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Constipation
Everything About Constipation
Overview Constipation is defined as infrequent or difficult bowel movements, often fewer than 3 per week. It may be acute or chronic and affects people of all ages. The causes are diverse, ranging from dietary to neurological or hormonal imbalances.
Causes of Constipation
- Low fiber intake
- Dehydration
- Sedentary lifestyle
- Hormonal imbalance (low thyroid, low estrogen, low progesterone)
- Endometriosis
- Gastroparesis
- Gut dysbiosis
- SIBO (Small Intestinal Bacterial Overgrowth)
- Fungal overgrowth
- H. pylori infection
- Low stomach acid (hypochlorhydria)
- Stress and high cortisol
- Medications (opioids, anticholinergics, iron)
- Slow transit colon, pelvic floor dysfunction
Conditions Associated with Chronic Constipation
- Irritable Bowel Syndrome – Constipation type (IBS-C)
- Hypothyroidism
- Parkinson’s disease
- Diabetes
- Colorectal cancer
- Diverticulosis
- Anal fissures or hemorrhoids
- Autism spectrum disorders (commonly linked to gut issues)
Symptoms
- Infrequent stools
- Hard, dry, or lumpy stools
- Straining or pain during bowel movements
- Feeling of incomplete evacuation
- Bloating and abdominal discomfort
Testing
- GI-MAP or GI Effects (checks pathogens, microbiota, inflammation, digestion)
- SIBO breath test
- Zonulin (leaky gut marker)
- Calprotectin (intestinal inflammation)
- Organic acid test (OAT)
- Blood work: thyroid panel, iron panel, vitamin D, B12, magnesium
Treatment Options Conventional:
- Osmotic laxatives (e.g., polyethylene glycol)
- Stool softeners
- Lubiprostone, linaclotide, or prucalopride (prokinetics)
Functional/Integrative:
- Magnesium citrate or oxide (500–800 mg/day)
- Triphala (Ayurvedic herbal blend)
- Motility agents like ginger or Iberogast
- LDN (Low-Dose Naltrexone) for inflammation and gut healing
- Probiotics (Lactobacillus plantarum, Bifidobacterium infantis)
- Prebiotics (partially hydrolyzed guar gum, inulin)
- Butyrate supplements for gut lining
- Bone broth, collagen, and glutamine to restore gut lining
Diet and Lifestyle
- High fiber diet: chia seeds, flaxseeds, leafy greens, legumes
- Adequate hydration
- Regular physical activity
- Deep breathing, stress reduction
- Avoid processed foods, alcohol, and high sugar
Hormones and Constipation
- Low estrogen and progesterone reduce motility
- Thyroid hormone deficiency slows transit
- Cortisol dysregulation (stress) can worsen symptoms
Interesting Fact Fecal microbiota transplantation (FMT) has shown promise in chronic constipation by restoring diverse beneficial bacteria.
Probiotic Diversity
- Important strains: Lactobacillus, Bifidobacterium, Akkermansia
- Support with resistant starches (e.g., green banana flour, cold potatoes)
