What exactly is constipation?
Constipation is not only irregularity of bowel actions. It also has to do with the hardness of the stool (bowel motion) and not only how often a bowel action is passed. In a healthy individual one to three motions per day is desirable.
Constipation can be due to not going to the toilet when nature calls! This results in the bowel reabsorbing water and therefore making the stool hard.
Eating large amounts of cooked and processed foods can contribute to sluggish bowels. Over a period of time, a layer of toxic waste products may build up on the lining of the sluggish bowel. This build-up can cause inflammation in the bowel, and the toxins are absorbed from the bowel and travel back to the liver via the portal vein. The liver has to work much harder to break down these internally produced toxins and symptoms of liver dysfunction may result. Thus constipation can lead to headaches, abdominal bloating, fatigue, allergies and skin problems.
Regular daily well-formed bowel movements passed without straining is desirable. This reduces the risk of conditions such as appendicitis, hiatus hernia, abdominal hernias, hemorrhoids and colon cancer. If the bowel moves as often as food is eaten, say 2 to 3 times a day, this can help prevent a build-up of toxic waste products in the bowel.
Common causes of constipation
Causes of constipation include -
- a diet deficient in fiber and/or raw fruits and vegetables
- food intolerance; most commonly to gluten and/or dairy products
- lack of exercise
- dehydration with inadequate intake of water
- abuse of laxatives
- Drug side effects
- under activity of the thyroid gland
- nervous tension
- a structural abnormality of the bowel
I remember a young woman who presented with severe constipation - she was only opening her bowels once every fortnight. A barium enema X ray revealed an extra loop of bowel as the underlying, albeit quite rare, cause of her problem. This redundant loop was removed surgically and she was cured! These extra loops of bowel are called "Megacolon". This can be congenital or due to poor diet and laxative abuse. A special X ray called a barium enema is able to diagnose megacolon with extra loops of unwanted bowel. In extreme cases the extra loops of bowel become huge and great help is achieved by surgically removing them in expert hands.
Treatment and general recommendations
Chronic use of laxatives should be avoided - they can actually be the cause of ongoing constipation.
- Good liver function is vitally important as bile is the body's own laxative.
- Include often - a good variety of high fiber foods such as raw vegetables, fruit, legumes, nuts and seeds.
- It's also vital to drink 8 to 12 glasses of water a day.
- Linseeds (or flaxseeds) are excellent to assist with constipation as these have the action of lubricating the bowel. A good way to take linseed is in a mix called LSA - this is linseed, sunflower and almond meal - this can be purchased or you can make your own with a coffee grinder.
- Avoid ALL margarines and hydrogenated oils.
- Avoid deep fried foods.
- Avoid processed foods.
- Avoid gluten (found in wheat, rye, oats and barley) and all foods containing these. Gluten is a digestive irritant.
- Avoid artificial sweeteners; see www.dorway.com
Other recommended books
- "Heal Your Gut an A to Z Guide"
- "Raw Juices Can Save Your Life"
- "Magnesium - The Miracle Mineral"
- "The Liver Cleansing Diet"
Here is an appropriate juicing recipe found in the "Raw Juices Can Save Your Life" book.
- 2 spinach or 2 dandelion or 2 cabbage leaves, well chopped
- 2 green apples, skin on
- 3.5 oz (100g) fresh prunes - stones removed
- 3.5 oz (100g) fresh figs
- 1.8 oz (50g) fresh rhubarb (remove leaves)
- 1.8 oz (50g) fresh cherries (stones removed) - optional
- Wash all fresh ingredients and chop.
- Soak dried fruits in water overnight.
- Blend in a blender and drink.
- Add one tablespoon of chia seeds and stir.
Over the counter preparations like Senokot, Durolax and Cascara all produce strong stimulation of the bowel and long-term use should be avoided. Other laxatives include Coloxyl which is a faecal softening agent and "Agarol" which contains liquid paraffin that coats the faecal mass to allow easy transition through the bowel. Agarol should only be taken at bedtime as it can interfere with the absorption of the fat-soluble vitamins. Duphalac, Osmolax and Movicol work by osmosis, drawing water into the stool with resultant distension and softening of the stool. Normacol granules and Metamucil are known as bulk laxatives; that is they are forms of fibre that absorb water.
Tests for bowel and digestive function
If you believe that you may have a bowel problem, it is a good idea to see a specialist in gastrointestinal disorders, known as a gastroenterologist. The most serious problems to exclude are malignant tumors of the stomach and bowels, which become far more common as we age. This is why it is important to have thorough investigations early on if you develop any change in bowel actions, unexplained weight loss or abdominal pains.
This involves passing through the anus a thin flexible tube that visualizes the lining of the entire colon and rectum, and transmits the picture to a television screen. Samples (biopsies) can be taken from suspicious looking areas of the bowel to enable accurate diagnosis. It is done under mild intravenous sedation and takes around 30 minutes. The colon needs to be cleansed with laxatives beforehand to enable an accurate assessment. Colonoscopy is the most accurate way to diagnose the cause of bowel symptoms and to screen for cancer and bowel polyps. Bowel polyps can be removed via this procedure.
Barium enema X ray
This is an X-ray examination of the large bowel (colon and rectum) which enables the doctor to assess the shape, size and smoothness of the outline of your large bowel. The X-ray is performed after you receive an enema to insert barium (a chalky radio-opaque) liquid into the rectum which will contrast and outline the wall of the large bowel. A barium enema will show up enlargement of the large bowel and irregularities of the bowel wall and bowel pockets known as diverticula. It can also reveal muscular spasm (spastic colon) in the wall of the large bowel. In some cases of severe constipation a barium enema X ray will reveal a huge dilated colon with extra loops of unwanted bowel (redundant bowel), and this is known as a “megacolon”. A barium enema may show some types of bowel cancer, however, it can also miss small cancers, and for this reason a colonoscopy is a far more accurate way to exclude bowel cancer.
Recommended supplements for constipation
- Livatone Plus Powder or Capsules
Take 1 teaspoon twice daily or 2 capsules twice daily with meals. Livatone Plus is the leading liver formula to improve liver function and bile production.
Take two to four teaspoons daily with breakfast – it is a gluten free fiber powder designed to cleanse waste products from the bowel. Fibertone powder acts like an “intestinal broom,” sweeping the walls of the colon clean. Fibertone is safe to use in the long term and for general health benefits.
- Magnesium Ultra-Potent Powder
Take one to two teaspoons daily in water or raw juice - A formula containing 4 different forms of magnesium is highly effective for reducing chronic constipation.
- Super Digestive Enzymes
Take 1 - 2 capsules in the middle of meals if poor digestion is associated with constipation.
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If it’s faulty or wrongly described, we’ll replace it.
Please don’t be afraid, the liver often becomes enlarged when subjected to significant inflammation and in most cases it is very reversible.
The first thing recommended is that you begin Dr Cabot’s 15 Day Cleanse and Maintenance Program. An inflammatory diet is often the trigger for the responses that tend to cause liver enlargement.
Fatty Liver or liver congestion is the usual cause of this inflammation.
To hasten the improvement of liver health Dr Cabot prescribes Livatone Plus, NAC, and Ox Bile.
Naturopath for Dr Sandra Cabot MD
You are mostly correct, although the main protein in oats is avenin which does still trigger reactions in a small fraction of the celiac population.
Contamination of oats with wheat berries continues to be a problem for celiacs and gluten sensitive people.
For those with autoimmune disease we recommend Dr Cabot's groundbreaking book 'Healing Autoimmune Disease'.
Naturopath for Dr Sandra Cabot MD