumed as part of the daily diet. They should be viewed not merely as nutrients but as foods contributing to the body’s metabolic and physiological activities. They are generally found in fruit, vegetables, milk and dairy products. Studies show that galactooligosaccharides in milk and dairy products increase bowel movement frequency. Xylooligosaccharides and fructooligosaccharides are found in fruit and vegetables. We recommend obtaining prebiotics from food rather than external products. Dietary prebiotics protect gastrointestinal health, benefit constipation and strengthen the immune system by reducing chronic disease risk through their mechanisms of action.