Who Cares About Constipation?
By Dr. Scott Olson, ND
The most pressing question people have about bowel movements is, "Am I officialy "constipated" and how do I know what's normal?"
Bowel movements and constipation are not exactly water-cooler conversation, so most people don't know if their situation is classified as "constipation", or how many bowel movements they ought to be having each day. No one really likes to think or talk about what's coming out of their rear end (well, almost no one over the age of twelve), but how often you go can have a dramatic effect on your health.
Am I Constipated? What Is Normal?
Whenever the subject comes around to constipation, people invariably ask how often they should be having a bowel movement. Some people have three or more bowel movements a day, while others only have one a week (you are definately constipated!).
On the one hand, someone who has a bowel movement every few days may feel constipated if they haven't had a movement in a week. On the other hand, there are people who believe they are constipated if they don't go every day.
The medical community is no help either. Depending on the source, they suggest that fewer than three bowel movements per week qualifies as constipation, or that someone is constipated if their stool is hard and/or difficult to pass.
So is normal once a day or three times a week?
Which Is Right...Who Defines Constipation?
To get an idea of what is normal or "not constipation", we can turn to three teachers.
Most animals will have a bowel movement soon after they eat a major meal. You can train a puppy to go outside by keeping them in a tight enclosure for half an hour after they eat, and then take them outside. Birds are famous for going while they are eating. Likewise, cats, dogs, goldfish, horses, and other animals all go shortly after they have eaten. Domestic animals suffer more constipation than wild animals because of the foods we feed them.
Small children also follow this pattern and can help us to determine what is normal. Breast-fed infants, especially, have a bowel movement with every large feeding. Parents can often time when their toddlers will go to the bathroom. They know that shortly after breakfast or lunch, their children will be headed to the bathroom, especially if they are running around and active. Much fewer children suffer with constipation than adults.
Another method we can use to uncover what is normal is to look at people who live in non-western cultures, and who eat a diet that is tied to their environment. Scientists who study these people note that they typically have two to three bowel movements a day, and the movements are usually much heavier than the stool of someone who eats a typical Western diet.
People in these cultures would scratch their heads at the concept of constipation. It just doesn't make sense to them. Non-western people don't have large stacks of reading material next to where they go to the bathroom because they don't sit and wait for a movement to happen...it just happens.
Taking our cue from these teachers, we find that a natural number of bowel movements is probably between two and three a day – one for each major meal of the day. For health reasons, it is good to have at least one bowel movement a day...if you are having less than you could be classified as suffering with constipation.
How did we become so Constipated?
Some four million Americans experience constipation on a regular basis; more than half that number will visit a doctor each year with constipation as a major complaint. Constipation tends to happen more often in the elderly and in pregnant women, but it can strike people of all ages. At last count, Americans were spending over $700 million dollars a year on laxatives!
The first major reason for so much constipation in the United States is that we are trained not to go to the bathroom when we have the urge. Remember when you were young and in school? You couldn't get up and go to the bathroom any time you wanted to. After you ate lunch and were sitting in class, you'd get the signal from your body that it was time to go. But did you go? No, you sat there and ignored what you body was telling you.
It is rare for an animal to hold onto their stool for very long. We have muscles and the ability to hold on to our stool, but in the wild world, this is a rare occurrence. Most animals and babies go when they have to go. We, however, are taught to hold it until the time is right.
The problem with this type of training is that the body eventually gets the message; it will stop telling you that it is time to go to the bathroom. The muscles that hold back stool also become stronger and better at keeping stool from coming out. It becomes a vicious cycle.
Another reason for the epidemic number of people who are constipated in the United States is the Standard American Diet. The stool of people living in native cultures is full of fiber. This means that the bowel movements they have are larger and bulkier. A larger stool is easier to pass.
Much of the food we eat in the United States is made from ground up seeds such as bread, cereals, cake, and other foods made from flours. Eating grains is fine, but it is much healthier to eat them in whole form – the way most people eat rice. The difference is that eating grains that have been ground makes for stool that is hard and compacted.
Imagine dirt or soil. If there is a high proportion of organic material called humus or fiber in the soil, it is light and airy; if there is no organic material, we call it clay. Your bowel movements are the same; they can either be light and bulky or clay-like, depending on what you are eating.
Another reason for all the constipation in the United States is that most people in our culture don't take care of their bowels by giving them a rest (more on this later).
The Consequences of Constipation
The medical community denies that there is anything really wrong with having a bowel movement every few days. I disagree.
The problems with constipation are many. The cells that make up the walls of the large intestine (the colon) are very tough, but even they can't handle constant abuse. Stool contains many waste products and these can affect the colon's cells.
Does cancer arise from this long-term contact between stool and the colon's cells? No one can say for sure, but it certainly doesn't help to foster good health. Are you at a higher risk for colon cancer if you are constipated? The answer is yes.1 You are two to three times more likely to develop colon cancer if you are experiencing constipation enough to warrant using laxatives. This risk is higher for women than men and higher in black women than other women.2
Other diseases are also more likely if you are constantly constipated including hemorrhoids, which can be caused by straining during a bowel movement. Anal fissures are caused when a hard stool actually rips the tissue on the inside of the anus.
Severe complications from constipation include rectal prolapse where the intestinal lining is pushed from the anal opening. Diverticulitis, an outpouching of the lining of the colon, is complicated or created by constipation. Fecal impaction is a potentially harmful condition where the stool becomes so stuck that it has to be removed manually.
While appendicitis is thought to arise from infection, the incidence is higher in people who are constantly constipated. In fact, the amount of fiber in a child's diet is directly related to the chances of getting appendicitis.
Your Anti-Constipation Action Plan
Clearly, being constipated is no fun for anyone, and it's a condition that can have long-lasting effects on your health. Be aware that many drugs and some diseases can cause you to become constipated. Even if your constipation is caused by drugs or a disease, you can find relief by following this action plan, but be sure to check with your doctor before beginning any plan.
Step One: Fiber Fiber Fiber
Okay, fiber is boring. It isn't flashy like some other supplements that you can take, but it is essential for your health. Not only will fiber add bulk to your diet, which can reduce constipation, but fiber also plays many other roles in the body.
Fiber is what helps to ensure that many toxins leave your body. Fiber has a way of grabbing on to other molecules. When your body wants to get rid of something, it sends it down your intestines. If there is enough fiber, that molecule is taken out of the body. If there is not enough fiber, that molecule is often reabsorbed.
Fiber also provides a food source to the bacteria in your gut. The bacteria munch the fiber and we enjoy the benefits of the vitamins and nutrients that are extracted.
High fiber foods include vegetables, fruits, and grains. Remember, consider eating grains in their whole form and not always ground up as flour. A fiber supplement is also a great addition to your health plan. Try mixing it in a smoothie or your orange juice every morning.
Step Two: Drink to Your Health
How many times have you heard that you should drink eight glasses of water a day? Yes, water is important.
What most people don't realize is that water is vital to consistent bowel movements. The more water you have in your body, the easier it is to have a bowel movement. If you aren't drinking enough water then, the body takes water from your stool, which results in dry, hard bowel movements.
How do you know you are getting enough water? Look to your urine. If your urine is bright yellow, then you are not drinking enough water. You want your urine to be close to water-color. Remember that certain vitamins will turn your urine bright yellow, so this color-test may not always work.
Step Three: Take a Seat
Remember that you have trained your brain not to remind you that you need to go to the bathroom! Well, you can re-train your brain by sitting on the toilet half an hour after eating.
While you may feel silly sitting there, this kind of training can really work. Take a book or some other reading material and spend about five to ten minutes just sitting on the toilet after your meal.
Step Four: Give Your Bowels a Break
We eat food every day. While that may sound normal, it is not. Every wild animal on the earth experiences days when they don't have food. While this thought may strike horror into your heart, it is actually healthy to take a break; especially for your colon.
The best way to experience this kind of break (and still eat) is to cleanse your colon. A colon cleanse is rejuvenating and can put your colon back into shape. Many people who use colon cleansing report that their constipation is gone after a good cleanse. In fact, when constipation returns it is often a signal from your body that it is time to cleanse your colon.
Step Five: Stay Active
Taking a walk is a great way to stimulate a bowel movement. Any kind of exercise will work, but the best are walking and running.
You can't lose with exercise, there are so many additional benefits that everyone should exercise as much as they can.
Break the Cycle
Being constipated is no way to go through life. It is uncomfortable, inconvenient, and unhealthy. Constipation is a discomfort that no one should have; it is a completely treatable condition. The solution is not that hard.
You need to take care of your gut like you take care of the rest of your body.
A colon cleanse a few times a year, adding fiber to your diet, and getting enough exercise and water can break the cycle of having infrequent bowel movements. The investment you make in taking care of your colon can have long-term payoffs in improved health and a more comfortable life.
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1. Watanabe T, Nakaya N, Kurashima K, et al. Constipation, laxative use and risk of colorectal cancer: The Miyagi Cohort Study. Eur J Cancer. 2004 Sep;40(14):2109-15.
2. Roberts MC, Millikan RC, Galanko JA, et al. Constipation, laxative use, and colon cancer in a North Carolina population. Am J Gastroenterol. 2003 Apr;98(4):857-64.
3. Adamidis D, Roma-Giannikou E, Karamolegou K, et al: Fiber intake and childhood appendicitis. Int J Food Sci Nutr. 2000 May;51(3):153-7.