If you’re feeling backed up, you’re in good company. According to Johns Hopkins Medicine, about 4 million people in the US experience frequent constipation and 2.5 million of these people visit a doctor for it each year, making it the most common GI complaint. It’s frustrating, uncomfortable, and can take a toll on your body image. While the first thing most people reach for is a laxative like Mirilax or Dulcolax, these can be extremely habit-forming and can make it difficult for you to have a bowel movement without them. The functional approach to constipation is to uncover the root cause of it, whether it’s stress, a lack of fiber, underlying gut coinfections, eating behaviors, etc. Once you know that piece, you can incorporate holistic ways of alleviating your constipation, hopefully for good!

Why Eating Dinner Early is Crucial for Digestion

If your schedule allows it, try to eat dinner 2-3 hours before you want to go to bed. Digesting your meal when you’re trying to sleep essentially pushes your natural sleep cycles back because your body is focused on eliminating food from your stomach instead of sleeping. Think about it. Have you ever gone out for a late meal with friends in the city and then you find yourself tossing and turning throughout the night? Whereas when you eat dinner on the earlier side, your body is finished digesting your meal well before your bedtime and your liver and digestive organs can rest while you sleep.

Root Causes of Constipation 

Nervous system dysregulation: Your vagus nerve is a cranial nerve that comes out of your brain stem and innervates multiple organs, many of which are digestive organs (like the small intestine and colon). It is the primary conduit of parasympathetic activity in your body, which means that, under resting conditions, your vagus nerve will decrease your heart rate, relax your blood vessels, stimulate gastrointestinal motility and secretion, and promote the release of digestive enzymes and bile. Yet when under stress, your vagus nerve isn’t able to activate and you remain in “fight or flight” mode instead of “rest and digest” mode when you’re trying to eat. 

An unhealthy relationship with food: Food fears and not feeling safe enough to receive food is a huge trigger. These thoughts and beliefs about food launch your body into a fight or flight state, where your digestion and peristalsis (intestinal motility) might even stop.

Gut coinfections, including SIBO: Small intestine bacterial overgrowth (SIBO) can disrupt the normal motility of your small intestine, leading to impaired peristalsis and delayed transit of waste from your colon. The overgrowth of bacteria also alters your secretion of fluids and electrolytes, which are necessary for maintaining proper intestinal function and stool consistency. 

Eating too frequently: Your migrating motor complex (MMC) is a cyclical pattern of contractions that occurs in the smooth muscles of your gastrointestinal tract, primarily in your stomach and small intestine. Its main job is to sweep undigested food, debris, and bacteria through your digestive system between meals and during periods of fasting, taking about 90 minutes in total. So when you’re eating every two hours, you are not giving your digestive tract enough time to rest and initiate your MMC. 

Hormonal imbalances:  Progesterone naturally slows down gut motility a little bit. This is why pregnancy constipation is a very real phenomenon. But even in the luteal phase or second part of your menstrual cycle, your progesterone levels rise following ovulation. So some of us might notice that we tend to get constipated a few days before our periods. 

Why Pooping is Your Most Important Form of Detoxification

When you think of detox and drainage, your mind probably goes to the liver. It’s true, your liver is a powerhouse when it comes to carefully filtering out toxins, metabolic waste products, drugs, and other harmful substances from your bloodstream. But your liver ultimately gets rid of these products through bile, which is secreted into your large intestine to be eliminated from your body with your poop. So if you’re constipated, this vital detoxification pathway is blocked and your body resorts to other methods, like through your skin or breath. Additionally, proper bowel movements prevent the reabsorption of toxins and waste products back into your bloodstream. When stool remains in your colon for an extended period of time, toxins and waste can be easily reabsorbed through your intestinal wall and circulated throughout your body, potentially leading to other downstream health issues.

How to Relieve Constipation Holistically

• Start your day with a warm beverage. To kick it up a notch, add some lemon, and/or a little bit of aloe vera juice to your hot water. Aloe vera juice is really soothing to your GI tract and is wonderful for those of us who have any intestinal inflammation. Since lemon is bitter on your tongue, it encourages your body to produce natural enzymes and acids. And we can’t discount the simple fact that the physical warmth of a hot drink stokes your digestive fire which helps to keep it active all day long.

• Try senna. Chemical compounds called anthraquinones in the Senna alexandrina plant exert laxative effects on your digestive tract. Sennosides are considered stimulant laxatives because they stimulate the muscles of your intestines, particularly your colon, to contract more vigorously. This stimulation increases the movement of stool through your colon while also accelerating the transit time for more regular,  frequent bowel movements. Note: this should only be used for occasional constipation, not as a regular part of your routine. 

• Take magnesium. Magnesium citrate in particular helps to pull water into your colon to prevent constipation. This can serve dual purposes because many of us are deficient in magnesium or at the very least have suboptimal levels. Plus taking a magnesium supplement at night can help you destress and sleep better. 

• Incorporate castor oil packs. Castor oil is rich in antioxidants that can penetrate the dermis of your skin to stimulate your liver and gallbladder to contract and release bile while also increasing circulation and encouraging movement.

• Consume more ginger. Ginger contains bioactive compounds such as gingerol and shogaol, which stimulate the production of digestive enzymes and gastric juices. It also relaxes the muscles of your GI tract to ease any tension or cramping and alleviate symptoms of constipation. And, finally, ginger is a powerful anti-inflammatory that can reduce and soothe chronic inflammation, which is often a leading cause of constipation and other digestive issues. Our favorite  way to get more ginger in is by drinking ginger tea in the morning or around meal times.

• Belly breathe. Did you know that many of us are chronic hyperventilators without even knowing it? As we discussed earlier, taking deep breaths from the bottom of your belly instead of shallow breaths from your chest can help to activate your vagus nerve and, therefore, your parasympathetic nervous system. When in rest and digest mode, your digestive system has the time and resources to properly digest your meals and your muscles can relax. Also, deep diaphragmatic breathing massages your abdominal organs and stimulates peristalsis, the wave-like contractions of the digestive tract that move food and waste through your intestines. 

• Move your body daily. Even just getting a little bit of stretching in each day can go a long way for constipation. Movement of any kind stimulates your intestinal and abdominal muscles to promote intestinal motility and speed up transit time. Exercise also improves circulation throughout your body, bringing blood flow to your intestines and supporting optimal digestive function and bowel regularity.

• Drink chia seeds. Soaking chia seeds in water reduces some of the anti-nutrients in the seeds while forming a high fiber gel that can help to bulk your stool and make it easier to pass through your GI tract. Chia seeds also contain prebiotic fibers which feed the  beneficial bacteria in your gut. For constipation, start with just 2 tbs of chia seeds in a glass of water and increase if needed. This is a really great travel hack if you get backed up while flying!

To learn more about constipation and why it’s such a nuanced topic you can listen to my conversation with Dr. Halie Schoff on the Quiet the Diet podcast. We discuss Dr. Halie’s personal journey of overcoming an eating disorder and gut issues, the connection between gut health and mental well-being, how to create a positive and stress-free environment for optimal digestion and more.

Want more support in eating healthier and losing weight?

By working with one of our Registered Dietitian Nutritionists at Michelle Shapiro Nutrition LLC, you will receive personalized recommendations and one-on-one nutritional counseling to help you reach attainable goals in a way that fits your lifestyle.