Constipation

First, let’s talk about the definition of constipation. Some people think that they are constipated if they don’t go three times per day, even if their stools are normal. As an acupuncturist I ask very detailed questions about bowel movements. It’s not something that people tend to compare notes about with each other; so many people don’t actually know what is “normal.” Even if they tell me their stools are normal, I ask follow-up questions to ascertain whether they are normal from a medical perspective.

So what is constipation? There are two criteria: frequency and difficulty passing feces. For some people, going only every three days is normal, and I’m not concerned about it if the stools are normal when they come out, and my patient doesn’t have to strain. For some people, going three times a day is normal, and if their stools are formed (rather than loose or diarrhea), and they are eating a lot of fruits and vegetables, I’m not concerned about that either. The other question I ask is what the stools look like. Are they formed, “like a log,” or are they in hard pieces, like stones or “goat turds”? If they are formed like a log, then your stools are normal. You are constipated if you frequently have to strain to pass feces, you frequently feel like your bowel movements are “incomplete,” your stools are frequently hard, and/or you have two or fewer bowel movements per week.

When constipation is severe, you may experience abdominal pain, gas, or even vomiting if there is a complete blockage. Long-term constipation can lead to hemorrhoids from straining.

There are several causes of constipation:

Perhaps the most common cause of constipation is not drinking enough water, especially combined with diuretic drinks that dehydrate you.

Poor diet – you need plenty of fruits, vegetables, and other sources of roughage to have normal stools. Too much dairy or processed food can cause constipation due to the low fiber and high fat.

Medications – there are many medications that will cause constipation, including many pain medications, antidepressants, antacids, diuretics, iron pills, and chemotherapy. Overuse of laxatives will also eventually cause constipation.

Lack of exercise.

Changes in routines, such as travel or eating patterns. (“The digestive system likes regularity.”)

Emotional symptoms such as stress, depression or eating disorders.

Fatigue – your body needs energy to digest and process food, and to eliminate waste. If you have an infrequent or very little/no urge to go, the Chinese Medicine diagnosis would be “Large Intestine Qi Deficiency” (a deficiency of energy).

Candida overgrowth in the intestines.

Food sensitivities.

Medical conditions such as hypothyroidism, diabetes, diverticulosis, diverticulitis, irritable bowel syndrome, colon cancer, Parkinson’s disease, and multiple sclerosis.

My recommendations:

If you have severe abdominal pain, vomiting, or blood in your stools (not due to hemorrhoids) seek immediate medical attention!

The simplest thing to do is to eat more fruits and vegetables, and add a calcium-magnesium supplement and/or a B-Complex to your daily routine (the magnesium and the folic acid usually will get things moving quite nicely, but don’t take calcium by itself or it may make your constipation worse and will deplete the magnesium and potassium in your body). Eat your meals on a regular schedule if you can.

Drink about two quarts of room-temperature water per day, or more if you have a larger body mass or sweat a lot. A general rule of thumb for kids and adults weighing more than 100 pounds is your body weight multiplied by the number of ounces (i.e., 140 lbs. = 70 ounces). Drink at least one extra quart per day if it is very hot out, and extra water during and immediately after a work-out. If you drink too much water, you can deplete Vitamin B-1 (thiamine). Thirst is not necessarily a good indicator of whether or not you are dehydrated. Your urine should be a light yellow, unless you have just taken a multivitamin or B-vitamin supplement. Cut down or eliminate your diuretic beverages such as coffee and sodas.

Identify any medications that may be causing your constipation. If you are in pain, try treating trigger points to see if you can cut down on medications. (I typically can get my patients either completely off their pain medications or at least greatly reduced with trigger point treatments.) Don’t take laxatives if you can help it; they are only good for short-term use and will make the problem worse in the long run due to their detrimental effect on the bowel muscles, and can also cause problems with vitamin and other nutrient absorption.

Exercise more. Just 15 minutes a day of walking can get all of your systems moving (literally!) and greatly reduce stress.

If you are stressed, depressed, or have an eating disorder, seek help.

If you are constantly taking antacids, see the page on digestion.

Try to defecate when you have an urge; holding it can cause your intestinal muscles to stop working properly.

Get more rest. See sleeplessness if you are having problems sleeping, and fatigue if you are frequently tired.

See the page on Allergies (food sensitivities or intolerance).

If you suspect a candida infection, see the section on Candida, Fungal, and Parasitic Infections.

It’s a good idea to use an easy take-home kit annually to screen for blood in your stools. Though it is called a “Colorectal Cancer Take Home Kit,” blood in the stools can also be caused by hemorrhoids, polyps, colitis, diverticulitis, ulcers, or fissures. This screening test only costs about $25. If your results are positive for blood you should see your health care provider for follow-up tests.

If your constipation lasts for more than two weeks and you aren’t already sure of the cause, be sure to see a health care provider to rule out more serious causes.

Disclaimer: The Food and Drug Administration has not evaluated these statements. Information on this web site is provided for informational and educational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. The products and information are not intended to diagnose, treat, cure, or prevent any diseases or, medical problems. Nutritional benefits may vary from one person to another.