Despite its prevalence, constipation is often not understood, nor mentioned to doctors and thus may go untreated for years. While perhaps not the most scintillating topic for polite conversation with new friends, I personally, as a naturopathic physician and mom, am fascinated with digestive health and, well, poop.

Constipation means all or any of the following: difficulty passing stool, incomplete passage of stool, or infrequent bowel movements. Ideally people would poop shortly after each meal, just like cats. The two main reasons few Americans have 3 easy-to-pass, formed, darkish brown, half-floating/half-sinking poops daily (the ideal) is because of chronic dehydration and a low-fiber, high refined-food diet. “Sinkers” mean the fecal matter has been in there too long and has become compacted, dense and heavy. The optimal “transit time” is 18 to 24 hours. Beets or corn are useful foods for evaluating how long it takes to go the several dozen feet from your mouth to your anus.

Many of us have been admonished to drink 8 cups of water daily. This may not be enough for some folks! I prefer to advise more individually: divide your weight by 16 and that will give you an approximate best number of 8 ounce cups to drink daily. Another way to look at the equation, if you’re not metrically challenged (!), is one ounce of water per kilo of weight. For example, if you weigh 130 pounds (or about 60 kilos), you need about 7.5 cups, or nearly 2 Litre bottles, of pure water daily. If you weigh 230 pounds, you need 14.5 cups, or close to 4 Litre bottles. Other forms of liquid refreshment simply don’t count. It takes at least a cup of pure water to offset the impact of a cup of coffee on the system. Soda pops are extremely nutrient depleting and dehydrating; it probably requires 3 to 4 cups of water to offset the negative impact on the system of drinking a Coke, which contains not only caffeine, but 12 teaspoons (YUCK!) of refined white sugar.

The best sources of soluble fiber are fruits and vegetables, especially crisp ones like apples, beets, carrots, celery, cherries, and greens. Whole grains are also good sources of fiber, especially if they are rotated (try not to eat wheat every day, for example), as are some seeds (sunflower, pumpkin) and seed husks (flax). Beware of seeds if your doctor has told you you have, or may have, diverticulitis. This condition involves little distended sacs in the colon which can collect fecal matter, causing inflammation and pain.

Constipation is not a disease, but the symptom of an underfunctioning digestive system. It may be remedied by more water, better diet and “adult potty training” or it may accompany a more serious underlying disorder. If your bowel habits don’t improve with regular exercise and adequate water intake, make sure to consult a doctor to rule-out structural, metabolic or endocrine problems (such as low thyroid hormone levels).

What I mean by adult potty training is quite simple. First, never repress the urge to defecate. Please don’t train your body that it’s OK to hold it for prolonged periods. Next, consider sitting on the toilet for up to 20 minutes after breakfast with some good reading material. If no stool is produced, take that as a signal to get exercise, drink plenty of water, and avoid refined foods today. If your schedule permits, try to poop again after lunch and again after dinner. The rest of the article will outline tips for helping regular elimination beyond the basics discussed above.

Most everyone has heard of using bran, or psyllium, or Metamucil (all bulking agents) to help produce wonderfully regular poops. This approach works well for a lot of people, but for some just means more “gas.” If bulking agents work for you, great! Take that as an indication that you need to also stay well hydrated (the large intestine squeezes as much water as it can out of our food for reabsorption) and avoid refined foods (food items with multiple ingredients that come packaged).

Many people, on the other hand, don’t need help bulking up their stool. They need help with their intestinal tone. What keeps the poop moving along nicely is the rhythmic, wave-like action of the large intestine called peristalsis. The nerves which activate this muscular action can become blunted for a variety of reasons. A few favorite herbal to promote regular elimination are Cascara Sagrada, Senna, Aloe Vera, Rhubarb and Yellow Dock. (Please read the post Foods That You Can’t Digest Tend To Linger In The Colon for additional suggestions on how to improve the digestion and assimilation of your food).

Cascara Sagrada and Senna are strong purgative herbs, available commercially in a variety of forms, usually tea. Traditional Medicinals makes a tea called “Smooth Move” which contains Cascara and generally takes overnight to live up to its name. Luci LaBeau has a variety of “dieter’s” teas that feature Senna. Both these herbs are very effective short-term, but can become habit-forming. Beware!

For a serious case of constipation (3 days and no pooping) don’t delay in consulting a trusted health care professional. For emergencies, I cautiously share this cathartic mix which is almost guaranteed to evacuate your bowels, and likely quite forcefully. In 1 cup of dilute pineapple juice put 1 tablespoon of Epsom salts (Magnesium sulfate) and 1 teaspoon of Aloe Vera juice (as pure as possible). Drink quickly while standing, then lie down and rest. For a milder concoction, omit the Epsom salts.

Rhubarb is an effective laxative, and a favorite purgative in Traditional Chinese Medicine. If it’s not summer and you don’t have rhubarb growing up all around your neighborhood you may be able to find it in the stores, as whole stalks or in juice form. The stalks should be cut into inch-long pieces and simmered for a 1/2 hour with plenty of water (to generously cover the cut up plant matter) and a squeeze of lemon and a few dollops of honey. You’ll get a soupy brew that can be taken at bedtime – not more than a cup. This brew can be frozen in small batches and stored for up to 2 years.

Yellow dock is a favorite herbal ingredient in herbal pregnancy formulas because it is such a safe and gentle, but effective, laxative. You should be able to find it in capsule or tincture form at your local health food store.

An Ayurvedic blend of 3 herbs (“Triphala”) is another increasing popular laxative and is sometimes found in “cleansing” formulas. Triphala is a blend of Indian Goosebery (Emla), Beahera fruit and Tropical Almond fruit. Two colon cleansing herbal blends that I like, both of which contain Triphala as well as probiotics, are “Super Cleanse” by Nature’s Secret and “Blue Heron” by NF Formulas, Inc. The “Super Cleanse” does contain Cascara Sagrada, so may cause intestinal cramping in susceptible individuals. The main ingredients of “Bue Heron” are ground Borage, Flax and Psyllium seed, as well as some bentonite clay (a drawing, detoxifying agent), prune fruit, fenugreek seed and slippery elm root.

References

• The New Holistic Herbal, David Hoffman. Element Books, Inc., 1990
• Taber’s Cyclopedic Medical Dictionary, F.A. Davis. Eliot Books, Inc. 1981
• Encyclopedia of Natural Medicine, Michael Murray, ND and Joseph Pizzorno, ND. Prima Publishing, 1990.
• Eat Right for Your Type, Peter D’Adamo. Putnam Publishing Group, 1996.