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Constipation can be a frustrating condition. There are many reasons for getting backed up, and it can take some detective work to discover the underlying cause. 

It is worth the time and effort to investigate the root of constipation and not become reliant on harsh purgatives. Laxatives have side effects, including a loss of bowel tone with long-term use. 

The first thing to rule out is dehydration. Increasing water intake will help clarify if dehydration underlies constipation. This is especially true for constipation that is worse in the summer when sweating is profuse. 

In addition to drinking more water, you might try dissolving 1 teaspoon of high-quality sea salt in 8-10 ounces of warm water and drinking the solution first thing in the morning on an empty stomach. This is an old but very effective remedy for constipation. The salt solution does not help overt dehydration but rather keeps water in the colon (where water is normally absorbed) to help flush the bowels. This method can be used daily, provided that hydration is sufficient the remainder of the day.

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If neither of these strategies solve the problem, fiber is the next best thing to try. Both soluble and insoluble fiber can help. Insoluble fiber does not readily get broken down in the small intestine and therefore acts as a bulking agent in the large intestine. Soluble and prebiotic fiber promotes healthy intestinal flora, indirectly aiding elimination when Lactobacillus microbes produce lactic acid in the colon. (The colon functions best when the environment is slightly acidic.) Probiotics also assist in this regard by supplementing the action of native colon species.

Next, ensure the colon is adequately lubricated. Formed but dry, hard-to-pass stool can be a sign of stasis in the gallbladder or bile insufficiency. Constipation that follows surgery to remove the gallbladder is best treated with supplemental bile salts taken with meals. I recommend Cholacol®, from Standard Process®, at a dosage of 2 tablets with every fatty meal.

Sometimes bile can become thick and sludgy from sluggish liver detoxification. Juiced beet greens (high in betaine) help thin and promote bile flow. For a supplement, I recommend A-F Betafood®, from Standard Process, at a dosage of 5 tablets with every meal. 

Working upstream with the organs of digestion can have a significant impact on the bowel processes downstream. Optimized bile flow requires ingesting healthy fats. Consume 1-2 tablespoons of coconut oil once or twice daily to see if it improves constipation. Coconut oil can either be consumed in its solid form or dissolved in a cup of warm water. If loose stools result, decrease the amount of coconut oil and adjust from there until you find an amount that works best. 

Certain nutrients cause loose stools as the body purges itself of excess. The opposite is also true a deficiency of those same nutrients can cause constipation. The two most common nutrients that affect bowel health are magnesium and vitamin C. 

Magnesium is often deficient due to poor diet, stress, and depletion from pharmaceutical drugs. Supplement with 200-400 mg of magnesium glycinate to treat constipation (no brand preference). For vitamin C, I recommend 5 tablets twice daily of Cataplex C®, from Standard Process.

There are other causes of chronic constipation, including food intolerances and stress-induced irritable bowel syndrome, but this basic treatment algorithm provides a number of simple and safe options that address several root causes.

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Author: Brandon LaGreca, LAc

Brandon is the founder and director of East Troy Acupuncture, an integrative medical clinic serving southeast Wisconsin, where he specializes in whole-food nutrition, ancestral health, and environmental medicine.

Link to bio page.


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