Stopped up. Bunged up. Full of it. Constipated. No fun.

Constipation is something I frequently see in practice, and something I notice that tends to effect women, the elderly and people taking more medication more commonly. Increasingly, I am seeing more issues with young women in their teens and twenties.

Typical recommendations are to avoid constipation is to increase water and fibre, and to consume more leafy greens (again, more fibre). But what if these things aren't helping... or are making the sh*tty situation worse?

Before we get into the why and more importantly, what you can do about it, let's back it up (get it?). You will definitely want to check out my digestion post for more in depth specifics on how the digestive system works.

Constipation is defined as infrequent bowel movements that are often difficult to pass and that is lasting a few weeks or more. Many physicians consider constipation to be 3 or less bowel movements per week. On the other hand, Traditional Chinese Medicine and Ayurvedic medicine consider normal frequency to be 1-3 bowel movements per day with any more or less to be abnormal. 

Normal bowel movements should be easy to pass, solid, medium brown in color, with no undigested bits of food, no blood, no mucous, no straining and with only minimal wiping required. Checking your stool every day is a great way to keep tabs on how things are moving.

Constipation can usually be resolved by:

• Increasing water intake, especially warm water. I like starting the day with a large glass of warm lemon water to help support healthy digestion. Since the majority of your stool is actually made of water, dehydration can definitely make for slow going.
• Easing up on the caffeine. Coffee acts like a laxative and may create dependence. It is best minimize so your bowels can work on their own.
• Regular walks and exercise. The movement of our psoas, quadratus lumborum, and abdominal muscles can increase circulation and stimulate your colon.
• Increase dark leafy greens and other vegetables in the diet. These turn into soluble fibre and will help lubricate the colon to move.
• Add or back off on insoluble fibre like psyllium, bran and others. These fibres are important to bulk up the stool, but in too high amounts without an increase in water they can sit like a brick. Experiment to see what amount feels good for you and drink lots of fluids.
• Stress Management. When we are constantly running around, eating on the run with a million things on the brain it can be hard for our body to let go. Practice meditation, allow yourself time to sit on the toilet each day, ideally in the morning, for several minutes without interruption. Yoga, counseling, music and building in down time into your day can also help relax the body.
• Acupuncture and Massage. Both can work wonders to gently move things along without creating a dependence.
• Sparingly using laxatives. Frequent laxative can create dependence. While they are sometimes necessary, it is better support the body naturally to get moving and save these only for especially stuck times. 
• Fixing your posture. Sit with a stool in front of the toilet so that your legs are elevated into a squatting position. This will help align the colon in a more natural shape for efficient elimination.
• Ruling out other causes. While constipation happens to all of us from time to time, it can also signal other medical issues. 

Constipation can also signify:

1. lack of exercise ("Vitamin Move")
2. dehydration
3. hypothyroidism and autoimmune thyroiditis (Hashimoto's Disease)
4. Food sensitivity
5. Irritable Bowel Syndrome
6. Hormonal imbalances
7. Small Intestinal Bowel Overgrowth
8. Hemorrhoids, fistulas
9. Poor pelvic floor muscle tone (or too much muscle tone)
10. Food hygiene habits

If you are experiencing frequent or long term constipation, be sure to check with your doctor or Naturopathic Doctor or pelvic floor physiotherapist to rule out the conditions listed above.

You can also book a Free 15 Minute Health Discovery Session with me to learn about your options.

In health & smooth moves,
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"My stomach hurts all the time", lamented my third client. That is, my 3rd client today alone. She continued, "I'm bloated all the time, even with healthy food. I'm constipated, then I have loose stool. I never feel like I'm getting everything out!". I also work with her father, who has heartburn, a "noisy gut" and suffers from urgent abdominal pain any time he has to go outside of the house.

2 out of 3 clients I work with have digestive issues. 

As long as I can remember, I have had abdominal pain while eating dinner. My immediate family all suffer from Irritable Bowel Syndrome ("Ass Crisis", as we've affectionately deemed it). I have had a vested interest in learning and working with the digestive system from the day I saw my first client.

Fortunately, I have found that most "gut problems" respond extremely well to Naturopathic medicine. If you, or someone you love, has been suffering, this post is for you.

The Digestive System - more than just your stomach

The digestive system encompasses everything from your mouth down until you see it in the toilet (hopefully) the next day.

The Head
Digestion starts in the brain, evoking a physical response long before food passes your lips. When we think about food, envisioning how it will taste and feel and actually let ourselves feel hungry, our body gets to work increasing saliva, stomach acid and digestive enzymes. Like a good seduction, digestion is as much a head game as the act of doing it.
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Problem Zone 1: eating mindlessly, not letting yourself get hungry, eating in a rush, over-eating etc. so that your body doesn't have time to catch up

The Mouth
Chewing your food thoroughly accomplishes two things:

1. Mechanical break down of your food into smaller pieces for further break down later on
2. Secretion of amylase, an enzyme in saliva that helps to break down starches in food

Problem Zone 2: eating without thoroughly chewing, drinking large amounts of fluids with meals that may dilute your digestive enzymes

The Esophagus
The esophagus is a flexible tube that carries food from your mouth to your stomach. At the bottom of the esophagus/top of the stomach is a muscle called the lower esophageal sphincter or the cardiac sphincter. When it opens it allows food from the esophagus in the stomach, otherwise it should stay shut to prevent splash up of acid causing heartburn.
 
Problem Zone 3: eating too quickly so that food gets stuck or the stomach becomes overloaded; heartburn that creates pain in the esophagus

The Stomach
In the stomach, hydrochloric acid (HCl) is produced by the parietal cells in the stomach. Another enzyme called pepsin begins to work on the food as well, breaking down protein. An acidic environment is required to breakdown our food and prevent pathogens (bacteria, fungi, parasites and other food borne illnesses) from taking hold. After churning in the stomach, the partially digested food (now called chyme) moves past the pyloric sphincter at the base of the stomach and empties into the upper small intestine.

Problem Zone 4: inadequate stomach acid causing poor digestion of food, heartburn and increasing risk of illness, ulcers

Liver/Gallbladder/Pancreas
As food enters the upper portion of the small intestine, it passes nearby to the liver, gallbladder and pancreas, which all make enzymes to help us digest fats, proteins and carbohydrates (lipase, protease, amylase and others like lactase for digesting lactose, renin, sucrase etc.). This will result in further breakdown of our food.

Problem Zone 5: inadequate fat in diet to stimulate production of lipase and bile, not enough protein in diet to make these enzymes, blood sugar issues that compromise the pancreas' ability to manufacture amylase and keep blood sugar in check, poor functioning of the liver and gallbladder

The Small Intestine
The small intestine has three parts: the duodenum, jejenum and ileum and collectively is about 6 meters (20 feet) long in humans. As it passes through each of these, food interacts with the lining of the intestines, is absorbed and utilized by the rest of the body. Nutrients from our food are absorbed along the small intestine and breakdown continues.

Problem Zone 6: food sensitivities create inflammation along the lining of the small intestine resulting in poor digestion and impaired absorption of nutrients. These can create very dramatic digestive symptoms, and malnutrition.

Colon Issues
The mostly digested food enters the large intestine, where water is reabsorbed back into the body along much of its 1.5 meters (5 feet). Different kinds of bacteria work on breaking down the remnants here.

Problem Zone 7: poor bacteria in the colon can cause bloating, gas, distention and pain.

Rectal Issues
Finally, stool exits the body. Stool is mainly water, combined with food remnants, dead bacteria and cellular waste. If there is inflammation here or in the colon, the remaining material may not be broken down properly.

Problem Zone 8: Hemorrhoids and anal fissures (small cracks around the anus) can block the passage of stool and create pain, bleeding and tearing of the delicate tissue.

Top 10 Tips to Hack YOUR Digestive System:

1. THINK about your food before you eat - how it looks, smells, will taste, how it was prepared
2. Pause before eating. Say grace, take 3-5 deep breaths.
3. Take 1 tsp-1 Tbsp of raw, unpasteurized apple cider vinegar 10 minutes before meals, to help improve stomach acidity. Digestive bitters and other supplements recommended by your Naturopathic Doctor may also be helpful.
4. EAT and ONLY Eat. No distractions - TV, phone, computer. This will help avoid over-eating, under-chewing and promote better digestion.
5. Chew your food thoroughly until is it liquid before swallowing. A good rule is 10 chews per bite of food.
6. Avoid liquids before and with meals, except to moisten mouth. This will help to avoid dilution of stomach acid and enzymes so that they can work effectively.
7. Take your time eating. Enjoy your meal.
8. Don't eat when stressed, angry or emotionally upset. Eating, like any other kind of work, can be affected negatively by a negative state of mind.
9. Check your stool. Is it formed, watery, soft, sticky or breaking apart? Knowing these details makes it easier for other health care providers to assist you.
10. Test your Stool Transit Time every few months. On an empty stomach in the morning, take 2 Tbsp of white sesame seeds, chewing lightly before swallowing. Then time how long it takes before you seem them again in your stool. This will give you a rough estimate of how long it takes food to pass through your system. Retest in a week to see if this varies.

If you experience gas, bloating, heartburn, diarrhea, constipation or other digestive concerns and are interested in learning more, please schedule your Free 15 Minute Health Discovery Session with me.

In health & happy digestion,
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