By Dr. Marika Berni, ND
Constipation is a common complaint for both my pediatric and adult patients. Whether it is a life long issue or temporary, constipation can have a great impact on our health. The bowel is an integral part of the body’s detoxification and elimination processes. Regular bowel movements allow harmful toxins and hormones to leave our body. Also, our body gets rid of excess cholesterol through our bowel movements. The liver pumps excess cholesterol that is not needed into the bile, which is stored in the gallbladder. Bile then enters our intestines and leaves our body in bowel movements.
If there is not much fiber in our diet, we don’t drink enough water and are constipated, cholesterol in bile can get reabsorbed back into our bloodstream and we end up with high cholesterol levels. Therefore, one of the best ways to lower your cholesterol is to ensure that you have regular bowel movements. Irregular bowel movements can also lead to hormonal imbalances. For instance, estrogen is broken down in the liver. Both men and women create estrogens that need to be removed. The “detoxified” estrogen is then passed into the intestines from liver processing and through the bile. Bacteria in the intestines can remove the estrogen from the bile, which is then absorbed through the intestinal lining. Your liver then has to process that same estrogen again. In a study, in the March 2016 issue of Atherosclerosis, which included more than 45,000 adults ages 40 to 79, after a follow-up that lasted just over 13 years, researchers found an association between infrequent bowel movements and a higher risk of dying of cardiovascular disease, especially death from stroke. One reason for this may be that with constipation comes straining, which can increase your blood pressure and result in a stroke. So we definitely want to limit straining! Links have also been found between chronic constipation and rectal cancer, gastric cancer, diverticulitis, and ischemic colitis. In children chronic constipation can lead to a loss of muscle tone in the bowel, setting the stage for a lifelong problem. Constipation can also lead to hemorrhoids and anal fissures, which can result in pain and bleeding.
Constipation is defined as a decrease in the frequency or consistency of bowel movements, or difficult, painful or incomplete bowel movements. In a child another indication could be frequent stomachaches, gas and bloating. If your child develops chronic and persistent constipation, they should be examined by a doctor. We should all be having at least one, fully formed, complete bowel movement every single day. Ideally we have 2 or even 3 bowel movements a day. Breastfed infants though, can have fewer bowel movements due to the efficient absorption of breast milk by the infant.
The most common cause of constipation is insufficient fluids and too little fiber in the diet. Other contributing factors in children are the introduction of a new food, emotional stress, too much emphasis on toilet training and as a result of holding back stool either due to the child not wanting to interrupt play or if they have had a previous painful bowel movement. In adults some of the common causes of constipation include laxative abuse, hypothyroidism, irritable bowel syndrome (IBS), taking certain medications, such as antidepressants, antacids (like calcium), blood pressure medications, and iron supplements. Food sensitivities can also be there cause of constipation.
So what can you do to combat constipation? First, rule out any possible causes such as hypothyroidism by getting blood work with your naturopath. If you believe that medication is the cause speak to your doctor about alternatives. Consider an elimination diet (which our naturopath can give you) to rule out any food sensitivities.
Increase fiber in your diet. The average person needs 35 grams of fiber a day (2 tbsp of ground flaxseed only gives you 4 gms!) Children’s requirements range from 19-30 grams per day.
There are 2 types of fiber:
- Soluble fiber attracts water and turns to gel during digestion. This slows digestion. Soluble fiber is found in oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables. It is also found in psyllium, a common fiber supplement.
- Insoluble fiber is found in foods such as wheat bran, vegetables, and whole grains. It adds bulk to the stool and appears to help food pass more quickly through the stomach and intestines.
Aim to minimize your intake of refined carbohydrates such as white bread and pasta and white rice. Increase in your diet complex carbohydrates such as beans and legumes, whole grains and fruits and vegetables. If you struggle to get your 35 grams of fiber daily you can take a fiber supplement such as AOR’s Solufiber. Or add chia, hemp hearts and buckwheat to your diet. Nature’s Path has a cereal called Qi’a, which is a combination of these. Take 2 tbsp and mix in applesauce or greek yogurt with berries for a delicious mid afternoon snack. Or try chia pudding:
- 2-3 heaping tbsp of black or white chia seeds
- 1 scoop of protein powder – any flavour you prefer
- 1/2 tsp cinnamon • 1 tbsp nut or seed butter or 1-2 tbsp slivered almonds
- 1 tsp cacao nibs – optional
- 1-2 cups unsweetened almond or cashew milk
- Mix dry ingredients well
- Pour almond milk and mix well; let sit for 15-20 min in refrigerator or make the night before
- Once gelatinous, mix well and stir in nut butter or nuts
- You may need to add more nut milk to reach desired texture
Supplements to consider
Researchers found that on average, probiotics slowed “gut transit time” by 12.4 hours, increased the number of weekly bowel movements by 1.3, and helped soften stools, making them easier to pass. Probiotics that contained Bifidobacterium appeared to be the most effective.
Triphala is a popular Ayruvedic herb used to treat constipation. It is seen as a bowel tonic and improves bile production and peristalsis. It is not stimulating, rather it tonifies the bowels and is very useful treating chronic constipation.
Essential fatty acids
Essential fatty acids (such as those found in Borage or Flax oils) are precursors for the production of local “short-term” hormones called prostaglandins. Some of these prostaglandins can be found in the gastrointestinal tract. Essential fatty acids may also play a role in relieving constipation since the prostaglandins they form may help to regulate movement in the bowels.
Magnesium citrate can also be helpful to encourage regular bowel movements.. An easy way to remember foods that are good magnesium sources is to think fiber. Foods that are high in fiber are generally high in magnesium. Dietary sources of magnesium include legumes, whole grains, vegetables (especially broccoli, squash, and green leafy vegetables), seeds, and nuts (especially almonds). Supplementation can be 200-400 mg before bed. Supplementation would be contraindicated in a child less than 2 years old.
With my patients I find that a combination of dietary changes, coupled with a few supplements can make a remarkable difference in bowel habits. The health benefits of regular bowel movements are many and it is worth focusing on to achieve optimal health for you and your family.