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.
Ditch the crash diets too, as they aren't going to help move your bowels either. Keto and low carb equal 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.
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 or work up upregulating your body's own production of B-vitamins in your gut.
4. Press Pause on 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.
5. Get More Magnesium
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.
Using magnesium as a laxative should be short-term support, not a long-term bowel moving dependency.
6. 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. Butyrate also aids in keeping the colonic pH from getting too alkaline, which can keep bad gut bacteria from hosting a party on your behalf.
7. 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.
Find out how to harness the power of prebiotics in the Bulletproof Gut Masterclass.
8. 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 cause of constipation 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.
9. 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.
10. Don’t Sit, SQUAT.
Did you know that the proper potty position is to squat, not sit? Learn more about this here.
When Nothing Helps
When nothing is helping your constipation and your stools look more like they came from a rabbit than a human, it's essential to get more information on what's going on. Relying on laxatives (even natural ones like magnesium) is not a healthy long-term approach.
Comprehensive stool testing gives you the information you need to target exactly what is out of balance in your microbiome, so you can set yourself up for success. Read more on stool testing here.
If stool testing is out of reach, consider the low-cost How to Build a Bulletproof Gut Masterclass to set your gut up for bowel-moving success.
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
Thanks for the article, Catherine. I'm especially intrigued by your fifth point -- Cascara sagrada. This is the first I've heard of it. Do you have recommendations on ingestion and timing of use? Tea vs. capsule? Thanks very much!
Since capsules often have additives, I would say powder and heat with a bit of water.
The key with Cascara sagrada is to find a good source of the aged bark, which can be tricky!
wondering if you can recommend a good brand of Cascara sagrada ...it would be a life saver for my youngest.
How do I prepare it? Justa like te?
Hi there 🙂
I'm very happy to have found your blog, especially since I am having symptoms of adrenal fatigue, thyroid issues...and I have elimination problems...
In any case, I don't want to bother you too much - just wanted to know if there's any other vegetable that can be replaced for carrots in no.1? I am somewhat "intolerant" to carrots...What about parsnips?
I have suffered from years from constipation also from AF, and thyroid issues. I eat so many vegetables as well so that is not it. It seems like once I had AF, things never were the same after.
is there someone who could address my question?
Bamboo shoots would work as well as carrots. Shredded raw beetroot I would think would have a similar effect.
Thanks for reading!
...can't your bowel become dependent on cascara sagrada?
That is what my research has shown. It should only be used temporarily.
Triphala is a safer alternative than Cascara. The Triphala capsules are considered safe for daily use, because the ingredients consist of only three sour fruits, and thus Triphala is essentially a food.
the whole thing with the estrogen-lowering properties of the carrots...what if you're ammenorrheic? in others...not ENOUGH estrogen?
0.o okay then....Learn something every day...
But carrots are an estrogenic food...
What is a good brand of cascara sagrada?
I would go to an herb store, or to http://www.mountainroseherbs.com and get the cascara.
GiGi Eats Celebrities
NOTHING works for me. Not even anything on this list. However, I really may need to invest in the squatty potty! ha ha -
Ground up chia seeds are another great thing that seem to work for a lot of people. Also, regular colonics are a great thing to incorporate into your life...NOW!:)...
You can use a small step stool! I bought mine at a TJMaxx a few years ago-tried that and it works like a charm. It's a small collapsible one.
Calm magnesium powder works great along with Heather's Tummy Fiber and for me I add 1/2 tsp of Muralax to two cups of water 1-2 x day depending. It's my miracle. Especially the magnesium.
It sounds funny, but I use my kids' stool like the "Squatty Potty" is used and it actually does make it easier! Try it!
Try coconut capsules. I like Frutrients. They work!!!
How are you doing now these days regarding constipation, if good plz help me, i have bee n constipated since 2011.
Forget squatty potty. Lift both lids, hang onto something either side of you and squat on the porcelain. Also, eat lots of raw carrots (Catherine's brilliant advice), loads of raw sauerkraut and try Colosan powder. NOT the capsules. Chase it w/ACV as opposed to lemon or lime and see what happens.
For immediate relief, look up baking soda for constipation. I drink water only with baking soda in it for reflux and it keeps me regular. Also what keeps me regular is thyroid, inclined bed sleeping, magnesium.
Even the squatty potty won't help if your bowel contents are dry. Try drinking a tall glass of cold water with a teaspoon of baking soda/bicarbonate of soda dissolved in it. Twice a day until you get regular relief
And also get the report on improving your metabolism. See also Matt Stone on water and the color your urine should be. Too much water is drying/dehydrating to the body..
Just eat the cascara bark, it's quite simple, increasing dose, I have used it straight for two years
been through the ringer
some bowel problems come from paralysis due to spinal injury, compression or something disturbing the nerves coming from the spinal cord. Most doctors won't acknowledge this. Cascara sagrada is extremely damaging so short term use is recommended and yes your bowels will stop working on their own and become dependent on it which is bad. physical activity, exercise and green foods are absolutely essential to better bowels so get off your duffs and get on to better health. otherwise, get a doc who will explore the possibility of back surgery. that is what helped me.
I have an Autistic daughter who deals with constipation routinely. We switched to a gluten free, dairy free and sugar free diet (except for an occasional treat). Every morning I give her a berry shake with camu camu powder, coconut kefir, and a fiber supplement recommended in the Body Ecology book. I also incorporate fermented vegetables like salsa that I put on her pastured eggs and a good quality probiotic. I do use the Magnesium spray and Ancient Minerals Magnesium flakes in a bath. I have also rubbed a layer of Castor oil on her abdomen, covered it with plastic wrap and applied a hot water bottle to her abdomen for 20 or 30 min. to help it absorb transdermally. All of these things have been highly effective, The most helpful though is the coconut kefir and fermented food along with eliminating the offending foods like gluten, dairy, and processed foods. I have learned that there is a gut- brain connection and my daughter is a testimonial to this. By keeping her regular and focusing on fresh whole foods and supplementing with vitamins and minerals her behavior has improved dramatically, she is calmer, cooperative and her cognitive function much improved! The brain fog has been lifted and I couldn't be happier to see her thriving!
what a good mom
I use molasses, 1 or 2 tablespoons a day. I mix it with my kefir drinks.. Works wonders. Molasses is high in potassium which draws water into the stool.
Thank you, Shirley, this turns out to be a most excellent recommendation. I've found it to be non-invasive and effective, not to mention tasty. Much appreciate your comment.
Heavily buttered bread works like a miracle. Im starting to think I hav a dry gut.
Coca cola works (I use it only as therapy) whn im terribly blockd...best colon cleanser...drain cleaner.
These work for me too. Sometimes a greasy burger and fries sends the stagnant bile and gallstones packing. But magnesium and a cup of coffee do as well. Coconut capsules are my go to for constipation. Smooth move tea is good too.
Where can i find kefir in South Africa?
I started Weight Watchers and increased my protein intake. After a couple of weeks, I had constant constipation. After doing some research, I started taking flaxseed geltabs daily. It has helped and now I'm back to normal.
Am also interested in recommendations for a source of Aged Cascara?
Ground flaxseeds are my life saver. I mix them in smoothies, yoghurt, porridge, anything I can mix them in. But be careful when you first take them as too much can clog you up. Start with half teaspoon a day and slowly work your way up to 2 tablespoons a day. It had worked wonders to keep me regular.
I would advise against ingesting whole flaxseeds as they with go straight through without doing anything. Whole flaxseeds need to me ground up first. Xx
Coconut oil in my coffee or tea is my go to. About a half to 1 tablespoon is perfect and foot stool or squatting. Also, drink lots of water.
Detoxing sometimes does not work by clearing toxins already absorbed by the body, it only works as a laxative i.e. clearing them before they are absorbed. And it is a bad idea to use laxatives frequently. The best detox I have found is the Dr. Max Powers 15 Day Cleanse. I dont do it for 15 days, I only take it for 5 days and that is enough.
I would recommend using the Dr Max Powers 15 Day Cleanse for constipation and perhaps occasionally when you have eaten and drunk too many bad things.
Interestingly, I've seen a lot of 'trendy' looking options to add to your diet and have even noticed that some don't even work for some. Curiously, psylium seed husk was not even mentioned. I have been using it for years, a few tablespoons before bed and you WILL be regular. Nothing else has really proved effective, but psylium works everytime.
Magnesium is the only thing that's worked for me consistently, not pills or supplement caps (they did nothing) I use powdered Natural Calm (it comes in flavors). I tried all the others mentioned here, and no go (as it were). with natural calm you can control pretty precisely how everything comes out (or goes) as it were!!
P.S. Women should be careful about ingesting lots of flax seeds, as it can be estrogenic.
hoe about flaxseed oil?
Psyllium seed husk, not powder! Regular use means regularity. PERIOD.!
Great post thank you. There could be a lot of things causing the consipation. I found that hydration, relaxation (yoga) and foods like Chia seeds and ginger work best for most people. But then again sometimes it can be a simple as adding some fiber or (healthy) fats to your diet to get the bowel movement started.
What works best for me is Aloe juice, ~ a half cup a day. No negative side effects, and helps maintain a healthy microbiome. Aloe is my favorite natural medicinal!
It obviously also helps to have adequate liquids in your diet, exercise, fiber, Magnesium, and importantly to eliminate food allergies (took me years to figure out this was my root cause), but when these fail (or you don't get around to them...), Aloe works!