Though there is often confusion about what actually constitutes constipation, I’m sure you know it when you have it! I can’t think of one good thing to say about it.
Constipation has been a significant part of my chronic health problems, but feeling bad when I have it is only one of the reasons it’s a pain in the butt (pun intended!). Making sure we can poop easily and regularly is a main pillar of a healthy life, and can improve all manner of health challenges.
The bloating, pain, foggy head, gas, straining, and worse might be no big deal every once in a while. But when you face constipation frequently on an ongoing basis, it’s time to dig down and start unraveling the puzzle.
In my own case, I had to dig for answers. Adhesions from endometriosis, which caused gut dysbiosis (including methane-dominant SIBO), inactivity due to fatigue, and food sensitivities all played a role.
Constipation is not only uncomfortable and a challenge in its own right. It can also compound other health problems in our chronic illness picture.
Clearing up constipation is of utmost importance.
There are likely many possible causes for your constipation. The key to solving your personal constipation puzzle is discovering your personal reason(s). Once you figure out the cause, you are much more likely to be able to create a reliable relief action plan.
What Is Constipation?
Technically, constipation is defined as irregular and infrequent or difficult bowel movements.
Though your normal may vary from the next person, we should be pooping at least once per day, and passing stool should be easy. I consider a person constipated when they have less than one bowel movement per day OR they have difficulty eliminating stool, even if they go once or more per day.
Our body only has a few ways to clean itself out, and pooping is one of them. (The others include urinating, sweating, and breathing.) It’s essential for this normal detox function to work well to keep us healthy, happy, and strong.
Pooping regularly is important because our body releases toxins in the stool. If we retain stool longer than necessary, we not only can re-absorb toxins, but the bacteria in the stool can begin to ferment. Hello gas and farts.
I have noticed that if I go longer than 24 hours between movements, my brain function declines. I become crabby and snappy with my kids and husband. I’m more tired. And my belly becomes swollen and painful, which never helps my patience, self-esteem, or confidence.
Some of these suggestions may resonate, others may not, and that’s ok. Everyone’s body is different. Follow up on the ones that seem to make the most sense for you. Start with simple interventions, and only try the more complicated or expensive options if the easier options don’t work.
One thing I find true again and again is that there often isn’t ONE magic pill, but that several things in combination together CAN make a difference. Experiment and see which tips move the needle, no matter how small.
Here are my top 9 tips for getting to the bottom of your constipation, so you can create a solid plan.
#1: Remove Inflammatory Foods to Relieve Constipation
Eating the specific foods that your body is sensitive to can cause constipation. Many people experience constipation when they eat dairy products, eggs, and gluten. But ANY food can be causing a problem. For example, I discovered that every time I ate broccoli, I became constipated for TWO days!
If you know that your body becomes constipated by eating a certain food, avoiding that food will obviously help. But how do you figure out which foods are causing the problem?
An elimination diet is the gold-standard for identifying problem foods. By eliminating suspected foods for a period of 3-4 weeks, and the reintroducing them one by one and observing the effects, you can create a diet that is customized for you to reduce symptoms.
The key tool to go along with this process is a Food-Symptom Diary, where you track your food intake alongside your symptoms.
IgG food sensitivity testing or Mediator Release Testing may also be helpful in this situation, but it is usually more useful for checking for an immune response to certain foods (though constipation could be an immune response as well).
#2: Add Nutrients to help Constipation
These three nutrients fall more into the relief-care realm. But while you are sorting out your root causes of constipation, it can be helpful to have support to encourage your body to poop.
Magnesium citrate, vitamin C, and ginger can all help stimulate the bowels to move. You will want to experiment with a dose to find the one that produces a bowel movement. Start low and go slow, until you find the appropriate dose for your body.
Additionally, psyllium husk, soaked in some water, can help bulk up the stool. But too much can cause bloating, so go slow!
#3: Increase Dietary Fat (With Caution)
Fat helps lubricate the digestive tract and move things along. If you aren’t consuming enough dietary fat, it can be difficult for your intestines to function properly.
The challenge here is that many people have compromised fat digestion. Some natural health coaches encourage people to eat spoonfuls of coconut oil or ghee at bedtime as a remedy for constipation.
Though this may help relieve symptoms in the short term, it could cause other problems downstream. If you plan to increase your fat consumption to remedy constipation, it is important to support fat digestion as well with enzymes, bitters, and other liver/gall bladder support. Start low and go slow!
#4: Increase Dietary Fiber to Relieve Constipation
Fiber has long been promoted as way to keep the bowels moving and to reduce long-term risk of colon cancer. Eating a low-fiber diet can be a significant contributor to constipation.
The key element to understand about fiber is that it is the insoluble fiber that helps keep the bowels moving. It absorbs water, increases stool bulk, and swipes the walls of the colon clean.
Sources of insoluble fiber include:
- Bran
- Whole grains, like brown rice, millet, quinoa, and buckwheat
- Seeds
- The skins of fruits and vegetables, including tomatoes, peppers, apples, etc.
If you eat a diet low in fruits, vegetables, whole grains, and seeds, see if you can gain some relief by incorporating an increase in whole fiber foods. Start low and go slow! Too much change in your fiber budget can lead to bloating and gas.
If you find that increasing high fiber foods seems to worsen your constipation, you may have sensitivity to certain high FODMAP foods. FODMAPS are Fermentable Oligo-, Di-, Mono- And Polyols. They are types of starches present in certain foods.
#5: Assess Your Microbiome
We can’t talk about the gut without considering the state of your microbiome. The community of bacteria and other microorganisms has a significant effect on how things move through your intestines. We want to investigate how your microbiome is doing, and how it may have changed recently.
Many people find that their constipation began with a shift in their microbiome terrain. This can happen from things like a course of antibiotics, a new medication, or a major stress event, like a death in the family, change of jobs, moving, or marital troubles.
Consider what else was happening at the time your constipation started. Did you experience a major stressor around the same time?
If it seems that the microbiome piece of the story is important in your case, evaluating yours is a helpful step. Completing a GI-MAP stool test (or similar stool test, like Doctor’s Data, Genova, or BioHealth 401H) to check for parasites, bacteria, and yeasts, can help you understand what specific bugs you are dealing with and can inform your approach.
Another very common microbiome cause of constipation is methane-dominant SIBO, or Small Intestine Bacterial Overgrowth. If you have an overgrowth of methane-producing bacteria in your small intestine, the methane exerts a powerful paralyzing effect on your small intestine.
Properly addressing dysbiosis, whether from parasites or SIBO or yeasts, is a very powerful way to resolve chronic constipation.
Some people find constipation relief with the addition of probiotic foods or supplements (or both), while others find that probiotic foods and supplements make their constipation worse. You will have to experiment for yourself to figure out what works right for you.
If you find that you react to the commonly available varieties on the shelves at your local health foods store, you may want to try spore-based probiotics, like MegaSpore Biotic, soil based probiotics, like Prescript Assist. You may also have better luck with a blend that does not include histamine-producing probiotics. I like Klaire Labs Ther-Biotic Metabolic Formula.
If you can’t find a probiotic that seems to work, this is a sign that you have some cleaning work to do before you are ready to repopulate your gut microflora. Dig for answers to understand your gut flora picture, and work a plan to reset your flora.
#6: Break Down Adhesions with Physical Therapy
Adhesions are internal scar tissue that can bind up tissue and organs inside the body. They can occur anywhere, and can cause problems no matter where they show up. This is nowhere more true than in the gut.
Possible reasons for adhesions include:
- Abdominal surgery
- Inflammatory disease, like endometriosis, gastroenteritis, diverticulosis, hepatitis, or colitis.
- Injury or blunt trauma (think car accident, sports injury, etc.)
- SIBO
- Appendicitis
- Gall bladder trouble
- Pelvic inflammatory disease
If adhesions are impeding the function of your gut organs, no amount of other help you throw at the problem will last indefinitely. Specialized abdominal massage, like that offered by the Clear Passage clinics, or physical therapy can help a lot with constipation.
When I had my wide-excision endometriosis surgery two years ago, one thing we discovered was that my colon was adhered to the wall of my abdomen. No wonder I suffered from constipation! The surgery likely created more adhesions as well, just in different places. For this reason, avoiding surgery unless absolutely necessary is important, to avoid creating more adhesions!
#7: Support Vagus Nerve Function
The vagus nerve is the largest nerve bundle in the body and controls automatic body functions like digestion, respiration, stress response, etc.
Because our digestion is highly regulated by the vagus nerve, and the vagus nerve function can be affected by the microbiome, sluggish vagus nerve function can be an underlying reason for constipation or slow motility (movement of food through the digestive system.)
The vagus nerve can be damaged by food poisoning, which can lead to chronic SIBO.
Fortunately, there are many easy and fun things to do to support the vagal function! They include:
- Singing loudly (shower or car time, anyone?)
- Jumping on a trampoline or rebounder
- Gargling
- Exercising
- Belly massage
- Yawning
See if incorporating any of these ideas regularly helps relieve your constipation, in addition to your work supporting a healthy microbiome.
#8 Assess Thyroid Function
One of the most common underlying causes of chronic constipation is poor thyroid function. The digestive tract, like all other body tissues, requires thyroid hormone to function properly.
Especially if your constipation occurs with other common thyroid symptoms, such as weight gain, depression, cold hands and feet, heart palpitations, dry skin, consider having your health provider evaluate your thyroid function.
Because of insurance payment standards, many doctors will only check your Thyroid Stimulating Hormone (TSH) levels. But to truly look at how the thyroid gland is doing, it’s important to look at a complete thyroid panel, including:
- TSH
- Free T3
- Free T4
- Reverse T3
- Thryoid Peroxidase Antibodies (TPO)
- Thyroglobulin Antibodies (TG)
If your doctor won’t order these, or your insurance won’t pay for them, you can order them directly from a direct-to-consumer service like Life Extensions or DirectLabs.
#9 Assess Your Current Medications
Many medications have either a direct or indirect effect on intestinal motility. Be sure to check your product inserts, or check with your pharmacist if you have concerns about a particular medication.
If you think a medication is contributing to your constipation, have a conversation with your doctor to explore possible alternatives. It’s important that you keep pooping!
I hope by now you can see that solving the root causes of your constipation is unlikely to come from just one source, but many. Finding the pathway to resolution requires some questioning, some digging, sometimes some deeper investigating, and experimenting to find the proper combination of solutions.
But even if it takes a little while, finding your particular solution means less long-term loss of quality of life, less symptoms, less lost work time, less lost pleasure time, less medications, and a whole lot more comfort.
When you’re ready for help to make sense of your constipation, I invite you download your free copy of Roadmap to Recovery. Inside, I detail the steps you can take to unravel your health challenges, so you can find the RIGHT solution for YOUR body.
When you know you are ready for some more robust support, I encourage you to schedule a free 30-minute Assessment Session with me.
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