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Constipation

We all know the basic concept of constipation: inability to move our bowels regularly and properly. However, discussing the criterion for moving our bowels well is often repressed due to the social discomfort of discussing our bodily functions. That is also a form of constipation— emotional and social constipation!

How do we define constipation?

Americans usually experience anywhere from mild to extreme constipation. A good morning BM upon rising, drinking something room temperature or warm, and urinating is good, but anything less than one bowel movement per meal, constitutes mild constipation. Extreme constipation (discomfort and swelling in the belly and days between forced, painful, and uncomfortable BMs) is generally what we think of but it’s not the only sign of constipation. During the workday especially, limited access to bathrooms and limited time to eat and process our foods is common. This can cause constipation for those in less than ideal circumstances. Any constipation at all initially causes buildup on the walls of the lower bowel, then the entire colon, then the small intestine, then all the systems of elimination begin to hold on to waste products and cease to function optimally. We often associate these symptoms with “aging”, but really, they are symptoms of toxic buildup that has worsened over time because we allow ourselves to become accustomed to them.

Healthy bowel function

Constipation occurs when you are unable to process your food/waste properly. Proper bowel movements are a foundational piece of health because they indicate if we are harvesting our nutrition from our food and eliminating our waste properly. The following benchmarks are what you should look for in your bowel movements: Frequency - Daily in the morning after rising and/or drinking warm fluid, and frequently throughout the day based on quantity of food intake and activity/exercise. - After eating a meal and chewing your food well, you experience no bloating, gas, pain or discomfort in your belly and you can feel and hear mild bowel sounds as the food moves through your GI tract - Within 20-60 minutes of eating a meal, you have the urge to move your bowels and can do so without strain Characteristics of healthy bowel movements: - Formed in the shape of a normal intestine (like a smooth, curved, sausage) - Soft but don’t fall apart when hitting the toilet - Brown in color but varying slightly based on diet (you should seek medical attention if black, white, or bloody stools occur). - Smooth without visible, undigested pieces of food - No putrid smell (rotting food) - No noxious gas/flatulence when bowels move. Other [indications] of healthy bowel movement & effective nutrition: - Clear, hydrated, and minimally blemished skin - Odorless/minimally odorous sweat - Odorless breath - Light yellow/amber colored urine. You should drink enough water to need to empty your bladder 3-6 times daily Anything outside of these descriptions — moving your bowels less often; undigested pieces of food in your feces; forced, painful to pass, hard feces; issues with your skin, breath and urinary tract; are all symptoms of constipation.

Constipation is a universal human challenge. All cultures have tried and tested remedies and management tools. Some of these are caustic and damaging, but do work. It is important to do your work and figure out which strategies are safe, accessible, manageable and affordable for you. The following are what we recommend.

Chew Your Food Well

Chewing your food well is essential to initiating proper digestion. The more we break it down initially, the less work required of our stomach and intestines, mitigating gas, bloating, and constipation.

Hydration

Sometimes just 18-36 ounces of hydrating fluids or foods will solve the problem. Prune juice will soften the stool, but not work on getting the bowel moving properly. It often works if dehydration is your only real reason for constipation.

Drink a hydrating, warm drink as your first input into your body in the morning. Clear liquids are best (coffee doesn’t work well, as it is dehydrating). we recommend:

Tea
Juice
Water

Afterwards, be still for 10-15 minutes. This will stimulate the bowel to move.

Repeating this for several days in a row makes it more effective. It is a good idea to do this every day whether or not you are constipated, as it is preventative and regulates digestion in other ways.

Electrolytes

An electrolyte drink is a good tool to help you stay hydrated throughout the day, especially if you are moving and sweating a lot.

Electrolyte beverage recipe

Fiber

Robust fiber intake is an integral piece of healthy digestion. Common foods that are rich in fiber include:

Unrefined grains (rice, oats, wheat, etc.)
Nuts and seeds (the most important one to include is flax seed)
Beans/legumes (well cooked, ground/well-chewed, warm)
Whole fruits (frozen, dried, and canned fruits are usually just as good as fresh ones, but remember to avoid additives and preservatives)
Vegetables (roots, stems, leaves, buds of plants)

We came up with some guidelines for making a smoothie that includes all of these elements. You can check it out at the link below.

Smoothie recipe

Enzyme Rich Foods

Without digestive enzymes we cannot break down and use the nutrition from our foods, causing build-up in the intestines. For optimal digestive function, all meals should include fresh fruits and vegetables in small quantities, as they contain high levels of naturally occurring digestive enzymes. Enzymes in capsule form can be helpful for long-term issues.

A combination of peppermint and ginger (capsule or tincture or tea) with each meal stimulates enzyme production and can be done with all meals until the taste of the herbs becomes bitter or distasteful to you, indicating that you don’t need it anymore.

Probiotics

Probiotic foods or beverages populate a diverse, healthy gut microbiome. Start including healthy forms of probiotics/fermented foods with every meal. Examples include:

KimChi/Sauerkraut
Pickled vegetables & vinegars (preferably unpasteurized and unfiltered)
Apple cider vinegar and Honey (both unpasteurized and unfiltered) combined together
Miso
Mead**
Dark red wine**
Dark, rich beers**
Sourdough bread
Kombucha tea
Water Kefir/Tibicos+
Bottled or powdered probiotic beverages
- Kevita®
Powdered Fermented products
- Garden of Life® Meal Replacement

**Should not be commercial products, but homemade/craft/non-heat-treated products.

+Cheese and yogurt are NOT good sources of probiotics; the only ones that have good numbers associated with them are brie cheese and kefir. They work well, but are some of the weakest probiotics in the studies.

more about probiotics

Cutting out Processed Foods

Extremely processed foods are high in trans fats, artificial colorings, artificial sweeteners, and chemical preservatives. These are extremely difficult for our systems to process, and contribute to a slow and poorly functioning digestive system and eventually overwhelm the liver leading to obesity, exhaustion and hormone imbalances.

Shop for whole foods, those with very few, simple ingredients

Additives like preservatives and artificial sweeteners are difficult for our digestive systems to process.

Flax

Flax seeds are the best form of daily support for a colon that has suffered from long-term constipation and/or IBS. The best way to take flax seed is to purchase whole seeds in bulk (organic if possible) and store them whole in an airtight container in a cool dry place. Daily, grind 2-4 teaspoons of them and add them to your morning cereal, smoothies or on top of a salad or entree. This not only adds an excellent quality fiber to your intestines, but also is a source of soluble fiber that heals and protects the vascular system and the fatty acids we need to repair and strengthen our joint tissues, skin and nervous system tissue (including our brains and spinal cord).

Next Steps

Long-term/Lifelong constipation is hard to correct and when you are not getting to a normal bowel habit using the above strategies, try the following in the order listed:

1. Self-Reflection

Take an honest look at the social and emotional reasons for your inability to move your bowels normally: Lifestyle, stress and emotional issues also greatly affect our bowel functions and must be addressed along with the following natural remedies.

2. Carrot Juice*

Drink fresh-squeezed carrot juice (in 4-8oz quantities, up to a gallon per day) for one day. If this works, keep drinking 4-8oz per day.

*Not a suitable strategy for diabetics

3. One-day Carrot Juice/Raspberry Fast*

Drink equal parts of carrot juice and whole raspberries blended well to make a smoothie. Drink as much as you need to not feel hungry, and at least half a gallon per day. Make sure to drink plenty of water throughout the day

*Not a suitable strategy for diabetics

4. Bentonite Clay Cleanse

To improve absorption of nutrition from your food, jump start weight loss, and to recover from a stretch of life with a poor diet this is a good cleanse. It is also recommended as a cleanse for diabetics and hypoglycemics who cannot do a carrot juice/raspberry cleanse.

Add ¼ tsp of bentonite clay to about ⅓ cup of warm water and stir until the clay is dissolved.
If you are using herbs add those to the mixture and drink.
Wait 15 minutes, then eat a meal.
Repeat twice daily for 3 weeks.

5. Flax Seed Oil

Take one tablespoon of Flax-seed oil (15000mg in gel capsules) per day for about a week.

6. Cáscara Sagrada

Cáscara sagrada bark (500-2000mg or 1-4 capsules taken at bedtime) generally stimulates bowels to move in the morning immediately upon rising or after drinking a warm cup of water or tea. The fiber stimulates healthy movement of the bowel. It also contributes to hydration of the colon so morning bowel movements are softer and more hydrated. It should be taken nightly until you are getting a regular morning bowel movement. At this point, begin decreasing your number of nightly capsules until you can wean off completely and still have a daily, soft morning bowel movement. This herb is the best of the herbal solutions because it doesn’t damage the walls of the intestine, nor does it create a dependence

7. Colonics

Colonics or colon hydrotherapy with a trained therapist are a great way to make rapid progress correcting a long-term imbalance. You can search online for someone who is trained in your community. A series of treatments (3-10 sessions) is a great way to clear old, dry feces and jump start the restoration of a bowel that has struggled for many years. Enemas are not the same as colonic therapy. A home enema can be helpful for many health reasons, but doesn’t address the underlying issues of constipation and can also create dependence for any bowel movement. We do not recommend them.

8. Applesauce & Wheat Bran

The following is a remedy that will help under all of these circumstances and that can be used daily. It is safe to use for a lifetime, especially if you are diligent and don’t skip days too often:

Mix equal parts (by volume, approximate measurements are ok) organic applesauce and wheat bran (can be bought in bulk at most health food stores).
Moisten the mixture with organic prune juice until it is the texture of a thick, breakfast cereal.
Store it in a glass container in the refrigerator and take 2 tablespoons of this mixture each morning with a warm drink.

The mixture will keep for up to two months when stored this way

WARNINGS

The most common herbs on the market for constipation are senna and aloe peel. They should only be used in extreme situations for a day or two. They are highly effective, but are purgatives and can cause colon damage when used regularly. They also create dependence by disrupting the colon’s natural movement for resolving constipation.

If constipation returns regularly no matter what you do, lifestyle, stress, hydration, medications, diet, level of exercise, compression of discs and/or vertebrae in the lumbar region of the spine, emotional issues/internalized trauma, and other medical issues are usually the reasons. Getting attention from a trained herbalist or doctor is indicated at this point, as knowing the source of the problem is important and can identify other remedies and approaches that can tend to the root of the problem.

If vomiting accompanies several bouts of intense diarrhea it can be a life-threatening problem due to the risk of extreme dehydration that can set in rapidly; if you are able to get to the emergency room, do so. In absence of an available emergency facility, an enema of cool raspberry leaf tea (or tea of the other herb as listed above that you have available) injected slowly into the rectum with a sterile enema bag (or bulb syringe for babies) can be a life-saving tool to hydrate someone long enough to get help or avert a crisis. A bath is also hydrating and placing the raspberry leaf tea in a bath while you are in the tub can often rehydrate a person well enough to avert a serious crisis.