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In this episode, Dr. Lisa and Dr. Toni talk about the causes and therapies for constipation in you and your kids. They discuss what is expected or ideal with respect to your bowel movements, the causes of constipation, and some tests and treatments to consider if you or your kids are experiencing constipation.
What is constipation?
Generally considered when you have less than 3 bowel movements a week, or discomfort, even you have a daily bowel movement.
As naturopathic doctors, we consider at least 1 bowel movement daily with a Type 4 rating on the Bristol stool chart to be ideal. You want your stool to sink without mucus, blood or undigested food (with the exception of corn).
What are some causes of constipation?
- Not enough water
- Not enough fibre from veggies and fruit
- Lack of movement and proper circulation
- Stress, especially in the case of irritable bowel syndrome (IBS)
- Travel or another break in your routine
- High intake of constipating foods: rice, toast, cooked carrots,unripe bananas
- Hypothyroidism or sluggish thyroid function – see Episode 42 for more info
- Reduced stomach acid, digestive enzyme and bile flow, often caused by stress and stimulation of sympathetic nervous system response
- Gut bacterial imbalance
- Certain medications
- Allergy medication
- NSAIDs like ibuprofen and opioid pain killers like Tylenol 3
- Nerve damage
- Hormone imbalance or PMS – constipation then possibly loose stools when your period comes is a common pattern in Traditional Chinese Medicine called Liver Overacting on Spleen
Harmful effects of constipation can include:
- Discomfort, bloating, just feeling crappy
- Reabsorbing toxins and hormones in your circulation
- Megacolon or the abnormal dilation of the colon
- Encopresis in kids, which is the uncontrollable leakage of stool
Some medical tests to consider:
- HCl challenge in adults
- Thyroid blood test – see Episode 42 for more info
- Stool testing through specialized labs, like Comprehensive Stool Analysis or GI-MAP
- Small Intestinal Bowel Overgrowth (SIBO) breath test
Common treatments for constipation include:
Restoralax or Miralax, also known as Polyethylene Glycol (PEG) 3350
- Adverse effects can include abdominal cramps, diarrhea, bloating, gas, nausea
- Potential link to development of tremors, tics and obsessive compulsive behaviour
- Contamination with small amounts of ethylene glycol and diethylene glycol
- Not meant to be used daily and over the long term
- The safety and efficacy of Restoralax for use in children under 18 years of age have not been established
Laxative herbs like senna
- Side effects can include developing a dependence causing further constipation and other digestive disturbance, electrolyte imbalance, darkening of your intestinal tract called melanosis coli, finger clubbing, kidney inflammation
What else can you do about constipation?
You can try one or more of the following:
- Increase fluid, especially pure water
- 8 oz (250ml) of water multiplied by age (number of years) up to 2 litres daily
- Increase fibre:
- Aim for 19g daily for kids 1-3 years, 25g daily for kids 4-6 years, at least 26 g and up to 31g daily for kids 9-13 years and up to 38g daily for kids over 14 years
- Beans or legumes – ½ cup = 6 g fibre
- Broccoli and other cooked veggies – ½ cup = 4 g fibre
- Apples, pears, berries – ½ cup
- Prunes or dates – see Episode 45 for more info on sugar balance
- Ground flaxseed
- Chia seed pudding
- Support stomach acid and digestive enzyme production
- Bitter foods and herbs like arugula, dandelion root/greens, artichoke, gentian
- Start your kids young with small amounts!
- Support gut bacteria with fermented foods or probiotic supplement and prebiotic fibre
- Magnesium citrate and vitamin C provides osmotic laxative effect
- Start with small amount and use only to bowel tolerance
- Support proper anatomical positioning with something like Squatty Potty
- Slippery elm found in powder, capsules, lozenges and teas, taken away from medications and other supplements
- Other herbs and homeopathy for relaxation
- Abdominal massage
- Clockwise on belly
- I Love You massage
- Can use castor oil for extra relief from discomfort
- Pelvic floor physiotherapy for kids with constipation
Dr. Aviva Romm’s fruit balls.
Dr. Toni’s breakfast bar recipe is on the show notes for Episode 32 on hot flashes.
This Week’s Mama Must Have:
Dr. Lisa is a big fan of her son’s Lunii storyteller audiobook device for screen-free entertainment.
Dr. Toni loves to have a light, easy read before bed and just read her first Bridgerton book! She highly recommends The Girl with The Make Believe Husband by Julia Quinn.
Dr. Toni’s next HypnoBirthing info session for expecting parents looking for increased calm, confidence and comfort during labour and birth is March 29th. Join her at https://www.hypnobirthingcalgary.com/register
Dr. Lisa’s Wild Mama free virtual 30-minute info session is happening on March 17th – SIGN UP HERE. Program starts on March 24th!
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Stay safe and healthy everyone!