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Constipation, Explained by a Doctor

The Cabinet — 05.17.22
by Dr. Georgia Close

An image of Dr. Georgia Close

What is constipation and what causes it? 

Constipation is generally described as having less than 3 bowel movements a week. Common causes include inadequate fiber and fluid/water intake and abnormal motility (colonic movement) are the most frequent causes. Newer studies are currently evaluating whether gut dysbiosis, or poor quality and diversity of gut flora, is a contributing factor as well.

About 15 to 20% of all adults struggle with constipation, but the rates are even higher- nearly 1 in 3- in patients over 60.

The difference between constipated and regular. 

Being regular doesn’t lead to any benefits (other than symptomatically if the patient feels uncomfortable) but the flip side of this is that regular, soft but formed stools is a sign of adequate fluid and fiber intake, and possibly a beneficial gut microbiome. Constipation itself isn't harmful to gut health, but it can be a manifestation of suboptimal gut health (including a lack of a diverse array of beneficial gut flora species). Constipation can be due to a number of dietary factors, and of course, can cause discomfort.

There is no hard and fast rule to how often or frequently someone should have a bowel movement. Everyone’s colonic motility is different. For some patients, that may mean a bowel movement 2 to even 4 times a day, other patients maybe 3 to 4 times a week. The diagnosis of constipation is made when a patient reports hard, and/or infrequent stools. There is great variability in colonic motility; therefore if a patient is having a substantial formed bowel movement without straining, bloating, or abdominal pain, the frequency is less consequential.

On a natural approach. 

While stimulant laxatives are highly effective and have their place in the arsenal of therapies to treat constipation, they can be habit forming if taken daily. While increasing dietary fiber is the first and best intervention for many with constipation, and is imperative for gut health at the cellular level for the colon, many fiber supplements contain food dyes or sugar alcohols, which can exacerbate bloating and IBS symptoms. Natural, safe and effective herbal and micronutrient supplementation (including magnesium supplements) is often my first intervention in a patient with constipation.

This information is for educational purposes only and should not be taken as medical advice. Please consult a physician before treating any disorder.


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