Constipation is one of the most debilitating and common problems I see in patients, yet no one mentions it! Studies estimate 30-40 million Americans struggle with pooping, so I thought I would be a brave one and talk about it! Below are tips for combatting a gut moving at snail pace. I know it seems like a lot of information, but in order to successfully treat constipation, a full lifestyle change is needed.
The first 5 tips are necessary for everyone while the remainder are optional. See which ones work well for you…it may be just a few or all of them. Take the time to plan for these…our digestive systems can’t keep up with our fast paced world!
- Try to get into a bathroom (aka pooping) routine: Initially start with sitting for 5-10 minutes on the toilet upon waking and after each meal. This should not be a rushed time…so plan your schedule accordingly. Eventually, you should notice which of these times your body eliminates the easiest, and you can stop the other long bathroom breaks.
- Position: Make sure your feet are flat on the floor (or a stool) when taking your bathroom breaks. A Squatty potty stool or other stool works well.
- Drinking a warm beverage or doing stretching/yoga prior to bathroom breaks may help.
- If you get the “urge” then STOP and GO! This is hard with our busy schedules, but it is perhaps one of the most important points. The longer stool sits in your rectum, the more water is reabsorbed and the harder the stool becomes to pass. It also stretches your rectum, so the “urge to go” eventually ceases to exist.
- Avoid eating constipating foods such as unripe bananas, applesauce, large amounts of dried fruit, rice, corn, dairy, and for some people gluten. When in doubt, I recommend a paleo diet.
- Nightly Magnesium (in the form of Magnesium Citrate or Natural Calm) can be helpful but start very slowly: ¼ tsp. in 8oz of warm water before bed and then gradually increase over several days or weeks if needed. If you develop diarrhea, decrease the dose rather than stopping Magnesium completely.
- Probiotics can be helpful but start slowly as they can cause bloating. Also make sure you’re using a type that survives your stomach acid and reaches your colon. I like SEED (https://seed.com). I do not believe probiotic supplements have to be long term…increasing fermented foods in your diet will eventually supply these.
- Fiber can also be helpful but can often cause bloating: Try Acacia fiber (NOW brand): Start very low dose (¼ tsp daily in 8oz fluid) and then gradually over one month increase to 1-2 Tbsp daily if tolerated. The key is to drink plenty of water with fiber supplements.
- If your constipation worsens during travel or (for women, during or after ovulation), think ahead and start or increase the above supplements one week prior.
- If you have not had a bowel movement in >5-7 days and require an over the counter treatment: I would recommend using a one time night time dose of Sennakot (or other laxative) and then also starting daily Miralax (½-1 capful in 8oz liquid daily) until daily bowel movements are achieved (this may take 1-2 months and it is ok to use Miralax for this time). AVOID daily laxatives (senna, glycerin suppositories, dulcolax, etc) and AVOID long term Miralax if possible.
- Getting Off Miralax: You must very SLOWLY taper Miralax…decrease dose by half daily for 1-2 weeks, then by another half daily for 1-2 weeks, and then every other day. If you are unable to taper, please contact me. If you stop Miralax suddenly, your constipation will return.
A key point with treating constipation is it will take time…several months or often a year. This is likely something you have had for years, so it takes time for your digestive system to return to a healthy state. Don’t give up!! Two steps forward and one step back is still progress!
If you would like to find the root cause of your constipation and treat it for the long term, please contact me for an appointment. I would love to help your pursue health. Become resilient, ever growing…MINT.
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