What’s Constipation?

Before talking about constipation relief remedies, let’s talk about what makes a healthy bowel movement. Most people think of how often they go. And even when they do, many don’t know what normal or healthy frequency is. I’ve come across patients who have, all their life, had 1 or 2 bowel movements a week. They thought that was healthy or typical because that’s what their experiences has always been. Let’s face it, most people don’t really talk about how often they go!

Healthy bowel movement frequency: once a day minimum. It’s ok if you go more than once a day, as long as it’s not turning into loose stool (which we will talk about at a different post). It takes 33 to 47 hours after eating for stool to form from what’s left of your meal. Since you’re eating every day, you should have a bowel movement every day.

Healthy bowel movement consistency: it needs to look like a banana or sausage. If it’s small and rounded like pebbles or peas, that’s also considered constipation.

You can use the Bristol Stool Chart to help you identify where your bowel movements fall. Type 3 and 4 are considered healthy. While the consistency will range depending on what you eat, if have you’re always having types 1 and 2 or types 5, 6, and 7, it’s a sign for trouble. Sometimes people alternate from one extreme to another, alternating between constipation and diarrhea. That’s also a sign of trouble.

Constipation Relief

As we talk about constipation relief, keep in mind that you need to cover the basics first. Consider this checklist as the first layer to peel. It would be great if you can solve your constipation by incorporating some of those simple steps.

If you have stubborn constipation despite this checklist, and if getting rid of it is important to you, the next step would be to think of what else may be happening. You’ll have to go deeper into your health and peel more layers. I share some suggestions at the end of this post. A complete solution for chronic and advanced constipation will only happen with an individualized assessment and plan that also includes proper testing. If your constipation is stubborn, you’ve probably tried many things already and may have even made things worse! You can read about my approach to complete gut health HERE, and I would love to chat about the possibility of helping you.

1. Drink 8 to 10 cups of water a day

It’s that simple, but many people are falling short. You need at least 8 to 10 cups of water each day. You’ll need more if you exercise more, sweat more, live in a humid hot area. Be careful in the winter! Many people are more dehydrated in the cold because they don’t get as thirsty and forget to drink.

2. Eat 3 to 5 cups veggies and 1 to 2 cups fruit a day

Vegetables and fruit have water and fiber that will help you go. Fruit typically softens the stool. Try berries, oranges, melons, pineapple, and grapes. Avoid banana as it will have a constipating effect. For vegetables, choose a variety of colorful vegetables like leafy greens, summer and winter squashes, cabbage, broccoli, cauliflower, mushroom, tomatoes, and cucumber. Read my note below on starches. Avoid corn as it’s a grain! Making a smoothie with coconut water (not milk, see note below), pineapple, spinach, and cucumber, for example, is a great way to get water and a couple of servings in.

3. Use healthy fats, especially coconut oil

If you’re still following a no-fat diet, let me bring to today’s research. Fats will not make you fat or increase your risk of heart disease. Bad fats will, but good ones will not, and, in fact, cutting back on healthy fats can lead to nutrient deficiencies. If you subscribe to the no fat approach, you may have constipation because there isn’t enough ͞grease͟ to ease the passing of your bowel movement.

For constipation relief, I recommend using oils over nuts and seeds as the they may cause bloating and stomach pain. Use olive, coconut, and avocado oil liberally. Add olive oil to salads or when cooking at low temperature. Drizzle over roasted or steamed veggies. Use coconut oil to saute or roast vegetables and protein. Add a tablespoon of coconut oil in the ͞Move it͟ recipe below. You can even add a teaspoon of coconut oil to your morning coffee. The combination of caffeine and coconut oil can stimulate a bowel movement.

4. Try “Move it” dry fruit Recipe

I’m sure you tried or heard of eating prunes or other dried fruits to stimulate bowel movement. It does the trick for some people, but not for everyone. Take it a step further and make this dried fruit concoction so you can also benefit from water, additional fiber, and coconut oil.

In a pot, add 2 cups of a variety of dried fruit like prunes, figs, apricots, and dates. Add water, just enough to cover the fruit. Stew for 20 minutes, then transfer to a blender. Add about ½ cup oat bran, chia seeds or flaxseed meal. Puree and add more liquid if needed. You can eat it warm or cold. Store the extra in the refrigerator and eat about ¼ cup per day.

5. Add magnesium citrate

I don’t typically recommend supplements publicly, but I feel pretty comfortable recommending magnesium. It works magic with my patients! Magnesium is a mineral needed for muscle contractions and relaxations, and deficiency can lead to constipation, among other things like muscle cramps and headaches. Magnesium deficiency is common, yet sadly, not something your doctor will recommend. People with blood sugar control issues, like diabetes, PCOS, or pre-diabetes, are likely to be deficient in magnesium.

There are many types of magnesium. You may have heard of Milk of Magnesia as a laxative. I don’t recommend that because it doesn’t actually fix the problem or address the root. It will make you have a quick bowel movement, but you eventually start depending on it and start needing more and more to see an effect. Magnesium oxide is another form that will make you have diarrhea, but it also doesn’t get absorbed. Again, it won’t fix the deficiency problem.

Magnesium citrate is the one I recommend for my patients. It comes in capsule and powder forms. Powders are often better absorbed, but some people prefer the convenience of a capsule. I’ve tried several, and there are 2 products that my patients consistently see results with. As far as dosing, some of my patients see relief at 300 mg per day, while others need to go up to 600 mg per day. If you want the specific ones I recommend, you can sign up to my supplement store HERE and contact us HERE and ask for magnesium so we send you specific product recommendations.

6. Cut back on grains and starches

Grains and starches are constipating because they absorb water. They’re a great solution if you have diarrhea! Replace grains and starches with non-starchy veggies, winter squashes like butternut or spaghetti squash, and fruit. Instead of toast with breakfast, have a cup of berries. Instead of regular pasta, use spaghetti squash or zucchini noodles. These small changes overtime add up. One simple swap is to replace white potatoes with sweet potatoes, as the latter tends to loosen the stool a bit.

7. Take out dairy

Dairy foods can cause constipation. Try removing milk, yogurt, cheese, ice cream, butter, creamers, and any milk-related products from your diet for 2 to 4 weeks and see if constipation improves. Yogurt does have some probiotics but not to the point where you’ll miss out a lot (plus you might need a full gut flora restoration as you can see in my note below).

8. Be careful with too much fiber (psyllium, bran)

While high fiber foods like psyllium, oat and wheat bran, beans, and lentils typically help improve bowel movements, they may have the opposite effect in some people, especially if they don’t drink enough water. The fibers in these foods can be irritating to your gut lining. If you tried adding them and they didn’t help, or may have even made things worse, stop. It’s possible that your gut flora needs a restoration before you can relieve constipation and enjoy these foods. More fiber isn’t always better.

How to Relieve Constipation if none of the above works

If you’re already doing the above and you still have stubborn constipation, you need a full assessment and individualized plan. I wish it was something easy and straightforward! Some of the things that can cause constipation include gut dysbiosis (imbalance of healthy to bad bacteria), especially having more methane-producing bacteria. SIBO, celiac, and food sensitivities can cause constipation. Slow or disruptions in digestion and gut motility, as in people with low stomach acid , gastroparesis, or hypothyroidism, also need a complete gut reset and healing protocol to relieve constipation. Sensitivity to tannins, a natural chemical and antioxidant, found in some vegetables, fruit, and beans, can cause constipation. As you can see, solving long-term severe constipation without proper assessment and testing is not going happen. You need a full gut healing approach . If this is something you’re interested to learn more about, you can book a  so we can talk about your options.

A note about probiotics:

While in theory, adding probiotics in the terms of fermented foods or supplements helps, I don’t find that it works for everyone. First, there are MANY probiotic products on the market, and many of them are inferior or won’t even do anything to budge your gut flora. Many products will not tolerate the acidity of your stomach, and you will have just wasted your money. If you have SIBO or overgrowth of methane-producing bacteria, adding more bacteria will make things worse. Some probiotic strains are designed to solve diarrhea so they can make things worse! If you want to give a product a try, you can, but understand that simply taking a probiotic capsule does NOT fix your gut dysbiosis problem. I don’t mass-recommend probiotics as each person and each case is different.