There's not much worse than not being able to "go" regularly. Constipation not only causes digestive discomfort, but it can also severely impact your mood, create the perfect environment for bacterial overgrowth in your gut, harm your intimate relationships, and even your self-esteem!
To combat chronic constipation, it's best to have a multi-faceted approach in order to increase bowel transit time and ease elimination; one that focuses on your diet, lifestyle, and also a digestive "helper" or two if needed.
1. Eat Enough Carbohydrates and Calories
For efficient digestion and elimination, it’s important that you are eating enough nutrient-dense food to support both your metabolism and bowel transit to avoid constipation. So double check that you are up-regulating your metabolism by eating nutrient dense protein, carbs and fat together.
Dieting doesn't help either (keto and low carb = constipation in a large subset of my clients). Too little carbohydrates or calories slows bowel transit time causing constipation.
2. Know your Calcium and Potassium levels
Did you know that in hair analysis your ratio of calcium and potassium determine how well your thyroid hormones are doing their job and thyroid hormones HUGE impact on constipation? Having high calcium levels in your body (often from taking too much vitamin D in supplement form) relative to potassium levels means that things in your body are literally slowing down, and that means constipation could become normal.
If your thyroid hormones haven’t been doing their job well for some time, you may know about it by experiencing even more unfavorable symptoms like: cold sensitivity, low energy, depression, weight gain and the list goes on. Read more on how to find out where your body's at here and consider finding out your own calcium and potassium levels here (with plans starting at as low as $119).
3. Get Enough Thiamine (B1)
Thiamine or vitamin B1 plays a huge role in digestive motility. Like HUGE. The connection between thiamine and digestive issues is twofold. First, bacterial overgrowth conditions, specifically involving bacillus and clostridia species(clostridia overgrowth causes constipation too) deplete thiamine. Secondly, thiamine is required to produce acetylcholine, the primary neurotransmitter used to communicate with your gut via the vagal nerve. The vagal nerve governs digestive motility and explains the upstream connection between gut dysbiosis and thiamine deficiency.
Getting more thiamine in your diet can be extremely helpful. Find out more ways to get thiamine here.
4. Eliminate Foods That Work Against You (i.e. food allergies and sensitivities)
Foods that work against you slow down bowel function and deduct from your nutritional bank account every time you eat them. They do this in three major ways. First, when you eat foods that you are allergic or sensitive to, they activate your stress response which reduces your digestive juices and lessens both your absorption and digestion of nutrients. Secondly, when you eat foods that cause bloating or that are difficult to digest, they down-regulate your appetite which causes you to eat less and leave you unable to make nutritional deposits, and then it slows transit time. Finally, food allergies and sensitivities distract your body from proper function and healing. When your body is preoccupied with a stressful food, it can’t focus on proper digestion and building health.
If you're having trouble identifying your food sensitivities on your own, then you should know all about this test.
5. Get More Magnesium (epsom salt baths, magnesium chloride spray and supplemental options)
Magnesium is one of the nutrients that is very much lacking in the highly processed standard American diet, making deficiency common. Getting your magnesium from food is always the best choice (properly prepared grains, fruits, chocolate, etc), but if you need more than you can obtain from food, both transdermal (through the skin) and supplemental magnesium are other options. Transdermal choices are epsom salt baths, magnesium lotion, magnesium spray, and my favorite supplemental options are magnesium ascorbate, glycinate, orotate or malate from a reputable source (you can find a list of my favorite supplements here). Magnesium works in two major ways to ease constipation: it relaxes the muscles of the intestines, and draws water into the colon to help initiate peristalsis (propel matter through your digestive tract).
Supplemental forms of magnesium that are specific to having a laxative effect are citrate and oxide.
6. Consider Trifala (Triphala)
Trifala is one of the most popular Ayurvedic herbal formulas, and literally means "three fruits," specifically Amala (Emblica officinalis), Bibhitaki (Terminalia belerica) and Haritaki (Terminalia chebula). It works to gently cleanse the digestive tract and support peristalsis, which aids in keeping your bowel movements regular. Trifala powder or capsules are typically taken on an empty stomach in the evening hours or prior to bed.
7. Try a Colon Anti-inflammatory Agent
Gut dysbiosis can leave your gut lining in fragile condition which usually involves some level of inflammation. Colon anti-inflammatory agents include things like butyrate (produced by fiber-fermenting gut bacteria) that provide nourishment for the cells in your colon called colonocytes.
8. Get More Prebiotic Fiber
When constipation happens, it usually has something to do with the bacteria thriving in your gut. Sometimes, an overgrowth of opportunistic or pathogenic bacteria is the cause of chronic constipation. Often a subtle way to help support your good bacteria (so they can help crowd out the bad guys) is by making sure they have enough prebiotic fiber to keep them alive. So give your good gut bacteria enough food to keep them thriving with fruits, veggies, and select prebiotic fibers that are safe for complex digestive situations and won't cause bloating.
9. Cascara Sagrada (for chronic constipation)
Cascara sagrada contains emodin, a laxative substance that has anti-cancer and anti-viral properties. Emodin also acts to absorb endotoxin from the intestines for excretion which can prevent “letting larger amounts of bacterial toxins enter the bloodstream, interfering with energy metabolism, creating inflammatory vicious circles of increasing leakiness and inflammation," according to Dr. Ray Peat, PhD. By using a very small amount of properly aged Cascara sagrada bark, you can help regulate bowel movements for a short time until your metabolism recovers and you can “go” on your own.
10. Drink Some Beet juice (and high potassium juices)
Beets are incredibly therapeutic to the liver, a beauty food, and a digestive aid (I love taking a “shot” of this stuff when I don’t have fresh beets on hand). They have the ability to help thin your bile, which allows the body to detox more efficiently, and can help with easier elimination. A common problem is sluggish/stagnant bile flow. After toxins are neutralized in the liver, they are dumped into the bile (bile duct is a river for toxins to move out of the body) and when the bile gets too thick, toxic matter can’t flow out of the body quick enough (leading to fatigue, low energy, constipation, PMS, toxicity and disease)! Regular beet consumption (and a wealthy diet) can help strengthen this process naturally!
The other great option vegetable juices that are high in potassium. Think 8-12 ounces of fresh celery, cucumber, or a potassium-rich veggie juice that fits your cravings.
11. Eat More Bowel Moving Foods (probiotic foods)
Fermented foods such as yogurt, kefir, kombucha, sauerkraut, or supplemental probiotics (my favorite here) can help to move your bowels and eliminate constipation due to the healthy bacteria they contain.
In certain gut conditions (SIBO, LIBO and more) probiotic foods won't be tolerated well or at all (or only certain strains may be tolerated). So keep this in mind, and consider stool testing (like a GI map) to find out specifically what is going on in your gut and what you can do to support it.
12. Don’t Sit, SQUAT.
When Nothing Helps
When nothing is helping your constipation and your stools look like they come from a rabbit more than a human, it's essential to get more information on what's going on. Relying on laxatives is not a healthy long-term approach.
How about you? What helps you get things moving to avoid constipation? Please share in the comments!
Cascara, energy, cancer and the FDA's laxative abuse by Ray Peat