Nearly everyone suffers from intermittent constipation at some point in their life, but chronic constipation is a serious health condition, affecting about 2%‐27% of Western population
Not only can it cause ongoing pain and be very upsetting, but can have dire consequences for the rest of the body.
Here we will outline the possible causes and suggest some natural solutions, potentially giving long-term relief.
(1) Constipation and Botanical Medicines: An Overview. PUBMED https://www.ncbi.nlm.nih.gov/pubmed/26171992
(2) (McMillanand Williams, 1989; Norton, 1996; Ross, 1998)
(3) Chronic constipation: Current treatment options. PUBMED https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206558/
(4) Mechanisms of constipation in older persons and effects of fiber compared with placebo. PUBMED https://www.ncbi.nlm.nih.gov/pubmed/7775727/
(5) 26. De Witte P. Metabolism and pharmacokinetics of the anthranoids. Pharmacology 1993, 47 (Suppl. 1):86–97.
(6) WHO monographs on selected medicinal plants. Vol. 1. Geneva, World Health Organization, 1999:241–258. http://apps.who.int/iris/bitstream/10665/42052/2/9241545372.pdf
(7) Lactobacillus reuteri (DSM 17938) for the treatment of functional constipation in adult patients: a double-blind, randomized, placebo-controlled trial. Cochrane Library https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01007954/full
(8) Demographic and Dietary Determinants of Constipation in the US Population. PUBMED https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1404600/pdf/amjph00215-0049.pdf
(9) Constipation and Botanical Medicines: An Overview. PUBMED https://www.ncbi.nlm.nih.gov/pubmed/26171992
(10) [Distribution characteristics of basic syndromes of chronic functional constipation and its related factors analysis]. PUBMED https://www.ncbi.nlm.nih.gov/pubmed/25509257
(11) Gluten Sensitivity. PUBMED https://www.ncbi.nlm.nih.gov/pubmed/26605537
(13) Capsaicin alleviates abnormal intestinal motility through regulation of enteric motor neurons and MLCK activity: Relevance to intestinal motility disorders. PUBMED https://pubmed.ncbi.nlm.nih.gov/26011134/
(14) Mild dehydration: a risk factor of constipation? PUBMED https://pubmed.ncbi.nlm.nih.gov/14681719/
On this page, we will investigate the following topics:
- What defines constipation and what are the types?
- What can cause constipation?
- What foods can be used to relieve constipation?
- What herbs can be used to relieve constipation?
- A Herbal Program for Constipation
Just click the headings above to skip directly to a section.
What is constipation?
The many definitions of constipation reflect the differences in what is perceived as normal; for instance, the frequency of bowel movements and the weight and consistency of feces are greatly diverse among individuals so that constipation perceived by one person may be the normal (physiological) condition for another one. (1)
Healthy people have a bowel evacuation frequency anything between three times daily to three times a week. The old belief that we should have a single bowel movement every day is not always correct. (1)
Less than 3 x week and we are starting to dsiplay a problem.
Indications of constipation
Because everybody is different, it’s important to make an assessment
Here’s a summary of the Rome III criteria used to diagnose functional constipation:
- Straining during at least 25% of defecations
- Lumpy or hard stools in at least 25% of defecations
- Sensation of incomplete evacuation for at least 25% of defecations
- Sensation of anorectal obstruction/blockage for at least 25% of defecations
- Manual maneuvers to facilitate at least 25% of defecations (e.g., digital evacuation, support of the pelvic floor)
Types & Causes of constipation
Three major causative groups of constipation are recognized
- Causes related to diet and lifestyle are called Functional Constipation
- Causes due to ill health are called Disease Related
- Causes due to pharmaceuticals are called Drug-Induced
Complications
Constipation can cause a range of complex issues, including abdominal pain and bloating, anorexia, and nausea.
Other problems outside the colon can begin, like headaches, hair loss, restlessness, and confusion.
Insufficient Water Intake
In the elderly, low fluid intake, which may be indicative of hypohydration, was a cause of constipation and a significant relationship between liquid deprivation and constipation has been reported.
Dehydration is also observed when saline laxatives are used for the treatment of constipation if fluid replacement is not maintained and may affect the efficacy of the treatment.
Try Going Gluten-Free
Going gluten-free can be a good idea in the beginning stages of resolving chronic functional constipation.
Studies have shown the ‘classical’ presentation of ‘Non-Celiac Gluten Sensitivity’ is a combination of irritable bowel syndrome-like symptoms, including:
- Abdominal pain, bloating,
- Bowel habit abnormalities (either diarrhea or constipation), and;
- Systemic manifestations such as ‘foggy mind’, headache, fatigue, joint and muscle pain, leg or arm numbness, dermatitis (eczema or skin rash), depression, and anemia. (11)
It also makes sense to avoid too many binding agents in any type of food. These include all types of refined grains, flour, eggs, and other sticky, glutinous processed food products.
Visit our recipe page for a range of gluten free recipes here.
How Red Meat May Cause Constipation
Red meat can take up to 14 hours to leave the stomach and up to 5 days to complete its entire digestive journey. Undigested or sluggishly digested heavy proteins, such as meat, can contribute to sluggish bowel movements or constipation. Here’s why:
- Low Fiber Content: Meat is rich in protein but contains no dietary fiber, which is crucial for maintaining good bowel movement regularity. Without sufficient fiber to add bulk and moisture to the stool, the digestive tract may move contents more slowly.
- Digestive Load: Proteins, especially those from red and processed meats, can be particularly challenging for the body to break down. This increased digestive effort can slow down the overall gastrointestinal motility, leading to slower bowel movements.
- Gut Flora Impact: A diet high in heavy proteins and low in fiber can also affect the balance of gut microbiota. Fiber feeds the beneficial bacteria in the gut, so a lack of fiber can lead to less microbial diversity, which is linked to poorer bowel health.
Foods For Constipation Relief
Incorporating digestive enzymes such as bromelain and papain into your diet can help break down proteins more efficiently, which might be particularly useful if heavy proteins like meat are contributing to chronic constipation.
Here’s how these enzymes could help:
- Enhanced Protein Digestion: Bromelain (from pineapples) and papain (from papayas) are proteolytic enzymes, meaning they help break down protein into smaller peptides and amino acids, making it easier for your body to process heavy meats.
- Potential Improvement in Bowel Function: More efficient digestion means less chance of undigested protein slowing down the gastrointestinal tract.
Read More About Enzymes
Dietary Soluble Fibre
Diet, particularly dietary fiber, has often been regarded as an important determinant of constipation, although personality factors may be important as well. (8)
Fiber can be soluble or insoluble and can be found in lots of fruits and vegetables.
Insoluble Fiber – It goes into our bodies and pretty much comes out the same! It doesn’t dissolve water and goes through us pretty much intact. It provides bulk and stimulates the bowel wall to move.
You can find these fibers in vegetables, seeds, nuts, whole grains, and the skins of apples.
Soluble Fiber – It turns into a gel by taking in water. It slows down digestion and the uptake of nutrients. Through this process, soluble fiber stops a rapid increase in blood sugar levels and they make us feel full.
Being vegetarian and especially vegan is strongly associated with a higher frequency of bowel movements as does a high intake of dietary fibre and fluids.
Some examples of soluble fiber include linseeds, slippery elm, psyllium hulls, chia seeds, lentils, strawberries, beans, nuts, cucumbers, celery, and carrots.
Spicy Food
It is fairly common to get a good ‘clean-out the night after a hot curry.
Capsaicin found in Chili alleviates abnormal intestinal motility through regulating gut motor neuron activity, which is beneficial for the treatment of gastrointestinal motility disorders, such as constipation. (13) Visit our recipe page for a range of spicy recipes here.
Natural Solutions to Reduce Constipation and Encourage Regularity
Probiotic Study: Lactobacillus reuteri significantly increased bowel frequency in adults with functional constipation compared to placebo, demonstrating its effectiveness in improving constipation symptoms, though it did not affect stool consistency. (7)
Before Probiotic Use:
- Patients had a baseline average of 2.8 bowel movements per week.
- All participants were diagnosed with functional constipation as per Rome III criteria.
After Probiotic Use:
- The probiotic group (Group A) had an increase in bowel movements to an average of 5.4 per week.
Lactobacillus reuteri
BioGaia’s probiotic products with Lactobacillus reuteri are among the most scientifically well-documented probiotics in the world with regard to both efficacy and safety.
To date the efficacy and safety of BioGaia’s different strains of L. reuteri have been documented in 203 clinical studies in 17,200 people of all ages. Click here to find out more
Herbs for constipation
Psyllium (Plantago ovata) seed husk
A popular ingredient in natural laxative products, psyllium husk is classified as a mucilaginous fiber due to its powerful ability to form a gel in water.
This bulking fiber acts as a sponge, absorbing water and waste material in the bowels.
Psyllium husks significantly increase the level of stool moisture and both wet/ dry stool weight, this is why it has such great effect at relieving constipation and improving bowel health. Psyllium is the most commonly used bulking agent in Canada. In placebo-control trials, psyllium has been shown to decrease stool transit time, and improve stool frequency, consistency and weight. (4)
Cascara (Rhamnus purshiana) bark contains contains anthranoids, mainly of the aloe-emodin type
The mechanism of action is twofold.
1. There is stimulation of colonic motility, resulting in increased propulsion and accelerated transit of faeces through the colon.
2. There is an increase in water content in the colon. The laxative effect of Cortex Rhamni Purshianae is not generally observed until 6–8 hours after oral administration.
Wormwood (Artemisia absinthium) bark:
Unlike other herbs traditionally used for their laxative effects, such as psyllium or cascara, wormwood does not directly induce bowel movements. Its role as a bitter supports digestion, liver function and enzyme production improves digestion and elimination generally.
Black Walnut (Juglans nigra) green hulls: Black walnut is used to treat parasitic worm infections and to expel tapeworms and other internal and external parasites.
Black walnut hulls have mild laxative properties, which can help alleviate constipation. These effects are attributed to the juglone, tannins, and other compounds that can stimulate intestinal activity.
Turkish rhubarb (Rheum palmatum) root: Rhubarb contains the anthraquinones rhein and emodin.
Emodin is traditionally used as a laxative and is found to increase or decrease the contractility of intestinal smooth muscle in low doses and high doses, respectively.
Slippery Elm (Ulmus rubra) bark: The demulcent mucilage of Slippery elm provides a protective, anti-inflammatory and healing coating to mucous membrane surfaces. It reduces inflammation and irritation.
Herbal Program For Constipation
Colonaid
Colonaid contains a blend of herbs specifically designed to reduce constipation and encourage regularity. These herbs inlcude:
- Psyllium (Plantago ovata) seed husk
- Cascara (Rhamnus purshiana) bark
- Wormwood (Artemisia absinthium) bark
- Black Walnut (Juglans nigra) green hulls
- Fennel (Foeniculum vulgare) seed
- Turkish rhubarb (Rheum palmatum) root
- Slippery Elm (Ulmus rubra) bark
- Cloves (Syzigium aromaticum) bud
You can find out more about the individual herbs and how they work by clicking on the herb names below.
Buy Colonaid Here
Complete Colon and Liver Cleansing Program
The Ultimate Herbal DETOX program contains all of the herbs mentioned above, plus dietary guideline and recipes which can resolve chronic constipation. Follow this plan for 14 days and continue with the dietary advice afterward to achieve long-term results.
Dig A little Deeper!
Exercise
An individualized supervised physical activity program (20 min to 30 min of moderate-to-vigorous activity, three to five days per week) over a 12-week period significantly improved the symptom severity scores of patients. I suggest simple bodyweight exercises such as sit-ups, push-ups, and squats are adequate. 20 of each 2-3 times a week can have amazing results.
Stress
One study showed related factors such as age, engaged professionals, sleep quality, poor emotional (depression and anxiety tendencies), mental stress, interpersonal relations, work fatigue, stimulating beverage use, exercise conditions, drug-induced constipation were all associated with the distribution of chronic functional constipation. (10) One of the most effective ways of reducing stress is 20 minutes of meditation per day.
See my suggested Meditation method here
Understanding the Various Types of Constipation
Chronic Constipation refers to those patients that experience symptoms of constipation for more than 6 months whereas acute constipation may be as short as a couple of days.
Chronic constipation has been reported in 15% to 25% of the general population. It affects patients of all ages and both sexes, and different cultures and ethnicities. It is more commonly reported in women, elderly patients, residents of chronic care facilities, and patients with concurrent psychiatric illnesses. (3)
Functional constipation
Functional constipation acute or chronic is common in 95% of subjects so this is what we will talk about in this text.
It is present in children, businessmen, or travelers who voluntarily, or not, delay defecation. It can be diagnosed when a combination 2 or more of the following symptoms are present within the previous 3 months. (1)
- the sensation of anorectal blockage
- straining during defecation
- infrequent bowel movements
- lumpy or hard stools in at least 25% of defecations
- going less than 3 times per week
- sensation of incomplete evacuation at least 25% of the time
- manual maneuvers to facilitate at least 25% of defecations
- loose stools are rarely present (1)
The pathophysiology of functional constipation is still unclear, but it has been traditionally thought to involve slow colonic transit and/or pelvic floor dysfunction, although there is a huge variation in the identification of the exact dysfunction, mainly due to the diagnostic methods used.
The majority of patients with functional constipation mainly use self-managed interventions, like changes of lifestyle and the use of over-the-counter laxatives. (1)
Contributing factors to functional constipation
- decreased intestinal muscle tone
- lack of exercise
- dietary changes
- hemorrhoids
- anal fissure
- colitis
- diverticular disease
- intestinal and/or ovarian cancer
- bowel obstruction (e.g. carcinoma)
- anal retention (e.g. proctitis)
- other physical or inflammatory conditions of the lower rectum or anus (1)
Drugs that cause constipation
- opiates
- antacids containing aluminum
- antianorexics (amphetamines)
- antianxieties(benzodiazepines)
- antiarrhythmics (verapamil)
- anticholinergics (atropine)
- anticonvulsants
- antidepressant (tricyclics, monoamine oxidase inhibitors)
- diuretic (benzothiadiazide,K-sparing diuretics),
- laxatives (when chronically administered)
- antineoplastics (decarbazine)
- anemia medications (iron and bismuth supplements) (1)
Causes of Disease-related constipation
- Systemic disorders (Parkinson’s, multiple sclerosis, hypothyroidism, diabetes, etc.)
- Local disorders (luminal and extraluminal obstruction, irritable colon syndrome, hemorrhoid, etc.) (1)
I hope this article has been helpful and you can implement some of these ideas into your lifestyle.
Many Blessings
Brett Elliott ©
