Taking laxatives on a regular basis can signal to the body that it no longer needs to take the initiative which can cause dependancy. Not withstanding that we may on occasion need a little herbal or even pharmaceutical assistance, it wouldn’t be wise to dive straight in to the laxatives before firstly exploring alternatives. Below are some of my top tips for dealing with constipation.
Fundamentals:
Water, fibre and regular movement are essential for proper stool formation and elimination. For most of us this is best achieved by consuming a healthy and well balanced diet and engaging in a regular exercise routine. I will address these three essentials, before discussing additional helpful strategies, some of which may surprise you
Stay Hydrated
I cannot emphasis enough, the importance of staying hydrated. Without sufficient water our body cannot properly form stools. Proper hydration is fundamental to optimal health and failing to maintain adequate water intake will undermine all other techniques mentioned here.
Our body consists of 60% water, therefore it makes sense that we must replenish liquids lost through perspiration, respiration, urination, defecation etc to maintain basic wellbeing and help avoid compromising bodily functions. In order to dissolve and eliminate metabolic waste, healthy people need approximately 100 ml of water per 100 calories of energy expended.
On average the colon absorbs 400 ml of water each day, largely contributing to stool formation. If you notice your stool is difficult or painful to pass, is hard, or if it forms small hard balls, this is a clue that you are not drinking enough water.
Teas, sodas and other beverages generally do not substitute water, and caffeine promotes dehydration. So make sure you start your day with a glass of water, and continue to hydrate throughout the day.
If you know you are not drinking enough water, or if you drink a lot of caffeine during the day, and you regularly suffer from constipation, consider introducing new habits to increase your water intake.
Here are some suggestions:
- Keep a large glass of water by your bedside and make sure you drink it as soon as you get up
- Replace at least one of your caffeinated drinks with a glass of water or a herbal tea
- Increase your fruit and vegetable intake to benefit from their juices and fibre.
- There are different theories on how much water you should drink in a day, and I would say it depends very much on individual needs, and activities. Some simply suggest drink when thirsty. This leaves it to chance as we often don’t realise we are thirsty. Mukunda Stiles in Ayurvedic Yoga Therapy states that as we age we lose the sense of thirst and this can be re-cultivated by reminding oneself to drink frequently until the thirst reflex naturally asserts itself. He suggests that in people over the age of 40, this can take two or more months. My suggestion is to drink at least 1.5 to 2 litres daily, depending on activity levels and overall weight, and if you feel thirsty, are suffering from constipation, or doing physical activity drink more.
- Track the amount you drink by filling your water bottles in the morning and making sure you drink up by the evening.
Eat lots of Fibre
Fibre, found in plant foods, and liquid are essential components of the body’s waste disposal system, and can be taken together in the form of fruits and vegetables. There are two types of fibre, and both are essential for healthy digestion.
- Insoluble fibre derived from wheat bran, whole grains and vegetables add bulk to stools and facilitate a faster transition.
- Soluble fibre found in nuts, seeds, oat bran, lentils, peas and some fruits and vegetables absorb water and soften the consistency of the stool.
The microbes in your gut thrive on fibre, breaking it down, and converting it into essential nutrients to support bodily functions, before discharging waste. Resistant starch is an important component of the fibre family and behaves like fermentable soluble fibre, improving consistency. It is especially important for feeding certain bacteria that produce short chain fatty acids such as butyrate that supports the health of the gut lining. Sources of resistant starch include oats, raw potato starch, cold rice, cold potatoes and green bananas.
Move frequently throughout the day
Sedentary lifestyles contribute to a host of health problems. Our body and its functioning was designed to move and too much sitting around can simply cause our muscles, tendons and ligaments to seize up. Try to be conscious about doing some movement for about 5 minutes at least once every two hours, preferably once per hour if possible. If you are driving, stop and take a walk. If you have a desk job, be sure to get up regularly to move your body.
Additionally, and perhaps more importantly, the functioning of the lymphatic system, the drainage and filtering system of the body, is optimized by muscle contraction. This puts pressure on lymphatic vessels, propelling fluids towards the lymph nodes where they are filtered. Waste products are channeled towards the colon, increasing motility, and nutrients are recycled into the blood stream.
Squatty Potty
There is a reason why the French, Indians and others use those squat toilets that always seem gross, smelly and inconvenient. It turns out that aside from minimizing contact with the WC and therefore the spreading of germs, this system helps preserve digestive health.
If you are an outdoor enthusiast, you probably know from wild camping experiences that it’s easier to to have a BM in the back country than it is in your domesticated toilet. Of course back in the day when toilets didn’t exist, humans would have to squat to get the job done, and our body was cleverly designed for the task. Squatting is the natural position for a complete bowl movement. It pushes the organs forward allowing digestive waste to fully pass. It has been suggested that cultures using the squat method have less digestive diseases including Crohn's, colitis, irritable bowel and constipation. In fact this is so well recognized that companies are selling inexpensive squat contraptions that can be used with modern toilets.
If you don’t wish to purchase a squatty potty, keeping a small step stool in the washroom, is a helpful alternative.
This short video illustrates the concept.
The Yoga Horse Seal Method
This is one of my top tips and has a great success rate in situations where stool has been formed, but movement is sluggish. The Horse Seal technique, known in Ayurvedic Medicine as Ashwini Mudra is so named because it mimics the movement of a horse's anal sphincter after emptying its bowels.
The procedure stimulates peristalsis of the colon. Peristalsis is the contraction of the muscles in the walls of the colon, resulting in the shunting of waste toward the rectum for excretion.
This procedure can be performed sitting on the toilet, but can be amplified if in a squatting position, or using a step or squatty potty. Start by focusing on your anal sphincter. The anal sphincter is a muscle in the rectum that prevents stool from exiting involuntarily. Contract and release, several times. It may take practice, but when successful, this can trigger the contraction of muscles along the colon (peristalsis) and result in a bowel movement.
Sometimes the results are almost immediate and other times it may take a few minutes. If it doesn’t work for you the first time, I suggest keeping this tool close to hand and practicing it a few times. It can be invaluable.
Ashwini Mudra has a variety of other health benefits. Some practitioners of Ayurveda promote regular practice for strengthening the muscles of the pelvis, and for helping to prevent incontinence of the bowels by strengthening the muscles in the rectum.
Start your day with this warm detox drink
This is a great way to stimulate your digestive system in the morning before you even think about consuming anything else, other than perhaps a glass of water. The acid promotes healthy digestion and stimulates the movement of the bowels. Taking this drink before any form of exercise, even if it is a short walk, will put more power behind your morning habit.
Ingredients
- Juice from 1/2 medium sized lemon
- 1 tbsp organic, unpasteurized apple cider vinegar
- Dash cayenne pepper (optional)
- Pinch of Himalayan salt or real sea salt (optional)
- 80ml cold water
- 100 ml hot (but not boiling) water
Directions
- Dissolve the salt in the hot water
- Add the cold water to cool it down before adding the remaining ingredients
- Stir and enjoy!!
Use a Rebounder
Rebounders are renown for stimulating the lymphatic system and they are a fun means of vigorously moving the body in the morning, without impacting the joints or feeling overworked. Fifty to one hundred bounces is often enough to get things moving!
Breathing Exercises
Breathing deeply into the base of the lungs, causes the diaphragm, to push down on the abdominal organs which may help stimulate digestion and ultimately assist with waste removal.
You will know you have achieved diaphragmatic breathing because your abdomen will expand to make room for the diaphragm to contract. Many of us utilize the upper parts of the lungs, by breathing into the chest area, but fail to breath deeply. If you are having trouble with this, consider that when you completely fill the lungs, air goes to the bottom of the lungs before filling the upper parts. This is in much the same way that when you fill a jug of water, the base of the jug fills first. Visualizing this may help you to gently push the air deeper as you inhale, and you can assist by consciously expanding the abdomen, to make room for the lungs to fill.
- Breath 10 full inhalations and exhalations
- If comfortably available to you, pause at the top of each inhale to extend the abdominal massage. This pause feels natural and comfortable, and should not feel as if you are holding the breath.
- Once you are comfortable with the first 2 steps, consider raising the arms with the inhale and lower on the exhale
Deep breathing is a great way to generate heat and to bring movement into the body in the morning, actively promoting the digestive system.
Find time to relax
Stress or emotional problems keep us in fight or flight mode, meaning that our parasympathetic nervous system is compromised. The parasympathetic nervous system, is also known as the state of “rest and digest”. The muscles in the walls of the colon are innervated when the parasympathetic nervous system is dominant, and therefore being in a state of calm can have a positive effect on excreting bodily waste. Meditation, breathing exercises, yoga, or taking the time to relax can all help the parasympathetic nervous system predominate.
Watch your diet
On becoming constipated it is useful to review recent changes in your lifestyle. Mentally check off some of the items mentioned in this article. Ask yourself, if you have been moving your body frequently enough, drinking enough water, eating enough fibre, or have recently made any dietary changes. Often changes in the diet can impact the digestive system while the microbes adjust to handle the new intake.
If you haven’t eaten meat for a while, your microbiome may not be able to handle a sudden intake of meat. White flour is stripped of its fibre and can be difficult to process, especially if you have not consumed it for a while. Any dietary change can temporarily affect digestion, while your body adjusts. Making changes in small steps can help, whilst increasing water and fibre intake.
Probiotics
Probiotics are often helpful in relieving constipation. As mentioned earlier, microbes play a crucial role in processing the food we eat. There are different schools of thought on how probiotics should be used. Everybody's microbiome is unique and so there is no one type fits all. However humans do have certain microbes in common and this is reflected in the probiotic supplements that are typically available in the health food store. Don’t forget that as well as being available in pill form, probiotics are abundant in fermented foods such as unpasteurized sauerkraut, kimchi or pickles. These promote a broad range of microbe activity in your gut. This is a healthy approach and I recommend including fermented foods in your daily diet.
Herbal laxative
If you have tried everything else and you are still struggling to move your bowels, it might be time to try a herbal laxative. Herbal teas such as Smooth Move, containing Senna are very helpful. Senna contains plant compounds that stimulate the nerves in the gut and promote peristalsis. It takes about 8 hours for the herbs to do their magic so taking a cup in the evening should guarantee some action in the morning. Laxative products can be helpful while you get to the root of your problem, but try not to rely on them as this could result in dependency.
Pharmaceutical Laxatives
Various types of laxatives are available, that have different mechanisms of action. Some are stool softeners, others stimulate the nerves and others bulk up the stool. As discussed, all of these mechanisms are available to us via other methods (hydration, fibre and herbs) and therefore it would be wise to explore these alternatives before using drugs.
Laxatives should not be used on a regular basis for simple constipation as they can interfere with the defecation reflex and may also damage the rectal mucosa. If you are unable to move your bowels on your own, after trying everything else then go for it. A reoccurring problem will need to be discussed with your doctor to investigate the underlying cause. If you have a sudden onset of constipation accompanied by pain, you must visit your doctor as this may be due to mechanical causes such as a blockage in the colon.
In Summary
If you do nothing else, do these 3 things every day
- Drink a large glass of water when you wake up
- Increase your fibre intake
- Move your body for 5 to 20 minutes within half an hour of getting out of bed.
Some suggestions include
- Go for a walk
- Jump on the trampoline
- Do some yoga - sun salutations or the 5 Tibetans are great sequences
- Do some deep breathing exercises
