Constipation, when things just aren’t moving the way you want them to be. The feeling of fullness or not being able to properly evacuate your stools is just very uncomfortable and often very painful. Luckily, there’s often something you can do about it! Read on to discover 12 home remedies for constipation
Constipation is quite common, and women seem to suffer from it twice as often as men do. About 10-30% of the world population has constipation at least once in their lifetime. So you’re definitely not the only one.
Types of Constipation
As mentioned in my post about Irritable Bowel Syndrome (IBS) there are different types of stool consistency according to the Bristol Stool Chart. Type 1 and 2 are the most common in constipation. But types 3 and 4 are the stools you want to have!
To set the diagnosis of functional constipation, often the ROME IV criteria are used. If there is no physical explanation for constipation, but you meet the ROME IV criteria, your diagnosis will be functional constipation.
In the case of functional constipation, there is no specific reason why you’re constipated. But there often is plenty you can do with nutrition and lifestyle to improve it!
Diagnostic criteria for functional constipation in Rome IV
|To officially be diagnosed with constipation, your symptoms must include 2 or more of the following for the last 3 months, and have started at least 6 months prior to diagnosis:|
|Straining during more than 25% of defecations|
|Lumpy or hard stools (Bristol Stool Chart 1-2) more than 25% of defecations|
|The sensation of incomplete evacuation of more than 25% of defecations|
|A sensation of anorectal obstruction/blockage more than 25% of defecations|
|Manual maneuvers to facilitate more than 25% of defecations (e.g., digital evacuation, support of the pelvic floor)|
|Fewer than 3 spontaneous bowel movements per week|
|Loose stools are rarely present without the use of laxatives|
|Insufficient criteria for irritable bowel syndrome|
So if you look at the criteria, constipation is not only dependent on ‘not being able to go’, also straining and the feeling of incomplete stools are symptoms that can lead to the diagnosis of functional constipation.
Constipation could be caused because too many fluids are being extracted from your stools, or because of too little movement of the intestines. Sometimes you can actually see the difference between the two. Too dry stools are easily recognizable as rock-shaped or tiny balls.
With too little bowel movement the stools might not come as often but they can have a good consistency as Bristol Stool type 4 or can also be very dry because they’ve been in the bowels so long.
Constipation can also be a symptom of IBS. If you experience constipation and have IBS, you probably have the IBS-C type. In that case, I advise you to read my article on IBS first to see if your solution is there.
Do you want to work in a targeted and structured way on the improvement of your constipation symptoms? Schedule a free symptom assessment, and we’ll discuss how I can help.
Symptoms of constipation
Most of the symptoms that are a direct result of funcitonal constipation are listed in the ROME IV criteria, but you can start experiencing other symptoms. For example as a result of pressure in the intestines.
|Dry, hard stools|
|The feeling of incomplete stools or constant need to go|
|Stomach aches or cramps|
|Bloating and gassiness|
|Losing stools or overflow diarrhea|
|Loss of appetite with the sensation of being full|
Constipation Red Flags
The symptoms mentioned above are quite normal (but very inconvenient) symptoms of constipation.
There are also some red flags to be aware of. If you start noticing any of the red flags, please consult your GP. There could be more going on than just constipation.
|The following symptoms are interpreted as red flags:|
|(Dried) blood in your stools|
|Fresh blood on your stools, but usually this is a hemorrhoid|
|Consistent constipation, and having no stools for over 5 days|
|Unexplained weight loss, more than 5% of your body weight in 6 months|
|Sudden (and persistent) change in stool consistency|
Constipation Home Remedies
Luckily, there’s a lot you can try to relieve yourself of functional constipation. Of course, there are medical laxatives you can use. And if nothing else works for you, that could certainly be the way to go.
But I do have the opinion that it’s important to look critically at your lifestyle and food choices and check if there’s anything that could be causing your symptoms. Why start using medications, if might be able to solve it the natural way?
Listed below you find evidence-based food- and lifestyle interventions that can help you solve your constipation.
Of course, you can try and figure out your triggers yourself, but with some of them, it can become quite hard to keep a nutritionally complete diet. So I would always advise seeking help from a specialized dietitian. The dietitian can help you find your triggers and keep a healthy food pattern that fits your needs. Click here to schedule a free symptom assessment with the Positive Gut dietitian.
Sufficient Fiber and Fluid Intake
Fiber is important for your gut health, as mentioned in my article ‘Are Your Gut Bacteria Keeping You Fat?’. They provide a great source of nutrition for your gut bacteria, they form bulk and hold on to fluids in your intestines. If you drink enough water (about 1,5 – 2 liters a day) the fiber can stay moist and will move smoothly through your colon. This can help you relieve your constipation.
The 3 largest groups of fiber you can find in foods are fermentable fiber, non-fermentable fiber, and resistant starch. For healthy stools, it is important to eat all 3 types of fiber.
- Fermentable fiber comes from fruits, vegetables and legumes. This type of fiber is a nutrition source for your gut bacteria, which produce nutrients for you such as short-chain fatty acids. The short-chain fatty acids can also stimulate the intestinal wall and thus keep the intestine moving.
- Non-fermentable fiber mainly comes from grain products. This type of fiber increases stool volume and can retain moisture.
- Resistant starch is a type of fiber that occurs naturally in products but also forms when you cool down cooked starch products like potato, rice, and pasta. To create resistant starch it is important to cool the product for at least 24 hours.
If you’re looking for more fiber in your diet, plant-based is the way to go. Basically, all plant-based foods contain a lot of fiber. Examples are:
- Vegetables; raw, baked or boiled
- Legumes, like white and brown beans, lentils and chickpeas
- Dried fruits like plums, raisins, figs, dates, and apricots
- Whole grain products like rye, muesli, whole grain bread, crackers or knäckebröd, muesli
- (Cooled down) potatoes, brown rice, wholemeal macaroni, and spaghetti
- Nuts, peanuts, sesame seeds, linseed, pumpkin seeds, sunflower seeds, chia seed
Studies have shown that flaxseed is an effective means to reduce constipation symptoms. Daily use of 10-15 grams of ground flaxseed is the dose that is proven to be effective. Much more than 15 grams is not necessary, and less than 10 grams is probably not very effective at all.
However, do not use flaxseed daily for long periods. It contains cyanogens, which can be converted in the body by the toxic substance cyanide. Usage up to 45 grams per day is safe, as long as you do not do this for a long time. So take a flaxseed break every now and then!
The ground flaxseed binds water in the intestine, to help moisten the stool and let it pass more easily. So it’s important to also keep drinking enough fluids with flaxseed use.
The flaxseeds can be combined with basically everything. You could mix it into your yogurt, sprinkle it over your salad, put it on your sandwich, or even bake cookies or crackers (recipe!) from it.
Dried plums have proven to be effective to increase the frequency and softness of the stool. Prunes contain sorbitol and a natural laxative, which helps keep stool soft. Daily use of 50 grams at breakfast and 50 grams at dinner is the effective dose used in the studies.
Psyllium fiber is also proven to be effective with constipation. In a comparative study with dried plums, the plums seemed to be more effective in the treatment of constipation. But everyone is different and it’s wise to trial-and-error what works for you!
The effective dose of psyllium fiber is 11g of psyllium fiber with 200-250 ml of water twice a day (breakfast and dinner). Add the water to the psyllium, and mix. Drink it fast, since the psyllium starts binding the water and the liquid will thicken a little.
The use of 2 green kiwi’s a day has been shown to reduce the transit time of the stool in the colon. A faster transit time of the stool leads to fewer constipation symptoms.
Probiotics are healthy bacteria you can add to your nutrition to aid your own healthy bacteria.
The bacteria in your gut influence your health in multiple ways (you can read more about that in my article about probiotics). But in terms of constipation, they can help with the movement of your gut (intestinal motility). The composition and the number of intestinal bacteria that you have are of great influence on your intestinal motility. A delayed movement in the intestine is linked to a reduced diversity of intestinal bacteria. A slow gut increases the risk of blockage and keeps your waste products in your body longer.
So adding healthy bacteria could boost your own gut bacteria, and help with the movement of your intestine. In my article about probiotics you can read how to choose a probiotic that is right for you.
Fructan Elimination / NCGS
Fructans are one of the FODMAP groups (click the link for more information on the FODMAP diet). Most FODMAP groups actually attract fluids to your gut and thus stimulate diarrhea. Fructans, on the other hand, can reduce the motility of your gut and this helps create constipation because your stool just gets stuck or moves really slowly. If you want to try and see whether the fructans cause your symptoms, try a 2-3 week elimination of the fructans. You should notice a difference by then if fructans are your triggers.
If you feel like you are reacting to gluten (click the link for my article), but don’t have celiac disease, there are studies that show that a low-fructan diet plan actually helps relieve the symptoms better than a gluten-free diet. So the fructan elimination would actually be the most effective in that case.
Foods containing fructans are: wheat, rye, garlic, onion, mushrooms, ripe bananas, dried plums, and this list can go on and on. To get yourself a full list of fructan-containing foods, check out the Monash University FODMAP app. You can set a filter for oligo’s to see the fructan-containing foods. Be aware of the nutritional value of your diet once you start eliminating foods though! Seek help from a dietitian if you have any questions. Or schedule a free symptom assessment with the Positive Gut dietitian.
Lactose intolerance usually shows itself with diarrhea symptoms. But in less frequent cases lactose intolerance actually leads to constipation. If you consume a lot of dairy products, it could be worth trying a 2-week elimination of lactose-containing dairy products. Do make sure to properly replace the lactose-containing products to keep your diet nutritionally whole. If you want my full article on lactose intolerance, you can read that here.
Magnesium is a mineral that can help moisten the stools. If it’s chemically bound in a certain way, your body can’t absorb it and it will attract fluids.
It is often prescribed by doctors in the form of magnesium hydroxide, but it can also be bought in supplement form in the store. If you do decide on buying it (after discussing this with your doctor or dietitian), make sure to buy a form you can’t absorb (anorganic) like magnesium oxide, magnesium chloride, magnesium hydroxide, and magnesium sulfate. There is not really a recommended dose for the magnesium, but if you take it do make sure to stay within the RDA of 300-400 mg. Side effects of magnesium supplements include cramps and bloating.
Bowel Retraining for constipation
We all know kids need to learn how to use the toilet. But not many people know that adults could have to relearn how to use the toilet! If you have gut issues, mainly constipation and bloating, retraining your bowel could improve your symptoms.
Nowadays, we often go about with our lives and expect our bodies to adjust to our rhythm. Whenever we feel the urge to use the toilet, but it’s not a convenient time, we ‘tell’ our body to postpone it. Just wait till I have time for you, body!
‘Not a convenient time’ could be at work, at friends, when we’re getting ready to leave or it could even go as far as when we’re watching a movie or TV series!
Unfortunately, the more we tell our bodies we don’t have time, the fewer signs it will give you. If you postpone your poop for one time, it’s not a big deal. But when we’ve done it several times, our body will stop telling us it needs to go!
This way, we can lose touch with our bodily signs and miss out on our normal bowel rhythm. So instead of telling our body we don’t have time for it, we should make time whenever our body is trying to tell us something.
To make this a little more convenient, for example, to have your body give you signs at moments that are good for you. You can train your gut to have movements at a set time.
Your body works on a circadian rhythm, so if you found the right time for your bowel movements, chances are your body will give you a sign again at the same time tomorrow! How convenient is that?!
Steps of the Bowel Retraining
Choose a time of day that works for you. Pick a time when you normally have a little time to spare and are not in a hurry. For example in the morning before work (if you set your alarm 10-15 minutes earlier than usual), in your lunch break, or after dinner. Your bowel has a natural movement after every meal (to make space for the new food that comes in!), so it’s usually most effective to choose a moment around mealtime.
For the coming 2 weeks, use the chosen time as your ‘toilet time’. Go and sit on the toilet for 10-15 minutes. Just sit there, relax, bring something to read, and don’t strain! If there are stools that are willing to come out, you’ll feel it and you can give it a little push if needed.
Don’t stay on the toilet for much longer than 15 minutes. If the stools didn’t come out after 15 minutes, they probably won’t.
If after 15 minutes nothing happened, just get off the toilet get on with your day, and try again tomorrow. However, if you get the urge to go to the toilet later on the day, please try not to dismiss that! Find yourself a toilet and listen to the signs of your body!
And if you did have a bowel movement and a poop on your ‘toilet time’, good for you!
Repeat the steps mentioned above for at least 2 weeks. Most people will notice their body starting to give signs to go to the toilet at the set time and will have a regular bowel movement every day (or every other day). Ideally, you would keep the set time to try and go to the toilet every day! And hopefully have your regular poop, to prevent constipation.
If you don’t get a regular bowel movement after 2 weeks, the bowel retraining wasn’t the solution for you, unfortunately. Try one of the other functional constipation home remedies in this article or talk to your doctor or dietitian.
Tips for Bowel Retraining
Apart from the steps described above, there are some additional steps you can take to improve the effectiveness of bowel retraining.
- Tip 1. Make sure you have a good posture. When sitting on the toilet, ideally your knees are above your hips and your feet are apart wider than your hips. Nowadays, there are a lot of high toilets, which let you sit at a 90-degree angle like you would on a chair. This way, the muscle that is keeping your anus closed is tightened, and stools are harder to pass. When your knees are above hip-height, the muscle is relaxed and stools are easier to pass. If your toilet is too high to get your knees above hip level, it is an option to buy a little step to put your feet on. This way you elevate your knees. Look for ‘toilet assistance step’. These steps are available in different heights, so make sure to pick a height that would fit your body. When a toilet step is too high, it gets uncomfortable and does not help you poop!
- Tip 2. Don’t get stressed when it doesn’t work right away! Give it some time, your gut usually needs 2 weeks to adjust. Whether it’s a new food pattern or new poop pattern.
- Tip 3. Bring a book or magazine with you, or put some music on. This can help you relax.
- Tip 4. Take your pants and underpants off. This way it’s easier to put your feet further apart. When your knees are above your hips, it’s also important to have your feet a little apart, preferably wider than your hips. This helps relax your anal muscle.
- Tip 5. It can help to ‘wiggle’ your knees a little to help relax your anal muscle. Slowly widen your knees and bring them back together. Or even slowly rock back and forward on the toilet seat a little. And, even if it might look silly (there’s no one there with you anyway), it can even help to open and close your mouth while you move your knees. Trust me.
Physical Activity and Yoga
If you move, your gut moves with you. So especially if you have a sedentary life (work behind a desk and little exercise in your free time) some extra physical activity can help reduce your constipation.
Physical activity will increase your gut motility and thus reduce the time your stools are in your colon.
Yoga will help reduce constipation since the twists in yoga actually massage your internal organs and your intestines. The massaging of your intestine relaxes your muscles and helps to move the stool through the intestine. For inspiration on yoga poses to help with constipation, check out this blog I wrote about that.
Stress Relief and Meditation
Stress can reduce the activity of the muscles in the intestines, and thus increase transit time (stimulating constipation). So if you can learn ways to relieve your stress, your functional constipation could improve!
Stress relief could be anything that helps you get relaxed. Just see whatever feels good to you. It could be anything from a walk in the park, reading your favorite magazine, taking a shower, or practicing yoga. Try to take at least 15 minutes each day to yourself. You can only flourish if you take care of yourself!
Meditation can help you relax. Since meditation helps you focus on one thing, your breathing. Breath is your source of life, and deep breathing (into your belly) helps you and your intestines relax.
You could try any type of meditation. Use an app or guided meditation if you’ve never done it before. Just 10 minutes a day can make a difference!
What has worked for you to reduce your functional constipation? Have you tried anything else that has helped you? Let me know!