Straight Talk on Constipation

As a naturopathic physician, I know that bowel function is an important indicator of overall health. That’s why within three months of starting my initial family practice, I changed my intake form, deleting constipation from the standard “have you had” section, and substituting two questions: “How many bowel movements do you have each day?” and “How many bowel movements do you have each week?”

I did this because the word constipation has a highly variable definition. For some people, constipation means difficulty passing stool. Others will say they are constipated if they fail to have a bowel movement at least once a week. Still others will say they are constipated if they don’t poop twice a day. In the medical world, constipation is defined as bowel movements fewer than three times per week. For me, a patient has constipation and needs treatment for that constipation if they routinely do not have a bowel movement at least once a day.

Why? Because it’s essential that waste leaves the body on a regular, daily basis. We eliminate via our bowels, but also through our kidneys, skin, and lungs. When the bowel quits working regularly, it strains the other organs of excretion. That strain can show up as illnesses, such as skin rash, bad breath, headache, and strong-smelling urine. Constipation can cause fatigue, headache, abdominal pain and cognitive problems.

To relieve constipation, you have to get your bowels to contract to push stool out of your body. The bowel contracts when it is distended or irritated. Popular over-the-counter laxative medications mechanically create this process: Metamucil is fiber-based and draws water into the fiber, enlarging the stool to cause bowel distention. MiraLAX is magnesium-based and distends the bowel wall by drawing water into the colon. Laxatives such as Senokot (made with the herb senna) or Dulcolax (made with bisacodyl, a synthetic chemical) irritate the bowel wall, stimulating contraction.

I recommend a more natural approach, one that naturally improves and restores the body’s normal bowel function:

• Take a look at your fiber intake. Raw vegetables and fresh fruit offer the best fiber. Eat some daily. Avoid bread and pasta, instead choosing whole grains and legumes such as brown rice, beans, and lentils. Cheese and meat can be constipating, so keep portions of these limited to no more than a few ounces daily.
• Drink half your body weight in ounces of water daily, most of it away from meals.
• Vitamin C and magnesium can both stimulate a bowel movement. They are also healthy and safe daily supplements for most people. For constipated patients, I often recommend 1,000 milligrams (mg) of vitamin C with meals, three times daily, or 300 mg of magnesium twice daily. Note: Vitamin C supplements can irritate the stomach and should be avoided in sensitive patients. Magnesium can cause diarrhea. Reduce your dose if this occurs.
• Chamomile and peppermint have a long history of use as medicines to tonify bowel function and eliminate constipation. Drink an 8-ounce cup of tea made from one or both of these herbs after dinner and again before bed. Use two teabags per 16 ounces of boiling water and steep, covered, for six minutes before drinking.