This post is not really geared for the person who is occasionally constipated, but for those people who deal with it every single day of their lives --- those who go to the bathroom every week or two ---- or even less frequently (yeah, I've seen it on numerous occasions). According to a 2006 meta-analysis of nearly 150 studies on the subject (Journal of Gastroenterology and Hepatology), "the incidence of constipation is determined to be >30% in the general population." In other words, darn near one in three Americans of all ages is constipated. In other words, there are a lot of folks you know who are, like you always suspected, literally full of it. Just remember that constipation is never really a diagnosis unto itself, but a symptom of a deeper problem. This means that dealing with this problem will probably entail more than simply taking that special formula you bought at the health food store.
The two types of constipation are "Obstructive" and "Hypomotility". Obstructive Constipation simply means that people "plug up" because they are full of impacted fecal matter. Hypomotility means that the rhythmic motion of the intestines called "peristalsis" slows to the point a person has trouble evacuating their bowel. Be aware that Hypomotility can and frequently does become Obstructive over time. Some of the reasons people become constipated also have to do with the medications they are on --- brutally common medications (STATINS, ANTIDEPRESSANTS, ACID BLOCKERS, and NARCOTICS are some of the biggest offenders). HYPOTHYROIDISM and UNCONTROLLED BLOOD SUGAR are both common causes as well. PARKINSON'S, MULTIPLE SCLEROSIS, and numerous other neurological issues can contribute to this problem also. IRRITABLE BOWEL SYNDROME can cause both constipation and diarrhea. This does not even begin to get into the potential problems caused by things like polyps. There is also the mysterious "Slow Transit" (Severe Hypomotility --- sometimes called STC), which simply means that things move through the digestive tract extra slowly, and which doctors sometimes try and deal with via colostomy. This problem is thought to be caused by a deficiency of one of the chemicals related to intracellular communication, SUBSTANCE P (one of those chemicals that falls under the heading of "Inflammation").
- CONTROL YOUR WEIGHT: Although this should come as no surprise, I found numerous peer-reviewed studies linking OVERWEIGHT / OBESITY to constipation in both children and adults.
- EAT THE RIGHT FOODS: This goes hand-in-hand with the bullet point above. Heavily processed foods, SODA, SUGAR, and JUNK FOODS, are highly associated with constipation when compared to a healthy diet. It goes without saying that you need to be consuming lots of soluble and insoluble fiber (fruits, vegetables, etc). However, fiber is not the be-all end-all it has been made out to be concerning constipation. More on this in a moment.
- STAY AWAY FROM BAD FOODS: Some of these are obvious and go without saying. Some are more subtle. GLUTEN, for instance (most people who are sensitive to Gluten are also sensitive to dairy). Make sure to learn how some of the neurological diseases mentioned earlier are related to Gluten (HERE). HERE is a video from one of our patients who had this problem her entire life --- until she changed her diet.
- DRINK LOTS OF WATER: Notice I did not tell you to drink lots of fluids. I told you to drink lots of WATER. In most cases, the difference is huge (Green Tea is an exception to this rule --- particularly if it is hot).
- EXERCISE: Although this is fairly generic, it is important nonetheless. I have written on this topic extensively (HERE).
- EAT THE RIGHT FATS AND PLENTY OF THEM: Americans have been freaked out by dietary fat ever since the FAT-FREE 80's, when they got fatter than ever. If you are not getting enough good fats in your diet, you are setting yourself up for a host of health problems, including constipation. Coconut oil and EVOO are both excellent fats. The Livestrong website once said, "Saturated fats are difficult for your body to digest and can contribute to hard, difficult-to-pass stools. Your child should eliminate consumption of saturated fats to help alleviate abdominal pain associated with constipation." Terrible advice to say the least. FISH OIL, cod liver oil, and castor oil, can be beneficial for constipation as well. When possible, add lemon to your oil to really get things moving along (it's great for the liver and gall bladder).
- TAKE CARE OF YOUR LIVER AND GALLBLADDER: This is huge. A sluggish Liver / Gallbladder is going to sludge up your bile production, which fouls up your digestion, and can lead to constipation. BEETS are a good way to do this. Just be aware that any and all the medications you take affect the liver. This is why your meds can cause or contribute to constipation. There are any number of Gallbladder Cleanses online that are all basically the same (EVOO, lemon juice, organic apple juice, etc).
- ACIDIFY YOUR STOMACH: Although this is possibly the single most important bullet point on the list, I will warn you that this point is going to sound counter-intuitive for many of you. As crazy as it sounds, most people have too little (or too weak) stomach acid. If you want to see how this all works and how you have been duped into thinking you have too much or too strong stomach acid, read THIS POST. Along with acidification of your stomach, DIGESTIVE ENZYMES can be extremely beneficial as well --- especially for those not consuming raw vegetables (a chief source for such enzymes).
- LEARN ABOUT GUT HEALTH: Be aware of the numerous things including ANTIBIOTICS that literally destroy your GUT'S HEALTH. Fail to understand Gut Health, and constipation will be the least of your worries. You may need to take PROBIOTICS. Kombucha, Beet Kavass, Sauerkraut, DIRT, and any number of other fermented foods are helpful in this arena as well.
- GET PLENTY OF FIBER: If you are consuming lots of vegetation, great --- you should be fine. If not, get on it. As an extra source of fiber, I prefer FLAX SEEDS in a special drink (click the link) as an extra boost of fiber. Just remember that the more fiber you take in, the more water you will need to make it work. If you fail to follow this step, the fiber will actually act like a plug.
- COLONIC IRRIGATION OR ENEMAS: I realize that to many of you, this old-school method of dealing with constipation sounds terrible, but here's a fun fact for you. Go back fifty or sixty years, and if you were admitted to the hospital for whatever sort of problem, you were likely to get an enema. Why? Doctors still understood Gut Health and the fact that a clean bowel helped their patients heal better and faster.
- HERBAL OR OTHER SUPPLEMENTS: Many people use synthetic Vitamin C in large doses to help with constipation (this can actually promote diarrhea). To see why I am not a fan of this, you can click HERE. People do something similar with the mineral Magnesium, which I think is not a problem for most people. There are a host of formulas on the market for helping with constipation. While most are certainly not harmful, how beneficial they are, I cannot say. I do know that Aloe Vera seems to work well for lots of people. Also, as part of the Master's Cleanse (one that I have done many times), part of the process involves the "Epsom Salt purge" each morning first thing. It definitely works.
- HAVE YOUR SPINE ADJUSTED: The nerves that emanate from the spine control every function of the body. I cannot begin to tell you how many people, over the years, have found the solution for their constipation via CHIROPRACTIC ADJUSTMENTS ---- even though they were coming in for something else (usually low back pain).
- FECAL MICROBIOTA TRANSPLANT: Look folks; if you've tried everything and nothing has worked, FMT is the likeliest answer. I put it last because many of these other things should be part of your health regimen anyway.