As with so many other health problems, the answer is fairly complicated. Possible culprits range from thyroid problems to fibre intake to gut flora, and almost everything in between. By fully understanding these potential causes, you’ll be much better equipped to identify which one (or more) is relevant to you, and then take action accordingly to handle it.
Increase Water Intake
One of the easiest causes of constipation to address is dehydration. Your body has a very sophisticated system for regulating how much water it absorbs and how much it excretes; if you aren’t drinking enough water, your body clings on to every last drop because it needs all that fluid to maintain blood volume and perform other important functions. Since you don’t have any fluid left over for less essential needs like pooping, the poop in your colon becomes very dehydrated and hard, which makes it difficult to pass and often painful on the way out. If you increase your water intake, your body will have more to excrete, so your faeces will become softer and easier to pass.
There is no magic amount of water necessary for proper bowel function, but since drinking more is such an easy and non-invasive remedy, it’s worth a try if you think it might be even a remotely plausible explanation.
Increase Fibre Intake
In conventional diet wisdom, fibre is the king of healthy bowel movements. Eating plenty of fruits and vegetables may simply be the solution to constipation. Eating wholefoods, unprocessed and natural foods may go a long way to solving the problem.
However if you are still constipated despite eating several servings of vegetables a day, the problem is probably not that you aren’t getting enough fibre. Barring occasional exceptions, you shouldn’t need supplements or over-the-counter solutions or other supplements just to have normal bowel movements. Instead of treating the symptoms, it’s more effective in the long run to address the real cause of your constipation.
Your gut flora – the friendly bacteria that inhabit your digestive tract – seem to be involved in almost every health-related issue, and constipation is no exception. Healthy gut flora help increase regular bowel movements. If you don’t have enough friendly gut flora one possible consequence is constipation. On the other hand, bacterial overgrowth (especially small intestinal bacterial overgrowth, or SIBO) is also dangerous: the ideal situation is to have a balanced population of gut flora, without either too many or too few.
Therefore, disruption of the gut environment in either direction (too many or too few bacteria) can lead to constipation. The solution to this problem is, of course, to treat the underlying gut flora dysfunction rather than constantly living with the symptoms. Prebiotics (supplements that help nourish friendly gut bacteria) and probiotics (supplemental bacteria either in pill form or in fermented foods) can both help.
Eating certain foods that you’re sensitive to can also cause constipation. Dairy, for example, often causes chronic constipation in people sensitive to lactose or casein. If you’re eating lots of yogurt every day in an effort to get more probiotic bacteria, you might try switching to another source of probiotics (dairy-free fermented foods like sauerkraut and kimchi, or a probiotic supplement).
Intolerance to FODMAPs (a family of carbohydrates found in legumes and grains, as well as some fruits and vegetables) can also cause constipation in some people (in others, it causes diarrhoea). Fructose is one type of FODMAP that some people are particularly sensitive to; fructose malabsorption can cause constipation even in people who aren’t sensitive to other FODMAPs. The good news is that restricting or eliminating these foods often frees you from the digestive symptoms associated with them.
Low Stomach Acid
The pharmaceutical industry spends so much time and money getting us to buy ‘Quickies’ and other antacid drugs that it seems ridiculous to cite “low stomach acid” as a problem. But in fact, most people actually have it backwards: having too little stomach acid is a more common problem than having too much.
As well as being the real root cause of acid reflux (if you don’t have enough stomach acid, your food is never digested, so it stays in your stomach and the pressure forces acid up into your esophagus), low stomach acid can also lead to serious constipation issues. For the digested food in your stomach to empty into the small intestine, it first has to reach a certain level of acidity, so low stomach acid can gum up the works and cause serious bloating and discomfort. Especially if you feel like your food just sits in your stomach like a brick, you may be suffering from this problem.
Fortunately, the solution is widely available and fairly cheap: Betaine HCL supplements are available online or over the counter at most health food stores. To find the correct dose for you, start with one tablet taken just before you eat, and add another tablet with each successive meal, until you feel a slight warm sensation in your stomach and throat. Go back to one tablet less than the dose that caused the warm sensation.
If you’re skeptical of taking acid as a supplement, you could also try increasing your intake of acidic foods. Vinegar is the most common example of this – a tablespoon full of apple cider vinegar in a glass of warm water or some balsamic sprinkled over a salad is often plenty for people with less serious stomach acid deficiencies.
Although scientists don’t completely understand the gut-brain axis, researchers are increasingly discovering that mental health plays a significant role in the development of all kinds of functional digestive symptoms, including constipation. For example, one study found that children enduring stressful life events (from divorce to warfare in their home country) had significantly higher rates of constipation than non-stressed children. Anxiety and depression are strongly linked to irritable bowel syndrome (IBS).
This makes intuitive sense to many people – when stress and tension often causes a stomach ache or “ties your stomach in knots,” so it’s not such a stretch to understand how it might affect other parts of the digestive system as well. A more frustrating question is what to do about it: stress seems to be a chronic feature of modern life and in many ways chronic stress is even harder to tackle than dietary changes. Yoga and meditation, breathing and mindfulness techniques, fresh air and exercises are elements you can include in your lifestyle which can go a long way to reducing tension, stress and anxiety.
Thank you to The Paleo Leap for the information contained in this Blog. For more information visit: The Paleo Leap http://paleoleap.com/dealing-with-constipation/