How to Holistically Heal Constipation

For many patients, by the time they come to see me, they have already undergone a colonoscopy or had an abdominal X-ray. These diagnostic procedures are commonly employed to investigate the underlying causes of gastrointestinal symptoms, such as prolonged constipation, abdominal pain, or irregular bowel movements. While we achieve considerable success in addressing the causes and restoring regularity for about 90% of our patients, the remaining 10% present unresolved challenges. This discrepancy often prompts deep reflection on the nature of healing.

Healing, as I have often shared, is not a singular event but a continuous journey of unfolding and understanding the various elements that contribute to stress, symptoms, and dis-ease. It involves an interconnected approach that embraces the mind, body, spirit, and soul. The solutions are not always immediately apparent nor readily addressable.

While we conduct comprehensive stool tests to evaluate the gut microbiome—identifying what should and shouldn't be present, and whether one is hosting pathogens such as parasites, worms, or significant bacterial overgrowth—we also focus on the most obvious imbalance: stress. Understanding the gut-brain axis and toning the vagus nerve are as crucial as advocating for a diet rich in diverse macronutrients, encouraging thorough mastication of food to liquid form, and supporting the resetting of digestive enzymes, acids, and bile with herbal bitters and supplements. Additionally, we address hormonal imbalances and recommend patients undertake profound work on their emotional and psychological states.

While awaiting results, we prioritise alleviating symptoms naturally, avoiding harsh remedies like senna, which is frequently prescribed over the counter. Senna can create dependencies akin to other laxatives, which we aim to avoid. Instead, our approach is to support regularity through safer, more holistic methods that respect the body’s intricate systems.

Before we delve deeper, it's important to first understand constipation and gain a clear insight into the digestive process, particularly how the large intestine, or colon, functions.

After food is chewed and swallowed, it travels down the oesophagus to the stomach, where it is further broken down by stomach acids. From there, the partially digested food moves to the small intestine, where the majority of nutrient absorption occurs. Enzymes and bile break down the food into smaller molecules, allowing nutrients to be absorbed into the bloodstream.

Once the nutrient absorption is completed in the small intestine, the remaining waste products and indigestible parts of food move into the large intestine. The primary role of the large intestine (along with hosting the gut microbiome) is to absorb water and salts from these remaining materials. As the waste moves slowly through the colon, water is continually absorbed, which helps form solid stool.

Constipation occurs when the colon absorbs too much water from the waste, which can happen if the waste moves through the colon too slowly. This slow movement gives the colon more time to absorb water from the waste, causing the stools to become hard and dry. Factors that can slow down the movement of waste through the colon were outlined in my previous article here but let’s go a little deeper…

Constipation can be categorised into several types based on its causes and characteristics. Understanding these types can help in diagnosing and treating the condition more effectively. The main types are functional constipation, chronic idiopathic constipation, and secondary constipation.

1. Functional constipation, often referred to as primary constipation, is the most common type. It does not have an identifiable organic, systemic, or anatomical cause. This type of constipation is diagnosed based on symptoms that persist for at least three months without a clear medical cause. These criteria focus on symptoms like straining, lumpy or hard stools, a sensation of incomplete evacuation, and fewer than three bowel movements per week. Functional constipation often results from lifestyle factors or bowel habits, such as:

• A low-fibre diet can reduce stool bulk and slow its passage through the colon.

• Not eating enough healthy fats as found in bone broths & soups, cultured butter, avocado, olive oil, almonds, macadamias, pecans, grass fed meats and sustainable fish & seafood.

• Not drinking enough fluids can lead to drier, harder stools that are difficult to pass.

• Reduced physical activity can decrease the motility of the digestive system, leading to slower movement of stools.

• Regularly ignoring the urge to go to the bathroom can lead to harder stools and more difficulty in passing them later.

2. Chronic idiopathic constipation is a diagnosis given when constipation persists for an extended period, typically six months or more, without an identifiable cause after thorough medical examination. This form of constipation affects a significant number of people and can be quite challenging to manage because the underlying reasons remain unknown. The condition is long-standing, often affecting individuals for years. Extensive testing does not reveal any specific underlying disorders that could explain the constipation.

3. Secondary constipation is the least common type and occurs as a direct consequence of other identifiable conditions. This form of constipation can be attributed to a variety of factors:

   • Certain medications, such as opiates, anticholinergics, and some antihypertensives, can significantly slow down bowel motility.

   • Medical conditions like hypothyroidism, diabetes, and neurological disorders, including Parkinson’s disease and multiple sclerosis, are also known to contribute to constipation.

   • Hormonal changes, such as premenstrual constipation followed by diarrhoea, are common in younger women.

   • Issues like eating disorders or very low-calorie diets can disrupt normal bowel function, as can food intolerances.

   • Physical obstructions due to conditions such as colorectal cancer, strictures, or anal fissures can directly block or impede stool movement.

   • Pelvic floor problems.

   • Post-abdominal or gynaecological surgery.

   • Periods of illness or surgery that result in changes to routine, diet, or mobility can impact bowel function.

   • Irritable bowel syndrome (IBS) is another factor that can lead to constipation, typically characterised by a pattern of chronic symptoms that fluctuate over time.

   • Emotional or psychological causes as described by Louise Hay suggest that constipation is associated with several deeply held emotional states. According to Hay, constipation reflects "incomplete releasing," indicating an inability to let go of old emotions or experiences, and "holding on to the garbage of the past," which metaphorically describes the accumulation of negative thoughts or feelings. Additionally, she links constipation to "guilt over the past," where individuals may physically tighten up as a subconscious form of self-punishment, and "stinginess," suggesting a reluctance to give or let go materially, mirroring an emotional withholding. Hay advocates for addressing these psychological and emotional blocks through therapy, counselling, or self-reflection, as part of a holistic approach to treating constipation, alongside other interventions like dietary changes and physical exercise, to nurture a healthier mind-body connection.

Understanding these subtypes is crucial for developing appropriate treatment plans. Each type may require different approaches, ranging from lifestyle modifications and dietary adjustments to specific medical interventions or management of underlying health conditions. If constipation is persistent and impacting quality of life, it is important to seek professional medical advice from a holistic health practitioner to explore the possible types and appropriate treatments.

Gentle Herbs For Alleviating Constipation

Addressing constipation with gentle herbs is a wise and effective approach, especially within a holistic health context where the goal is to support the body's natural processes without causing harsh side effects or dependency. Here are some gentle herbs that can be used to alleviate constipation: Please ensure you seek expert advice from your holistic naturopath or herbalist to dispense these in the right form—liquid, tablets, capsules, infusions—and the correct dose for you and your condition, along with assessing any potential interactions with other supplements or medications. 

• Gentle laxative herbs promote defecation . Use them along with a carminative or antispasmodic herb to ease the pain associated with using laxatives. Dandelion root, licorice root, cascara, and yellow dock are among my favourites. Our Hygieia I Tisane  by Apotheca is the blend we created that supports healthy bowel motions.

• Carminative or antispasmodic herbs helps ease pain, spasm, wind, and bloating. My favourites include aniseed, chamomile, ginger, fennel, peppermint, and rosemary. Our Meadow Tisane by Apotheca is the blend we created that soothes the gut. Discover more here long with our Harmonia Tisane

• Demulcent herbs soften and soothe irritated bowels and dry stools. Licorice root and marshmallow root are among my favourites. Our Althea Tisane  by Apotheca is the blend we created that soothes an irritated and inflamed gut.

• Adrenal and nervous system regulating herbs can significantly impact mood and mind, which in turn can greatly affect bowel transit times. My favourites include chamomile, hops, magnolia, lemon balm, saffron, licorice root, skullcap, lavender, and withania. These herbs help modulate stress responses and promote a calmer, more balanced nervous system, contributing to improved digestive function.

• Digestive bitters stimulate the production of digestive juices, ranging from saliva to stomach juices, bile, and pancreatic enzymes. My favourites include angelica, barberry, chamomile, cascara, yellow dock, dandelion root, gentian, and globe artichoke. These herbs can enhance digestion and promote a healthy gastrointestinal environment by encouraging the natural secretion of digestive fluids. 

Good Toilet Habits

Developing good toilet habits is essential for maintaining healthy bowel movements and overall digestive health. Here are some practices that can promote regularity and ease in the elimination process:

• Using a squatting stool during defecation is a practice that aligns the body in a way that mimics the natural squatting position, which humans used for thousands of years before the invention of modern toilets. This position is thought to be beneficial for several reasons related to the anatomy and physiology of digestion and elimination. The main advantage of using a squatting stool is that it changes the angle of the rectum during bowel movements. When sitting on a standard toilet, the angle between the rectum and the anus is not optimal—there is a slight bend, like a kink in a hose, which can create resistance and make elimination more difficult and incomplete. In contrast, squatting straightens this angle, providing a clear and direct path for stool to pass. This alignment reduces the need to strain and can help facilitate a smoother and more complete bowel movement.

• Go when the urge calls you to go.  It's crucial to go to the bathroom when you feel the urge. Delaying this response can lead to desensitisation over time, where the body's natural signals are ignored due to busy morning or day schedules or reluctance to use public or workplace toilets. This can cause the stool to become harder and more difficult to pass later. Failing to heed the body's signals to defecate is analogous to using your own bowels as a storage container, which is far from their intended physiological function. It's akin to allowing waste to accumulate unnecessarily, which can compromise not just comfort but also overall health. Thus, the adage "better out than in" is particularly apt when it comes to bowel health—it emphasises the importance of listening to and respecting your body's natural urges to maintain a healthy, functional digestive system. Creating time in our schedules to slow down and tune in can help us recognise these important bodily signals. Mindfulness and presence can be enhanced through practices like meditation or simply pausing regularly to check in with oneself.

• Regular physical activities , such as yoga, walking, or specific exercises, can improve digestion and aid in the regularity of bowel movements. Yoga, for instance, includes poses that can help stimulate the digestive system and enhance bowel movement. Consult with an exercise physiologist or a yoga instructor to help you work on specific movements designed for bowel clearance. These professionals can tailor exercises and yoga poses that specifically aid in enhancing digestive efficiency and stimulating bowel movements. Yoga is particularly well-suited for aiding digestion because it combines physical movement with deep breathing, which can help relax the digestive tract and stimulate bowel movements. A yoga instructor can guide you through specific poses known to help with digestion, such as:

• Apanasana (Knee to Chest Pose): Helps compress the abdominal organs and stimulate the bowels.

• Pawanmuktasana (Wind-Relieving Pose): Specifically targets gas and bloating, promoting the release of trapped gases and improving digestion.

• Twisting poses: Such as Ardha Matsyendrasana (Half Lord of the Fishes Pose), which can massage the abdominal organs and encourage the movement of stool through the system.

Strengthening the pelvic floor muscles is crucial, especially for postpartum women or as we age. Pelvic floor exercises, often known as Kegel exercises, are designed to strengthen the pelvic floor muscles, which support the bladder, bowel, and uterus. Strengthening these muscles can help improve bladder and bowel control and reduce the risk of prolapse. Here’s how to properly perform pelvic floor exercises:

Identify the Correct Pelvic Floor Muscles

To identify your pelvic floor muscles, try to stop urination mid-flow. The muscles you use to do this are your pelvic floor muscles. This method should only be used to identify the muscles and not as a regular exercise routine.

Another method is to try to tighten the muscles that would prevent passing gas.

Perfect the Technique:

• Once you’ve identified your pelvic floor muscles, empty your bladder.

• Lie down, sit, or stand in a comfortable position. You can perform these exercises in any of these positions, though starting out lying down may be easier.

• Tighten your pelvic floor muscles, hold the contraction for three to five seconds, and then relax for three to five seconds. It’s important not to contract the abdominal, thigh, or buttocks muscles while performing the exercise.

• As you get more comfortable with the exercises, you can gradually increase the time you hold the contraction for up to 10 seconds, followed by a 10-second relaxation.

Maintain Focus:

• For best results, focus on tightening only your pelvic floor muscles. Be sure to relax your other muscles — your abdomen, thighs, and buttocks.

• Breathe freely during the exercises to keep from holding your breath.

Repeat Regularly:

• Aim for at least three sets of 10 repetitions per day.

• Consistency is key. Try to make Kegel exercises a regular part of your daily routine.

Personalised Remedies – Prescribed by Our Naturopaths

If you’re experiencing persistent constipation, bloating, sluggish digestion, or discomfort in your elimination pathways, our bespoke herbal tonics may offer the restorative support you need. Carefully formulated by our naturopaths, these personalised remedies blend gentle bitters, carminatives, anti-inflammatory, and liver-supportive herbs to stimulate digestive secretions, promote healthy bowel movements, and restore gut motility. Whether your symptoms are rooted in poor diet, stress, microbiome imbalance, medication use, or chronic digestive stagnation, a tailored herbal prescription can help guide your system back to regularity, comfort, and ease.

To receive a remedy specifically crafted for your unique needs—and to uncover and address the deeper causes and contributing factors of constipation—we invite you to book a naturopathic consultation. Our holistic approach looks beyond the symptom to support your body’s natural healing processes, using traditional and evidence-based therapies aligned with your constitution and lifestyle.

Book your consultation here