Adam's Corner

Natural Medicine for Constipation

You don’t need to be medically constipated to be… just a little backed up. In fact, a lot of people are just fine, but can still use a little helping “going.” Do you miss some morning, feel a little bloated sometimes…? In no particular order, here are five things you can do about it.

 Water: drink enough water. Enough said.

 Fiber: Fiber is a generic term for indigestible starch. Since it’s not digested, it pretty much goes in one end, and comes out the other. On the way through, it acts like a brush (insoluble fiber) or a sponge (soluble fiber). And since it absorbs water, it takes up space, and creates bulk in the stool.

So, how does fiber work? Think of it this way: it’s easier to squeeze toothpaste out of the tube when the tube is full.

Beyond that, soluble fiber feeds the healthy probiotic gut bacteria.

I could go on and on about research studies, but I won’t. After all, nobody needs me to prove to them that fiber works. We all know it does.

Instead of adding fiber-rich foods to the diet, perhaps considering replacing existing foods with higher-fiber versions. Instead of pasta with sauce and cheese, try half pasta/half broccoli… with the same sauce and cheese. Or sub out regular pasta for a higher-fiber bean pasta like Banza™. Try carrots dipped in hummous vs. tortilla chips dipped in sour cream. Bean chips instead of tortilla chips. Roasted parsnips instead of baked potatoes. A piece of fruit instead of a bag of chips. Dark chocolate is surprisingly high in fiber… And of course Debra’s bread recipe this month. You get the picture.

If you’re looking to supplement, you can keep it simple with psyllium husks. Psyllium provides a good combination of soluble and insoluble fiber, to form bulk, absorb toxins, and scrub the gut clean. Or flax fiber, which also contains healthy fats and detoxifying lignans which help balance your hormones. Or acacia fiber, which is especially good at feeding your healthy gut bacteria. Or glucomannan, which absorbs so much water, it can expand and fill you up, so you eat less if you take it before meals.

A standard dose is… enough for it to work. Make sure to ramp up doses slowly, and to match your fiber with plenty of water.

Magnesium: magnesium is an abundant mineral in both the diet and the human body. Having said that, most of us aren’t getting enough for optimal health. First of all, magnesium-rich foods – whole grains, beans, nuts, seeds, sea vegetables, and mineral-rich water – are some of the first to go when we adopt modernized diets. There’s also the issue of magnesium vs. calcium: the more calcium we get, the more magnesium we need to counterbalance it. And our modern American diets tend to supply plenty of calcium.

So, magnesium supplements are good for most of us. Outside of regularity, magnesium is needed to maintain healthy bones and hearts, healthy blood pressure and kidney function. It may also help with muscle tension, especially night-time leg cramps. It may also help with emotional tension: anxiety, and PMS mood swings. If you’ve ever taken an Epsom salts bath (basically solubilized magnesium), you know how tension-relieving it can be.

And then there’s magnesium in the bowels. When we take magnesium orally, not all of it absorbs (because not all of anything absorbs). The magnesium that doesn’t absorb – the magnesium that stays in the gut – sets up a diffusion gradient, and draws more water into the stools. This leads to the #1 side effect of magnesium: loose stools, in people who don’t want them. It also leads to the #1 side benefit: looser stools, in people who need them.

If you’re trying to avoid loose stools, but still want the other benefits of magnesium, stick to a very well-absorbing form (glycinate, aspartate, or taurate), and take lower, regular doses. If, on the other hand, you want it to help loosen things up, take larger doses all at once, and/or a poorer-absorbing form (oxide). Magnesium citrate is a good form that does a little of both.

When it comes to constipation, magnesium can help anyone. But I especially like it for people who get a lot of calcium. Or who have other indicators of magnesium deficiency, especially night-time leg cramps. Or anyone with stools that seem especially dry and compacted. A standard dose is 400-500 mg in one dose at night. You can double that if you need to, and you can also add more in the morning.

 Triphala: Here in America, we’re constantly inventing and reinventing things, nowhere more so than in herbal medicine. We see new formulas, it seems, every day. A few may stand the test of time, and still be around in a decade or two.

And then there’s India, with a recorded herbal tradition extending back thousands of years, often using the same formulas, unchanged. So when we talk about a traditional formula from India (or China, or Japan), we’re talking about something that truly has stood the test of time. And no Indian formula is more trusted than or canonical as Triphala, or “three fruits.” Even today, it’s one of the most widely used medicines – not just herbal medicines, but medicines – on the planet.

Triphala is a reliable, uncomplicated stimulant to intestinal peristalsis. In other words, it helps you “go” without any of the cramping or habituation we risk with stronger medicines. Tens of millions of people take it every day.

In India, Triphala is considered a rasyana – one of the rare class of herbal medicines that promote health and vitality in almost anyone, at almost any life stage. It is not uncommon for people to use Triphala daily for decades.

A standard dose is 1-3 grams nightly. It may work overnight for some, or take 3-4 days for others.

Triphala is also a general antioxidant. Based on some preliminary research, it also appears to enhance immunity and liver function, and reduce the risk of eye diseases.

Probiotics: “probiotic” (noun or adjective) is a general term for the “friendly” bacteria that live on, and in us. Probiotics help our immune systems, help our livers, help our… everything.

And intestinal probiotics help us stay regular. They don’t work quickly. Generally, you take them for a few weeks, sometimes as long as three months, before they establish themselves. But once they do, you don’t need to keep taking them daily. After all, probiotics are living organisms: they can grow and multiply on their own.

I like to recommend probiotics in people who have spent a long time eating less-than-ideal diets. Or who developed constipation around the time they began a course of antibiotics. Or who also suffer from allergies (another thing probiotics can sometimes help). I especially like them in people who have poorly formed stools, or who suffer from IBD or IBS (inflammatory bowel disease or irritable bowel syndrome). And in children, even infants. Probiotics can be especially useful in colicky infants.

You can increase your probiotics consumption through the diet, by adding traditional fermented foods to the diet. There’s yogurt, of course, and all the other kinds of fermented dairy (Russian kefir,

 Indian lassi, Turkish ayran). There’s also sauerkraut and pickles. These days, sauerkraut and pickles are usually made by souring the vegetables in a vinegar brine. But you can also get traditional fermented versions, plus a world full of “ethnic sauerkrauts” like Korean kimchee, Hawaiian poi, and the Phillipine atchara.

And of course there are probiotic supplements. For daily use, I’d look for something that has a strength of at least 10 billion CFUs, and at least a few different species. For more of a corrective or therapeutic potency, or to kick-start your probiotic program, look for something with 25-70 billion CFUs. Or more. You don’t have to worry about overdosing on probiotics. You don’t absorb them. You don’t metabolize them. They don’t get into the bloodstream.

Probiotics are more of a nudge than a push, in my experience. You take them for a month or two and – nothing dramatic – you just suddenly wake up and things are just… easier. Some people may prefer something that’s a little more immediate, or emphatic.

Adam Stark

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