12 Ways to Overcome Constipation
Throughout my first 23-24 years of life, I suffered with constipation. Growing up, my family used to joke that if someone had to use the bathroom while I was in there, you might as well do something else because it was going to take a while!
I felt terrible when I was in a constipated state and it impacted by breath, body odor, mental clarity, skin and overall energy levels. It wasn’t unusual to spend 10-15+ minutes training to strain at the stool. At that time in my life, I thought it was a normal part of life. I didn’t know that my diet and lifestyle impacted it. In my early 20’s as a personal trainer, I began to realize that drinking a lot of water seemed to help and that was the first big clue in that I could do things to reduce or even get rid of constipation naturally.
When waste sits or moves very slowly throughout our digestive tract, it gets fermented by microbes and becomes a literal breeding ground for all kinds of nasty microbial species. These species than release all kinds of toxins that create a stress response in our body and increase whole body inflammation levels. If you are struggling with constipation than take it seriously! It is a major problem and must be addressed in order to reduce inflammation and adapt to the stressors of life successfully.
Healthy Bowel Movements
Constipation is a gastrointestinal disorder symptomatic of the difficulty or infrequency to have a healthy bowel movement. Signs of constipation include abdominal pain, protrusion of the lower gut, poor appetite, headache and even dizziness. This problem can significantly impact the quality of life for all ages affecting 20% of the population (1).
Gastroenterology associations such as the Rome III Criteria for Adults classifies individuals who have fewer than 3 bowel movements weekly as constipated (23).
The Bristol Stool Scale is a tool used to relate colonic transit time, or the time it takes for stool to pass through the colon, with the physical appearance and consistency of stool. According to the scale, types 1 and 2 are associated with constipation. The opposite end of the scale (types 5-7) is associated with diarrhea and types 3 and 4 are generally considered normal stool. (24)
Healthy digestion is reflective of normal stool that is brown in color, does not have visible food remnants, and is smooth, soft and snake-like in appearance. Individuals struggling with constipation will have stool that is hard and difficult to pass separated lumps that resembles nuts. Stool that is formed but still lumpy is also associated with constipation. If you suffer from constipation, read on to overcome your health struggle.
Top 10 Causes of Constipation
Chronic constipation can be affected by various factors relating to biological, behavioral, and psychological health. The following causes are of the top 10 associated with constipation.
1. Intestinal Dysbiosis
One of the most important disturbances related to this multifactorial gastrointestinal disorder is linked to abnormal gut microflora which induces a variety of adverse health consequences such as lowered immunity and nutrient deficiency. Researchers propose that the an imbalance of the 1000 unique species of bacteria that reside in the gut can reduce intestinal motility and change the homeostatic mechanisms that allow the gut to function optimally (1).
A healthy balance of gut bacteria is essential to healthy digestion and preventing constipation. Beneficial bacteria coexist in the gut with other potentially pathogenic bacteria which can be harmful if allowed to overpopulate.
Intestinal microbes breakdown food particles and produce essential compounds for modulating total health and immunity such as short chain fatty acids. Increased concentrations of pathogenic bacteria inhibit metabolic functions in the gut which normally aids in the movement of waste through the intestines. Partly responsible is the reduction of mucous production. (1)
2. Insufficient Dietary Fiber
Dietary fiber is essential for the fermentation process of bacteria. This fermentation process feeds bacteria such as Lactobacilli and Bifidobacteria that produce a “pro-motility” like effect on the intestines (1). Fiber is therefore also believed to suppress the growth of pathogenic bacteria species. A lack of adequate fiber in an individual’s diet can cause a significant reduction in the bulk of stool resulting in difficulty to have a bowel movement.
Another contributing factor to stool weight are the gases produced during bacterial fermentation. Hydrogen, carbon dioxide and methane are three primary gases which increase the size of stool and quicken the transit time of stool through the colon.
3. Food Sensitivities
Individuals with food sensitivities are often affected by an altered gut microbiota. These individuals should seek ways to restore their intestinal microbial balance to reduce the occurrence of constipation.
Some of the most common foods you should consider eliminating include gluten, soy, corn, peanuts and pasteurized dairy. Other foods may be triggers of your intolerance including processed foods and alcohol which increase inflammatory disturbances in the gut. (25)
SIBO (small intestinal bacterial overgrowth) is a condition which as the name suggests, is characteristic of the abnormal growth of bacteria in the small intestine which are typically present in the colon.
The reasons for the impaired transit time of stool in patients with SIBO are not completely understood. One reason for this constipation and abdominal distension in these individuals may possibly be due to excess bacterial fermentation and overproduction of certain gases. (1)
5. Poor Sleep
Problems associated with lack of sleep can cascade into a series of health disturbances which result in symptoms of constipation. Adequate sleep is essential for behavioral, physiological, psychological and physical health.
Restricting sleep is associated with hormonal dysfunction, inflammation, lowered immunity, metabolic complications and an overall reduced quality of life. These factors increase stress and are also associated with symptoms such as weight gain.
Sleep is a critical time the body is able to repair itself and is also a period that the digestive system is given time to relax. Sleep experts recommend 7-8 hours of sleep per night is vital to health. (19)
Chronic stress has several negative consequences on the gastrointestinal tract. Whether or not a threat is real or perceived, the human body has developed an innate flight or fight response. This means that all bodily functions that are not essential for preparing the body for flight or fight are temporarily put on hold so that energy can be directed accordingly. Thus chronic stress on the body inhibits the digestive system from effectively digesting, absorbing and removing waste.
The muscle relaxant magnesium also becomes depleted due to stress further hindering the movement of stool through the bowels (10). Furthermore, the secretion of inflammatory chemicals like cortisol and histamine are released from the vagus nerve in the brain and gut weakening immunity and slowing digestion (18).
The lack of proper hydration is a common occurrence in people who experience constipation. Water is required to help maintain electrolyte balance and to provide the support for indigestible fiber by adding bulk to stool for easy passage (5). Water secretion aids in intestinal motility by lubricating stool during contractions for the easy movement of waste into and out of the colon.
8. Electrolyte Imbalance
Critical minerals are essential for promoting the health of the colon. A few of these include sodium, magnesium and phosphorus (10). A specific concentration is required to provide the healthy function of nerves and muscles in the colon. These electrolytes aid in muscle contraction to move stool through the bowels and support nutrient absorption. (5)
You may have skipped reading the side effects and warnings label but the medications you are taken can commonly produce side effects of constipation. Medications influence gut health and can disrupt the healthy concentration of gut bacteria. The gut also contains receptors for many pain killers like ibuprofen and aspirin which bind to these compounds and interfere with motility. Other medications act as diuretics and increase the likelihood of hard to pass stool. (20)
Discuss the problem with your prescribing physician to determine if your pharmaceutical drugs are to blame.
10. Chronic Conditions
Chronic conditions that affect an individual’s health can cause constipation. A few examples are listed.
- Irritable Bowel Syndrome
- Inflammatory Bowel Disease
- Leaky Gut Syndrome
Some of these conditions can be associated with diarrhea but also cause health problems that disrupt digestion and contribute to signs of constipation. Inflammation in the intestines and colon can disrupt the flow of stool, promote nerve damage and cause symptoms associated with constipation such as cramping and bloating.
Gas and Your Gut Health:
Some research indicates that individuals who experience constipation have a higher concentration of methane gas than healthier individuals (1). Patients with constipation exhibit the excessive production of methane gas by bacteria in the gut microbiota. This results in a slower transit time for stool to pass through the colon. Individuals with constipation related irritable bowel syndrome were detected to have high methane production. (12)
In a case study, researchers found that the treatment of methane producing of bacteria given using antibiotics significantly improved stool frequency from less than 3 times per week to 1 time per day. Other studies have shown that the infusion of methane gas in animal studies resulted in the slowed rate of gut motility. All mechanisms by which excess methane gas slows gut motility is unclear but may be associated with a reduction in serotonin production along with abnormal intestinal motility. (12)
How Laxatives Work:
Various forms of laxatives exist today and can be taken as an enema, a tea or a pill to swallow. Each type of laxative has a different function that can alter the digestive process.
Unaware of this, most people also don’t realize that several environmental conditions of the gut can contribute to constipation including electrolyte balance, enzymes, water, blood flow and even hormones. It is necessary to understand how laxatives work given that 85% of doctor’s visits today end with a laxative prescription (2).
Generally taken because a person is struggling with constipation, laxatives are substances that promote bowel movement through various strategies. Over-the-counter laxatives act as stimulants increasing the contraction of muscles in the intestines and improving hydration of stool. Other types of laxatives function as:
- Bulking agents: Increase slow transit times and include common products such as Metamucil and Benefiber.
- Surfactants: These laxatives act as lubricants reducing the surface tension of stool creating a slippery effect using mineral oils.
- Osmotic or hyperosmolar products: These forms of laxatives hydrate the intestines using fluids like saline in an enema.
Bulking agents are typically first recommended to patients for the treatment of constipation. Unfortunately, most people consume over-the-counter stimulant laxatives such as Dulcolax, Senokot and Ex-Lax. Overuse of laxatives pose the risk of upsetting the normal biological function required for healthy regularity.
Dangers of Laxatives:
One of the primary reasons for laxative abuse can be said to have originated as a means for weight control. Laxatives have the appeal as a quick and easy fix in dropping pounds in society where the majority of men and women are concerned about food intake and weight gain.
The notion that laxatives can interfere with the absorption of calories and thus inhibit weight gain is not only false but also dangerous. The overuse of laxatives is associated with dangerous side effects including: (4, 5)
- Weight loss/ weight gain
- Struggle between constipation and diarrhea
- Irritable Bowel Syndrome (IBS)
- Reduction of digestive enzymes
- Electrolyte imbalance
- Cardiovascular system problems
- Faint or dizziness
- Water retention/ bloating (edema)
- pH imbalance
- Damage or infection to digestive organs and colon
- Colon cancer
- Possibly death
Once laxative use is ended, it is common for individuals to experience gastrointestinal discomfort. Laxatives which stimulate the muscles in the intestines to contract can actually weaken the natural involuntary ability of these muscles to function on their own following long term exposure to a stimulant agent.
This hazardous effect can lead to laxative dependency to promote intestinal movement (3). Lubricant style laxatives can also interfere with the ability of the intestines to absorb fat-soluble vitamins resulting in a vitamin deficiency.
Another problem following laxative consumption is that the body desires to retain water in the digestive system leading to problems like bloating, “water weight” gain, and possibly a slower metabolism. This discomfort typically leads people to continue laxative use again because they are left with signs of irregularity and anxious about their misunderstood temporary weight gain (5).
Instead of consuming a laxative opt for a high quality probiotic. Probiotics contain live microorganisms which support the softening of stool and can increase the frequency of having a healthy movement. Probiotics reduce symptoms of constipation by: (1)
- Improve intestinal microbiota
- Enhance gut motility and function
- Stimulate factors that regulate the homeostatic mechanisms of the gut
11 Ways to Prevent Constipation
Most people think about taking in more fiber when it comes to improving bowel tone. This can be a good strategy for many, although certain individuals may struggle with various fibers. In general, consuming fiber rich foods like avocados, fruits, vegetables, nuts and seeds can be helpful. Here are some additional great strategies to apply:
1. Consume More Fat
The body demands fat for the optimal functioning of our organs and cellular processes. Fat helps regulate hormone function and is also partly responsible for intestinal motility. One clinical study showed that consuming a high fat diet for only three days decreased the time frame for which food remained in the stomach.
The study also indicated that cardiovascular health also improved following a high fat diet indicating that fat is essential to the overall function of the human body. (13) Good fats to consume include coconut oil, coconut butter, coconut flakes, grass-fed butter or ghee, avocados, olives and olive oil.
2. Consume More Salt
Just as many people are convinced to hitch up to the diet craze bandwagons that flood the markets around us, perhaps you thought you should be avoiding salt altogether as well. Salt is a life-sustaining nutrient that promotes thyroid function, adrenal health and electrolyte balance. Alterations to these life processes very easily can create symptoms of constipation.
Research supports that you should be consuming 1.5 to 3.5 teaspoons of salt per day (14). You can consume the some of the salt you need from natural sources such as beets, carrots, spinach, turnips, fish and sea vegetables (ie. kombu, kelp, dulse). (15) I also recommend using a high quality sea salt or even better, pink salts on your foods.
3. Super Hydrate
Reducing your consumption of the caffeinated and sugary beverages throughout the day may be your first battle in receiving proper hydration. These drinks can offset the osmotic balance of the gut and inhibit gut motility.
Increase your water consumption to include drinking a minimum of half of your body weight in ounces daily and three quarters of your body weight in ounces during the summer. Drinking up to 24 oz and no less than 8 oz of water when you first wake up is a great way to support healthy bowel activity.
For immediate relief of constipation, try drinking 4 oz of water with 2 tsps of pink salts mixed in, this is called sole. Drink the sole (it will make you gag a bit!) and then follow-it up with 8 oz of water and then slowly sip water for the next 15 minutes. The salt water will create an osmotic pressure that will draw more water into your colon and flush out waste. You will have major urges to go and wet stools. This technique acts like giving yourself an oral enema.
4. Improve Your Stomach Acid Levels
Most people with chronic constipation have very low stomach acid levels. Stomach acid is important for triggering the entire digestive system by properly breaking down proteins and stimulating the release of bile from the liver and gallbladder as well as pancreatic enzymes from the pancreas.
Stress depletes our ability to produce adequate stomach acid, which then causes poor digestion and inflammation in the gut and worsening stress and inflammation on the body. This pattern is a vicious cycle that results in progressively worsening health. This article discusses how to improve your stomach acid levels.
5. Aloe Vera
Aloe vera has been traditionally used as a natural laxative treatment and is well supported by research. Aloe vera is compact with gut healing compounds and nutrients including vitamins, minerals, electrolytes and enzymes.
Aloe vera has anti-inflammatory properties that stimulate digestive secretions, regulate pH, enzyme activity and support healthy bacteria. Part of its laxative effect is a result of the anthraquinones found in aloe. These compounds enhance intestinal hydration, mucus secretion and intestinal peristalsis. (6)
I enjoy drinking aloe vera juice and gel and it does help to soothe the gut and improve bowel motility to break the chain of constipation!
6. Fermented Foods and Drinks
Increasing the healthy bacteria in your gut can be achieved by consuming fermented foods and beverages. Fermented foods contain live and active cultures of bacteria which support intestinal health. Add fermented veggies like sauerkraut, kimchi and homemade pickles into your diet as well as coconut water kefir and kombucha.
7. Eat Seeds
Seeds such as pumpkin, chia and flaxseeds are excellent sources of adding fiber into your diet. Combined with increased water intake, chia seeds swell and form a gelatinous substances which easily moves through the digestive tract.
Flaxseeds exhibit much of the same laxative activity as do chia seeds and can be easily added tastelessly into your foods (7). Seeds like pumpkin are also some of the most nutrient dense food sources and contain minerals that promote digestion (8). Snack on these, use flax crackers and sprouted pumpkin seeds like these here
Using a pea protein powder can also be a great strategy to help improve bowel motility. I have seen great success helping many clients overcome constipation issues with my gut healing protein powder here.
8. Bone Broth
Bone broth is a rich source of anti-inflammatory nutrients containing collagen, chondroitin sulfate, gelatin, calcium, phosphorus, magnesium, potassium and amino acids (16). Bones contain a gelatinous material and the raw nutrients required to sustain digestive system function and healing.
Bone broth is especially critical for individuals with gut disorders such as leaky gut syndrome because it is effective in killing the overgrowth of bacteria and parasites that can invade neighboring tissue. (17)
A diet rich in magnesium has been shown to have tremendous anti-inflammatory abilities (9). Magnesium is one of the most popular supplements used to treat constipation for its ability to relax the muscles encouraging the movement of stool (10).
Adding a high quality magnesium supplement to your diet and increasing your uptake of magnesium rich foods sources can help you overcome constipation. Excellent plant sources include green veggies, nuts and seeds.
I personally drink my Brain calm magnesium supplement in water throughout the day. Taking 1-2 scoops (or more) in water is a great way to improve your bodies ability to adapt to stress, think more clearly and stimulate bowel motility.
The signs you would be getting too much magnesium would either be loose stools, light headedness or leg cramps in conjunction with high dose magnesium intake. Until you notice these things, you can continue to take more magnesium.
Due to my heavy workload and stressful responsibilities, I will easily do 3-4 grams of supplemental magnesium on some days and it makes a HUGE difference in how I feel and how mentally alert I am. On top of that, I seem to move my bowels the best when doing these large doses of magnesium on a regular basis.
Increasing the amount of physical activity you perform daily will not only help treat symptoms of constipation but it may also help you in the fight against what was leading you to take laxatives to begin with. One movement that is particularly effective for stimulating bowel activity is rebounding off of a small trampoline. This light bouncing motion helps to stimulate intestinal contractions and move fecal material. You can read more about rebounding in this article.
Exercise has countless other health benefits including combating fatigue, relieving stress, reducing signs of depression and anxiety, lowering pain sensitivity and improving the frequency of your bowel movements (11).
11. Elimination Diet
An elimination diet can help you understand what foods may be contributing to the constipation. Here are 5 steps to take to practice an elimination diet in this article. This process involves eliminating the most common food triggers for inflammation and constipation for a period of time and then later reintroducing them and observing for any increase in symptoms.
Some of the major foods that are known to contribute to constipation include:
- Gluten containing foods
- Dairy containing foods
- Processed Foods
- Corn and Soy containing foods
- Sugar alcohols such as xylitol, manitol and erythritol
- Higher FODMAP foods for some individuals.
12. Cop a Squat
Our ancestors used to poop in a hole in the ground. In many cultures, the toilet is much lower to the ground than the traditional western world has it. Squating down deep is not only very good for our back and legs but it also helps to open up the colon in such a way as to get a better release of fecal material.
This process has been shown to relieve the tension from your intestines and allows for a much easier elimination process.
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