Stress / Psychological Factors & Constipation – The Gut Brain Connection
The gut-brain connection, also known as the gut-brain axis, refers to the bidirectional communication loop between the gastrointestinal system and the central nervous system. When the body experiences stress, whether it’s emotional (such as a break-up), physical (such as over-exercising or an injury), or psychological stress (anxiety), the brain releases hormones like Cortisol and Adrenaline, aka: Epinephrine. Cortisol and Adrenaline / Epinephrine directly affect the muscles in the digestive tract, slowing down the movement of food and stool[3]. Additionally, stress can alter the composition of gut microbiota, leading to dysbiosis, inflammation, and changes in intestinal permeability, all of which can contribute to constipation. Because of this, stress, and lack of stress-management techniques, is one of the most commonly overlooked causes of chronic constipation.
Where Laxatives and Traditional Treatments Fall Short
If you’ve sought help from a conventional doctor or clinic for chronic constipation, you’ve likely heard the standard advice: boost your fiber intake and consider using a laxative like Miralax or Dulcolax. However, these one-size-fits-all recommendations can backfire and worsen constipation over time, especially when given without a thorough understanding of your individual health profile. As mentioned, one of the most common causes of constipation is Dysbiosis and / or Small Intestinal Bacterial Overgrowth [4]. When “bad” bacteria are overgrown in the digestive tract, they can cause impaired gut motility as well as inflammation and intestinal permeability, leading to constipation. As it turns out, fiber acts as the main source of food for these organisms. While feeding your gut microbiome is usually beneficial, it can spell trouble when your microbial organisms are imbalanced, exacerbating symptoms instead of alleviating them.
Most people who struggle with chronic constipation have turned to over-the-counter or prescription laxatives for symptom relief at some point. While there are cases where laxatives may be necessary, it is important to be aware of the risks that come with prolonged laxative usage.
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Dependency and tolerance. Like with any drug, the body can develop a tolerance to laxatives, to the point where you not only depend on laxatives to have a bowel movement, but you need to continuously increase your dose in order to achieve the same effect.
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Dehydration. Many laxatives work by drawing water into the intestines to soften stool and promote bowel movements. In the absence of sufficient fluid intake, this redirection of water in the body can lead to dehydration, which can worsen constipation, among other potential health issues.
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Electrolyte imbalances. Laxatives can cause electrolyte imbalances by increased fluid loss in the stool. Prolonged electrolyte imbalances can have detrimental health effects, including worsened constipation, muscle weakness, and cardiac arrhythmias.
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Damage to the nerves and muscles of the intestines. Prolonged laxative use can irritate and damage the colon lining, which can permanently impair bowel functioning [5].
How to Address Constipation Naturopathically
Testing
The first step in treating chronic constipation is determining each individual’s unique dietary, lifestyle, and biological contributing factors. Along with your healthcare provider taking a thorough personal history, tests can be conducted to determine possible underlying causes:
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GI MAP – This comprehensive stool test provides detailed information about the abundance and diversity of bacteria, parasites, fungi, and viruses present in the gut, as well as markers of gut inflammation and digestive function.
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Bloodwork
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Thyroid Panel (TSH, T3, T4, free T3, free T4, reverse T3, TPO, antithyroglobulin)
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Comprehensive Metabolic Panel: Electrolytes, kidney markers
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Cortisol-AM
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Vitamin B12, Magnesium, Zinc
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Inflammation: hs-CRP, sedimentation rate, homocysteine
Dietary Interventions
Depending on your unique health and dietary history, nutritional interventions for alleviating chronic constipation may vary from person to person. Some common dietary suggestions include:
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Reduce intake of positive food sensitivity foods
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Reduce intake of processed foods
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Decrease or eliminate alcohol
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Consider a low FODMAP diet
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Increase or decrease fiber intake, depending on test results
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Address any nutrient deficiencies
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Increase fluid and electrolyte intake (DLW loves LMNT)
Supplements
Supplements for treating constipation will be highly individualized. We recommend speaking with your healthcare provider before starting any new supplements. Some common supplements we may use for chronic constipation include:
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Magnesium Citrate or Oxide Powder
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Buffered Vitamin C
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Pre + Probiotics (DRLANA10 for 10% off)
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Digestive Enzymes (DRLANA10 for 10% off)
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Certain types of fiber including psyllium husk + slippery elm + marshmallow root
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Herbal laxative alternatives (Triphala, Senna)
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Adaptogens + nutrients such as Ashwagandha, L-Theanine, and GABA for stress relief
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Herbs such as Valerian, Passionflower, and Lemon Balm as nerve relaxants
Lifestyle
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Incorporate daily stress management techniques (yoga, meditation, acupuncture, gratitude practice, time in nature) to lower Cortisol and bring the body into a parasympathetic (rest and digest) state.
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Get moving! But no need to overdo it. A regular exercise routine, or even just incorporating daily walks, is a great way to increase blood flow as well as lymphatic drainage, in addition to the muscles of the colon to promote bowel movements [6].
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Try not to rush out the door first thing in the morning. Create a calming morning environment and give the body ample time to get things moving.
Source link: https://www.drlanawellness.com/new-blog/how-to-conquer-chronic-constipation by Dr Lana Content at www.drlanawellness.com