Constipation is becoming an increasingly common health concern in our society. It can make you feel sluggish, tired, bloated, and just downright uncomfortable. While most doctors will suggest eating more fibre and other generic recommendations, most people who experience regular constipation have probably already tried these without success. This article covers underlying causes of constipation, why you should avoid laxatives, information on fibre consumption, common remedies, and unconventional remedies for constipation.
Symptoms of Constipation
Symptoms include difficulty passing or straining during a bowel movement, hard and/or dry stool, a sense of incomplete bowel movement, and/or going more than 3 days without a bowel movement. More severe symptoms include abdominal pain and even vomiting (source).
While everyone is different and some people will go longer between bowel movements, if you feel constipated (bloated, uncomfortable, etc), then you likely are.
What Causes Constipation?
Constipation can be caused by many underlying problems, here are some of the most common:
- Poor diet and/or insufficient fluid intake
- Lack of exercise
- Conditions affecting hormones such as hypothyroidism
- Overuse of laxatives and/or antacids
- Some supplements such as iron pills
- Some pharmaceuticals such as anti-depressants and painkillers
- Imbalanced gut flora such as SIBO or Candida
- Hypochlorhydria (low stomach acid)
- Food allergies and intolerances
- Poor digestion (lack of digestive enzymes)
- Poor circulation, nerve, and/or muscle function
While much less common, structural abnormalities can also cause constipation. If you experience chronic constipation, it is recommended that you make an appointment with your doctor or alternative health care provider to get tested for some of the underlying conditions. This will help you determine the most effective remedies for your body.
Why You Should Avoid Laxatives
Stimulating laxatives (such as Ex-Lax) should be avoided at all costs, especially for those who deal with chronic constipation. This is because they are severe gut irritants and can worsen constipation in the long run. WebMD states "This type of laxative may weaken the body's natural ability to defecate and cause laxative dependency" (source). Stimulating laxatives work by irritating the colon which increases contractions and causes the colon to expel its contents to rid itself of the irritant. Although it may be obvious that over-the-counter products such as Ex-Lax fall into this category, many herbal remedies do as well, including Senna and Cascara Sagrada.
Why Eating More Fibre is Not Always The Best Remedy
There are two types of fibre: soluble and insoluble. While soluble fibre is helpful for constipation and gut health, insoluble fibre can have the opposite effect. What's the difference? While there are some exceptions to this rule, soluble fibre works as a prebiotic, meaning it feeds the beneficial bacteria that live in the colon. This can help constipation by correcting bacterial imbalances and healing the gut. On the other hand, insoluble fibres primary function is to increase bulk in the colon, but it can also irritate the gut in large amounts and promote inflammation. This added bulk was once thought to help constipation, but now it it has been implicated as a possible cause of constipation itself (source). Anyone who suffers from IBS/IBD should avoid large amounts of insoluble fibre in their diet. While most foods contain both soluble and insoluble fibre, there are foods that are much higher in insoluble fibre includinggrains, legumes, nuts, some fruit, and most seeds. Foods that are higher in soluble fibre include vegetables, some fruits, and chia seeds.
Bottom line: To help constipation, eat lots of vegetables along with fruit and chia seeds in moderation, while avoiding grains, legumes, nuts, and some seeds. A great drink to help constipation would be GTs Chia Kombucha, lots of soluble fiber, probiotics, and essential fatty acids!
Common Remedies For Constipation
1. Drink More Water
Being dehydrated is a common cause of constipation, so make sure you are drinking around 8 cups of water a day. This helps hydrate your colon and makes bowel movements easier to pass. While there is no set amount of water that you should be drinking, I find the 8 cup rule to be a helpful guideline. Make sure the majority of this amount is drank as actual water and not soda or juice.
Exercising can help constipation because it helps stimulate the natural contraction of the intestinal muscles and decreases the time it takes for waste to move through the large intestine. By decreasing this time, it reduces the amount of water that can be absorbed from the waste which makes bowel movements easier to pass. Exercise can also help constipation in other ways such as reducing stress and balancing hormones.
3. Increase Fat Intake
Eating more fat helps lubricate the intestines and also increases bile secretions, both of which contribute to digestive motility which makes bowel movements easier to pass. Make sure you are getting your fats from healthy sources (such as grass-fed butter, coconut oil, and olive oil), while avoiding vegetable oils and other refined fats.
4. Supplement Magnesium
Magnesium is a natural muscle relaxant that many people find useful for easing constipation. It works by helping relax the muscles in the intestine and also hydrating the colon by attracting water. Magnesium citrate is the most commonly used magnesium supplement for constipation. Magnesium oxide is not recommended as it is not well absorbed in the body. Magnesium gluconate, bisglycinate, and other chelates may also be helpful, but magnesium citrate is the most effective for immediate constipation relief. Magnesium hydroxide is sometimes used as a stronger laxative, but this should not be supplemented regularly. It is recommended to supplement magnesium citrate before bed because it also has a relaxing effect that is helpful for falling asleep.
5. Supplement HCl and Digestive Enzymes
Constipation can be caused by low stomach acid (hypochlorhydria) and poor digestion. While proper diet and lifestyle factors are very important to both these conditions, supplementing HCl and digestive enzymes can also be useful to help support digestion initially. There are 2 at-home tests that can be done to test for low stomach acid; the beet test, and the HCl test. For the beet test, simply drink a glass of beet juice and observe the colour of your urine. If you have pink or red urine after drinking beet juice, this is a sign of low stomach acid. Check with a doctor before trying the HCl test as certain medications can increase the risk of ulcers. For the HCl test, take a capsule of betaine HCl on an empty stomach. If you experience a burning feeling in your stomach, you can alleviate it with milk; this means you have sufficient stomach acid. If no burning sensation is experienced, you most likely have low stomach acid.
If you or your doctor have determined that you have low stomach acid, you should supplement a digestive enzyme complex that also contains betaine HCl such as NOW Super Enzymes. If you do not have low stomach acid, you should supplement a digestive complex without HCl such as Assertive Wellness Enzyme Spectrum. Keep in mind that overeating is a common cause of low stomach acid, so its a good idea to practise mindful eating at meal times as well.
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6. Supplement Magnesium Peroxide
Magnesium peroxide is different than supplementing magnesium citrate. It works by oxygenating the colon which helps remove dry fecal matter that the body may be having difficulty removing. This supplement helps keep you regular without a sense of urgency or cramping. Many people who suffer from chronic constipation have found relief supplementing magnesium peroxide. Give this supplement a try if you haven't found other supplements helpful. Read more about the supplement here.
7. Vitamin C Flush
A vitamin C flush is a safe way to create a strong laxative effect. This is helpful for people who experience chronic constipation as a way to get things moving. The basic protocol for a flush is to use a buffered vitamin C powder and drink a dose every 15 minutes until an evacuation has been achieved. Vitamin C tolerance is different for everyone, some people will flush at low amounts while others can require over 50 grams to achieve a flush. Some added benefits to a vitamin C flush is increased energy and immunity! Read here for a full description on how to do a vitamin C flush. Keep in mind that this is not a long term solution to constipation, but rather a way to get things moving without using harsh stimulating laxatives.
Enemas are another safe way to get things moving. Purified water or coffee enemas are the most gentle types. Enemas can be performed occasionally for constipation, but some people also use coffee enemas more frequently to help with detoxifications and a variety of other health conditions. Keep in mind that if you chose to perform an enema you must replenish your electrolytes quickly once finished. This can be done in the form of bone broth, coconut water, or electrolyte drink. Read here for more information on coffee enemas and how to get started with them.
9. Abdominal Muscle Massage
Manual stimulation is another way to get things moving. You can usually find a registered massage therapist that would be willing to do an abdominal massage for you, but you can also do it yourself. Abdominal massage is especially helpful if your constipation issues are due to poor circulation or lack of exercise/movement.
10. Autoimmune Paleo (AIP)
What about Prunes?
Prunes, prune juice, and other dried fruits (such as apricots) have long since been recommended as a natural constipation reliever, but they won't work for everybody. People with bacterial imbalances, IBS-C, or FODMAP intolerance may find that prunes create bloating, gas, and discomfort without constipation relief. This is because prunes are high in sugar and FODMAPs. Eating prunes or drinking prune juice is worth a try if you have never tried it as a constipation remedy, but you may want to keep a back up plan in mind!
While constipation is usually not considered a serious health problem, if you have gone 6 or more days without a bowel movement you should seek medical help immediately. If left untreated, severe constipation can have some extremely serious health consequences such as nerve damage and even (in rare cases) death.
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