Most integrative & functional dietitians would agree; you should be pooping dai-ly! 😅 Very proud of myself for that rhyme.
On a serious note, it can be really uncomfortable not to have a sufficient* bowel movement daily- which for some can lead to abdominal pain/cramping, bloating, and/or a general feeling of fullness in the lower abdomen. Constipation is certainly the most common digestive complaint I see in practice as a holistic trauma-informed dietitian.
*Sufficient = feels complete, varying length person-person & depending on how often you go, but generally at least 6 inches daily in total.
This daily elimination is not only important for getting rid of food remnants like fibers which the body can't use, but also eliminating many other things such as byproducts of detoxification processes in the liver & even "inactive" hormones!
Fun fact: some people with constipation might show signs of estrogen dominance, as estrogen can be reabsorbed & recirculated from stool that hangs out too long in our large intestine.
Did you know you can have watery/loose stool and still be constipated?! Yep! This can also be a sign of impacted stool that's stuck in your intestine if you haven't been having complete bowel movements. Other signs of impacted stool (Fecal impaction) include pain in abdomen/lower back, feeling like your abdomen is swollen (bloated), feeling the need to poop but can't, stomaches, and lethargy. This is definitely something you should mention to your doctor if you this sounds like you.
What influences constipation?
Not eating enough/often enough
History of restriction
Not eating enough fiber or variety of fibers
Not drinking enough fluids
Chronic stress/nervous system dysregulation (which affect stomach acid production & pelvic floor muscles)
Chronically "sucking in" your stomach (leads to pelvic floor dysfunction- plays a role in digestion)
Rushing to try to have a bowel movement, not relaxing pelvic floor
Delaying actually going when you feel the urge
Certain types of Iron supplementation
Some medications
All of this being said, you are NOT alone if you suffer from constipation. Squash any feelings of shame or blaming yourself because ultimately, are those gonna serve your best self? You know the answer!
So, what should you do if you're experiencing constipation? It's imperative to take a holistic (whole-person) approach to constipation, otherwise we aren't getting to the root cause or covering all our bases.
Tips to treat constipation & support digestion holistically:
Optimize your digestion.
Make sure you are chewing adequately (food should be applesauce consistency before swallowing).
Stop sucking your stomach in! This can impair pelvic floor function along with other abdominal muscle function, which play a role in digestion.
Practice relaxing before beginning to eat. This helps the body switch into the parasympathetic or "rest & digest" state, where it actually will focus a bit more attention on the digestive tract. The 4,7,8 breath 3x before a meal works wonders.
Sit upright to eat and stay upright at least 2 hours after.
Choosing warm foods more often than cold foods may also help.
Hydrate ya'self!
A good rule of thumb is to drink half your body weight in oz of water or similar beverages per day. (Alcohol doesn't count).
If you often forget to hydrate, would it help to set a reminder on your phone for every AM to set a timer for 1 hr to remember to drink, and restart it every hr it goes off? Also-set a water bottle out at night to have the visual!
If water is too boring for you, consider add-ins or other beverages that contribute to hydration status! Add-ins: citrus, mint, cucumber, splash of juice, etc.
You may find that warm liquids in AM & PM are more soothing & help aid digestion better.
Fuel with Fiber
Aim to choose MOSTLY higher fiber carbohydrate-rich options, when it's not compromising to your satisfaction. Get my carbohydrate handout here that breaks down higher fiber vs lower fiber carbohydrate sources.
Aim to get a VARIETY of fiber sources. This supports diversity in our gut microbiome (all the microorganisms that live in our intestines). Those lil buggers are suuuuper important for gastrointestinal health & optimizing bowel movements!
Eat consistently & enough-
Beginning in the AM within 1 hour of waking up, and again every 3-4 hours. Our bodies have SIGNIFICANT needs each day, even if we were to lay in bed all day! This is thanks to our basal metabolic rates (the energy it takes to keep us alive).
Those with a history of restriction often see improvement in constipation over time with consistently eating enough (and with addressing the other important factors:)
Consult with a dietitian if you're uncertain how much food you need, or have trouble identifying hunger/fullness cues!
When it's time to go...
A squatty potty or other stool that allows you to elevate your feet 6 inches or so while pooping optimizes our pelvic floor muscles to relax and release!
Don't delay when you feel the urge! This can cause reabsorption of water from stool making it more difficult to pass or encourage constipation.
Breathwork can also help. Consider the 4,7,8 breath mentioned earlier with expanding your belly like a balloon on inhale, and totally relaxing everything on exhale.
Get off your phone!
Give yourself time, but not too much. Experts say longer than 10-15 minutes on the toilet can actually be unhelpful.
See a pelvic floor PT!
Especially if you feel like you're doing everything "right" nutrition-wise, or have already worked with a dietitian and are still struggling. Pelvic floor PT helps identify ways that our pelvic floor might be suboptimal/dysfunctional and gives tailored exercises & support to fix these issues!
Consider functional foods*: *Try introducing one at a time and stay consistent for a few days to see how each affects your body.
Kefir: 4 oz
Dates: 1-2, pitted
Kiwis: 2/day, peeled or unpeeled.
Yogurt: 4+ oz
Ginger/ginger tea (super easy to chop up some ginger and boil it for tea!)
Spicy foods (those with capsacian) work for some people as well to stimulate motility.
Consider supplements: (DISCLAIMER: ASK YOUR DOCTOR BEFORE INTRODUCING)
Magnesium Citrate (250-400mg )after dinner- or a citrate/glycinate blend if you'd also like nervous system/sleep support (NOW makes a softgel blend- no affiliation-check the nutrition facts label to see the forms of Magnesium)
Senna tea- tends to be a little more "encouraging" than Magnesium if you're looking for more of a laxative effect.
Metamucil (according to instructions on package)
Triphala* Take after a meal rather than on empty stomach. *May interact with blood-thinners or anti-hypertensives.
Try the "I L U" Massage Here's a video showing how. This may encourage stool to move through your large intestine and soothe discomfort. Drinking a warm beverage prior may help even more, as well as incorporating some circular movement as you follow the recommended path. It may also be done while laying on your back.
I hope this post has encouraged you to try some things out to improve constipation and support your overall digestion, or perhaps you know someone who could benefit from these tips that would love for you to share this post with them!
If you found this helpful and don't want my carbohydrate handout linked above, you may like to sign up for my newsletter here for more holistic health & wellbeing tips. Don't worry, I won't bombard your inbox and strive to provide relatable, realistic tips!
Thanks for reading, and happy digesting!
Medical Disclaimer:
Although I am a registered dietitian, I am not YOUR dietitian. All content and information on this website is for informational and educational purposes only, does not constitute medical advice, and does not establish any kind of client-provider relationship by your use of this website. A client-provider relationship with you is only formed after we have expressly entered into a written agreement with you that you have signed including our fee structure and other terms to represent you in a specific matter. Although we strive to provide accurate general information, the information presented here is not a substitute for any kind of professional advice, and you should not rely solely on this information. Always consult a professional in the area for your particular needs and circumstances prior to making any professional, legal, medical, and financial or tax-related decisions.