There are safe and effective ways to reverse constipation. Lifestyle, natural supplements and prescription medications, along with bowel/body cleansing and detoxification methods, help many people.
Dietary Treatment For Constipation
In 2004, it was reported that 5.3 million prescription medications were written by physicians to treat constipation. [1]
There are several natural ways to reverse constipation that you should consider before taking a prescription drug for it. Let’s first look at dietary lifestyle.
In January 2011, the U.S. Department of Health and Human Services (HHS) came out with dietary recommendations. [2] In concept, I am quite happy that they wrote, “Americans are experiencing an epidemic of overweight and obesity. Poor diet and physical inactivity also are linked to major causes of illness and death. To correct these problems, many Americans must make significant changes in their eating habits and lifestyles.”
Therefore, take a serious look at what you eat in regard to the amount of fiber you consume. In 2008, the Academy of Nutrition and Dietetics recommended that we adults should consume 20 to 35 grams of fiber daily. Americans reportedly consume only about 15 grams a day on average. [3] However, in terms of preventing (and reversing) chronic disease, it is now recommended that we consume 75 grams of fiber daily at a minimum. I recommend much more if you want to treat constipation. This corresponds with the new recommendation to consume nine servings of fruits and vegetables daily, which should easily put you past the 75 grams of fiber per day goal.
What does this look like in terms of quantities and types of foods? Below I have included a simple chart from the HHS report [4] to assist you in adding up the amount of your daily dietary fiber.
food
|
standard portion size
|
Calories
|
dietary fiber (grams)
|
| Beans (navy, pinto, black, kidney, white, lima), cooked |
½ cup
| 104–149 |
6.2–9.6
|
| Bran cold cereal (100%) |
1/3 cup
| 81 |
9.1
|
| Split peas, lentils, chickpeas, or cowpeas, cooked | ½ cup | 108–134 | 5.6–8.1 |
| Artichoke, cooked |
½ cup hearts
| 45 |
7.2
|
Pear
| 1 medium | 103 |
5.5
|
| Soybeans, mature, cooked |
½ cup
| 149 |
5.2
|
| Plain rye wafer crackers |
2 wafers
| 73 |
5.0
|
| Bran ready-to-eat cereals |
1/3–¾ cup
| 88–91 |
2.6–5.0
|
| Asian pear |
1 small
| 51 |
4.4
|
| Green peas, cooked |
½ cup
| 59–67 |
3.5–4.4
|
| Whole-wheat English muffin |
1 muffin
| 134 |
4.4
|
| Bulgur, cooked |
½ cup
| 76 |
4.1
|
| Mixed vegetables, cooked | ½ cup | 59 | 4.0 |
| Raspberries | ½ cup | 32 | 4.0 |
| Sweet potato, baked in skin | 1 medium | 103 | 3.8 |
| Blackberries | ½ cup | 31 | 3.8 |
| Soybeans, green, cooked | ½ cup | 127 | 3.8 |
| Prunes, stewed | ½ cup | 133 | 3.8 |
| Shredded wheat cold cereal | ½ cup | 95–100 | 2.7–3.8 |
| Figs, dried | ¼ cup | 93 | 3.7 |
| Apple, with skin | 1 small | 77 | 3.6 |
| Pumpkin, canned | ½ cup | 42 | 3.6 |
| Greens (spinach, collards, turnip greens), cooked | ½ cup | 14–32 | 2.5–3.5 |
| Almonds | 1 ounce | 163 | 3.5 |
| Sauerkraut, canned | ½ cup | 22 | 3.4 |
| Whole wheat spaghetti, cooked | ½ cup | 87 | 3.1 |
| Banana | 1 medium | 105 | 3.1 |
| Orange | 1 medium | 62 | 3.1 |
| Guava | 1 fruit | 37 | 3.0 |
| Potato, baked, with skin | 1 small | 128 | 3.0 |
| Oat bran muffin | 1 small | 178 | 3.0 |
| Pearled barley, cooked | ½ cup | 97 | 3.0 |
| Dates | ¼ cup | 104 | 2.9 |
| Winter squash, cooked | ½ cup | 38 | 2.9 |
| Parsnips, cooked | ½ cup | 55 | 2.8 |
| Tomato paste | ¼ cup | 54 | 2.7 |
| Broccoli, cooked | ½ cup | 26–27 | 2.6–2.8 |
| Okra, cooked from frozen | ½ cup | 26 | 2.6 |
Additionally, I recommend fermented milk (kefir) and other fermented foods, along with a probiotic supplement, to establish optimal bowel flora (bacteria) known to important in bowel-wall health. I recommend removing all grains that contain the gluten protein (wheat, barley, rye, spelt, kamut, triticale and, possibly, oats) from your diet. Use stevia to sweeten your foods and avoid refined sugars, processed foods, artificial sweeteners and other food chemicals (preservatives, colors, additives).
Natural Supplements
Fiber supplements are an effective way to soften and bulk up your stool with water so they do not become compacted. This way, your colon moves stool more easily. I have personally used Metamucil and Citrucel to give my stool form because I was having more than six stools per day for years after my total colectomy surgery. Be aware that they can bind up nutrient supplements and medications, so be careful to take these separately. In my opinion, fiber-bulking agents are best for maintaining a normal stool pattern and not as an initial treatment for constipation since they can lead to bloating and abdominal pains if used with an already constipated bowel. You are better off achieving a normal stooling pattern first with short-term medications (as I explain below).
The next category I look to are the herbal preparations that are safe for ongoing use, with certain precautions. For example, the herb cascara sacrada (Spanish for sacred bark) comes in a pill or tea. It quite effectively stimulates bowel wall peristalsis and is best when used only five days a week or three weeks per month to maintain its effectiveness.
For better results, add another laxative herb, senna, and use it in the same fashion as cascara sagrada to prevent dependency. Other herbs that can have laxative effects are cayenne, ginger, fennel, dandelion root and chickweed.
Medications
There are various over-the-counter osmotic medications to get your bowels moving. They are used for bowel cleansing, but only in preparation for effective longer-term methods (diet, herbs, physical activity) because they can lead to dehydration or a mineral imbalance if used continuously:
- The Fleet enema contains ingredients to cause evacuation of just the sigmoid colon and rectum.
- Milk of Magnesia works well; but better is oral magnesium citrate, which tastes pretty bad and is more effective than the Fleet enema.
- The Fleet Phospho Soda oral saline laxative is more powerful still; and although it tastes like I imagine radiator fluid tastes, it will clean you out for a full colonoscopy — or if you just need clean bowel again.
There are also various prescriptions medications to consider. The osmotic agents that work well are oral Sorbitol and Miralax. Stool softeners such as Colace and Docusate have been minimally effective for patients in my experience. Better are the bowel stimulants Dulcolax and Senokot. The most effective prescription bowel stimulant medication for longer-term use (six to 12 months) is the calcium channel activator called Amitiza.
Non-Medication Interventions
Once you have addressed probable causes underlying your constipation, and if supplements or medications are still not correcting the problem, there are still other interventions to reverse constipation that you can consider. Biofeedback training can improve your use of perianal and perineum muscles involved in stool elimination over time. Surgery can be useful to correct rectal prolapse or an inactive bowel segment.
Not Always Simple
Reversing constipation is obviously not usually a simple fix. If you take a look at potential causes, as I discussed in my previous article, you may find your treatment. If not, dietary intervention, supplements, medications used wisely and physical exercise (even walking) usually make huge improvements to the problem. In my final article next week about constipation, I’ll take a more in-depth look at bowel and body cleansing as a way to eliminate causes of constipation and chronic disease progression.
To feeling good,
Michael Cutler, M.D.
Easy Health Options
[1] Everhart JE, editor. The Burden of Digestive Diseases in the United States. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Dept. of Health and Human Services; 2008. NIH Publication 09–6433.
[2] U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2010. Available online (open the pdf, find page i) at: http://www.health.gov/dietaryguidelines/2010.asp
[3] Slavin JL. Position of the American Dietetic Association: health implications of dietary fiber. Journal of the American Dietetic Association. 2008;108:1716–1731.
[4] U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2010, p.88.
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