Constipation: Solutions to Make All Systems “Go”!
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Supporting the nervous system, microbiome, and nutritional status for healthy, easy elimination
Balancing the nervous system
Running from tigers in the jungle, our ancestors were well acquainted with the sympathetic stress response, also known as the “fight-or-flight” response. By expanding the lungs and increasing the heart rate to send more oxygen and blood to the muscles, the sympathetic response helped our ancestors flee from harm. When they were being chased by 400 pounds of teeth and claws, our ancestors’ bodies likewise knew that stopping to squat behind a tree to have a bowel movement was not the priority. Pausing to respond to the “call of nature” could be the difference between life and death.
Fast forwarding to today’s world, most of us aren’t running from tigers. Nevertheless, when we are in a state of sympathetic dominance, our bodies can’t tell the difference between the everyday stress at work and a predator in the jungle. When the sympathetic nervous system is activated, blood is shunted away from the digestive tract and directed to the muscles. This means that stress slows down the bowels, leading to poor digestion and compromised elimination (aka constipation).
The parasympathetic nervous system, on the other hand, is active when we’re relaxed. This is the state in which we can best absorb the nutrients in our food, eliminate toxins regularly, and find it easy to fall asleep or take a nap. This is the state we want to be in when it comes to digestive function, and thus treatments to alleviate constipation are often in part aimed at soothing the stress response.
One way to trick the body into a parasympathetic state is simply by sitting down and… doing nothing. After drinking a full glass of water in the morning, it can be helpful to sit on the toilet and give yourself time to breathe and relax (so no reading stressful news articles or work e-mails on your smart phone when you’re on the toilet!). Just sitting and breathing for five minutes can, over time, train the body to have a bowel movement in the morning. (And there’s nothing like a morning bowel movement to put a spring in your step for the rest of the day!)
There is also a wealth of herbs and supplements to help alleviate the stress response and thus indirectly augment digestion. (Read more about some of our favorites here.) Magnesium can also be supportive, as it not only supports the parasympathetic state, but also helps to draw water into the stool, thereby improving elimination.
Hydration and nutrition
The role of hydration on digestive health cannot be overstated., Stool is made up primarily of water, and thus the body requires adequate hydration to ensure healthy elimination. A good goal for daily water intake is half of your body weight (in pounds), in ounces. For example, a person that weighs 150 pounds could aim to drink 75 ounces of water daily (and for those of you into the metric system simply convert the kilograms to ounces of water). Do note that in certain conditions like congestive heart disease and kidney failure, drinking too much water may be harmful and medical advice from one’s physician should be sought.
Foods rich in fiber, such as nuts and seeds, are important for preventing and troubleshooting constipation. Beans, freshly ground flax seeds or chia seeds, nuts, and whole grains are all excellent choices, and a quality fiber supplement with cellulose powder, psyllium, and/or apple pectin can also help get things moving in the right direction.
Certain foods, namely dairy products, refined carbohydrates (especially those made from white flour), starchy foods, and red meat can increase the likelihood of constipation. Avoiding these foods and steering clear of any known or suspected food intolerances can be of great value.
Get the migrating motor complex (MMC) humming!
The migrating motor complex (MMC) refers to a pattern of electromechanical activity that occurs in the smooth muscle of the digestive tract. This activity creates a gentle “sweep,” essentially helping to push undigested material through the tract, which is much like a long tube. The MMC does this job best away from mealtime, as it is inhibited by the ingestion of food. For this reason, avoiding unnecessary snacking or “grazing” between meals can support healthy elimination. This may be of particular value for menopausal women, who tend to have slower gastric emptying as they age.
In addition to spacing out meals, helpful substances known as motility agents can be of value in optimizing MMC function and combating constipation. One noteworthy motility agent is an extract from perilla leaf, commonly known as shiso, a green leafy plant often used as a garnish or in Asian foods.
Perilla leaf extract has been shown to gently support normal gastrointestinal motility without irritating the digestive tract
Whereas it’s common for people to become dependent upon stimulant laxatives like senna, cascara, and many over-the-counter medications, and for these laxatives to kick in suddenly and send us running frantically to the loo, perilla leaf extract has been shown to gently support normal gastrointestinal motility without irritating the digestive tract. In addition to augmenting normal elimination patterns, perilla leaf extract also has anti-spasmodic and anti-inflammatory properties,, making it a useful therapy in irritable bowel syndrome (IBS).
Balance the bugs
Both our digestive tracts and our health in general are supported by a healthy mix of bacteria, fungi, and viruses collectively known as the microbiome. In fact, there are more microbial cells in the human body than there are human cells! The largest repository of these microbes by far is found in the gut; strategies to support a healthy microbiome must therefore begin in the digestive tract. Including fermented foods like kimchi, sauerkraut, kefir, and plain yogurt in the diet is a simple way to support a healthy microbiome., Taking a probiotic supplement can also support a healthy microbial balance, which benefits not only digestive function but may also play a role in conditions such as depression, obesity, heart disease, and type II diabetes.,, Ensuring adequate stomach acid levels can also help safeguard the microbiome.
Taking a probiotic supplement can also support a healthy microbial balance, which benefits not only digestive function but may also play a role in conditions such as depression, obesity, heart disease, and type II diabetes.
GI happiness and harmony
As with everything in medicine, no one organ operates in a vacuum. Balanced health is reflective of a number of systems working in harmony, the digestive system being no exception. In addition to focusing on the health of the small and large intestine, it is also important to consider the role of the other organs of digestion. Secretions from the stomach and gallbladder not only help with the proper breakdown of food, but also impact gastrointestinal motility., Strategies to improve stomach acid production, such as supplementing with berberine, apple cider vinegar, gentian (commonly found in cocktail bitters), or hydrochloric acid (HCl) may all be helpful in the management of constipation.
Enhancing the action of the gallbladder with vitamins A and D, or supplementing with ox bile to augment the emulsion of dietary fats may also help kick constipation symptoms and improve digestive integrity. As the master organ of detoxification, and the source of the bile that the gallbladder stores, the liver is also a key player in healthy digestion and elimination, and might also need some love and care.
An integrated approach to kicking constipation
Considering the interplay of the various systems of the body, with the digestive tract running as a superhighway in the middle of it all, a sustainable approach to constipation entails more than just laxatives. Understanding the factors contributing to the ailment and then nourishing those causes with simple, natural approaches can make all the difference.
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 Buchwald-Werner S, et al. Perilla extract improves gastrointestinal discomfort in a randomized placebo controlled double blind human pilot study. BMC Complement Altern Med. 2014 May 27;14:173.
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Dr. Erica Zelfand
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