A Holistic Approach to Constipation

Constipation is the most common digestive complaint in the United States, as more than 4 million Americans have frequent constipation, accounting for 2.5 million physician visits a year. In addition, over $ 725 million is spent on laxative products each year in America. (2)

In a healthy body, waste travels through the digestive tract in a predictable, regular cycle, usually taking between six and twenty-four hours to pass. Sometimes, however, waste matter passes through the large intestine too slowly, and the result is called constipation. When the bowels are constipated, it may be difficult or impossible to pass stools; in fact, the urge to pass may be absent altogether.

How to tell if you’re Constipated (2)

• Infrequent bowel movements (typically three times or fewer per week)

• Difficulty during defecation (straining during more than 25% of bowel movements or a subjective sensation of hard stools)

• The sensation of incomplete bowel evacuation

• Two or fewer bowel movements in a week.

Sometimes constipation has no signs other than the lack of bowel movement, but, usually, it is accompanied by a host of uncomfortable symptoms, ranging from a general feeling of malaise to a distended abdomen and painfully hard stools. Many people think of constipation as an uncomfortable but essentially harmless condition. In reality, recurring long-term bouts can lead to other problems, some merely distressing and others very serious.

Constipation has been linked to the following disorders:

• Arthritis

• Skin disorders

• Bad breath

• Mood disorders, including depression

• Headaches

• Irritable bowel syndrome

• Fatigue

• Hemorrhoids

• Hernias

• Insomnia

• Malabsorption syndrome

• Weight gain

• Varicose veins

A healthy person generally has one to three complete bowel movements daily. Although constipation is the number-one gastrointestinal disorder in the United States, its unwelcome effects are actually rather easy to avoid.

Our Western diet—high in fat and low in fiber and fluids—is the cause of most constipation.

The Mechanism Behind What's Going on in Constipation

When fiber and fluids are lacking, the contracting motions of the large intestine are not stimulated in a regular fashion, and waste is therefore not propelled through the tract. That is why a primary treatment is through dietary implementation.

Other factors, such as stress, inactivity, and certain medications, can cause or contribute to constipation as well. Dietary changes are still encouraged in these cases, along with the removal, when possible, of the offending factor. No matter how much or how little discomfort you have, it is always important to address the causes of constipation.

When waste matter remains in the colon for a long period of time, recent studies show that bacteria and other harmful matter can be reabsorbed into the bloodstream.

One of those harmful matters is excess estrogen. Regular bowel movements with the help of fiber is our primary way to remove excess estrogen in the body in order to avoid reabsorption back into the bloodstream. This is important due to most of our hormonal imbalances being due to an excess of estrogen in the body.

Stress or suppressed emotions are often overlooked factors with constipation. There is a direct connection between perceived stress levels and gut motility. In addition, people with hectic lifestyles often do not take the time for regular bowel movements. And sometimes children hold back on stool movements for fear of pain or inconvenience.

A poorly functioning digestive system can also be a major contributor to constipation. This is particularly true with deficient bile flow from the liver and the gallbladder. We will look at some Herbal options below that help to improve bile production and flow.

The Truth About Laxatives

The use of over-the-counter laxatives is a significant problem for many people with constipation. Although these medications relieve constipation, many of them make the bowels lazier over time.

Note: Occasionally, constipation can be a sign of a more serious condition. If you have bloody stools, intense abdominal pain, or a cut near your rectum, see your doctor.

And since chronic constipation can cause other illnesses, make an appointment if you have constipation that recurs or a single episode that lasts longer than a week.

SYMPTOMS

• Difficulty passing stools

• Decreased frequency passing stools

• Bloated, tender abdomen

• Loss of appetite

• Flatulence

• Malaise

ROOT CAUSES

• Poor diet (low fiber, low water intake)

• Stress

• Inactivity

• Medications

• Intestinal parasites

• Lack of beneficial intestinal flora

• Colitis

• Laxative or enema abuse

• Underactive thyroid

• Magnesium deficiency

• Liver problems

Other Common Causes of Constipation(2)

• Inadequate fluid intake

• Lack of physical activity (especially in the elderly)

• Medications: Pain medications (especially narcotics), Antacids that contain aluminum and calcium, Blood pressure medications (calcium-channel blockers) ,Anti–Parkinson’s disease drugs, Antispasmodics, Antidepressants, Iron supplements, Diuretics, Anticonvulsant

• Pregnancy

• Ignoring the urge to have a bowel movement

• Specific diseases or conditions: Stroke, Multiple sclerosis, Low potassium stores, Diabetes, Kidney disease, Hypothyroidism, Pituitary disorders

• Problems with the colon and rectum: Diverticulosis, Irritable bowel syndrome (alternating diarrhea and constipation), Colon cancer

Testing Techniques that May Be Helpful

The following tests help assess possible metabolic reasons for constipation: Stool analysis for good bacteria levels, parasites, fungi, and infection

Thyroid hormones—blood, saliva, or urine

HOLISTICALLY TREATING CONSTIPATION

Diet Recommended Food

Introducing Fiber

If you’re unaccustomed to a high-fiber diet, incorporating them slowly is best. A sudden increase in dietary fiber can be quite a shock to the system and can even cause further digestive problems.

High levels of dietary fiber increase both the frequency and the number of bowel movements, decrease the transit time of stools, decrease the absorption of toxins from the stool, and appear to be a preventive factor in several diseases.

How to Read the Fiber Content on a label Using the Five to One Rule

Look at the ratio of grams of carbohydrates to grams of dietary fiber. We’re looking for about five to one or less. So, for example, whole-wheat Wonder Bread passes the first test: first word is whole, but then it’s like corn syrup and a chemistry set. Let’s see if it passes the five to one rule? What you do is divide the carbohydrates by the dietary fiber. 20 divided by 2.7 is about 7, that’s more than five, so goes back on the shelf. Better than white, though, which clocks in at over 18. Here’s one that makes the cut. 15 divided by three equals five. (5)

The Recommended Daily Intake

The recommended daily intake is 25–35 g fiber from dietary sources. However, higher amounts may be optimal for health, as the diet humans evolved with contained approximately 100 g fiber per day. Most Western diets provide only 10 to 15 g.

Healing with Whole Foods Regiment

The basic, wholesome diet recommended at the beginning of this book is an excellent source of fiber. Eat lots of whole grains, especially brown rice; raw or lightly cooked fruits and vegetables; and beans, nuts, and seeds.

Chew thoroughly, and don’t eat too much at one sitting, even of healthful foods. People with constipation often have a magnesium deficiency.

Veggies High in Magnesium include:

Green leafy vegetables are high in this mineral, as well as in fiber, so now you have another reason to eat kale, broccoli, spinach, brussels sprouts, and the like.

Prunes and figs are great sources of dietary fiber and can easily be worked in as a part of your breakfast. Four to 8 fl oz prune juice or 5 to 10 prunes will usually be an effective dose.

A prune is a dried plum, just as a raisin is a dried grape. Prunes are well known for their ability to prevent and relieve constipation. In addition to providing bulk and decreasing the transit time of fecal matter, prunes’ insoluble fiber also provides food for the “friendly” bacteria in the large intestine. When these helpful bacteria ferment prunes’ insoluble fiber, they produce a short-chain fatty acid called butyric acid, which serves as the primary fuel for the cells of the large intestine and helps maintain a healthy colon. These helpful bacteria also create two other short-chain fatty acids, proprionic acid and acetic acid, which are used as fuel by the cells of the liver and muscles. Prunes contain large amounts of phenolic compounds (184 mg/ 100 g), mainly as neochlorogenic and chlorogenic acids. As well as aiding in the laxative action, these compounds inhibit free radical damage to LDL cholesterol and might serve to protect against heart disease and osteoporosis. Eating five prunes or drinking 4 fl oz prune juice is all that is required to help relieve constipation in many sufferers.

Click Here for more Foods High in Fiber

Flaxseeds are a lesser-known but highly concentrated source of fiber. Don’t cook with flaxseeds or subject them to heat; instead, sprinkle them on cereals or salads. Adults should take 1 to 2 tablespoons of ground flaxseeds daily, along with 10 ounces of water. Children can take 1 to 2 teaspoons. (1) Flaxseeds are also high in healthy fats, Omega 3’s.

Hot cereals or warm liquids like lemon water at breakfast can stimulate contractions of the lower intestine. Other examples are hot oatmeal (which you can add your flaxseeds to) or herbal tea.

Consume fermented products on a regular basis to keep your intestinal flora in balance. Kefir and sauerkraut are good choices, as is live unsweetened yogurt once the acute constipation is relieved.

Drink at least six to eight glasses of water per day. Drink plenty of water to keep stools soft. A glass of clean, quality water every two waking hours is usually an adequate amount.

Bran cereal can be helpful; start with 1/ 2 cup daily, increasing over several weeks to 11/ 2 cups.

ULWC Constipation Meal Plan.pdf

Nutritional Supplements

*Please consult your primary physician before taking any of the supplements listed below, especially if you have multiple conditions. These supplements do not serve as a substitute for any current medications that you are currently taking.

Helpful Supplemental Remedies

Psyllium Husk: Take 1 teaspoon or 5 grams of psyllium husks twice daily or as directed on the container. Take it with 10 ounces of water. Psyllium acts as a bulk-forming laxative. (1)

*Note about Metamucil: Metamucil is not a quality form of fiber or psyllium due to the additives included. The ingredients include: psyllium husk (Plantago ovata) 0.6 g. Nonmedicinal ingredients: acesulfame potassium, aspartame, citric acid, FD&C Red No. 40, maltodextrin, and natural lemon flavour, along with an amino acid phenylalanine which has posed risk concerns

Chia seeds or ground flaxseed: Take 1 to 2 tablespoons daily with 8 to 12 ounces of water. This provides fiber to bulk the stool. (1)

Magnesium Citrate: Take 250 mg two to four times daily for the relief of acute constipation. Magnesium improves gut motility and retains water in the colon. Do not use on a long-term basis, as it can lead to malabsorption and electrolyte imbalance. (1)

*Clinical Note: Bowel movements may be unpredictable while using this particular drink or supplement. Plan to be in a comfortable place for the day.

Soil Based Or Spore Based Probiotic: Take a product containing at least twenty billion active organisms daily. Probiotics help introduce healthy and friendly bacteria (Lactobacillus acidophilus, bifidus) help with digestion and elimination. An example of a Quality Spore based Probiotic can be found by Megaspore Probiotic which you can find in the Digestive Support Catalog here. A great example of a Soil based probiotic can be found by Solluna called SBO Probiotics here.

Learn more about choosing probiotics here!

General Herbal Remedies

Milk thistle (Silybum marianum) improves liver function and bile flow. Take 200 to 250 mg of a product standardized to 80 percent silymarin with each meal. (1,2)

Aloe vera juice improves bowel movements. Take a quarter cup twice daily or as directed on container. (1)

Enzymes improve digestive function. Take 1 or 2 capsules with each meal.

Using Bitters

Bitters are those herbs and foods that literally taste bitter. Sour and pungent herbs and foods can have similar actions. “Relaxing bitters” tend to be a bit milder and more aromatic. (4)

General Uses: Bitters single-handedly turn on your GI tract: peristalsis (the wave-like motion that moves everything through), saliva, enzyme production and excretion, stomach acid production, bile production and excretion, and (thanks to peristalsis) bowel movements. Indirectly, bitters also benefit liver function and detoxification, lower blood sugar, reduce cholesterol, alleviate skin conditions, and fix some cases of heartburn or reflux.

Think of bitters for sluggish digestion and elimination, constipation, indigestion, excess fullness, poor nutrient absorption (especially fat indigestion), and high cholesterol.

Examples of bitters: dandelion (the leaf or root), burdock, turmeric, schizandra, and citrus peel or the gentler relaxing bitters like lemon balm, chamomile, holy basil, or catnip.

Dandelion root (Taraxacum officinale) stimulates bile flow and improves constipation. Take 250 to 500 mg or 2 ml with each meal. (1,2)

Gentian root (Gentiana lutea) improves overall digestive function. Take 300 mg or 10 to 20 drops five to fifteen minutes before meals.

References:

1. Stengler, M., Balch, J, Young, R. Constipation. Prescription for Natural Cures 3rd Edition

2. Murray, Miachael, Pizzorno, Joseph. Constipation. Encyclopedia of Natural Medicine. 3rd Ed.

3. Iacono, G., F. Cavataio, G. Montalto, et al. 1998. Intolerance of cow’s milk and chronic constipation in children. New England Journal of Medicine 339( 16): 1100–4.

4. Groves, Maria. Body Into Balance. An Herbal Guide to Holistic Self Care. Digestion and Elimination.

5. Greger, M. MD. How Not to Die. How Not to Die from Digestive Cancers.