Chronic constipation is very common. It has been estimated that up to 24% of the population struggles with chronic constipation (1). Fortunately, there are many natural constipation remedies that can help you overcome this condition.
In this article, I’ll go over exactly what chronic constipation is, what causes it, and my best tips to help you deal with it.
What is Chronic Constipation?
Despite the prevalence of chronic constipation, it has no exact definition because it affects everyone differently. Chronic constipation is characterized by typical constipation symptoms (like difficulty passing stool, infrequent bowel movements, etc) that have persisted for at least 6 months (2).
Constipation definition: “a disorder in the gastrointestinal tract, which can result in the infrequent stools and/or difficult stool passage with pain and stiffness.” (3)
There are two different types of chronic constipation:
Primary chronic constipation: Chronic idiopathic constipation that has no clear cause.
Secondary chronic constipation: Constipation that results as a side effect or comorbidity of medications, systemic, or neurological disease. (4).
Chronic constipation treatments vary depending on the type and root cause. Most people can manage chronic constipation by making lifestyle changes, such as adjusting their eating habits or exercise behaviors. With that said, in some instances chronic constipation may become so severe that medications or surgeries are needed to treat it (5).
There are several complications of constipation that can result if left untreated. Perhaps the most common adverse effect is a poor quality of life from the discomfort and embarrassment that chronic constipation sufferers tend to struggle with. Complications of constipation also include hemorroids, anal fisures, pelvic floor damage, fecal incontinence, and urinary retention (6).
Chronic Constipation Symptoms and Diagnosis
Chronic constipation symptoms vary depending on the severity. You may have chronic constipation if you’ve been dealing with more than two of the following symptoms for more than six months (7):
- Less than 3 bowel movements per week
- Straining during bowel movements more than 25% of the time
- Lumpy, hard stools more than 25% of the time
- Incomplete evacuation during bowel movements more than 25% of the time
- Feeling of blockage more than 25% of the time
- Requiring manual stimulation to pass stool more than 25% of the time
Additionally, those with chronic constipation commonly have secondary symptoms, such as abdominal pain and discomfort, bloating, gas, and decreased appetite.
What Causes Chronic Constipation?
There are many chronic constipation causes that range from your genetics, to the motility in your colon, all the way down to the foods you eat and lifestyle behaviors you engage in. Certain medications and physiological conditions, such as pregnancy, are also known to be chronic constipation causes (8).
Some populations struggle with chronic constipation more than others. For example, women are more likely than men to have chronic constipation. In particular, premenopausal and pregnant women report chronic constipation more often, likely due to hormone fluctuations. Further, older adults are diagnosed with chronic constipation at a higher rate than younger people (9).
How to Remedy Chronic Constipation
There are many different constipation remedies that can help you overcome this debilitating condition.
Water for Constipation
I know, I know — you’ve possibly heard this one before. But before we jump into some of the more complex issues associated with chronic constipation, let’s make sure you’re drinking enough water!
One of the most overlooked chronic constipation treatments is the simple notion of drinking more water. Since your body is made up of 60 percent water, it makes sense that it plays a role in constipation if you’re not drinking enough.
When you’re dehydrated, water may be withdrawn from the colon to help support other parts of your body. This prevents your colon from doing what it needs to do to promote healthy bowel movements, making your stool hard and difficult to pass (10, 11).
Low water intake has been shown to be a common chronic constipation cause. Drinking more water for constipation is an easy adjustment you can make to your lifestyle to help you deal with the condition (12, 13).
It’s generally recommended to drink at least 8 cups of water per day, but you may need more or less depending on how much you exercise and how many water-rich foods that you eat.
Another way to calculate how much water you need is by dividing your body weight in half. The number you get is the ounces of water to aim to drink per day. For example:
150 pound female divided by 2 = 75 = 75 ounces of water/day
So do a quick calculation and make sure you’re drinking enough water! And if you are, let’s jump into some other issues to look at when considering chronic constipation.
Fiber for Constipation
Fiber is an indigestible component of plants that plays a role in your digestive health. All plant foods contain fiber in some form, which can promote regularity by bulking up your stool and making it easier to pass, as well as supporting the health of your microbiome.
Fiber for constipation is typically categorized based on its solubility:
Soluble fiber: As it travels through the digestive tract, soluble fiber absorbs water and is fermented by bacteria in the colon. It slows down the time it takes for food to leave your stomach and improves the consistency and form of your stool, making it easier to pass.
Insoluble: Insoluble fiber remains intact as it travels through your digestive system. It is known for speeding up the movement of food through your digestive tract by adding bulk to your stool.
But can too much fiber cause constipation? In my clinical experience, I have noticed that increasing insoluble fiber tends not to help constipation that much (and sometimes even makes it worse), while increasing soluble fiber tends to be very helpful for my clients.
Prebiotic Fiber for Constipation
Prebiotics, a specific type of soluble fiber, are especially helpful for those with constipation.
Prebiotics can be described as “food” for your gut bacteria. Prebiotics fuel your healthy gut bacteria and support those bacteria in their primary functions — producing antiinflammatory compounds like short chain fatty acids (SCFAs), strengthening the lining of your gut wall, and helping to eliminate harmful bacteria and other toxins from your digestive tract.
Without prebiotics, your gut bacteria and overall digestive health struggle to thrive. When your gut bacteria are not in healthy balance, you may develop constipation.
High Fiber Foods List for Constipation
The best foods for constipation are typically high in prebiotic fiber. Listed below are some high prebiotic foods:
- Chicory root
- Dandelion greens
- Jeruselem artichokes
- Jicama root
- Burdock root
- Yacon root
Including these foods in your diet on a regular basis may help balance your gut bacteria and prove to be beneficial for chronic constipation.
It’s worth mentioning that if you’re not used to eating high fiber foods, you should gradually introduce them into your diet. Eating too much fiber at once, especially when your body isn’t used to it, can cause symptoms such as bloating and abdominal pain.
Prebiotic Fiber Supplements for Constipation
Taking prebiotic fiber supplements for constipation can sometimes be useful, especially if you’re unable to consume enough high fiber foods.
That’s where fiber supplements for constipation come into play. There are many prebiotic fiber supplements that you can try for chronic constipation, including the following:
- Fructooligosaccarides (FOS)
- Galactooligosaccarides (GOS)
- Partially hydrolyzed guar gum (PHGG)
Sunfiber (partially hydrolyzed guar gum) is one of the most well-tolerated prebiotics on the market and is especially useful for those dealing with chronic constipation.
The research on Sunfiber is particularly impressive; many studies have shown that those who take Sunfiber even at dosages as low as 5 g/day report improvements in bowel movement frequency, abdominal pain related to constipation, and stool frequency. (14)
I have found Sunfiber so useful in my own practice that I created Gut Power Matcha to make getting it into your diet even easier. Gut Power Matcha contains a blend of Sunfiber, probiotics (Bacillus coagulans GBI-30 6086), and organic matcha green tea from Japan to support the health of your gut.
In just one serving, you get 6g of Sunfiber, 1 billion CFU probiotics, and a delicious cup of matcha tea!
If you suffer from constipation, incorporating prebiotic fiber into your diet whether it be in food or supplemental form, is a very wise idea.
The Gut-Brain Connection: Addressing Stress to Help Constipation
Your gut and your brain are interconnected, so stress and constipation often go hand-in-hand.
In fact, the gut is often referred to as your “second brain” because it contains over 100 million nerve endings (15). It produces neurotransmitters, including serotonin and dopamine, and has many other similarities to your true brain.
When you are stressed, your body goes into “fight or flight” mode where it focuses much more on short-term survival versus thriving long-term. This means that during these times, your body is focused on pumping blood to your muscles (in case you need to fight or run away from a threat) and pushing glucose to your brain to help you think clearly.
What it’s not doing when you’re stressed is getting blood to your digestive system; because of this, your digestive system may not function properly. For some people, this results in diarrhea, while for others it means constipation.
Stress is also known to disrupt the balance between good and bad bacteria in your gut. This imbalanced gut bacteria is associated with a multitude of chronic health conditions, including digestive conditions like IBS, which is a common cause of chronic constipation. We’ll discuss imbalanced gut bacteria in further detail a bit later in this article, so hang tight!
Many studies have shown a correlation between certain psychological disorders and chronic constipation. Stress and constipation are often a result of anxiety, depression, and other emotionally taxing life events (16).
The truth is that no one has the ability to live a completely stress-free life (if you do, please share your secrets!). But working to manage your stress can make a big difference in your chronic constipation.
Remember that self care isn’t all bubble baths and pedicures…it’s more about parenting yourself to make sure you go to bed on time, schedule time for exercise, pack your healthy lunch, and do all the things you can to make sure you’re living a healthy lifestyle and taking care of yourself.
Do some deep breathing, take a walk, talk to a friend…do what you need to do to relax and take care of yourself for at least a few minutes every day. Managing stress is important for everyone, but if you suffer from stress-induced chronic constipation, it’s especially beneficial.
Probiotics for Constipation
Probiotics are good gut bacteria that support your health — they can be found in both food and supplemental form.
The research on probiotics and their effect on constipation is mixed.
However, this is to be expected since probiotic effects are strain-specific. That means that not every strain of probiotic will be useful for a condition. Instead, you need to choose the probiotic strain that is appropriate for the condition or symptoms that you are dealing with. You can learn more about how to identify probiotic strains and why they’re important in this article.
Because of this, we see that some probiotic strains may be useful when it comes to constipation, while others make no difference at all compared to placebo.
There are a few probiotic strains that have been shown to be helpful in reducing constipation symptoms:
- VSL #3: This is a blend of a few different probiotic strains that were studied in combination. (Please note that the probiotic blend found in VSL #3 is now found under the brand name Visiome, which is why you will see the VSL #3 link direct you to Visbiome.) (16)
- Lactobacillus casei Shirota: This strain is found in the beverage brand Yakult, which is sadly not available in the United States. (17)
Other strains, such as Bifidobacterium lactis NCC2818, have not been found to reduce constipation symptoms any better than a placebo. (18)
Because researchers for so long have not been studying specific probiotic strains and instead focusing on probiotic species, we are really just at the beginning of finding out more about how we can use probiotics to affect our health.
It would not surprise me to find out that there are many more probiotic strains that could help alleviate constipation in the near future as we gather more research, so keep an eye out!
For the time being, you can try one of the strains listed above to see if it helps reduce your constipation symptoms.
Balancing Gut Bacteria to Relieve Chronic Constipation
If you suffer from chronic constipation, it’s a good idea to test your gut bacteria.
This is because an imbalance of good and bad bacteria in your gut can play a significant role in constipation.
Methane gas production from specific bacteria within the microbiome may play a role in constipation. When researchers give patients antibiotics like rifaximin, methane production decreases and, subsequently, constipation symptoms dissipate. (19)
Testing your bacteria to determine if you have conditions like SIBO (small intestinal bacterial overgrowth) or dysbiosis (an imbalance of bacteria in the large intestine) can help your healthcare practitioner determine if antibiotics or herbal antimicrobials may be appropriate for you.
In addition to killing off certain bacteria with antibiotics or antimicrobials, using microbiome-modulating supplements like prebiotics and probiotics can also help to rebalance your gut bacteria and potentially improve your constipation symptoms as well.
If you’re interested in testing your gut bacteria and learning more about rebalancing your microbiome, you may want to check out my 8-week online program, Build Your Biome.
The Bottom Line
Chronic constipation is challenging to deal with, as there are many different causes that can be tricky to identify. The good news is that there are plenty of strategies to help you deal with chronic constipation. Managing chronic constipation is crucial for your overall health and quality of life.
Strategies for managing chronic constipation range from making lifestyle and dietary changes to testing your gut bacteria and incorporating microbiome-modulating supplements.
It’s important to note that you should work with a healthcare practitioner if you are dealing with chronic constipation. They can help you to rule out underlying conditions that may be causing it, as well as help you come up with a treatment plan that makes sense for your symptoms and lifestyle.