Dr. Mary Simon
Causes of Chronic Constipation
As a naturopathic doctor, I seek to find the root cause(s) of illness. Digestion is a huge component of overall health, because your entire body is 100% dependent upon what you eat, breathe, and drink. When patients present with chronic constipation, there are several things for me to consider when determining a course of action:
4- bathroom time
5- small intestinal bacterial overgrowth (SIBO)
The first factor to consider is nutrition. The bulk of stool is fiber, bacteria, waste material, and water. I assess the patient's current diet for fiber intake, both soluble and insoluble, and more specifically the sources of fiber, such as fruits, vegetables, and grains. Some people take a lot of fiber supplements, however, getting natural, unprocessed dietary fiber is best for overall health.
Hydration is also towards the top of the list because the main job of the colon is to absorb water, and 75% of fecal material is also water! If there is little water intake to begin with, the colon will absorb a good amount in order to provide the rest of the body with the fluids it needs, thereby leaving the stool very hard. Hard, dehydrated stool is difficult to pass and can contribute to other ailments like hemorrhoids and fissures, in addition to constipation.
Stress is a huge factor when it comes to constipation! The body has the autonomic nervous system which consist of two parts: the sympathetic nervous system and parasympathetic nervous system. The sympathetic nervous system is what's commonly known as "fight or flight" and the parasympathetic nervous system is also know as "rest and digest." Think of it this way, if you are being chased by a bear, your sympathetic nervous system takes over so you either try to fight it, or you take flight and try to run away from it. If this happens, your body won't be sending blood flow and energy to the digestive tract to digest food.
In our daily lives, we aren't exposed to bears, but think about the cumulative of all stressful events that may occur and work, in traffic, at home, keeping you in the fight or flight response... thereby preventing the "rest and digest" from occuring fully.
Using stress reduction techniques, we can help manage stress and prevent the "fight or flight" from dominating, allowing the autonomic nervous system to be more balanced.
Time is of the essence. Planning out a solid 30+ minutes to use the toilet is one step you must take if you're constipated. With a busy lifestyle, which also ties into stress, you may not make bathroom time a priority and ignore or suppress the body's natural signals telling you it's time to go. Allowing the body enough time on the toilet will assist with peristalsis, the wavelike motion the intestines make as they contract and push food down.
Lastly, if the first 4 factors are all in order, I always consider and investigate a small intestine bacterial overgrowth (SIBO) causing the chronic constipation. SIBO is becoming increasingly more common. In fact, it's estimated that 40% of people suffering from irritable bowel syndrome (IBS) have it. To test for SIBO, a series of breath tests are collected in the privacy of your own home and sent into the lab to assess the amount of hydrogen and methane. An overgrowth of bacteria in the small intestine will feed on the food you ingest, and they release hydrogen as a byproduct. Then, some people have a separate overgrowth of an Archaea organism called m. smithii, which feeds on the hydrogen and produces methane. The high methane levels can cause chronic constipation. This is a very brief overview of SIBO, a complex condition, and more blog posts will be dedicated to it in the future.
Written by Dr. Mary Simon, ND
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Disclaimer: The information in this article is intended for educational use only; it is not intended to diagnose, treat, cure, or prevent any disease. Consult your physician or other qualified healthcare practitioner with questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.