Reverse or treat constipation: Your health depends on it

In last week’s article you learned why constipation is a major, yet subtle contributor to heart disease, cancer, arthritis, diabetes, skin aging, and other chronic illnesses.

In this article I want you to understand what causes constipation so you can reverse it, or at least treat it safely. Your health really depends on it…

Contributors to constipation

Here’s what contributes to slow stool transit that leads to constipation:

• Diet low in fiber: stool becomes compacted, hard, and larger over time
• These medications: narcotic pain relievers, antacids, calcium channel blockers, Parkinson’s disease medications, antispasmodics, iron supplementation, some antidepressants, diuretics, and anti-seizure medications. Also, consistent use of laxatives weakens colon smooth muscle contractions over time
• Lack of physical activity, travel, and prolonged bed rest (i.e. after surgery) decreases your colon smooth muscle contractions too
• Sitting on the toilet or ignoring your urge for a bowel movement
• Low thyroid function, advancing diabetes, Parkinson’s disease, other neurological disorders
• Intestinal tract problems such as celiac disease, tumors, polyps, diverticulosis, or irritable bowel syndrome
• Older women with excessive perineal descent ¹ from previous pregnancies or pelvic surgery. ²
• Environmental toxins such as organochlorine insecticides or heavy metals; possibly from bacterial or parasitic infection. ³

When a patient reports no apparent cause for constipation which came on gradually over years, I suspect low thyroid function. Other likely possibilities are lack of dietary raw food or the latent effect of chemicals from personal care products, non-prescription medications or other environmental source.

If you cannot identify and eliminate the cause, still there are safe and effective ways to treat constipation.

Dietary treatment for constipation

In 2004, it was reported that 5.3 million prescription medications were written by physicians for constipation. ⁴  I’d like you to know there are several natural ways to reverse constipation before resorting to medications. Let’s first look at dietary lifestyle.

In January 2011 the U.S. Department of Health and Human Services (HHS) wrote dietary recommendations ⁵ on their website. They wrote “Americans are experiencing an epidemic of overweight and obesity. Poor diet and physical inactivity also are linked to major causes of illness and death. To correct these problems, many Americans must make significant changes in their eating habits and lifestyles.”

To me this translates into not enough high fiber raw food. Americans reportedly consume only about 15 grams of dietary fiber per day on average. ⁶  But to prevent and reversing chronic disease you’ll need to consume 75 grams per day as a minimum. And to treat constipation I recommend 9 fruits/vegetable servings daily, which is much more than 75 grams of fiber per day. Here’s what it looks like in terms of quantities and types of foods:

Source: HHS report ⁷

Additionally, I recommend fermented milk (kefir) or plain yogurt and a probiotic supplement to establish healthy intestinal bacteria known to be important in bowel wall health. I also recommend removing all grains that contain the gluten protein (wheat, barley, rye, spelt, kamut, triticale) from your diet for 3 weeks to see if this helps. Use stevia or honey to sweeten your foods and avoid refined sugars, processed foods, artificial sweeteners and other food chemicals (preservatives, colors, additives).

Natural supplements to treat constipation

Psyllium fiber supplements (Metamucil, Citrucel) are an easy and safe way to soften stool by drawing more water into the stool itself. These are best for maintaining a normal stool pattern and not as an initial treatment for constipation because they can lead to bloating and abdominal pains if used with an already constipated bowel.

The herbal preparations that are safe are cascara sagrada ⁸ (Spanish for sacred bark) and Senna, which come in a pill or tea. These stimulate bowel wall muscle contractions. In order to prevent loss of effectiveness and “dependence,” use them not more often than five days a week or three weeks per month. Other herbal laxatives are cayenne, ginger, fennel, dandelion root, and chickweed.

Medications for constipation

If you are constipated and need to get your bowels moving in preparation for effective longer term methods (diet, herbs, physical activity), consider the following over the counter medications:

• The Fleet enema: evacuates just the sigmoid colon and rectum
• Milk of Magnesia: even better is magnesium citrate (taste not so good)
• Miralax: tasteless, odorless, and effective. Double or triple the dose if needed.
• The Fleet Phospho Soda oral saline laxative: most powerful, but taste is terrible.

Here are some prescription medications for constipation:

• Colace is a stool softener
• Dulcolax is a intestinal smooth muscle stimulant
• Amitiza is a bowel stimulant medication that works through calcium channel activation and is safe for 6 to 12 months

To feeling good for health,

Michael Cutler, M.D
Easy Health Options

[1] Camilleri M, Lee JS, Viramontes B, Bharucha AE, Tangalos EG. Insights into the pathophysiology and mechanisms of constipation, irritable bowel syndrome, and diverticulosis in older people. J Am Geriatr Soc. 2000 Sep;48(9):1142-50.
[2]Johanson JF, Sonnenberg A, Koch TR. Clinical epidemiology of chronic constipation. J Clin Gastroenterol. 1989 Oct;11(5):525-36.
[3] Ibid
[4] Everhart JE, editor. The Burden of Digestive Diseases in the United States. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Dept. of Health and Human Services; 2008. NIH Publication 09–6433.
[5] U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2010. Available online (open the pdf, find page i) at: http://www.health.gov/dietaryguidelines/2010.asp
[6] Slavin JL. Position of the American Dietetic Association: health implications of dietary fiber. Journal of the American Dietetic Association. 2008;108:1716–1731.
[7] U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2010,  p.88.
[8] http://livertox.nih.gov/Cascara.htm