Ginger

 

Evidence exists for ginger decreasing stool transit time. A study on the effect of ginger on intestinal transit time found that ginger significantly propelled a charcoal meal through the small intestine by potentially mimicking the action of acetylcholine.

 

Another study demonstrated that (6)-gingerol and (10)-gingerol found in ginger root had bile-stimulating effects, thereby enhancing laxation [22]. 

 

Okra

 

Okra contains a pectic polysaccharide that forms a mucilage gel that absorbs water and expands. This gel has excellent mucoadhesive properties and helps lubricate the intestines to facilitate the passage of the stool. The gel also exhibits anti-inflammatory and anti-irritant activity of the intestinal lining. 

 

The gel of Okra is also used in conventional medicine as a binder and carrier for medicines, allowing targeted release of a substance within the colon [51].  

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Several probiotics have also been encapsulated in the mucilage of both linseed and okra to encourage targeted delivery to the colon [23]. 

 

Okra can be found fresh, frozen or canned in the supermarket year round. Simply by adding water to okra to form a gel, and straining the gel to separate it from the okra. A probiotic can be mixed into this gel and swallowed to help avoid degradation and improve delivery to the colon. 

 

Flaxseed Meal and Oil

 

Flaxseed oil and the mucilage from Flaxseed meal both exhibit laxative activity, mediated primarily through cholinergic pathways [24]. 

 

Cholinergic pathways are part of the autonomic nervous system that plays a crucial role in controlling gut motility, secretion, and overall digestive processes.

 

In one study, subjects experiencing Intestinal Hypomobility were assigned to receive 50 g per day of flaxseed meal. After 4 weeks, the bowel habits significantly improved, with bowel motion frequency per week increasing significantly from 2 to 7 [25].

 

In another study 55 patients received 6 - 24 grams per day of either flaxseed or psyllium husk for 3 months. In the flaxseed group, Intestinal Hypomobility and abdominal symptoms decreased significantly, whereas in the psyllium group the reduction was not statistically significant [26].

 

Prunes

 

Prunes are powerful laxatives due to their high content of a sugar molecule called sorbitol, containing 14.7g per 100 g. Sorbitol acts as an osmotic laxative, as it has the capacity to hold onto water [27].

 

By increasing water retention, it increases stool weight, and also softens the stool, making it easier to pass. 

 

Studies also reflect intake of prunes supports increased bowel motions, stool consistency and reduced straining. When compared directly to psyllium husk for Intestinal Hypomobility, both studies reflect Prunes are superior [28],[29]. 

 

Kiwi Fruit

 

In a study carried out with 42 elderly patients suffering chronic Intestinal Hypomobility. Kiwi fruit consumption was set at one kiwi per 30 kg of body weight per day for 3 weeks. The results reflected a significant increase in the frequency of defecation, stool volume, stool softness, and ease of defecation.  

 

It is proposed that a compound known as Actinidin, which is a cysteine protease, a type of enzyme that breaks down proteins by cleaving peptide bonds, thereby enhancing protein digestion and decreasing gastrointestinal transit time [30]. 

 

To note: other protease cysteines are found in pineapple, papaya, and figs. 

 

In another study, 32 Participants received three kiwis or 14.75 g Metamucil ® daily for 4 weeks. Results showed the number of bowel motions per week were significantly greater during daily consumption of three kiwis compared to the Metamucil®. Furthermore gastrointestinal discomfort and abdominal pain also improved during the kiwi fruit consumption [31].

 

Cayenne Pepper and Chilli 

 

Capsaicin is the active constituent in Cayenne Pepper and other forms of Chilli. Studies have shown that Capsaicin activates cholinergic excitatory nerves, adrenergic nerves, and neurons containing nitric oxide synthase, which are the main muscle motor neurons of the enteric intestinal nervous system [32]. 

 

By activating these motor neurons, gastrointestinal motility increases, and subsequent bowel motions are more regular. 

 

Bitters

 

Activation of bitter taste receptors (TAS2Rs) within the foods we eat plays an advanced biological role in protecting us from harm by supporting elimination means of substances that could potentially be toxic due to the nature of their bitter state. 

 

This impressive protective mechanism works in our favour with bitter compounds that are not harmful by stimulating these receptors to still provoke gastric motility rates [33].

 

A unique Bitter Receptor is TAS2R16, which responds to 30 different bitter glucoside compounds, some of which do not need to have a particularly strong bitter taste.

 

Increase Foods Activating TAS2Rs
 

• Bitter Melon

• Brussels Sprouts

• Kale

• Cabbage

• Broccoli

• Rocket

• Horseradish

• Radishes

• Mustard Greens

• Coffee

• Grapefruit

• Cocoa

 

Fibre, friend or foe

 

Fibre is fermented by the microbiota, with production of short chain fatty acids (SCFAs), including butyrate, acetate, and propionate, which create osmotic load, accelerating intestinal transit. 

Therefore fibre is necessary for alleviating Intestinal Hypomobility, but particular fibres can actually make Intestinal Hypomobility and other GI symptoms much worse, so it is important to understand the different types of fibre. 

 

Primarily there are 2 types of fibres, Soluble fibre and Insoluble fibre. 

 

Insoluble fibre does not dissolve in water, therefore it serves to add bulk to the stool. In the case of regular stools with slow transit time or partial emptying, insoluble fibre is beneficial. In the case of compact and hard to pass stools, insoluble fibre should be limited. 

 

Soluble fibre on the other hand dissolves in water and has been shown to provide a natural laxative effect by improving stool water content, softness and consistency, all of which support transit, increase the amount of bowel motions and support the ease of elimination [34]. 

 

Although, soluble fibre is fermentable by gut bacteria, and in order to preserve its mechanism of action fermentation needs to be resisted. Soluble fibres that have rapid fermentation rates do not provide the same laxative benefits, and can exacerbate GI symptoms such as bloating, discomfort and even Intestinal Hypomobility. Whereas soluble fibres with low fermentation rates encourage laxation [35].   

 

Low Fermentable, Soluble Fibre 

Increase for Laxative effects 

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• PHGG - Partially Hydrolyzed Guar Gum

• Psyllium Husk

• Flaxseed

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Rapid Fermentable Fibres

Limit in the case of excessive gas and bloating 

 

• Inulin

• Fructooligossacarides (FOS)

• Galactooligossacaides (GOS)

 

FOS and GOS foods can be found in the dietary section of our SIBO information, click here: 

 

Insoluble Fibres, per 100g

Limit in the case of compact and hard to pass bowel motions 

 

• Wheat Bran: 42g

• Rice Bran: 38g

• Chickpeas: 7.6g

• Beans: 7g

• Lentils: 6.5g

• Almonds: 3.5g

• Unripe Banana: 2.6g

• Potatoes: 2.4g

• Rice with the husk: 2g

 

To note: Wheat Bran can be found in products such as Weet-Bix, Up & Go and Kellogg’s All-Bran. 

Wheat bran is a large and coarse fibre that mechanically irritates the gut mucosa to stimulate water and mucous secretion and Remedy Lane recommends avoiding this type of laxative [36].