Constipation is not fun and can consume your life! I used to struggle with chronic constipation myself without even realizing I was constipated! Years ago, I experienced painful bloating where my stomach looked 9 months pregnant. Because I was so focused on my bloat, I didn't even realize that I wasn't going to the bathroom as often as I should (I was going maybe once or twice a week!), which ultimately was a contributor to the bloat. It wasn't until I went to a Functional Medicine Doctor that I learned that it wasn't normal to go to the bathroom less than once a day! If you go to the bathroom less than once a day, you are considered to be constipated.
Constipation can be a tricky one because there are many factors which can cause it. When working to address constipation, it's important to look at all factors which include: medications, diet, digestion, gut health, liver function, stress, movement, fiber intake, and hydration status. Most often, it's a combination of more than one of these factors which contribute to constipation. While there are temporary fixes for alleviating constipation, it's important to still identify and work on addressing the root of your constipation in conjunction to eliminate constipation long-term.
In today's post, we're going to go through each of the factors that can cause constipation and tips for addressing them.
Medications. There are many many medications which can cause constipation, but specifically acid medications are a big culprit. Acid medications include, Tums, Zantac, Prilosec, Pepsid, Nexium, and any others that suppress or block stomach acid production. While these medications are used to temporarily provide relief for acid reflux or heartburn which occurs in the esophagus, they cause further issues down the digestive tract and within the stomach itself. Contrary to popular belief, acid reflux is most commonly caused by having inadequate stomach acid, not too much. What happens is, the lack of sufficient stomach acid causes food to sit in the stomach undigested longer than it should instead of continuing through the digestive tract as it's supposed to. This causes the pyloric sphincter, a valve which allows food to pass from the esophagus to the stomach, to open back up allowing the undigested food to reflux back into the esophagus along with any acid you have in your stomach, hence the burn you feel. So while the acid medications suppress acid and prevent it from entering your esophagus, they also reduce the acidity in your stomach so you're unable to digest food properly, causing stagnant digestion (hello constipation!). Additionally, when food isn't digested properly, it turns to bad bacteria and pathogens which cause tons of other symptoms to develop such as, chronic stomach pain, bloating, fatigue, brain fog, anxiety, and inflammation. Rather than work against your body's natural abilities, it's crucial to support optimal function in order to break free of the vicious cycle of band-aid medications and temporary, quick fixes.
Diet. The most common diet today is the Standard American Diet aka SAD. This is a diet that is higher in refined, processed carbs (bread, pasta, baked goods, etc), processed foods, fried foods, and sugar, and low in nutrient-dense whole foods. This diet leaves our body starving for nutrients, unable to thrive. Nutrient deficiencies lead to organ dysfunction which then causes the symptoms you experience such as, constipation. By improving your diet and shifting to focus on eating more nutrient-dense whole foods such as, meat, poultry, fish, seafood, nuts, seeds, veggies, and fruit, you can restore organ function and naturally alleviate symptoms!
Digestion. As we talked about in the first point, if your digestion is poor, you're going to automatically end up constipated because food is not moving through the digestive tract as quickly as it should. Some simple ways to improve digestion are: eat only while relaxed, take 3 deep breathes before eating, use digestive bitters before meals, stimulate the vagus nerve around meals, chew 20-30 times each bite, avoid excess fluid around meals which dilute your digestive enzymes, supplement with lemon or apple cider vinegar to support healthy stomach acid levels, take digestive enzymes with meals, perform a belly massage after meals, avoid laying down immediately after meals, and allow yourself time to digest before engaging in activities or anything stressful.
Gut Health. Often, people who experience chronic constipation have dysbiosis and leaky gut as well which are a result of poor digestion, and go hand-in-hand. Dysbiosis is an imbalance of bacteria in the gut ecosystem which create symptoms like bloating, constipation, diarrhea, gas, and brain fog. Leaky gut is when the intestinal lining becomes weakened, allowing bacteria and food particles to escape into the bloodstream. Once in the bloodstream, the immune system identifies these particles as foreign invaders and sends an attack to destroy them. Overtime, if not addressed, the immune system becomes less accurate and confuses these foreign invaders with your body's own cells, also known as "cell mimicry", and sends an attack on your cells. This is how autoimmune diseases develop. Leaky gut is also a cause of food sensitivities which can lead to the digestive symptoms you experience. In order to address any digestive issue, it's crucial to address dysbiosis and leaky gut. Addressing dysbiosis and leaky gut must always start with dietary changes. Along with dietary changes, addressing dysbiosis may involve using natural antibiotics/antimicrobials (oregano, berberine, olive leaf, etc) and/or probiotics which introduce more friendly bacteria into your gut to fight off the bad bacteria. Ways to address leaky gut in addition to dietary changes can include: using gut healing nutrients such as L-glutamine, aloe, okra, marshmallow root, cabbage juice or Vitamin U, digestive support (improvement of eating habits and supplements that promote digestion such as ginger, ACV, lemon, enzymes, bitters, etc), reducing stress, engaging in low impact exercise, and anti-inflammatory herbs such as turmeric.
Liver Function. The liver is the main organ of detoxification. If the liver is overburdened, your body won't be able to detox properly putting added stress on the rest of the digestive system. This also prevents toxins from eliminating properly, allowing them to re-circulate in the body causing inflammation among many other issues. If you are addressing dysbiosis, it's highly important to ensure your liver is supported as your body needs to be able to eliminate any pathogens you're working to kill off. Ways to support your liver include: eliminate alcohol, medications, & sugar, reduce your toxic exposure by switching to non-toxic skin care, cleaning products, candles, air fresheners, & more, drink plenty of water with lemon and Himalayan salt (1/2 your bodyweight in oz at minimum), exercise regularly, sweat, eat cruciferous veggies (broccoli, Brussel sprouts, cauliflower, kale, etc), eat beets, rub castor oil under the right rib cage (where your liver is), lymphatic massage, oil pulling, dry brushing, sauna, milk thistle, burdock root, liver bitters, and eating grass-fed liver (or taking capsules).
Stress. In my opinion, stress is the root of all evil! It causes countless health issues because of the brains connection to every organ system. If the brain is under stress, it won't signal the digestive system to fire up for digestion. This causes issues down the rest of the digestive system. Additionally, if your're dealing with chronic unmanaged stress, your body and mind can end up stuck in a sympathetic state. In order for majority of your body's processes, especially digestion, to be carried out, you must be in a parasympathetic state. This is why it's highly important to manage your stress! Some ways you can manage stress include: meditation, journaling, exercise, therapy, dancing, yoga, walking in nature, playing with an animal, making time for fun and laughter, and self care.
Movement. Moving your body is essential to good health. Movement is essential for stimulating the lymphatic system which helps to rid the body of toxins and waste. Additionally, most of us are sitting for long hours in poor postures which puts a strain on the body's digestive system. Therefore, it's important to move your body in any way that feels good to you regularly. I'd recommend at least 2-3 days of moderate exercise and 1-2 days of more gentle movement (cleaning, dancing, yoga, walking).
Fiber Intake. Fiber is important for moving waste through your digestive system. There are 2 types: soluble and insoluble. Both have different benefits for the body, but typically insoluble is the more beneficial fiber for constipation. The reason is because it doesn't dissolve in liquid meaning it stays whole in the digestive tract and adds bulk to more easily move food through your system. It is important to note that when increasing fiber, you want to start slowly as it can create more constipation if your body is not used to it. You also want to increase water intake to ensure hydration when adding fiber. Foods to include in your diet for fiber are: veggies, nuts, seeds, fruit with skin, and beans. Additionally, supplementing with prebiotics, a form of dietary fiber that feed the “friendly” bacteria in your gut, can help promote regular bowel movements. You can get these from whole foods as well such as: dandelion greens, artichokes, bananas, oats, apples, garlic, onion, and seaweed or by taking them in powdered supplement form.
Hydration. Water is the most common nutritional deficiency. Most people simply don't drink enough water, and then add in caffeinated beverages in addition to loss of water from any exercise, it's easy to become dehydrated! Early signs of dehydration include: fatigue, anxiety, irritability, depression, cravings, cramps, and headaches. More long-term signs of dehydration include: heartburn, joint pain, back pain, migraines, fibromyalgia, constipation, and colitis. If your body is dehydrated, the large intestine (colon) ends up absorbing any water it can from food you consume, making it too hard to pass, causing pain and constipation. This is why it's crucial to drink at minimum 64oz of pure filtered water daily plus an additional 12-16oz for every 8oz caffeinated beverages and with exercise to stay properly hydrated. While it is important to drink enough water, it's even more important to ensure you're actually absorbing the water! If you don't absorb the water, you end up peeing it out and excreting minerals with it, disrupting our body's mineral balance. To absorb water efficiently, we need electrolytes. Electrolytes are electrically charged minerals that help your body absorb and use the fluids you consume, as well as promote healthy nerve and muscle function. These include the minerals sodium, potassium, calcium, and magnesium. When people think of electrolytes, most think of sports drinks like gatorade, which mostly just contains sodium, a lot of sugar, and other junk! A natural, healthier alternative to getting in electrolytes is by adding in a pinch of Himalayan or Celtic sea salt to every 8oz of water. Himalayan and Celtic sea salt are minerals which then act as electrolytes to help you absorb water. You can also try adding a squeeze of lemon in addition to the salt if it doesn't taste good to you on its own. The water should not tasty salty, but simply taste good!
As you can see, there is no single remedy for constipation which is why people can get so frustrated when trying to improve it when it's chronic. By focusing on where your body needs the most support and implementing small changes, you can address constipation and get back to regular bowel movements!
Jenn Horowitz, FNTP, CPT, CES is a Functional Nutritional Therapy Practitioner, Certified Personal Trainer, and Corrective Exercise Specialist who works to address the root cause of illness. Jenn is the founder of JTH Wellness, a holistic nutrition and wellness practice, specializing in helping people with stomach issues, disordered eating, and weight management problems, take back control of their health through 1:1 nutrition and lifestyle counseling. Jenn works to teach others how to live a balanced lifestyle that allows them to achieve their goals while enjoying life. Learn more about Jenn’s nutrition counseling services and schedule a free 15-minute discovery session by visiting her website, http://www.JTHwellness.com.