Constipation & Bowel Irregularity
Constipation is characterized by infrequent bowel movements (typically fewer than three per week), difficulty passing stools, or a sense of incomplete evacuation. It affects approximately 16% of adults worldwide and up to 33% of people over age 60. Chronic constipation can significantly impact quality of life and may indicate underlying issues with gut motility, microbiome balance, thyroid function, or lifestyle factors including inadequate fiber, hydration, or physical activity.
Symptoms
- •Infrequent bowel movements (fewer than three times per week)
- •Hard, dry, or lumpy stools that are difficult to pass
- •Straining during bowel movements
- •Feeling of incomplete evacuation after bowel movements
- •Bloating, abdominal discomfort, or cramping
- •Need for manual maneuvers to facilitate bowel movements
Causes & Risk Factors
- •Slow intestinal motility due to hormonal imbalances, particularly hypothyroidism
- •Inadequate fiber intake, dehydration, or insufficient dietary diversity
- •Gut dysbiosis with reduced beneficial bacteria that support healthy bowel movements
- •Chronic stress affecting the gut-brain axis and impairing peristalsis
Naturopathic Approach
Naturopathic treatment for constipation addresses underlying physiological imbalances while providing both immediate relief and long-term resolution. Comprehensive assessment identifies root causes including thyroid dysfunction, magnesium deficiency, gut dysbiosis, or pelvic floor dysfunction. Dietary optimization emphasizes adequate fiber intake from diverse plant sources, proper hydration, and foods that support healthy gut motility such as prunes, flaxseed, and kiwifruit. Magnesium supplementation, particularly magnesium citrate or oxide, supports muscle relaxation and draws water into the bowel to soften stool. Prokinetic herbs such as ginger, triphala, and cascara (used cautiously and short-term) stimulate natural bowel movements. Probiotic therapy, especially strains like Bifidobacterium lactis, improves stool consistency and frequency. Addressing thyroid function is essential as hypothyroidism commonly causes constipation. Establishing healthy bowel habits includes responding promptly to the urge to defecate, allowing adequate time for bowel movements, and using proper positioning such as a footstool to simulate squatting. Physical activity and stress management support the migrating motor complex and healthy gut motility. For some patients, pelvic floor physical therapy may be indicated to address dyssynergic defecation. This comprehensive approach aims to restore regular, comfortable bowel movements without dependency on laxatives.
Related Modalities
Frequently Asked Questions
How often should I have a bowel movement?
While 'normal' can vary, most healthy individuals have bowel movements anywhere from three times daily to three times weekly. Ideally, daily bowel movements are optimal for removing waste and toxins. More important than frequency is consistency, ease of passage, and feeling of complete evacuation. If you're outside this range or experiencing difficulty, it's worth investigating underlying causes.
Are over-the-counter laxatives safe for long-term use?
Most over-the-counter laxatives, particularly stimulant laxatives like senna or bisacodyl, are not intended for long-term use as they can cause dependency, reduce natural bowel motility, and lead to electrolyte imbalances. Osmotic laxatives like magnesium and polyethylene glycol are generally safer for longer use but ideally should be temporary while addressing root causes. Natural approaches that support your body's own motility are preferred for long-term management.
Can constipation be a sign of thyroid problems?
Yes, hypothyroidism is a common cause of constipation as thyroid hormones regulate metabolic rate, including gut motility. Slow intestinal transit time is a frequent symptom of underactive thyroid. If you have constipation along with fatigue, weight gain, cold intolerance, or other hypothyroid symptoms, comprehensive thyroid testing including TSH, free T4, free T3, and thyroid antibodies is warranted.
How much fiber should I be eating to prevent constipation?
Most adults should aim for 25-35 grams of fiber daily from diverse plant sources including vegetables, fruits, whole grains, legumes, nuts, and seeds. However, it's important to increase fiber gradually and ensure adequate hydration as sudden increases can worsen bloating and discomfort. The type of fiber matters too—both soluble fiber (from oats, beans, fruits) and insoluble fiber (from vegetables, whole grains) are important for healthy bowel function.
References
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Dr. Sanika Kshirsagar, ND
Doctorate of Naturopathic Medicine (ND)
Bastyr University, Kenmore, WA
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