Although researchers are just beginning to understand the connection between our gut and full body health, we know definitively that one of the most important aspects of digestive health is bowel regularity. Our stools are a vital sign that indicates balance (or imbalance) within our bodies. The frequency is important, but the colour, texture, smell and buoyancy are all good indicators from within. I know, I know – you don’t want to look… But you really should! Ideally, everybody needs to have regular bowel movements between 1 and 3 times per day, and the stool should be well formed and smooth, with a total length of about 12 inches. Anything less than this is diagnosed clinically as constipation – and chronic constipation is one of the most common digestive complaints, especially in aging populations. Chronic constipation can lead to build up of toxins in the body, sluggish liver function, abdominal discomfort, cramping, gas, nausea, poor appetite, and brain fog and fatigue.
Addressing the root cause of constipation is key – stimulant laxatives (think: senna leaf or cascara sagrada) may work short term, but are habit forming and can cause damage to the muscular function of the colon. Proper bowel function relies on a number of variables, including adequate hydration, physical activity, nutrient intake, gut bacteria, and stress management. Starting with a foundation of drinking 2-3 litres (that’s 8-12 cups) of water, incorporating at least 30 minutes of daily movement, and ensuring the diet is balanced with a variety of vegetables, seasonal fruits, fermented foods, and other fibrous foods is a non-negotiable starting point.
Next, forming a regular morning routine can help establish regular elimination – even setting aside 15 minutes for yourself each morning can greatly lower stress, which ultimately relaxes the muscles of the digestive tract, improving their ability to efficiently contract and release. This improves the mechanical function of the digestive system and can contribute to more effective and regular bowel movements.
Optimizing micronutrient status is another important step. In particular, electrolytes such as magnesium and potassium play an important role in hydrating the stool, as well as regulating muscle relaxing and contracting within in the digestive tract. Women, individuals with high blood pressure, and those eating a diet low in carbohydrates are especially susceptible to deficiency in these nutrients. These minerals are highest in plant based foods, so eat your vegetables! Leafy greens, avocados, and potatoes are particularly dense in magnesium and potassium. If supplementing with these minerals, note that magnesium should be in the bisglycinate form rather than a citrate or oxide, which can further disrupt mineral imbalance. Potassium should be taken in split doses throughout the day. Note that supplemental calcium and iron can both contribute to constipation.
Those who have been on antibiotics, or individuals who consume diets high in sugar, refined carbohydrates, caffeine, or alcohol may want to support their gut bacteria with extra fermented foods such as kombucha, traditionally made pickled vegetables and sauerkraut, and kefir; fibrous vegetables such as leafy greens, cruciferous vegetables, and summer squash; and foods high in resistant starches (prebiotics) such as asparagus, artichokes, potatoes, and white rice. Supplemental probiotics may be beneficial to some individuals, as can supplemental fibre.
After the basic principles are satisfied with hydration, regular movement, stress management, and optimizing nutrient intake and gut bacteria, downstream interventions for symptom management may be appropriate. Adding supplemental fibre, probiotics, or specific minerals may help regulate bowel function, depending on the root cause of the constipation in the individual.