The Gut "Connections to Health & Disease"

For individuals who are dealing with constant constipation due to medications, stress, or lack of fiber, can walking exercise help encourage regular bowel movements?

Walking For Constipation Assistance

Constipation is a common condition. Too much sitting, medications, stress, or not getting enough fiber can result in infrequent bowel movements. Lifestyle adjustments can regulate most cases. One of the most effective ways is to incorporate regular moderate-vigorous exercise, encouraging the bowel muscles to contract naturally (Huang, R. et al., 2014). This includes jogging, yoga, water aerobics, and power or brisk walking for constipation alleviation.

The Research

A study analyzed middle-aged obese women who had chronic constipation over a 12-week period. (Tantawy, S. A., et al., 2017)

• The first group walked on a treadmill 3 times a week for 60 minutes.
• The second group did not engage in any physical activity.
• The first group had greater improvement in their constipation symptoms and quality of life assessments.

A gut bacteria imbalance is also linked to constipation issues. Another study focused on the effect of brisk walking versus exercises that strengthened core muscles like planks on intestinal microbiota composition. (Morita, E., et al., 2019) The results showed that aerobic exercises like power/brisk walking can help increase intestinal Bacteroides, an essential part of healthy gut bacteria. Studies have shown a positive effect when individuals engage in at least 20 minutes of brisk walking daily. (Morita, E., et al., 2019)

Exercise Can Help Decrease Colon Cancer Risks

Physical activity can be a significant protective factor in decreasing colon cancer. (National Cancer Institute. 2023) Some estimate the risk reduction to be 50%, and exercise can even help prevent recurrence after a colon cancer diagnosis, also 50% in some studies for patients with stage II or stage III colon cancer. (Schoenberg M. H. 2016)

• The best effects were obtained through moderate-intensity exercise, such as power/brisk walking, about six hours per week.
• Mortality was reduced by 23% in individuals who were physically active for at least 20 minutes several times a week.
• Inactive colon cancer patients who began exercising after their diagnosis had significantly improved outcomes than individuals who remained sedentary, showing that it is never too late to start exercising.(Schoenberg M. H. 2016)
• The most active patients had the best outcomes. 

Exercise-Related Diarrhea Prevention

Some runners and walkers experience an overly active colon, resulting in exercise-related diarrhea or loose stools, known as runner's trots. Up to 50% of endurance athletes experience gastrointestinal problems during intense physical activity. (de Oliveira, E. P. et al., 2014) Prevention steps that can be taken include.

• Not eating within two hours of exercising.
• Avoid caffeine and warm fluids before exercising.
• If sensitive to lactose, avoid milk products or use Lactase.
• Ensure the body is well-hydrated before exercise.
• Hydrating during exercise.

If exercising in the morning:

• Drink about 2.5 cups of fluids or a sports drink before bed.
• Drink about 2.5 cups of fluids after waking up.
• Drink another 1.5 - 2.5 cups of fluids 20-30 minutes before exercising.
• Drink 12-16 fluid ounces every 5-15 minutes during exercise.

If exercising for over 90 minutes:

• Drink a 12 - 16 fluid-ounce solution containing 30-60 grams of carbohydrates, sodium, potassium, and magnesium every 5-15 minutes.

Professional Help

Periodic constipation may resolve with lifestyle adjustments like increased fiber intake, physical activity, and fluids. Individuals who are experiencing bloody stools or hematochezia, have recently lost 10 pounds or more, have iron deficiency anemia, have positive fecal occult/hidden blood tests, or have a family history of colon cancer need to see a healthcare provider or specialist to perform specific diagnostic tests to ensure there aren't any underlying issues or serious conditions. (Jamshed, N. et al., 2011) Before engaging in walking for constipation assistance, individuals should consult their healthcare provider to see if it is safe for them.

At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to achieve improvement goals and create an improved body through research methods and total wellness programs. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Poop Testing: What? Why? and How?

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Huang, R., Ho, S. Y., Lo, W. S., & Lam, T. H. (2014). Physical activity and constipation in Hong Kong adolescents. PloS one, 9(2), e90193. https://doi.org/10.1371/journal.pone.0090193

Tantawy, S. A., Kamel, D. M., Abdelbasset, W. K., & Elgohary, H. M. (2017). Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women. Diabetes, metabolic syndrome, and obesity: targets and therapy, 10, 513–519. https://doi.org/10.2147/DMSO.S140250

Morita, E., Yokoyama, H., Imai, D., Takeda, R., Ota, A., Kawai, E., Hisada, T., Emoto, M., Suzuki, Y., & Okazaki, K. (2019). Aerobic Exercise Training with Brisk Walking Increases Intestinal Bacteroides in Healthy Elderly Women. Nutrients, 11(4), 868. https://doi.org/10.3390/nu11040868

National Cancer Institute. (2023). Colorectal Cancer Prevention (PDQ(R)): Patient Version. In PDQ Cancer Information Summaries. https://www.cancer.gov/types/colorectal/patient/colorectal-prevention-pdq
https://www.ncbi.nlm.nih.gov/pubmed/26389376

Schoenberg M. H. (2016). Physical Activity and Nutrition in Primary and Tertiary Prevention of Colorectal Cancer. Visceral medicine, 32(3), 199–204. https://doi.org/10.1159/000446492

de Oliveira, E. P., Burini, R. C., & Jeukendrup, A. (2014). Gastrointestinal complaints during exercise: prevalence, etiology, and nutritional recommendations. Sports medicine (Auckland, N.Z.), 44 Suppl 1(Suppl 1), S79–S85. https://doi.org/10.1007/s40279-014-0153-2

Jamshed, N., Lee, Z. E., & Olden, K. W. (2011). Diagnostic approach to chronic constipation in adults. American Family Physician, 84(3), 299–306.

Dr. Alex Jimenez and Dr. Mario Ruja discuss the reasons why functional medicine is important and how it can safely and effectively improve overall health and wellness in a person.

Why Choose Functional Medicine?

Should individuals with existing gastrointestinal problems eat bananas?

Bananas

• Bananas can be easy to digest and are often recommended for nausea and diarrhea, however, not everyone can tolerate them. (MedlinePlus. 2021)
• Bananas are high in fructose, sorbitol, and soluble fiber, which makes them a common trigger for gastrointestinal problems.
• Additionally, individuals not used to eating a high-fiber diet may find it helpful to gradually increase fiber and drink more water to alleviate unpleasant symptoms.
• If there is a suspicion of intolerance, IBS, or malabsorption, it is recommended to speak with a healthcare provider for an evaluation.
• Bananas can make the stomach hurt due to:
• Irritable bowel syndrome (IBS)
• Cramping
• Gas
• Bloating
• Other gastrointestinal (GI) problems.
• Individuals can experience stomach discomfort if there is a fructose intolerance or a rare banana allergy.

Stomach Pain

• Bananas are used to replenish potassium and other essential nutrients lost from vomiting or diarrhea.
• Some individuals can experience bloating and gas after eating them.
• One reason is because of their soluble fiber content.
• Soluble fiber dissolves in water and is more readily fermented in the colon than insoluble fiber.
• This can lead to gas and bloating. (Jackson Siegelbaum Gastroenterology. 2018)
• Bananas also contain sorbitol - a naturally occurring sugar that acts as a laxative and can cause gas, bloating, and diarrhea when consumed in large amounts. (U.S. Food and Drug Administration. 2023)

Irritable Bowel Syndrome - IBS

• Bananas can be a common trigger food for individuals with IBS.
• This is because as bananas break down in the stomach, they can generate excess gas. (Bernadette Capili, et al., 2016)
• Bananas are also high in fructose/simple sugar especially when they have overripened.
• Individuals who have IBS are advised to avoid bananas because they can trigger many of the same side effects as undigested lactose/sugar in milk. (Johns Hopkins Medicine. 2023)
• Ripe bananas are considered to be high in FODMAPS - fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
• Individuals following a low FODMAP diet to manage IBS may want to avoid or limit consumption.
• Unripe bananas are considered to be low-FODMAP food. (Monash University. 2019)

Allergy

• Banana allergies are rare and affect less than 1.2% of the global population.
• Many individuals with a banana allergy are also allergic to pollen or latex because of similar protein structures. (Dayıoğlu A, et al., 2020)
• An individual with a banana allergy may experience wheezing, narrowing of the throat, or hives within minutes of eating.
• They can also experience nausea, abdominal pain, vomiting, and diarrhea. (Family Medicine Austin. 2021)

Fructose Intolerance

• An individual with fructose intolerance has difficulty digesting fructose.
• Individuals with this intolerance should restrict or limit fructose. (UW School of Medicine and Public Health. 2019)
• Fructose malabsorption is when the body cannot digest or absorb fructose correctly. This causes bloating gas and abdominal discomfort.
• Hereditary fructose intolerance is very rare. It happens when the liver cannot assist in the breakdown of fructose.
• This condition often causes more severe symptoms and requires additional treatment besides removing fructose from an individual's diet. (UW School of Medicine and Public Health. 2019)
• Most can tolerate small amounts of fructose found in fruits like bananas.
• There is often more difficulty tolerating large fructose amounts found in honey and high fructose corn syrup. (UW School of Medicine and Public Health. 2019)

Prevent GI Symptoms

• If experiencing gas, bloating, or abdominal discomfort after eating bananas, consider limiting the portion size.
• For example, instead of eating one or more bananas a day, try eating half of a banana to see if symptoms resolve.
• Alternatively, if there is a belief that there is fructose malabsorption, try temporarily removing all high-fructose foods.
• If the body begins to feel better, slowly add foods that contain fructose.
• This can help you pinpoint the foods that are causing the problem. (UW School of Medicine and Public Health. 2019)
• If you're eating bananas that are too green or unripe, you may also experience stomach discomfort.
• Unripened bananas contain high amounts of resistant starch. In large quantities, this can cause mild symptoms like gas and bloating. (Jennifer M Erickson, et al., 2018)
• Resistant starch ferments slowly, so it usually does not cause as much gas as other fiber types. (The Johns Hopkins Guide to Diabetes. 2020)
• Ripe or cooked bananas have less starch and more simple sugars, making them easier to digest. (University of Hawaii. 2006)
• Drinking more water and gradually increasing fiber intake can also reduce GI side effects. (The Johns Hopkins Guide to Diabetes. 2020)

Gut Dysfunction

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

MedlinePlus. Bananas and nausea.

Jackson Siegelbaum Gastroenterology. Colon gas and flatus prevention.

U.S. Food and Drug Administration. Sorbitol.

Capili, B., Anastasi, J. K., & Chang, M. (2016). Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management. The journal for nurse practitioners: JNP, 12(5), 324–329. https://doi.org/10.1016/j.nurpra.2015.12.007

Johns Hopkins Medicine. 5 foods to avoid if you have IBS.

Monash University. Bananas re-tested.

Dayıoğlu A, Akgiray S, Nacaroğlu HT, Bahçeci Erdem S. The clinical spectrum of reactions due to banana allergy. BMB. 2020;5(2):60-63. doi: 10.4274/BMB.galenos.2020.04.013

Family Medicine Austin. Banana allergy.

UW School of Medicine and Public Health. Fructose-restricted diet.

Erickson, J. M., Carlson, J. L., Stewart, M. L., & Slavin, J. L. (2018). The Fermentability of Novel Type-4 Resistant Starches in In Vitro System. Foods (Basel, Switzerland), 7(2), 18. https://doi.org/10.3390/foods7020018

The Johns Hopkins Guide to Diabetes. What is resistant starch?

The University of Hawaii. Cooking banana.