Constipation is a condition that affects all age groups. It is the most common gastrointestinal complaint. In fact, 16 in every 100 adults have constipation, although that statistic increases to 33 out of 100 adults after age 60. While constipation can affect people of all ages and ethnicities, it is more common in older adults, non-Caucasians, and women after childbirth. Dietary factors can also make people susceptible to constipation, especially low-fiber diets and lack of hydration. Sedentary lifestyles, specific supplements, medications, and other medical conditions can cause constipation, too. Constipation can be a temporary problem, or it can be lifelong. Β
What is The Medical Definition of Constipation?
Constipation is a condition of the gastrointestinal tract, encompassing the following:
It may be hard to communicate or identify if you have constipation if you've had the same type of bowel movements your entire life. The Bristol Stool Chart can be helpful when assessing stool and constipation.
4 Medical Conditions That Can Cause Constipation
Medical conditions that cause constipation include:
Blockages From:
Cancers, including rectal and colon
Anal fissures, or tiny tears around the anus
Rectocele, a bulge of rectal tissue into the back wall of the vagina
Bowel obstruction, a blockage in the intestines
Bowel stricture, a narrowing of the intestine
Neurological Conditions:
Multiple sclerosis
Parkinson's disease
Spinal cord injuries
Stroke
Autonomic neuropathy, nerve damage causing an array of bodily functions to work improperly
Muscular Problems:
Dyssynergia, where pelvic muscles have difficulty coordinating contracting and relaxing
Anismus, where the pelvic muscles are unable to relax
Weak pelvic muscles
Hormonal Conditions:
Pregnancy
Hormone Imbalance
Hypothyroidism
Hyperparathyroidism
Diabetes
Functional Constipation
Functional constipation, or constipation not caused by an underlying medical condition, may be due to the following:
Functional Medicine Labs to Test for Root Cause of Constipation
Comprehensive Stool Analysis
The gut microbiome is a group of collective organisms, including bacteria, viruses, and fungi, that help with digestion, hormone and immune production, and other processes. Dysbiosis, or an imbalance in the microbiome, can cause constipation. The GI-MAP test can detect dysbiosis and provide an insight into the bacteria of the microbiome, looking at both pathogenic or harmful bacteria and some microbes that are a part of the normal flora. Β
SIBO Breath Test
Small Intestine Bacterial Overgrowth (SIBO) is another condition involving the microbiome. It occurs when some of the microbiome microbes move into the small intestine. A small amount of these microbes can always be found in the small intestines. But, when they are present in large quantities, they can cause problems, one of which is constipation. In turn, constipation can also cause SIBO. The best way to assess SIBO is through a Breath Test, which can test various gases produced by the bacteria in the small intestine.
Thyroid Panel
The thyroid gland, located in the neck, releases hormones that affect every body system. Hypothyroidism is a condition where the thyroid gland does not make enough hormones. When this occurs, GI transit can be affected, causing constipation. A Thyroid Panel can help evaluate the health and function of the thyroid.
Hormone Panel
A full hormone panel, such as the DUTCH Complete test, is beneficial when assessing constipation. Sex hormones, including progesterone and estrogen, can affect motility within the GI tract and thus influence the frequency of stools. For women, these hormones fluctuate monthly, and men have hormones that fluctuate daily. These fluctuations in hormones may cause constipation. In addition, this test shows cortisol, our body's primary stress hormone, metabolism. High levels of stress hormones can affect gut motility and the microbiome, leading to constipation.
Other Lab Test to Check
To properly assess constipation, the following labs may be recommended:
Endoscopy, a procedure using a camera to see inside the GI tract
Colonoscopy, a procedure to view the large intestine
Sigmoidoscopy, a procedure to view the lower portion of the large intestine and the rectum
Transit study, a test that assesses movement through the colon and rectum
Radiopaque markers, x-rays that track a radioactive substance through the GI tract
Scintigraphy, similar to a radiopaque, except small cameras and computers are used to monitor movement
Balloon expulsion test, a test that pushes a small water balloon through the rectum and then assesses the ability to push
Anorectal manometry, a test to evaluate anal sphincters, how sensitive the rectum is, and how it is functioning
Defecography: X-ray of the anus and rectum to see how well stool can be held and expelled
Lower GI series: a series of x-rays of the colon using barium, a substance that makes the colon show up clearer on x-rays
Magnetic resonance imaging (MRI), images produced from a large magnet and radio waves
Computed tomography (CT)
Integrative Medicine Treatment For Constipation
Nutrition and Lifestyle
Dietary fiber is a main nutritional recommendation for those with constipation. Increased fiber intake helps improve stool consistency, making it softer. It also increases the weight and size of the stool. Fruits, vegetables, whole grains, legumes, nuts, and seeds are good sources of fiber. Current data suggests the average dietary fiber intake should be 25-30g per day for optimal health. However, most Americans are only consuming about 15g per day.
Increasing water intake and exercise should also be included in every treatment plan for constipation, as both can help to alleviate it.
Complementary and Alternative Medicine
Besides increasing fiber in the diet, fiber supplements are also beneficial. The American Journal of Clinical Nutrition published a meta-analysis of randomized control trials (RCT) regarding fiber supplementation for chronic constipation. Their review of 16 RCT with over 1,200 participants concluded that fiber supplementation improved constipation. Optimal recommendations included Psyllium fiber at over 10g/day for at least four weeks.
Probiotics may also be useful supplements for the relief of constipation. In a RCT of 132 people, a combination formula including Lactobacillus and Bifidobacterium species were given at differing doses for 30 days. Both groups saw an improvement in both frequency and stool quality.
Acupressure is a physical treatment based on the belief that everyone's body has Qi or energy flow. Pressure points are found throughout the body based on energy pathways referred to as meridians. Pregnant women were instructed to do 15 minutes of self-acupressure to a specific acupressure point believed to relieve constipation. The acupressure group saw a significant improvement in bowel movement frequency compared to the control group.
If hypothyroidism is an underlying cause for your specific constipation, the addition of certain thyroid cofactors, such as vitamin A, zinc, vitamin D, omega-3 fatty acids, and selenium, may help since they are all nutrients required by the thyroid to function properly.
Adaptogenic herbs are herbs that help the body adapt to, or combat, stress. Ashwagandha, licorice root, and Rhodiola are herbs that have been shown to reduce stress and can balance stress hormone levels. Because of their ability to reduce stress, they may help with constipation.
Summary
Constipation, the most common gastrointestinal complaint, affects people of all ages and ethnicities. To get to the root cause and adequately treat constipation, it is essential to rule out other medical conditions that could be causing constipation. Β
For functional constipation, functional medicine testing can help to find the root cause or causes and aid in the creation of a personalized treatment plan.
Constipation is a condition that affects all age groups. It is the most common gastrointestinal complaint. In fact, 16 in every 100 adults experience constipation, although that statistic increases to 33 out of 100 adults after age 60. While constipation can affect people of all ages and ethnicities, it is more common in older adults, non-Caucasians, and women after childbirth. Dietary factors can also make people more likely to experience constipation, especially low-fiber diets and lack of hydration. Sedentary lifestyles, specific supplements, medications, and other medical conditions can contribute to constipation, too. Constipation can be a temporary problem, or it can be lifelong. Β
What is The Medical Definition of Constipation?
Constipation is a condition of the gastrointestinal tract, encompassing the following:
It may be hard to communicate or identify if you have constipation if you've had the same type of bowel movements your entire life. The Bristol Stool Chart can be helpful when assessing stool and constipation.
4 Medical Conditions That Can Cause Constipation
Medical conditions that may contribute to constipation include:
Blockages From:
Cancers, including rectal and colon
Anal fissures, or tiny tears around the anus
Rectocele, a bulge of rectal tissue into the back wall of the vagina
Bowel obstruction, a blockage in the intestines
Bowel stricture, a narrowing of the intestine
Neurological Conditions:
Multiple sclerosis
Parkinson's disease
Spinal cord injuries
Stroke
Autonomic neuropathy, nerve damage causing an array of bodily functions to function abnormally
Muscular Problems:
Dyssynergia, where pelvic muscles have difficulty coordinating contracting and relaxing
Anismus, where the pelvic muscles are unable to relax
Weak pelvic muscles
Hormonal Conditions:
Pregnancy
Hormone Imbalance
Hypothyroidism
Hyperparathyroidism
Diabetes
Functional Constipation
Functional constipation, or constipation not caused by an underlying medical condition, may be due to the following:
Functional Medicine Labs to Test for Root Cause of Constipation
Comprehensive Stool Analysis
The gut microbiome is a group of collective organisms, including bacteria, viruses, and fungi, that help with digestion, hormone and immune production, and other processes. Dysbiosis, or an imbalance in the microbiome, may contribute to constipation. The GI-MAP test can detect dysbiosis and provide an insight into the bacteria of the microbiome, looking at both pathogenic or harmful bacteria and some microbes that are a part of the normal flora. Β
SIBO Breath Test
Small Intestine Bacterial Overgrowth (SIBO) is another condition involving the microbiome. It occurs when some of the microbiome microbes move into the small intestine. A small amount of these microbes can always be found in the small intestines. But, when they are present in large quantities, they may contribute to problems, one of which is constipation. In turn, constipation can also contribute to SIBO. The best way to assess SIBO is through a Breath Test, which can test various gases produced by the bacteria in the small intestine.
Thyroid Panel
The thyroid gland, located in the neck, releases hormones that affect every body system. Hypothyroidism is a condition where the thyroid gland does not make enough hormones. When this occurs, GI transit can be affected, potentially contributing to constipation. A Thyroid Panel can help evaluate the health and function of the thyroid.
Hormone Panel
A full hormone panel, such as the DUTCH Complete test, is beneficial when assessing constipation. Sex hormones, including progesterone and estrogen, can affect motility within the GI tract and thus influence the frequency of stools. For women, these hormones fluctuate monthly, and men have hormones that fluctuate daily. These fluctuations in hormones may contribute to constipation. In addition, this test shows cortisol, our body's primary stress hormone, metabolism. High levels of stress hormones can affect gut motility and the microbiome, potentially leading to constipation.
Other Lab Test to Check
To properly assess constipation, the following labs may be recommended:
Endoscopy, a procedure using a camera to see inside the GI tract
Colonoscopy, a procedure to view the large intestine
Sigmoidoscopy, a procedure to view the lower portion of the large intestine and the rectum
Transit study, a test that assesses movement through the colon and rectum
Radiopaque markers, x-rays that track a radioactive substance through the GI tract
Scintigraphy, similar to a radiopaque, except small cameras and computers are used to monitor movement
Balloon expulsion test, a test that pushes a small water balloon through the rectum and then assesses the ability to push
Anorectal manometry, a test to evaluate anal sphincters, how sensitive the rectum is, and how it is functioning
Defecography: X-ray of the anus and rectum to see how well stool can be held and expelled
Lower GI series: a series of x-rays of the colon using barium, a substance that makes the colon show up clearer on x-rays
Magnetic resonance imaging (MRI), images produced from a large magnet and radio waves
Computed tomography (CT)
Integrative Medicine Approaches for Constipation
Nutrition and Lifestyle
Dietary fiber is a main nutritional consideration for those experiencing constipation. Increased fiber intake may help improve stool consistency, making it softer. It can also increase the weight and size of the stool. Fruits, vegetables, whole grains, legumes, nuts, and seeds are good sources of fiber. Current data suggests the average dietary fiber intake should be 25-30g per day for optimal health. However, most Americans are only consuming about 15g per day.
Increasing water intake and exercise should also be considered in any approach to managing constipation, as both can help to support regular bowel movements.
Complementary and Alternative Approaches
Besides increasing fiber in the diet, fiber supplements may also be beneficial. The American Journal of Clinical Nutrition published a meta-analysis of randomized control trials (RCT) regarding fiber supplementation for chronic constipation. Their review of 16 RCT with over 1,200 participants suggested that fiber supplementation may improve constipation. Optimal recommendations included Psyllium fiber at over 10g/day for at least four weeks.
Probiotics may also be useful supplements for supporting digestive health. In a RCT of 132 people, a combination formula including Lactobacillus and Bifidobacterium species were given at differing doses for 30 days. Both groups saw an improvement in both frequency and stool quality.
Acupressure is a physical treatment based on the belief that everyone's body has Qi or energy flow. Pressure points are found throughout the body based on energy pathways referred to as meridians. Pregnant women were instructed to do 15 minutes of self-acupressure to a specific acupressure point believed to support regular bowel movements. The acupressure group saw a significant improvement in bowel movement frequency compared to the control group.
If hypothyroidism is an underlying factor for your specific constipation, the addition of certain thyroid cofactors, such as vitamin A, zinc, vitamin D, omega-3 fatty acids, and selenium, may help since they are all nutrients required by the thyroid to function properly.
Adaptogenic herbs are herbs that may help the body adapt to, or manage, stress. Ashwagandha, licorice root, and Rhodiola are herbs that have been shown to reduce stress and can balance stress hormone levels. Because of their potential to reduce stress, they may help with constipation.
Summary
Constipation, the most common gastrointestinal complaint, affects people of all ages and ethnicities. To get to the root cause and adequately address constipation, it is essential to rule out other medical conditions that could be contributing to constipation. Β
For functional constipation, functional medicine testing can help to find the root cause or causes and aid in the creation of a personalized approach.
The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.
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Lab Tests in This Article
DUTCH Complete (Dried Urine) by Precision Analytical (DUTCH)
Urine
The DUTCH Completeβ’ is a comprehensive assessment of sex and adrenal hormones and their metabolites and includes the daily, free cortisol pattern, organic acids, melatonin, and 8-OHdG. This test cannot be ordered for patients under 12 years of age.
GI-MAP by Diagnostic Solutions
Stool
The GI-MAP is a comprehensive stool test that utilizes qPCR technology to detect parasites, bacteria, fungi, and more, allowing practitioners to create personalized treatment protocols to address gut dysfunction.
trio-smart SIBO Breath Test by Gemelli Biotech
Breath
The trio-smart breath test measures the levels of hydrogen, methane, and hydrogen sulfide in a patientβs breath to determine if any are elevated abnormally. βIt aids in the identification of small intestinal bacterial overgrowth (SIBO), intestinal methanogenic overgrowth (IMO), and excess hydrogen sulfide. This test comes with a GLUCOSE substrate.
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