Getting Rid of Yesterday: Constipation and Its Remedies

Constipation is a common complaint that I hear from clients in my office. I have learned to ask clients what they mean by constipation, because it is not always immediately obvious that we are using the same definition. Many years ago, I had quickly skimmed over asking a client about her elimination when she said that she had “regular” bowel movements. Much later, I found out that “regular,” to her, was at least once every two weeks! THAT is constipation! By not getting out the residue from yesterday, we are setting ourselves up for a toxic today. We should eliminate feces at least once per day in a well-formed, easy-to-pass bowel movement. There should be no undigested food observable in the bowl, and the shape should be a “gentle S” curve, mimicking the shape of the intestine.

In this article, I want to spend a few minutes talking about the types of constipation, and what we can do about each kind. There are 4 main kinds of constipation:
1. Not enough fluids
2. Not enough fluid absorption
3. Not enough fiber
4. Not enough motility


1. Not enough Fluids: Sometimes, we just don’t take in enough fluid to make the waste in our systems “passable” in our intestines. The symptoms of this condition are constipation (non-daily stool) and sludgy, hard, dry, tarry-consistency stool that is hard to pass, requiring strain and effort. If you think you are drinking a lot of fluid, let’s just review some basics about fluids so that you will be able to determine if what you are drinking is the right kind of fluid, and enough of it to boot:

a. List your body weight in pounds. Divide that number in half and write it down. Now add 8 for every caffeinated beverage you drink each day; add 8 for every carbonated beverage; add 8 for every alcoholic beverage you drink in a day. (Each of those kinds of fluids is DE-hydrating, so you lose fluid when you drink those, and end up with a net deficit.) The resulting number (after all those additions) is the net number of fluid ounces of fluid (water) you need to drink daily.
b. The best fluid to drink is water, but sometimes it’s hard to down that much water, especially if you are carrying excess poundage. To make it easier, you can flavor the water (with decaffeinated tea, fresh lemon or lime juice, non-sweetened flavored additives, etc.). You can also add in the soup you “drink” (brothy, not creamy).
c. This strategy should loosen up the stool considerably to help it pass easier.
d. Beware, however, that at first, you will urinate A LOT before the water stays in the intestine long enough to fully moisten the stool. The water first will be claimed by all the cells in your body to help rid the cells of toxins that have been building up through your period of dehydration. Once you get re-hydrated on a cellular level, the water will stay in the intestines and work to soften the stool. This can sometimes take a few weeks.

2. Not enough Fluid Absorption: Sometimes you drink a lot and your intestines simply don’t absorb the fluids enough to help the stool move. This is akin to watering a dried out plant, where the water is simply not being absorbed by the dirt and roots, while it drains out the bottom of the pot. Fluids will make you urinate but won’t ever loosen the stool in the intestine. If this is the case, then you might have to help yourself absorb the liquid by using products meant to keep the water in the intestine. Possible products are Mira-Lax or similar, non-flavored powders that you add to drinking water, so that water is absorbed INTO the intestine. The hitch here is that you must drink a lot of water, so that your cells are not left dehydrated when the body’s fluid goes into the intestine to moisten the stool.

3. Not enough Fiber: Most of us do not get anywhere near the 25-30 grams of fiber per day that is recommended for the adult diet. Before you assume that this is the case for you, however, take a count of how much fiber you are getting. If you are not eating enough daily fiber, seriously consider changing your diet, because in addition to not getting the requisite fiber, you are most likely not getting the vitamins and minerals that you need either. After a diet change, if you are still having constipation issues, then you might have to add a fiber supplement to your diet. Products such as Metamucil, Benefiber, Citrucel, or similar products or their store-brands might help. Some of these products create uncomfortable gas for some people, so you might want to try a couple of brands to see which is right for you. It has been the experience of my own clients that Citrucel capsules (or its store-brand equivalent) don’t have the same gas-potential that some of the other products have. The caveat to be heeded however, if you take fiber supplements, is that you MUST take them with a LOT of water. If you take a fiber supplement and do not drink enough water, then it will be like adding cement to your system—and you will create painful, hard-to-pass feces.

4. Not enough Motility: Sometimes, your intestines just don’t move. We naturally have a gentle “wave” of movement in our guts (called peristalsis) that causes food to descend and waste to pass through our intestines in a smooth, even way. For some people, this “wave” doesn’t have a lot of energy (or qi) behind it, and as a result, the stool can’t move. Often, this is where things like acupuncture, massage (including self-massage), and exercise come in. Your acupuncturist can discuss these techniques with you and show you how to employ them.

Motility of the intestine is also what gets “moved” with many laxatives. Laxative dependence can be a huge problem, however, so you might want to discuss the other, more drug-free, natural ways to “get moving” with your healthcare provider. And don't think that "herbal laxatives" are free of risk--some of the most addictive laxatives on the market are "herbal" or "natural."

If these strategies don’t describe your issue, or if applying these strategies doesn’t work, there might be something serious going on (like an obstruction or intestinal paralysis), which might warrant a visit to your gastroenterologist.

An acupuncturist can work with you to help you with determining which of these strategies (together or in combination) can help stimulate the movement potential of your intestines, and can help with a re-balancing of the fluids in your system so that all the organs are working smoothly to get you feeling better—cleaner, healthier, more robust and ready for your life.

(*Note: This article is not intended to endorse any product. The reader is responsible for applying any advice listed herein. A visit to the appropriate healthcare provider may be warranted before taking any of the advice listed here.)