Foods that cause constipation:

A strategy to discover
Your own triggers

We all have our list of foods that cause constipation.

One theme you will hear over and over again on this website is this: even though we all suffer from the same condition, we are all different.

We are not our disease. We need to nurture the person (you, me) in all of our complexity and specificity. Therefore, there is no common list of foods that cause constipation for all of us.

We all have different constipation triggers. For example, I can tolerate any kind of dairy products. But caffeinated drinks tend to increase my stress level. Stress tends to constipate me.

Some of you may say "I can drink as much coffee as I want, but those morning bagels at the office seem to throw me off base".

Whatever your food triggers are, the purpose of this article is simple. We would like to give you a framework that will allow you to think, experiment, and build your very own list of foods that cause constipation.

First, we will cover major food groups and point to the potential constipation risks. Then, in a separate article, we will discuss how to keep a detailed nutritional journal in order to help you get to the bottom line.

So no pre-digested list of foods that cause constipation for you today, sorry. That is simply not possible. But a personalized approach, tailored just for you.

One last point, this article is not about foods that relieve constipation. That will be covered under the "remedies" section.

Ready to start? Let's go.

Dairy products

Dairy products should definitely be part of your list of foods that cause constipation.

People can be sensitive to two different types of dairy constituents:

• lactose, a sugar contained in milk
• milk proteins

Lactose sensitivity or intolerance is a known condition today. It is due to the lack of the lactase enzyme, and is mostly an inherited (genetic) condition. Most of the time, it leads to bloating and diarrhea, not constipation.

Here is why. In a lactose intolerant person, the lactose goes through the intestine undigested, and ends up in the colon. The amount of lactose in the colon creates what is called "osmotic pressure". Water from our body wants to dilute that amount of sugar that is not supposed to be there. The "osmotic force" pulls the water from our mucosa into the colon, leading to diarrhea. Also, the colon bacteria have a feast on undigested lactose, creating lots of gas.

Milk protein sensitivity is different, and can lead to constipation. We are not talking about the milk sugar anymore here, but about the protein. This is not a well known fact, but it has been raised as an issue in scientific literature, with several studies focusing on chronic constipation in children(1)(2)(3).

In those people sensitive to milk proteins, fragments of proteins (called peptides) travel undigested to the intestine, and gets absorbed into the blood. Those foreign fragments trigger an inflammatory response, a swelling of the intestinal lining, which leads to constipation (possibly through partial obstruction due to the swelling).

Here are a few quotes from those scientific studies:

• "Although chronic diarrhea is the most common gastrointestinal symptom of intolerance of cow’s milk in children, our current results confirm our earlier observation that chronic constipation can also occur."(1)
• "These results suggest that cow's milk protein allergy or intolerance should be considered as a cause of chronic refractory constipation in children."(2)
• "A clear association between cow's milk consumption and constipation has been found in more than one third of children."(3)

If milk products can cause constipation in children, they should also be considered as food triggers in adults.

Milk proteins can be found in milk, yoghurt, and cheese. People sensitive to milk proteins may react to all of those products. All three should be on your list of foods that cause constipation.

Breads, Pastries and other white flour products

White flour based products should be on your list of foods that cause constipation. White flour can be found in large quantities in:

• white bread
• cakes and pies
• cookies
• crackers, pretzels
• doughnuts, bagels, and muffins
• breakfast cereals

The reason why those products cause constipation is simple. We are in known territory here - the fiber universe. A large white flour bagel has no fibers in it. Fibers found in whole grain are water sponges. They add bulk and humidity to our stools. A lack of those fibers can lead to dry stools and constipation.

As a side note: nobody should overdo fibers. I am against the message some are broadcasting regarding fiber supplementation. I will explain why in another section of this website in due time.

And don't ask me why certain people prone to constipation can eat one bagel in the morning, one whole baguette at lunch, and a white bread sandwich in the evening and not get constipated. We are back again to the overarching message of this website - we are all different.

However, if you are chronically constipated and you are looking for the cause, you must include white flour products on your list of foods that cause constipation.

By the way, do you put cream cheese on your bagel? Dunk cookies in milk? Eat cereal in milk for breakfast? If yes, don't forget to look at the "Dairy products" section above.

Grains in general

Here is one more reason why grains in general should be on your list of foods that cause constipation.

Grains contain a number of proteins you could be sensitive to, including one called gluten. The discussion here gets very similar to the one we had regarding dairy proteins. The sensitivity to those proteins cause an immune reaction, accompanied with a swelling of the intestine which causes constipation.

But this is not the whole story. When broken down into peptides, gluten releases opioids, opium-like substances called "exorphins". Those exorphins can be partially released in the gastrointestinal tract by the action of our enzymes(4)(5).

Remember what opioids drugs (like codeine) carry as a side effect: any opioids, by slowing down the activity of the colon, can lead to serious constipation.

As you can see, this applies to any grain that contains gluten, whether whole or white. So if you are constipated and are looking for the cause, please include any grains on your list of foods that cause constipation. We will see later how to figure out what substance is the real culprit, so that you don't end-up taking everything out of your diet.

Remember that gluten is insidiously added to many types of processed foods: sauces, marinades, salad dressings, seasonings, frozen and canned foods, etc. Check the labels.

Animal proteins

Now let's talk about meat, fish, eggs and other forms of animal proteins. Should you put those on your list of foods that cause constipation?

On a generic level, my opinion is no. I do not believe, based on my research, that they cause constipation for most of us. This is true if you eat a balance diet that includes fruits, vegetables, nuts, fats, and other essential nutrients of course. You do need a balanced diet for good gastrointestinal health. But if you balance your proteins well, there should not be anything to worry about. For most of us.

As usual there will be some exceptions to that rule.

Proteins do cause gastrointestinal issues in certain cases. This cause is not as widespread as dairy products and grains though, but it needs to be presented here.

The problem was very well documented by Dr. Jean Seignalet, a French doctor who specialized in nutritional science. He reported that cooking transforms proteins into a form that some people have trouble digesting(6).

Those undigested fragments of proteins penetrate the gastrointestinal tract and create an immune reaction, sometimes followed by constipation. I am aware of multiple cases of constipation cured by the Seignalet diet.

The Seignalet diet is a type of "paleolithic" diet where dairy products, cereals and cooking are proscribed. It is a tough regime to follow, so you will want to try this as your last resort.

So what should you do with animal proteins? Put them at the bottom of your list of foods that cause constipation for now, but do keep them there, hopefully we will be able to eliminate them when we do the diet journal.

Fats

There are good fats and bad fats. We all know that.

You should not consume any hydrogenated fats. Hydrogenated means that the fat has been made rancid at the factory, for shelf life purposes. Once hydrogenated, those fats pretty much have an infinite shelf life. Please note that sometimes they can be "partially hydrogenated" too (you will see that mention on some packaged foods). Partially hydrogenated is as bad as hydrogenated. Both should be eliminated from your diet.

Now let's cover a touchy subject: saturated fats. Those come mostly from animal products (meat, cheese, etc), and they have been accused of all evils in the 80's and 90's. Today, we know that they do have a place in our diet. Since they are saturated, they are stable and not subject to oxydation (oxydation makes a fat rancid, toxic in another word).

Monounsaturated (e.g. from olive oil) are pretty stable too.

Polyunsaturated (e.g. from seed oils like sunflower or canola) are best avoided because they are very unstable and can oxidize quickly.

Barring hydrogenated fats which are categorically unhealthy, and polyunsaturated fats that are unstable, should you put fats on your list of foods that cause constipation? My opinion is absolutely no.

As we will see in the remedies section, good fats may even help. They lubricate our gastrointestinal tract to some extent, and make us secrete more bile, which is a natural laxative.

Unripe fruits and tannins

Constipation sensitive people know that unripe fruits can be a constipation trigger. The "banana constipation" link is often brought up because unripe bananas are so commonly consumed in western industrialized countries. See the detailed article on that subject.

But this applies to all type of fruits, particularly those rich in tannins (pomegranates, persimmons, grapes, guavas, etc).

Tannins are astringent. When in contact with our mucosa (inside the gastrointestinal tract), they "shrink" the tissues (think of the mouth puckering effect applied to your bowel) and thus diminish our secretions. This leads to a drier gut, and therefore to constipation.

All ripe fruits, including bananas, should not be on your list of foods that cause constipation.

Beans

Constipated? Get more fibers. How? Eat beans. Have you heard that piece of advice before? I have.

But not all beans are created equal. Some do not contain as much fiber as the health food industry suggests. We need to focus on the different types of beans and their content. Too much carbohydrate content and not enough fiber in beans can actually be detrimental to our digestion and clog things up.

Here is a simple rule to follow: in the table below, pick the type that has the higher amount of fibers and the lower amount of carbohydrates(7), say chickpeas or pinto beans for example. And then stop worrying about beans.

Dark chocolate

Chocolate does not have a clear profile as culprit. Historically, mothers liked to tell their children to not eat too much chocolate or they would get constipated. In reality, quality dark chocolate does not seem to create much of a problem overall.

Milk chocolate could potentially create trouble. Please read the section titled "Dairy products".

Similar to animal proteins, put dark chocolate at the bottom of your list of foods that cause constipation for now. Don't remove it completely because it does contain some tannins (see "Unripe fruits and tannins" section). But don't stress over it too much either.

Caffeinated drinks

Caffeinated drinks can be part of your list of foods that cause constipation. Those drinks include coffee, black tea, caffeinated sodas (Coke, Pepsi, Dr. Pepper, Red Bull, etc), and green tea if you are very sensitive to caffeine or you drink a large amount of it.

But why would coffee and constipation, or more accurately caffeine and constipation be related?

Coffee and other caffeinated drinks play a double role. First, when consumed in large doses, they are diuretics. They make us urinate more water than we ingest. The net result is a mild form of dehydration. Those fluids excreted via the kidneys won't be available to moisten our stools.

But coffee has a more insidious side too. It increases our stress level. It makes our body secrete adrenaline and, on the longer term, the stress hormone cortisol. As we will see in a separate article, stress reroutes our vital resources (like blood) to the parts that need energy during a fight or flight situation.

Is the digestive tract vital when we are trying to escape danger? Absolutely not. Blood is rerouted to the lungs, the heart, and the skeletal muscles. The gastrointestinal tract, colon included, will be put on the back-burner. Not good for constipation sufferers.

Why does coffee constipate me, and not you? Because we all have different tolerance to stimulants. I am usually fine with one or two cups a day. Beyond that, I am taking risks.

You will know whether or not you should put coffee on your list of foods that cause constipation. If too much caffeine makes your heart beat a little faster, makes you a bit jumpy and on edge, sometimes gives you heart palpitations, then it is increasing your level of stress in a significant manner. You should avoid that.

By the way, do you add milk or cream to your cup of coffee or tea? If yes, don't forget to look at the "Dairy products" section above.

One last note: black tea is significantly astringent as well, due to its tannic nature. So please read the section titled "Unripe fruits and tannins", which addresses the effect of tannins on the gut.

The following table provides the caffeine content of different drinks, for your information(8):

Alcohol, wine and beer

Beer and wine contain two constituents that may make your constipation problem worse:

• Alcohol
• Tannins

Tannins have already been discussed in the section "Unripe fruits and tannins". As for alcohol, it is a great dehydrator. For those of us who ever drank a little too much at a party, we know the dry mouth effect the next day, and the urge to drink lots of water. Alcohol is diuretic. It makes us urinate more water than what we ingest. The net result is dehydration. Those fluids excreted via the urine won't be available to moisten our stools.

One beer, or one glass of wine should not be a source of trouble. But larger consumption of alcohol should definitely be on your list foods that cause constipation. Or drinks I should say.

Conclusion

You have successfully reached the end of the list. There are indeed many foods that cause constipation. But please don't get depressed. You, as an individual, may have just one trigger out of this whole list. Or maybe none. Maybe the problem is somewhere else.

Our goal will be to figure out exactly which one is the trigger, and subsequently remove it from your diet. It is as simple as that. This will be explained in a future "keeping a diet journal" article.

References for "Foods that cause constipation"

(1) Iacono G, Cavataio F, Montalto G, Florena A, Tumminello M, Soresi M, Notarbartolo A, Carroccio A. "Intolerance of cow's milk and chronic constipation in children." N Engl J Med. 1998 Oct 15;339(16):1100-4.

(2) Daher S, Tahan S, Solé D, Naspitz CK, Da Silva Patrício FR, Neto UF, De Morais MB. "Cow's milk protein intolerance and chronic constipation in children". Pediatr Allergy Immunol. 2001 Dec;12(6):339-42.

(3) Irastorza I, Ibañez B, Delgado-Sanzonetti L, Maruri N, Vitoria JC. "Cow's-milk-free diet as a therapeutic option in childhood chronic constipation". J Pediatr Gastroenterol Nutr. 2010 Aug;51(2):171-6.

(4) Fukudome, S. and Yoshikawa, M. 1993. "Gluten exorphin C. A novel opioid peptide derived from wheat gluten". FEBS Lett 316 (1): 17-9.

(5) Fukudome, S., Jinsmaa, Y., Matsukawa, T., Sasaki, R. and Yoshikawa, M. 1997. "Release of opioid peptides, gluten exorphins by the action of pancreatic elastase". FEBS letters 412 (3): 475-479

(6) See Seignalet, "L'alimentation ou la troisième médecine", a very thorough nutritional book written in French, addressing the impact of modern foods on health. I am not aware of any English translation unfortunately.

(7) See carbohydrate and fiber content of foods at: http://www.carbs-information.com/

(8) See WIKI page on caffeine at: http://en.wikipedia.org/wiki/Caffeine

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