Let’s get down to business. Your business, that is. No one likes talking about bathroom habits, but the truth is, gastrointestinal (GI) issues are incredibly common — particularly constipation. It’s estimated that 16% of all adults and 33% of people over the age of 60 experience constipation, which involves having small, hard, or infrequent bowel movements (often fewer than three times a week) that may be accompanied by bloating, cramping, and nausea.
Living with constipation can be stressful, not to mention it can contribute to other unpleasant issues like hemorrhoids. The good news: Much of the time, with some strategic dietary and lifestyle changes, you can alleviate constipation and boost your overall health in the process.
Below, we’ll break down:
- The common causes of constipation
- Natural solutions that promote regularity
- When to talk to your doctor
What Causes Constipation?
A variety of things may cause constipation, but one big and often overlooked factor is stress, says Dr. Bill Rawls, MD, Medical Director of Vital Plan. In fact, according to a review published in the journal Medicine, stressful life events and psychological disorders such as depression and anxiety may be associated with chronic constipation.
“Constipation is about slow motility — when things just are not moving quickly enough through the GI tract — and that can be tied to all kinds of stress,” says Dr. Rawls. When you experience traumatic events, distressing thoughts, or even challenging health conditions, the sympathetic nervous system (SNS) becomes activated, which, in turn, triggers the body’s “fight or flight” response, and your body pumps out stress-related hormones noradrenaline, adrenaline, and cortisol.
Back in the days of our ancestors, this “fight or flight” response would only be activated in instances of true danger — say, when a bear was approaching and you had to either fight or flee for your life. It would prime you for swift action by enhancing alertness, sharpening reflexes and vision, and increasing blood flow to the brain and muscles. In the process, however, these hormones would also divert resources from bodily functions considered less essential for survival (at least in the moment), such as digestion.
The problem today? Given the chronically stressful nature of modern life, our “fight or flight” response has the potential to be activated almost constantly — and digestion suffers as a result. This low level stress can slow things down at nearly every stage of digestion and trigger a cascade of GI troubles, from reflux to increased growth of bad bacteria to bloating and constipation, says Dr. Rawls. The longer waste sits in the colon, for example, the more time your body has to extract water from the stool, so it becomes dry, compact, and harder to pass. Research shows that stomach acid secretion is also reduced during times of stress, which makes it difficult to break down food and keep the digestive process running smoothly.
But stress isn’t the only thing that can stop you up. Another big driver of constipation is a diet high in processed foods, which are devoid of the fiber and water that help keep things moving. Age is also a contributor. According to Dr. Rawls, the muscle contractions that help move food through the GI tract become weaker with age, and the stomach naturally produces less acid, both of which can back you up.
9 Natural Ways to Prevent or Alleviate Constipation
1. Activate Your Parasympathetic Nervous System.
You may not be able to cut out all the stressful aspects of your life, but you can take steps to counter the negative effects it has on health and digestion. Clinical trials on patients with irritable bowel syndrome (IBS) — a condition involving abdominal pain, bloating, and constipation, diarrhea, or both — have found increased SNS activity among those with IBS compared to healthy controls. Remember, the SNS governs the body’s “fight or flight” response, which can wreak GI havoc when overstimulated.
The good news: A variety of practices may help hit the pause button on an overactive SNS by activating its counterpart, the parasympathetic nervous system (PNS), which controls the “rest and digest” response and primes the body for optimal digestion. Slow, deliberate, deep breathing activates the vagus nerve, which upregulates the PNS — try out one of these simple breathing exercises or any activity that involves mindful breathing, such as yoga and meditation. Also, consider walking or working out in nature (think: forests, grassy parks, or near a body of water), which has been shown to increase PNS activity.
2. Move Your Body Every Day.
Any physical activity can also help improve constipation, says Dr. Rawls, as it decreases stress, normalizes adrenaline, and improves the balance between the parasympathetic and sympathetic nervous systems. But other factors may be at play as well.
In a study involving 125 obese women with chronic constipation, those who took part in regular physical activity, ate a low-calorie diet, and received standard constipation care experienced greater improvements in constipation and quality of life scores than women who followed the same protocol minus the physical activity.
Why? Researchers suspect that exercise may speed up colonic motility by stimulating the vagus nerve, which could increase the release of certain beneficial GI hormones; or that the bouncing movement and contraction of abdominal muscles during exercise may help mechanically stimulate the gut and move waste into the rectum.
Additionally, some studies have found that exercise improves the diversity and abundance of certain bacterial species in the gut microbiome. While more research is needed, this could potentially help reverse the gut dysbiosis that’s been associated with chronic constipation.
For optimal regularity, aim for around 20-30 minutes a day of moderate-intensity physical activity such as walking, cycling, or biking. Or, if you’re less mobile, consider a gentle yoga flow or simple bodyweight exercises such as sit-ups, push-ups, planks, and leg lifts.
3. Eat More Veggies Than Anything Else.
Dietary fiber increases the weight and size of stool and helps waste move more easily through the lower GI tract, but most adults only get about half the recommended daily intake of fiber. Adults should aim for at least 25-30 grams per day. But don’t just load up on any old fiber and assume it will alleviate your GI woes; focus on vegetables. According to Dr. Rawls, vegetables contain the form of fiber that our bodies were designed for — cellulose, which helps keep food moving through our intestinal tract and serves as food for our friendly gut bacteria. Eating loads of grains, on the other hand, can promote the growth of the bad bacteria in the gut, damage the intestinal wall, and hinder GI motility.
In addition to fiber, vegetables are loaded with vitamins, minerals, and antioxidants to support overall health. “Most vegetables are also around 70% water, which adds hydration to the digestive process that is slowly released and also helps keep things moving,” says Dr. Rawls.
Aim to make at least half of the foods you eat vegetables, such as leafy greens, broccoli, cabbage, Brussels sprouts, carrots, green beans, asparagus, zucchini, squash, and mushrooms. Certain fruits can also boost your fiber quota without a lot of sugar, particularly berries — a cup of raspberries contains 8 grams of fiber, or about a third of your daily needs.
4. Keep Yourself Hydrated.
Drinking enough fluids to avoid dehydration is important for preventing or alleviating constipation — but you don’t have to go overboard. Optimal fluid intake will be different for everyone depending on factors such as physical activity levels and overall diet, but your thirst levels and urine color are usually good indicators. A pale yellow urine color and not feeling thirsty typically indicate sufficient hydration. Just keep in mind, hydrating in excess may not offer any additional benefits for constipation.
In addition to drinking water, eating plenty of vegetables and low-sugar fruits goes a long way toward keeping you hydrated. If you find it hard to hydrate adequately with water, consider sipping on herbal teas, water with cucumber and lemon, flavored seltzers, or even broth during the day.
5. Give Fermented Foods a Chance.
Fermented vegetables such as kimchi, sauerkraut, and even certain types of pickles may support healthy digestion and potentially alleviate constipation by delivering a one-two punch of fiber and probiotics. “You’re getting vegetable fiber, including prebiotic fiber that helps grow favorable bacteria in the gut, and you’re getting an inoculation of not just one or two strains of bacteria but a wide spectrum — and a big load of it, too,” says Dr. Rawls. “Where probiotics never did anything for me, kimchi and other types of fermented vegetables do.”
To be sure you’re getting a dose of live, active bacterial cultures, look for the terms “raw,” “fermented,” and “unpasteurized” on the labels of fermented foods. If you’re not sure about the taste of something like sauerkraut, know that you have lots of options — many brands (such as Wildbrine and Farmhouse Culture) are now offering varieties with additional flavor-boosting ingredients like ginger, carrots, jalapenos, apple, caraway seeds, and more.
6. Sit On the Toilet at the Same Time Every Day.
Even if you don’t have the urge to go, try sitting on the toilet for about five minutes at the same time every morning without straining. According to Dr. Rawls, over time, your body will eventually learn that you’re trying to have a bowel movement. “Our body does follow rhythms, and the more we can get into those rhythms, the better,” says Dr. Rawls.
To boost your odds of success, consider timing this bathroom ritual after you’ve had your morning cup of coffee — both regular and decaf coffee have been shown to trigger contractions in parts of the colon that may stimulate your urge to poop.
7. Boost GI Motility With an Abdominal Massage.
A DIY abdominal massage may be a simple but effective way to improve GI motility and ease constipation. According to a review published in the Journal of Bodywork and Movement Therapies, several studies have shown that abdominal massage stimulates peristalsis (or the wavelike contractions that propel waste forward through the intestines), increases the frequency of bowel movements, and decreases the feelings of pain and discomfort associated with constipation and bloating. To try it yourself, watch this abdominal massage video tutorial.
8. Take a Magnesium-Based Laxative or Supplement.
Magnesium is one of the best in-the-moment solutions for constipation, hands down, according to Dr. Rawls — but it has to be a specific type of magnesium: Good old, inexpensive Milk of Magnesia from the drugstore, which contains magnesium hydroxide. “Your body can only absorb so much magnesium,” says Dr. Rawls. “What isn’t absorbed is held in the intestines, where it acts as an osmotic, meaning it will pull water into the colon, which helps hydrate the stool so you can pass it more easily.”
Taking the recommended dose can help flush out your system if you’re really backed up, but magnesium hydroxide can also be used as a preventative if you tend to get constipated regularly. “Typically, what I recommend for people with chronic constipation is to use a small amount of Milk of Magnesia — about ½ tablespoon before bed every night — to keep stool soft and prevent constipation,” says Dr. Rawls. “You can use it in small amounts on a regular basis without causing any problems or damage to the colon.”
Regular magnesium supplements — particularly in the form of magnesium citrate or magnesium oxide — also function as osmotics and may also offer more subtle constipation relief, says Dr. Rawls, but it can be harder to control the dose with these capsules or tablets.
9. Consider Herbal Support.
A variety of herbs may safely and subtly promote regularity and ease constipation. Just be sure to steer clear of strong laxative herbs such as senna, which is found in a variety of laxative and detox teas and may actually damage the intestinal wall in the small bowel, cautions Dr. Rawls. Instead, consider these milder herbal options:
Triphala is a combination of three fruits (amla, bibhitaki, and haritaki) that has been traditionally used in Ayurvedic medicine to nourish the colon, support a healthy intestinal lining, and offer very mild laxative effects to promote the passage of waste.
Dandelion root stimulates bitter taste receptors in your mouth and throughout your digestive tract, which alerts your body to start making enzymes that break down food. Dandelion root functions as a digestive stimulant and is known for its mild laxative properties that may help regulate bowel movements and ease constipation. Roasted dandelion root tea makes a great coffee replacement.
Slippery elm bark
Slippery elm bark contains a soothing, somewhat gelatinous compound called mucilage, which may help keep the lining of the GI tract healthy and soothe indigestion. A small study in The Journal of Alternative and Complementary Medicine found that two natural medicine formulas containing slippery elm bark improved bowel movement frequency and reduced straining, abdominal pain, and bloating in people with constipation-predominant IBS.
For the vast majority of individuals, constipation doesn’t have to be something you suffer with for the long haul. Most people will get relief by optimizing their diet, staying hydrated, keeping stress down, staying active, or implementing one of the other natural solutions above. But if you can’t seem to get into a healthy rhythm, talk to your doctor. They may be able to offer additional solutions or identify an underlying condition that’s contributing to your constipation.
Discover more in Dr. Bill Rawls’ new #1 Bestselling book: The Cellular Wellness Solution: Tap Into Your Full Health Potential with the Science-Backed Power of Herbs.
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