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Getting to the Bottom of Constipation

Written by Meghan Rhodes MCPP MAPA

Constipation is an uncomfortable, yet common message the body sends us to let us know something needs getting back in balance. There are many potential root causes of constipation, so it is important to tune into the body and think things through to provide the most effective support. So before you reach straight for the laxatives (herbal or otherwise), let's look a bit deeper to uncover more supportive ways you can get things moving again.

fresh dandelion plants and dandelion roots on a wooden table top with chopping board

Dietary causes

Diet is a common root cause. This can be due to insufficient fibre intake (e.g. leafy greens, fruits and grains [when appropriate]), insufficient hydration (through water intake, rather than fizzy drinks, caffeinated beverages, alcohol, etc.), a change in water source or improper water filtration, excessive carbohydrates (especially refined flours and eating gluten if you're sensitive to it) and overconsumption of processed foods.

Lifestyle considerations

Lifestyle is another common factor. Lack of exercise or a sedentary lifestyle can lead to constipation (as it increases the time of transit through the colon; the longer it takes to move towards the exit, the more fluid is absorbed, resulting in a harder stool, which is more difficult to pass), as well as ignoring the urge to have a bowel movement (like when we're too busy or it's just not convenient). Other life factors cause the digestive system and bowels to either slow down or tense, preventing the easy and regular passage of bowel movements, including stress, anxiety, depression, fear and trauma. Someone who has had a particularly jarring experience, for example, may find themselves really straining to shift their bowels.

Poor digestive system function, particularly a liver that needs support

Poor digestive system function can also result in constipation. This can stem from slow transit, poor or insufficient liver function, including low bile production, as the liver is responsible for processing fats and hormones, which results in a laxative effect. Poor digestive system function can also be due to more serious gastrointestinal conditions, so it's important we look after our guts!

Hormone cycles throughout the month and stages of life

As hormone levels change throughout the month and as we navigate the waters of perimenopause, constipation may occur given the laxative effect created by the liver processing hormones mentioned above. Constipation typically occurs in the few days before menstruation. It is also common during pregnancy and in the six weeks after giving birth. In pregnancy, it may be a result of the combination of stress, liver function, hormone fluctuation and the weight of the baby pressing on the nerves, getting in the way of the right signals getting sent to the body to trigger natural movement in the bowels). Low levels of thyroxine secreted by the thyroid due to hormonal imbalances can also cause constipation, for example with an overactive thyroid or PCOS.

Side effects of pharmaceuticals

Many allopathic medications are known to cause constipation as a side effect, most commonly codeine, tramadol, opiate-based drugs, hypotensive agents, anticholinergics, calcium antagonists/supplements, iron supplements, aluminium alkalis/antacids, antidepressants, antihistamines, morphine and anaesthetics (as they impact the nervous system, e.g. epidurals) - so yes, it is a very common side effect!

Overusing stimulant laxatives

Prolonged use and/or misuse of stimulant laxatives can also result in constipation, as it damages the nerves of the colon wall. This may, over time, end up as watery diarrhoea, so it is something to consider and keep an eye on if you feel you need the assistance of laxatives for a prolonged or regular period of time.

Be aware of more serious gut conditions

Constipation can be a message there's a more serious gut imbalance in the works, especially if it's prolonged. These can include Coeliac disease, Irritable Bowel Syndrome (IBS) (diarrhoea and constipation often alternate), rectal tumour/bowel or colon cancer (blood in the stool is a red flag and should always be checked out). At the end of the day, always trust your gut - if something feels really off, get a second opinion. The more information you have, the better position you are in to choose how you want to support your body.

What can you do to help yourself get regular before reaching for laxatives?

  • Establish a toilet routine, setting a regular time and place to have a bowel movement, with plenty of time to relax and complete.

  • Use the loo when the urge to have a bowel movement arises; do not delay!

  • Use a low stool whilst sitting on the toilet; raising the knees above the hips by placing the feet on a low stool unkinks passageways, facilitating evacuation.

  • Increase physical activity - even just a daily walk can make a difference!

  • For infants, gently massage their stomachs or move their legs in a bicycling motion to help stimulate the bowels.

So what are some laxative herbs that can help you move things on their way?

  • If your body needs support relaxing and letting go of tension to allow a bowel movement to pass, consider chamomile.

  • If peristalsis (the movement in the colon that pushes things along) needs help getting going gently, try a bath of Epsom salts or a high quality magnesium supplement.

  • If the liver needs support processing nutrients, hormones or emotions to let bowel movements flow, consider dandelion root (but don't overdo it!).

  • If you need a bit of internal lubrication to get things through, consider marshmallow root.

  • If you need some bulking, look to psyllium husks.

  • If you need hard stools softening, aloe vera.

  • If you desperately need a clear out, senna or castor oil packs will do the trick, just make sure you're home and comfortable, as these are stimulant laxatives and can cause some griping. These are not ones to use regularly or long-term.

We often say 'all roads lead to the gut', and it's true - so it's extra important to really sift through the gut's messages - like constipation - to give your body the most appropriate support and get yourself back into balance.

And, as always, if your gut's been off for a while and you'd like personal support getting back into balance, do feel free to book in a 1:1 private consultation with me. I'm always happy to support.


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