Constipation

Picture by Kat Smith

Quick jump index

What is constipation?

What causes constipation?

How to relieve constipation

SIBO and IBS

Common Symptoms of SIBO & IBS

Preventing Constipation

What is constipation?

Constipation can be defined as not passing a stool within 24 hours to a few days. Some say that not passing a proper stool (passing “rabbit droppings”) is classed as constipation. However, it affects you, it isn’t pleasant and can make you feel irritated, bloated and can actually be the primary cause of your Acid Reflux.

What causes Constipation?

There are a number of possibilities why someone is constipated. It’s not just a simple case of eating more fiber, although that will help. It may be that you are not drinking enough water, have a very poor diet, stress and many other factors. It helps to understand how waste moves through the body and those factors that can disrupt this movement which is known as the Migrating Motor Complex or MMC.

The Migrating Motor Complex – is a wave like motion of our gastrointestinal system in a regular cycle during fasting. Interestingly, this activity stops when you eat, so the habit of constant snacking will actually worsen your constipation and compound the amount of waste material sitting in your digestive tract. This movement helps keep bacteria in the large intestine – the colon. Impairing the MMC will typically result in Small Intestine Bacterial Overgrowth or SIBO, which, in turn, creates a build up of gasses in the intestine as waste is fermented by overgrowing bacteria. This “distention” can also have an impact on MMC effectively slowing down or even stopping peristalsis – the waves of movement which transport waste products. This then leads to a vicious cycle of continuous constipation, causing SIBO and impairment of the MMC.

How to relieve Constipation

If you are currently constipated and you want to know how to fix your constipation, there are a number of things you can try. Here is what worked for me:

  1. Lin Seeds or Flaxseeds – Natures laxative. Put 1 tablespoon of seeds in a glass and fill with water. Leave until the water soaks through and you can see that it has formed a jelly like substance in the water. This usually takes about 10-15 minutes. Drink the whole thing, seeds and all. Repeat this 3 times a day until you get a bowel movement. Ensure you are drinking of plenty of water in addition to this during the day. Once you have had a movement, you can reduce to once a day to help regularize your movements.
  2. Senna Tea – The senna plant leaves are a natural laxative. There are compounds in the plant which are irritating to the bowel so be careful not to overuse. However, when used irregularly to handle the most challenging constipation situations it can be helpful.
  3. Opti-Fiber – This is a Psyllium Husk in powder form which you can add to any food or drink. It has no taste or texture and is very easy to use.
  4. Glycerin Suppositories – If you are in a desperate situation and you need some relief then these can be very effective. Glycerin belongs to a class of drugs known as hyperosmotic laxatives and acts by drawing water from the surrounding area, in this case the bowel. Note of caution – you must only use once during a day and stop using once you have a bowel movement. Long term use can be damaging.

There are lots of other options available but by far the best option is prevention. Of course there can be other reasons why you are constipated outside of your diet such as medications and hormonal changes (especially for women), but there is a lot you can do to improve your rate of movement through the digestive tract.

SIBO & IBS

The cause of IBS in 40-80 percent of sufferers, depending on what research you read, can be attributed to Small Intestine Bacterial Overgrowth (SIBO) .

SIBO is a condition where bacteria that are normally found in the Large intestine are overgrown in the small intestine.  The Colon is where most of our microbiome is supposed to be naturally.  The small intestine really is reserved as an area of digestion.  So this is where you break down  your food, you release enzymes to help absorb nutrients of food, together with a small amount of bacteria to help with immune function and digestion.

When you have bacteria that have overgrown in the Small intestine, what happens is, they eat the food before you digest it.  So they eat the fibers in your food and ferment it and this creates a lot of gas. So SIBO isn’t necessarily a pathogenic bacteria or opportunistic bacteria, it’s normal gut bacteria growing in the wrong place.

If you go from your belly button to your right hip in the midway point, you will find the ileocecal valve. This valve empties the contents of the small intestine into the large intestine.  So it is constantly opening and closing allowing things to move through.  If it gets stuck or opens too often, this is one way these bacteria can swim up and get into the small intestine. Another way that bacteria can get into the small intestine is if they survive the journey through stomach acid and thus move into the small intestine intact.

SIBO is a symptom of a larger problem going on with our microbiome.  The use of anti microbial and antibiotic medications are also compounding the problem.  We know that in SIBO both the Peristaltic and MMC actvities are completely compromised. So the big question is WHY? Can it be reversed?

    Studies seem to show that the reason why these two mechanisms are switched off in SIBO,  is that there is a disruption between the communication with the GUT and the Brain.  When the brain is not communicating with the gut, the MMC and Peristaltic activity turn off. 

    Chronic anxiety and stress means that you are always in a state of sympathetic nervous system overdrive

    The opposite state is rest and digest – in a relaxed state using the parasympathetic system which aids in the process of digestion

    So what stops this Gut Brain connection?

    Studies show that inflammation in the region of the dorsal vagal complex, an area in the brain stem where LPS (lypopolysaccharides) or endotoxins from your gut can actually leak in and make its way up in the dorsal vagal complex, where it initiates an inflammatory response (read more here about Leaky Gut).  That response completely stops communication between the gut and brain where the peristaltic and MMC actvities are turned on.  Animal studies on this have been extremely clear, intestinal permeability and the leaking of endotoxins in particular from the microbiome into the neurological system, causes the blocking of the signal.

    What was interesting was that when they stimulated the brain with prokinetics, they were still unable to get the signals to transmit.  However, when adding in an anti-inflammatory molecule into the brain stem, the signals resumed, so the inflammatory process is blocking the signals from the Brain to the Gut.

    Low stomach acid can allow dysfunctional bacteria from the mouth to make it through the stomach into the small intestine and make themselves at home.  When you look at the studies of what kind of microbes are overgrowing, they are often the same microbes that are present in the mouth.  We are swallowing billions of bacteria each day that should be killed by the stomach acid. However, if the stomach acid is comprised through H-Pylori or overuse of anti-reflux medication such as antacids and proton pump inhibitors this allows microbes to survive passing into the small intestine and start overgrowing.  

    SIBO are a part of a group of bacteria call proteobacteria and all are Gram-Negative.  In their cell wall they have a substance called LPS (lypopolysaccharides).  LPS is one of the most inflammatory substances known to the human body.  As we now understand with Leaky Gut, it is these endotoxins that leak through the gut wall causing systemic inflammation.

    Serotonin is made by an amino acid called tryptophan, but when you’re inflamed, it’s shunting the tryptophan to another pathway called quinolinic acid.  This acid is extremely irritating to the brain and very often when people have SIBO, they also have anxiety or depression.

    Common Symptoms – SIBO

    Bloating can be painful, Constipation, Diahorrea, Looser stools, IBS, acid reflux (gerds) indegestion.

    Stomach makes stomach acid which is a natural anti-bacterial as well as other functions such as digestion of proteins but it controls bacteria.  Bile from the liver is stored in the gall bladder and is caustic to bacteria. Pancreatic Enzymes makes up the 3rd of the juices and all three act together in killing the bacteria passed down from the mouth.

    Preventing constipation

    Water – by far the most under rated action that can be taken, drink more water. Water is used by the body to help it get rid of waste. You may find that increasing your water intake may resolve your issue without doing anything else.

    Fiber – without question, most of the modern western diet is devoid of natural fiber. So increase your fruit and vegetable intake to bring about the natural movement of waste through your body.

    Leafy Greens – include as many leafy greens as you can in your daily meals. Not only are they high in fiber, they are a great source of magnesium which is an electrolyte that has the natural ability to safely help draw in water from your gut and soften the stool (poop).


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