Constipation - A Modern Epidemic

[Watchman]

March 2003
Constipation - A Modern Epidemic
by Tarilee Cornish, Nutritional Consultant

Today's stressful, sedentary lifestyles and highly-processed, low-fiber diets predispose us to constipation. Since good statistics on the prevalence of the problem don't really exist, medical and holistic health professionals have widely differing views as to what defines constipation.

The time it takes for food to pass from the mouth to elimination through the rectum is generally referred to as "transit time". In the view of holistic practitioners, transit time should be somewhere between 12 and 24 hours, and that anything longer than a 24-hour transit time indicates constipation. However, many conventional medical professionals consider even longer transit periods perfectly normal. According to the Physician's Manual for Patients, "Daily bowel movements are not essential to health".

Even if the statistics available were not skewed by contradictory opinions within the medical community, their accuracy could be affected by a public somewhat shy to discuss the issue. Let's face it; bowel function is not a subject that many folks feel comfortable talking about. Instead, let's consider some of the symptoms that holistic practitioners believe could be due to constipation. When looking at the following list, we begin to get a sense of how many people may be suffering from this unpleasant condition.

SYMPTOMS ASSOCIATED WITH CONSTIPATION
According to holistic practitioners, symptoms that may be due to constipation include the following:

* abdominal pain
* bad breath, body odor
* fatigue, low energy
* depression, irritability
* headaches
* mental sluggishness
* skin eruptions, sallow skin, dark circles under eyes.

IS CONSTIPATION A SERIOUS HEALTH RISK?
When wastes do not move from the colon in a timely manner, the waste material stagnates and the toxic compounds within the waste grow. The wastes can also become impacted and adhere to the intestinal walls. In serious cases, the toxins in the impacted fecal matter can be reabsorbed into the bloodstream, leading to a condition known as autointoxication (self-poisoning).

As a result, chronic constipation can contribute to reduced nutritional absorption, hemorrhoids, anal fissures, premature aging due to increased free radicals from higher levels of toxicity, inflammatory conditions such as rheumatoid disease, colitis, appendicitis, prolapsed rectum, and diverticulitis. A higher incidence of breast disease and colon cancer has also been associated with constipation.

WHY IS CONSTIPATION COMMON IN CANDIDA RELATED COMPLEX (CRC)?
CRC sufferers typically have a deficiency of healthy flora, and frequently food intolerances as well. In addition, yeast toxins cause congestion of the eliminative organs, resulting in compromised digestive function. These factors can all add up to constipation.

OTHER CAUSES OF POOR ELIMINATION
Many other dietary, lifestyle, and even emotional factors can contribute to constipation. Following are the most common underlying causes for this condition:

* Candida overgrowth and other intestinal flora imbalances
* Coffee (high consumption disturbs bowel function)
* Constitutional predisposition
* Chronic dehydration
* Digestive deficiencies, such as inadequate pancreatic secretions, stomach acid, intestinal enzymes, or intestinal flora, or weak liver or kidney function
* Emotional tension or repression (e.g. fear, self consciousness, anxiety, depression)
* Endocrine disorders (eg. hypothyroidism) and hormonal imbalances
* Low fiber, high sugar, high salt, high processed food diet
* Fecal build-up (impacted waste material.) Fecal build-up can also cause diarrhea
* Food intolerances
* Herbs, if they are astringent and diuretic. Many herbs (including herbal teas) are both diuretic and astringent and can therefore reduce bowel lubrication, leading to constipation.
* Laxative and enema misuse. Many laxatives, especially irritating ones such as whole leaf aloe, senna, and cascara sagrada may bring about dependency and/or damage bowel function.
* Structural abnormalities
* Medications. Anti-hypertensive drugs, diuretics, antacids, antidepressants, muscle relaxants, anti-inflammatory drugs, and some antibiotics may significantly slow transit time.

In addition, a number of diseases and conditions can contribute to inadequate bowel function; including diabetes, intestinal obstructions, lupus, multiple sclerosis, Parkinson's disease, pregnancy, scleroderma, spinal cord injuries, thyroid abnormalities, and uremia.

STRATEGIES FOR MAINTAINING BOWEL REGULARITY
There are a number of things that can be done to re-establish healthy bowel function and support improved health. Try to incorporate one or two of the following suggestions every week, adding new habits every week, until your bowels are functioning well:

* Do not ignore the urge for a bowel movement.
* Restore healthy intestinal flora by using a probiotic supplement such as UAS Laboratories' DDS Plus or Probioplus
* Tone the colon by increasing dietary fiber, and consider using supplemental fiber to help restore muscle tone. Different types of supplemental fiber are discussed below.
* Decrease or gradually eliminate the use of irritant, dependence forming laxatives. This process may require the supervision of a health care practitioner. (See more detailed discussion on Laxatives below.)
* Exercise regularly. Walking after meals helps stimulate digestion; sit ups and leg lifts strengthen the abdominal muscles that aid in bowel movements.
* Relax regularly. Unalleviated stress can cause digestive and eliminative functions to slow down.
* Increase your fluid intake - divide your weight in pounds in half, and drink that many ounces of plain, purified water daily.
* Chew food thoroughly to allow more digestion to take place in the mouth.
* Eat an alkalizing diet ideally consisting of fifty to sixty percent vegetables and fruits.
* Use supplemental digestive enzymes and bitters to enhance digestive efficiency.
* If you are constitutionally prone to constipation or on a medication contributing to the problem, you may need to use a safe laxative (see list below of non-irritating laxatives) to prevent blockage.

FIBER IS YOUR FRIEND!
Consumption of both dietary fiber and supplemental fiber supports colon health and regularity in several ways. Fiber increases bulk. Bulkier feces speed bowel transit time by filling up the colon faster so that elimination occurs more frequently. Fiber lubricates the stool by holding water and also provides nutrients for beneficial microflora.

A healthy, balanced diet will provide enough fiber for many people, since plant foods such as vegetables, legumes, whole grains, and fruits are naturally high in fiber. Meats and dairy products contain no fiber, so eat these foods in moderation. Fiber is lacking or non-existent in refined and processed foods. To support adequate fiber intake, avoid or limit these foods.

FIBER SUPPLEMENTS
The Attogram brand psyllium husk and seed blend is an excellent quality, hypo-allergenic, pharmaceutical-grade psyllium product that is tolerated well by almost everyone. The Attogram blend is superior in texture and cleansing capabilities to most other fibers, providing effective bulking and lubricating functionality.

If, for some reason, you need to find an alternative to psyllium, there are other fibers that may be combined to make an effective supplement. Consider mixing several or all of the following: flax, fresh rice bran (vacuum packed), hemp seed powder, slippery elm bark powder, marshmallow root powder, raw chicory root powder, and small quantity of licorice root powder, dandelion root powder and rhubarb root powder (rhubarb root powder should only be used in very small amounts).

Apple fiber and oat bran can also be used, but be aware that they have a high allergenic potential and may be more likely to cause flatulence.

For exact formulations, please consult with your herbalist or naturopathic doctor. If you are exploring fiber usage independently, please experiment cautiously. Slowly increasing the amounts you use will help to ensure a healthy, successful outcome.

LAXATIVES AND DEPENDENCY
Laxatives (both prescription and herbal) that cause elimination by irritating the intestinal lining can lead to dependency, meaning that the bowels become less capable of moving wastes out without the aid of the laxative. The irritant is used to induce the spasms of the colon (called peristalsis), that cause bowel movements. As dependency on this stimulation develops, the muscles become weaker and eventually do not move at all without the irritant.

Irritant laxatives include prescription laxatives, senna, cascara sagrada, castor oil, coffee, and whole aloe. Avoid these completely if possible, since once you become dependent on them, it is very difficult to retrain the bowel to function without them. These substances can even cause damage to the bowels.

There are gentler, yet potent options for encouraging elimination.

NON-IRRITATING LAXATIVES
If you find that you need occasional laxative support to help facilitate bowel movements, one or more of the following substances may be helpful:

* Triphala Ayurvedic herbal digestive blend
* Vitamin C (ascorbic acid) up to 6,000 milligrams per day or up to bowel tolerance (increase the dosage daily until your bowels become loose and then stay at that dosage. Reduce gradually as bowel function is restored.)
* Flax gel* (see recipe below)
* Ground flax seed (two tablespoons to a cup per day)
* Lemon ginger tea** (see recipe below). Drink upon arising.

RECIPES:

*Flax Gel (water decoction of flax)
Bring two cups water to a boil and add one-eighth cup golden flax seeds (brown will do in a pinch). Simmer for approximately twenty minute or until the water has approximately half the consistency of egg whites. Strain the seeds out while the mixture is hot and use the gel one-quarter cup at a time up to three times per day. If the gel becomes too thick during cooking and you cannot strain it, you may use the whole seed as well. Just be aware that once the seeds are boiled, they do not contain essential fatty acids (EFA's) so you will want to acquire your EFAs from another source.

This gel adds a wonderful "slippery" texture to smoothies or puddings (it's a great substitute for fat or bananas) Or you can just eat on its own if you can get it onto the spoon! . It is tremendously soothing to the intestinal tract while providing gentle softening and lubricating action.

*Lemon Ginger Tea
Start your day with this tea, taken hot. Always drink on an empty stomach. Bring one cup water to a boil, pour into mug and add one-eighth teaspoon dry organic ginger powder and one to two tablespoons fresh lemon juice (or Santa Cruz brand organic lemon juice). Or gently simmer one teaspoon fresh grated ginger in one and a half cups water for ten minutes and add one to two tablespoons fresh lemon juice.

MORE AGRESSIVE NON-IRRITATING LAXATIVES
Osmotic agents such as magnesium (aspartate or citrate), taken in dosages of up to 800 milligrams daily (with equal amounts of calcium) or Epsom salts work by promoting a secretion of water into the colon.

Epsom salts should be used in a crisis only and magnesium should not be used daily unless absolutely necessary. If magnesium is used on a daily basis, the body will adjust to it and you'll eventually need a higher increase in dosage to achieve the same results. However, unlike the case with irritating laxatives, your bowels should be able to return to their normal functioning once you "wean" yourself off of these products.

THE WHOLEAPPROACH PROTOCOL AND CONSTIPATION
The WholeApproach Program with the Attogram products, (including Bentonite, Caprol and the Psyllium blend described previously) create changes in bowel function that may occasionally lead to a temporary slow down in transit time. There are several reasons for this.

The slow-down may occur whenever increasing the amount of fiber. Detoxification of the bowels may also temporarily change elimination patterns. As quantities of waste materials are loosened and flushed out, there is a potential for evacuation to be slowed down. Also, the Bentonite component in the program is highly adsorptive. If you are prone to constipation, you may find that you need to keep your dose of Bentonite below the recommended amount for the duration of the program.

If a slow down occurs during your first few days on the program, we recommend cutting back on the amount of all ingredients to one-fourth of the ultimate recommended dosage in order to give your body time to adjust to the products. Once you have restored regularity (one to three bowel movements per day), you can resume a very gradual increase of your Attogram products.

If your bowel movements cease for three days, see your naturopathic or holistic physician. In extreme cases, mineral oil may be used internally or as an enema under the supervision of a practitioner.

The first step towards achieving relief from constipation is to incorporate some of the diet and lifestyle changes discussed in this article. If your constipation symptoms have been problematic for a number of years, it may take some time to "retrain" your system. Your patience and persistence will prove to be well worth the effort.

[fern]

This is the number one problem with any human body today and the beginning of every disease. I worked in a colonics dept of a retreat for a few months once discovered how wide spread this problem is. The people were passing stuff they hadn't eaten in 20 years just caked into their bowels...and never digested.

I remember a nephew that was just a few years older than my kids that didn't go to the bathroom for weeks at a time. His doctor assured my aunt and uncle that this was normal...!