Sounds simple, but one of the biggest “thank you’s” I get in my practice is when I help someone have normal bowel movements. Constipation is a problem for many Americans and it is no surprise why. Low mineral status, inadequate water and fiber intake, drug therapy and “bad bugs” in the colon all can create problems with regularity. Not only is it extremely uncomfortable, it can lead to developing hemorrhoids as well as disrupt the normal heathy gut flora. Studies have found that a reduced number of bowel movements are associated with an increased risk of colon cancer – the number two cancer killer in America. In my book, living with constipation is not an option.
The most common recommendations given to overcome constipation, increasing fiber and water intake, often does not take care of the problem. In fact, it can create other problems; for instance, gas and bloating.
Constipation occurs primarily because of decreased peristalsis, the muscular movement of the intestines that promotes digested food through the GI tract. But what causes decreased peristalsis? The main cause is not enough bulk to the stool. That’s what fiber and water are supposed to do – increase bulk. So what can you do if they don’t work? For colon health as well as regularity of bowel movements, you also need to address balance of gut flora and magnesium intake.
Gut flora or probiotics are the beneficial bacteria in human intestines. They have many functions like helping to digest foods, make vitamins such as B-12 and K, and interfere with illness-promoting bacteria. Probiotics also produce organic acids that in turn help stimulate peristalsis and keep the pH of the intestine in balance. Gut flora can be wiped out in the intestines by a number of factors, but the primary one is taking antibiotics. To keep a good gut flora population, I have always recommended to take probiotics in through diet and supplements.
Eating yogurt may help a little, but the number of beneficial bacteria in a serving of yogurt is very low compared to the number actually needed. Supplementing with a good human strain probiotic supplement is far better to ensure you are getting enough. Find a probiotic that has data on how well it adheres to the intestine and that it is stable through the shelf life of the product. Don’t be fooled by how many CFU’s are in each dose, instead look for proven efficacy.
You can help good intestinal bacteria thrive by making sure they have a good food supply. Friendly intestinal flora feed on oligosaccharides, a type of carbohydrate found in foods like Jerusalem artichokes, asparagus, onions and garlic. Foods enriched with inulin from chicory root also contain oligosaccarides. If you don’t like these foods, oligosaccharides can be found in supplement form. I have found artichoke extract supplements to be extremely helpful for constipation, especially when given along with probiotics.
If probiotics, adequate fiber and water have not adequately restored regular bowel movements, I turn to magnesium, especially if I see other signs of functional metabolic deficiency, like muscle cramps or weakness, restless legs, fatigue or headaches. Magnesium helps peristalsis by allowing relaxation of the smooth muscle tissue in the intestines. In chronic long-term constipation, you may need to start with as much as 800 mg of magnesium per day in divided doses to get the intestines moving. Most Americans are low in magnesium status to begin with, then add any regular exercise and the deficit can become even bigger.
A well-absorbed form of magnesium is crucial; amino acid chelated forms like magnesium taurate, citrate, malate and glycinate are some of the best supplement forms of magnesium.
Anyone suffering from constipation or irregularity with their bowel movements, should look first to probiotics, as they can help you digest and break down dietary fiber. If increased probiotics, fiber and water don’t do the trick, then look to artichoke as a source of oligosaccharides and finally, you should take magnesium since many studies now have pointed to the fact that most Americans do not get enough magnesium in their diet.
Supplement Recommendations
- Tri-Mag 300: 4 capsules daily divided between AM & PM if no improvement, add another capsule to each dose.
- Kyo-Dophilus® 9: 1 capsule 2 times a day for 30 days then 1 capsule daily
Resources
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- “Common Myths About Constipation Dispelled.” Am J Gastroenterol. 2005;100:232-242
- Salminen S, et al. 1998. “Clinical applications of probiotic bacteria.” International Dairy Journal, 8; 563-572.
- “Survival and therapeutic potential of probiotic organisms with reference to lactobacillus acidophilus and bifidobacterium.” Immunology and Cell Biology (2000) 78, 80–88
- Laroia S, Martin JH. “Bifidobacteria as possible dietary adjuncts in cultured dairy products: A review.” Cult. Dairy Prod. J. 1990; 25: 18–22.
- http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/fru_0313.shtml
- Iannello S, Belfiore F. ”Hypomagnesemia, a Review.” Panminerva Med. 2001 Sep;43(3):177-209.
- Susanna C. Larsson, MSc; Leif Bergkvist, MD, PhD; Alicja Wolk, DMSc. “Magnesium Intake in Relation to Risk of Colorectal Cancer in Women.” JAMA, January 5, 2005;293:86-89.