Health Topics > Bowel health > constipation

CONSTIPATION

What exactly is constipation?

Constipation is thought to affect a quarter of the population at some time.
Constipation is not necessarily irregularity. It has to do with the hardness of the stool (bowel motion) rather than how often one is passed. In a healthy individual one or more motions per day is desirable. The quicker toxins are eliminated from our body the less time they have to either ferment or cause other problems.

Mostly constipation is due to poor dietary habits, or by not going to the toilet when nature calls! This results in the bowel reabsorbing water and therefore making the stool hard. Stop that car, leave that meeting, if "yer gotta go, yer gotta go"! We should all try to drink 6 to 8 glasses of water per day.

Individuals suffering from constipation need to look at their daily intake of fibre, whole grains, vegetables and fruit. There is really no excuse for not taking in fibre. There are many delicious choices for fibre rich foods. "The Liver Cleansing Diet book" has brilliant advice and ideas in this area.

Foods to be avoided during constipation are hard cheeses, apples and bananas. Some drugs including analgesics that contain codeine and some anti-depressants can cause constipation. The same may be true of other medications. If you suspect your medication, then check with your doctor.

Many of our older readers would have heard of Cascara, senna or psyllium husks. These remedies have been around for a very long time. Or perhaps the perennial glass of warm water with lemon juice upon rising each day. The very best way to set things right is to improve your diet. It is not good practice to rely on laxatives and they can cause dependence very quickly. Just to add a little "metaphysical" side to this question. In her book "You Can Heal Your Life" Louise Hay says constipation sufferers are "Refusing to release old ideas, or are stuck in the past". Definitely worth a thought!

Eating large amounts of cooked and processed foods can contribute to sluggish bowels. Over a period of time, a layer of toxic waste products may build up on the lining of the sluggish bowel. This build-up can cause inflammation in the bowel, and the toxins are absorbed from the bowel and travel back to the liver via the portal vein. The liver has to work much harder to break down these internally produced toxins and symptoms of liver dysfunction may result. Thus constipation can lead to headaches, abdominal bloating, fatigue, allergies and skin problems.

Regular daily well-formed bowel movements without straining should be normal. This reduces the risk of conditions such as appendicitis, hiatus hernia, abdominal hernias, haemorrhoids and colon cancer. If the bowel moves as often as food is eaten, say 2 to 3 times a day, this can help reduce a build-up of toxic waste products in the bowel.

Common causes of constipation are -

A diet deficient in fibre and/or raw fruits and vegetables.
Lack of exercise
Dehydration with inadequate intake of water.
Abuse of laxatives or drug side effects.
Under activity of the thyroid gland.
Nervous tension
Food allergies
A structural abnormality of the bowel.

Mechanical problems with the bowel are common, such as prolapsed bowel or extra loops of bowel or bowel pockets. These pockets form in the wall of the colon and this condition is called diverticulitis. These conditions can only be diagnosed with a barium enema X-ray and colonoscopy.

Excerpt from "The Healthy liver and Bowel Book"
"The normal frequency of bowel actions varies greatly between people. You should have from one to four bowel actions a day. They should be a brownish colour, be soft and grainy and passed without undue straining. Many of my patients have told me that their stools have changed significantly after commencing the Liver Cleansing Diet. In particular they find that they are softer, easier to pass and much longer. They may contain obvious pieces of undigested vegetables such as sweet corn skins, small parts of plant skins and small parts of leaves. This is a good sign because this increased fibre acts like a broom to cleanse the bowel walls. Signs to worry about are red blood or a black colour in the stools, or an obvious change in bowel habits from your normal pattern. It is good to look at each bowel action after you pass it to check for general appearance and blood or blackness."

Megacolon

I remember a young woman who presented with severe constipation - she was only opening her bowels once every fortnight. A barium enema X ray revealed an extra loop of bowel as the underlying, albeit quite rare, cause of her problem. This redundant loop was removed surgically and she was cured! These extra loops of bowel are called "Megacolon" This can be congenital or due to poor diet and laxative abuse. A special X ray called a barium enema is able to diagnose megacolon with extra loops of unwanted bowel. In extreme cases the extra loops of bowel become huge and great help is achieved by surgically removing them in expert hands. If your constipation is very severe - Have you had a CT scan of your bowel or a barium meal?

Prolapsed colon

This condition can be improved with good effort on your part, by the use of diet, supplements, colonic irrigation therapy, walking and swimming exercises daily.
Follow the principles of eating in "The Healthy Liver and Bowel Book" found on page 126 onwards and follow recipes in this book, including juice recipes daily.
Drink up to one litre of juices daily e.g. carrot juice freshly squeezed. Consult a very experienced colonic irrigation therapist.

Treatment and general recommendations

Try to establish a regular time for sitting on the toilet to train the bowel. Aerobic exercise like brisk walking is beneficial, preferably three to four times a week for a minimum of twenty minutes. Some specific abdominal exercises are also worth the effort. Sit in a straight backed chair and tighten the abdominal muscles for a few seconds then relax. Repeat ten times. Whilst lying, try some gentle massage of the colon - up the right side of the abdomen, across the top from right to left and down the left side. Learning to do some relaxation exercises or yoga will also help in those whose constipation is anxiety related. General exercise is also very helpful - aim for 20 - 30 minutes of exercise 3 - 4 times per week. Walking is ideal.

Chronic use of laxatives should be avoided - they can actually be the cause of ongoing constipation.

Diet

Follow the principles of eating outlined in "The Healthy Liver and Bowel Book" Good liver function is vitally important as bile is the body's own laxative. This way of eating must be followed for life. It is not hard. You can use the recipes in the back as a guide and make your own recipes/meals up as long as they stick to those basic principles. Members of Dr Cabot's online clinic will have access to lots of new recipes also.
Include often - a good variety of high fibre foods such as raw vegetables, fruit, legumes, wholegrains, nuts and seeds. Unprocessed bran is an excellent form of concentrated cellulose fibre. It absorbs a lot of water helping to form soft, moist stools that are easily passed. Start with a tablespoon a day on cereal or mixed with vegetables and gradually increase to a maximum of four to five tablespoons. Don't overdo it as too much bran will inhibit absorption of essential minerals.
It's also vital to drink one and a half to two litres of water a day.
Linseeds (or Flaxseeds) are excellent to assist with constipation as these have the action of lubricating the bowel. A good way to take linseed is in a mix called LSA - this is Linseed, Sunflower and Almond meal - this can be purchased or you can make your own with a coffee grinder - the recipe is in "The Healthy Liver and Bowel Book" To improve your liver and bowel function you should limit dairy foods including milk, cheese, cream, butter, ice cream, yoghurt, chocolate etc. Try some different brands and varieties of malt free soy as they vary greatly. The fresh soy products in the dairy cabinet are much lighter and not as strong in taste as the long life products. There are also rice, almond and light coconut and oat milks to try.
Avoid ALL margarines and similar type spreads.
Avoid deep fried and fatty foods.
Avoid sugary processed foods and drinks
Limit chicken and turkey that is not free range, as this contains artificial growth hormones, antibiotics and steroids that increase the liver's workload. Avoid gluten (found in wheat, rye, oats and barley) and all foods containing these. Gluten is a digestive irritant.
Avoid artificial sweeteners; see www.dorway.com

Other recommended books

Raw juicing

An appropriate juicing recipe is the "Constipation' juice on page 73 found in the "Raw Juices Can Save Your Life" book.
A blend of apple and pear juice is a great regulator or try juicing a combination of parsley, carrots, garlic and celery for a wonderful spring clean. Avoid excessive tea drinking, too many dairy products and refined processed foods.

Laxatives

Over the counter preparations like "Senokot" and "Durolax", herbs like licorice, cascara and senna and even prune juice all provide chemical stimulation of the bowel , so long-term use should definitely be avoided. Other laxatives include "Coloxyl" which is a faecal softening agent and "Agarol" which contains liquid paraffin that coats the faecal mass to allow easy transition through the bowel. Agarol should only be taken at bedtime as it can interfere with the absorption of the fat-soluble vitamins. "Duphalac" works by osmosis, drawing water into the stool with resultant distension and softening of the stool. "Normacol" granules and Metamucil" (powdered psyllium) are known as bulk laxatives; that is they are forms of fibre that absorb water. An alternative is to take psyllium seed husks one to two teaspoons in water. Long term abuse of laxatives can lead to conditions such as megacolon or Black colon (melanosis coli ).

Tests For Bowel and Digestive Function

If you believe that you may have a digestive or bowel problem it is a good idea to see a specialist in gastrointestinal disorders, known as a gastroenterologist. These doctors will take an extensive history of your eating patterns, symptoms and bowel actions. The most serious problems to exclude are malignant tumours of the stomach and bowels, which become far more common as we age. This is why it is important to have thorough investigations early on if you develop any change in bowel actions, unexplained weight loss or abdominal pains. Specialised tests known as a “Complete Diagnostic Stool Analysis” (CDSA) can be done by Analytical Reference Laboratories in Melbourne, Australia, and your health care provider can arrange these tests for you. Their phone number is (613) 9328 3586. In the USA these tests can be done at the Great Smokies Diagnostic Laboratories, Phone: (828) 285 223.

Colonoscopy

This involves passing through the anus a thin flexible tube that visualizes the lining of the entire colon and rectum, and transmits the picture to a television screen. Samples (biopsies) can be taken from suspicious looking areas of the bowel to enable accurate diagnosis. It is done under mild intravenous sedation and takes around 30 minutes. The test is usually not uncomfortable. The colon needs to be cleansed with laxatives beforehand to enable an accurate assessment. Colonoscopy is the most accurate way to diagnose the cause of bowel symptoms and to screen for cancer and bowel polyps. Bowel polyps can be removed via this procedure.
There is a slight risk of perforation of the colon (1 in 2000 cases) during colonoscopy.

Sigmoidoscopy

This is similar to colonoscopy, however the flexible tube that is passed up into the bowel is much shorter and can only assess the lower part of the large bowel (rectum and sigmoid colon). It is usually done in your doctor’s office and does not usually require intravenous sedation. This test takes around 5 minutes and may cause a feeling of gas and slight cramping. An enema is required to cleanse the bowel beforehand.

Barium Enema X ray

This is an X-ray examination of the large bowel (colon and rectum) which enables the doctor to assess the shape, size and smoothness of the outline of your large bowel. The X-ray is performed after you receive an enema to insert barium (a chalky radio-opaque) liquid into the rectum which will contrast and outline the wall of the large bowel. A barium enema will show up enlargement of the large bowel and irregularities of the bowel wall and bowel pockets known as diverticula. It can also reveal muscular spasm (spastic colon) in the wall of the large bowel. In some cases of severe constipation a barium enema X ray will reveal a huge dilated colon with extra loops of unwanted bowel (redundant bowel), and this is known as a “megacolon”. A barium enema may show some types of bowel cancer, however it can also miss small cancers, and for this reason a colonoscopy is a far more accurate way to exclude bowel cancer. Sometimes a barium swallow is done to outline the stomach and small intestines.

Recommended supplements:

To help improve bowel movements and symptoms, supplements can assist, but check with your doctor that there has not been a blockage or twist in the colon before starting.

Liver tonic powder or capsules

Take 1 teaspoon twice daily or 2 capsules with meals. A good formula will include a combination of herbs, taurine and vegetables which are very high in fibre, thus also useful for sluggish digestive function such as constipation.

Fibre powder

Take one tablespoon daily with breakfast – A gluten free fibre powder containing soy bran, rice bran and pectin will help to cleanse the toxins from the bowel - fibre formulas are suitable for all types of constipation, as they act like an “intestinal broom,” sweeping the walls of the colon clean, and so removing layers of encrusted and dried faecal matter. These are safe to use in the long term and for general health benefits.

Magnesium powder or tablets

Take 2 tablets twice daily or 1 teaspoon daily in water or raw juice - A formula containing different forms of magnesium is effective for aiding bowel muscle tone.

Digestive enzyme capsules

Take 1 -3 capsules three times daily with meals to aid in enhancing sluggish digestion of carbohydrates, proteins and fats.

IBS capsules

Take 1 capsule containing peppermint oil three times daily to assist with abdominal cramping, bloating, noises etc.

MSM plus Vitamin C powder

Take 1/2 teaspoon twice daily in a little water or raw juice - MSM is an organic sulphur and is very beneficial for the liver as it assists detoxification pathways. It has also been shown to be of benefit in assisting those with constipation.