Tips for Preventing Constipation

The other day when the dialysis health care team met with a peritoneal dialysis (PD) patient for their monthly doctor visit, the nephrologist asked the patient, “How are your bowels doing? Are you having a bowel movement daily? You know, PD doesn’t only stand for peritoneal dialysis—it also stands for poop daily.” Of course, we all laughed while agreeing with the doctor. Bowel movements are not on the top of anyone’s list to discuss; however, it is important to discuss with your dialysis health care team. Read on for three tips for preventing constipation.

Constipation Issues

Whether you are a hemodialysis or peritoneal dialysis patient, having regular bowel movements is important to prevent constipation. If you are constipated, it may negatively affect your food intake. Even worse, for peritoneal dialysis patients, it may lead to low drain volumes or peritonitis. Peritonitis is an inflammation of the peritoneum caused by bacteria or fungus. Work with your dialysis health care team to keep your bowel movements regular.

The tips below may help to prevent constipation.

Physical Activity

Add in physical activity. Increasing your activity helps to stimulate the bowels. Try walking, gardening, stretching or light housework. Always discuss your physical activity options with your physician before starting an exercise or activity.

Routine

Get into a routine. Eating meals at the same time of day may help promote regular bowel movements. Listen to your body and do not delay using the bathroom.

Dietary Fiber

A diet high in dietary fiber may help to keep your bowels regular. There are two important types of fiber, soluble and insoluble. Both of these fibers are found in plant-based foods.

• Soluble fiber is easily broken down into a gel-like substance that helps stool retain water, softening the stool and making it easier to pass. This type of fiber may also be beneficial in lowering cholesterol levels. Sources of soluble fiber are oats, peas, beans, citrus fruits, apples, carrots, barley and psyllium.
• Insoluble fiber does not dissolve in water. It adds bulk to stool, which helps waste pass more quickly through the intestines. Insoluble fiber may be beneficial to those who have constipation issues. Sources are wheat bran, whole wheat flour, nuts, beans and vegetables.

If you have been on dialysis for a number of years, you may have been told to limit your consumption of beans and whole grains due to their potassium and phosphorus content. Today’s kidney diet is more liberal to include these high-fiber foods. Speak to your dialysis dietitian on how to plan these into your dialysis diet. Portions and frequency are important.

Phosphorus and Potassium

When it comes to the phosphorus in plant-based foods, they contain organic phosphorus. This phosphorus is bound to phytates and this form is not easily absorbed into the bloodstream, unlike the inorganic phosphorus additives.¹ See the article “Including Whole Grains in a Kidney Diet” for more information.

In regards to potassium, work with your dialysis dietitian to find out how much of these foods you may include in your diet to keep your potassium levels within goal. Peritoneal dialysis patients may enjoy more potassium-rich food choices because of the increased frequency of treatments and easy removal of potassium through peritoneal dialysis.

High Fiber Recipes

Here are some kidney-friendly bean recipes:

• Amaze-ing Bean Dip
• Crock-pot ® Chicken and White Bean Chili
• Southwest Holiday Pasta Salad
• Spicy Chickpeas (Chana Masala)
• Zucchini, Black Beans and Rice Supper

Read “Embracing More Plant-Based, Kidney-Friendly Foods” for more information on plant-based eating. Download Today’s Kidney Diet: Veggie Lovers cookbook, which contains great vegetarian recipes to get you started, or visit DaVita.com for additional recipes.

The Academy of Nutrition and Dietetics states that women should aim for 25 grams of fiber per day, while men should target 38 grams, or 14 grams for every 1,000 calories.²

For more information on how to add dietary fiber to your diet, read “Fiber in the Kidney Diet” on DaVita.com and speak with your registered dietitian. If you are constipated, inform you dialysis healthcare team. They may prescribe a kidney-friendly medication to help alleviate it. Do not take any over the counter medication before speaking with your dialysis health care team.

Resources:

1. Bump, Michelle. Journal of Renal Nutrition. Organic Phosphorus Versus Inorganic Phosphorus: Empowering Adult Kidney Patients With Nutrition Education. Vol 26, No 5. September 2016, pp 31-33.
2. https://www.eatright.org/food/vitamins-and-supplements/types-of-vitamins-and-nutrients/easy-ways-to-boost-fiber-in-your-daily-diet.  Accessed 9/23/20.
3. “Managing Constipation” DaVita educational material; 2017.

Visit DaVita.com and explore these diet and nutrition resources:

• DaVita Food Analyzer
• DaVita Dining Out Guides
• Today’s Kidney Diet Cookbooks
• DaVita Kidney-Friendly Recipes
• Diet and Nutrition Articles
• Diet and Nutrition Videos
• Kidney Smart® Virtual Classes

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.