A Doctor's Guide to CONSTIPATION: Root Causes and Natural Treatments

Welcome Friends today's video is all about that horrible symptom known as constipation we're going to go over what are the most common root causes of constipation and how can you overcome constipation with a more natural approach for those of you new to my channel I'm Dr rajrina woodrupad I'm board certified in Internal Medicine and I also trained in gastroenterology and I see patients every day in my practice with constipation the great news is it's a very treatable condition so my goal is to help you have a full and satisfying bowel movement every day because this can greatly improve your overall health so let's dive into it so constipation is a very common problem it affects 20 percent of Americans and it only gets worse as you get older so a third of adults over the age of 60 suffer from constipation constipation can present in different ways in different people in some people it's just infrequent bowel habits so they have less than three bowel movements a week I once had a patient who came to me and was having a bowel movement once a month so that's extreme constipation and we're gonna come back to her case later in this video for other people constipation means that their stools are really hard dry or lumpy and then for some people constipation means they're straining really hard to have a bowel movement finally for some people constipation just means that they get that sensation of incomplete evacuation meaning you can have a bowel movement every day but still be constipated if it feels like it's incomplete how many of you actually look at your stools well believe it or not it can actually give you a lot of Clues to your health what's the consistency of your stool do you see undigested food particles is there oil droplets at the top so one way for a patient to communicate with their doctor about the consistency of their stool is to use the Bristol stool skill so this is a way of raiding your stool hardest stool is considered a number one so this is like stool that's like rocks or marbles a number two is very hard and lumpy stool so both the Bristol one and two could indicate constipation because those types of stools are really hard to pass so my goal is to help you get your stools to a Bristol 3 which is like a sausage or Bristol four which is like soft serve ice cream because those are more easy to pass now what's fascinating is you can even have looser stools like a Bristol five six or seven but still be constipated if you get that feeling of incomplete evacuation so some people actually have multiple battles throughout the day but they're still constipated because only a little bit is coming out so the best way to know if you're constipated is based on the feeling you get after the bowel movement a successful bowel movement should give you that full sense of relief so that you feel clean and fully evacuated so my goal is to help you get that amazing feeling you can get after a good bowel movement so why is constipation even a problem I mean some people have a bowel movement every three days so why is that a big deal well that's because our stools are one of the ways our body eliminates toxins so it's one of our biggest detox Pathways our liver our gallbladder and our pancreas all dump toxins into our intestines so if you don't evacuate your bowels on a daily basis then the excrement is just sitting in your colon and toxins can get reabsorbed into your body this process can increase inflammation in the body that's why people with chronic constipation are at higher risk of a whole host of health problems ranging from a poor immune system to skin rashes to migraine headaches to cancers in general not to mention colon cancer and even neurodegenerative conditions like Parkinson's disease has been associated with chronic constipation did you know that certain hormones get recycled back into the body if you're constipated and estrogen is one of these hormones so women who are constipated are higher risk of developing estrogen dominance which is when their estrogen levels are really high I've seen women with estradiol levels over 300 which is super high and this is usually in the setting of some constipation so once we get their bowels moving regularly we're able to see either estradiol levels normalize for those of you who are not familiar with estrogen dominance this is where high blood levels of estrogen can cause symptoms like weight gain breastes fibroid tumors PMS heavy periods and painful periods next constipation can really affect your energy and your mood because when you're backed up you just feel lousy and gross now did you know that your gut is considered the second brain you actually make 90 percent of your serotonin which is that happy brain neurotransmitter in the lining of your gut so that's why if you're constipated and your gut is inflamed you're not going to be able to make as much serotonin and dopamine which is the other happy brain neurotransmitter so that's why chronic constipation can impact the production of these brain neurotransmitters and contribute to depression as well as anxiety next chronic constipation can cause structural problems one of the most common ones is hemorrhoids so hemorrhoids are basically dilated blood vessels that are swelling up in your rectum due to all the pressure from the stool and these can be a problem because they can bleed and cause a lot of pain so the best way to fix your hemorrhoids is to fix the constipation you know some people go to a colorectal surgeon to get their hemorrhoids removed but unless you fix the constipation the hemorrhoids can come right back next chronic constipation can cause diverticulosis so this is when the pressure in the sigmoid colon cause weakening of the wall so that it develops little out pouches we call this diverticula the problem is these little out pouches can get infected just like the appendix can get infected so we call that diverticulitis so if you've been told you have diverticulosis based on a colonoscopy or a CT scan the best way to prevent it from getting worse is to address the underlying constipation so most of us have experienced constipation at some point in our lives either due to travel or due to changes in the diet but if constipation persists for over six months we call this chronic constipation now let's get into what are the root causes of constipation so constipation can be primary or secondary primary constipation is caused by problems in the colon itself so either the muscles or the nerves are not working properly so this can be labeled as as primary idiopathic constipation or slow Transit constipation secondary constipation is caused by something else so most of the time we're dealing with secondary constipation so one of the most common causes of constipation in the United States is the standard American diet also known as the sad diet for example if you're eating a donut for breakfast burger and fries for lunch and some takeout tacos for dinner you're probably barely hitting 10 grams of fiber and fiber is needed to bulk up the stools so diet is a big cause of constipation another big cause of constipation is being sedentary so movement and exercise is so important for the motility of your gut and exercise also promotes the growth of healthy bacteria in your gut microbiome so unfortunately people who are sedentary are in higher risk of constipation next we have dehydration so are you drinking enough water throughout the day or maybe you're drinking too many caffeinated beverages like multiple cups of coffee a day or multiple glasses of iced tea because caffeinated beverages actually cause you to lose more water so when you're dehydrated Your Body compensates by taking the water out of your stool as it's passing through the colon so this causes the stool to become really hard and difficult to pass which is constipation next we have hypothyroidism so if you have a sluggish thyroid that affects the motility in the gut so it's good to have your doctor run a full thyroid panel to rule out hypothyroidism next we have diabetes so if you have uncontrolled blood sugars this can impact the motility of the gut and lead to constipation pregnancy can obviously lead to constipation because high levels of progesterone can slow motility in the gut if you have an autoimmune disease like a connective tissue disorder such as Scleroderma this can impact the motility throughout the GI tract and can cause constipation next we have medications and supplements among medications narcotic pain medications and opioids can cause constipation that's why a lot of times people get constipated when they're recovering from surgery because they're sedentary and they're taking pain medications among supplements synthetic iron pills can sometimes cause constipation and calcium supplements can also cause constipation so that's why I like to balance iron and calcium with magnesium we're going to talk a lot about magnesium today but magnesium is wonderful for moving the bowels next we have food sensitivities some people notice when they eat gluten or dairy boom they're constipated for example if they have a pizza they'll be backed up so gluten sensitivity is on the rise so the best way to figure out if you have this problem is to avoid gluten and dairy for at least two weeks and observe if your bowels improve another cause of secondary constipation is hyperparathyroidism so the parathyroid glands are tiny glands that sit behind your thyroid in your neck and if they're producing too much hormones your blood calcium levels goes up and that can slow motility in your colon leading to constipation next we have intestinal methane overgrowth so this is caused by a species called archaeo and they can be located in your small intestine or colon and they convert hydrogen gas into methane the problem is methane gas for whatever reason slows the motility in your bowels if the archaea are located primarily in your small intestine they can cause a lot of bloating and we call this small intestine bacterial overgrowth caused by methane producing archaea but now we know these arcade can be also located in the colon and that's why the terminology has been changed to intestinal methane overgrowth intestinal methane overgrowth is a tough condition because it can create this vicious cycle where the constipation is causing the overgrowth of these Archaea and these are KR producing methane which is making the constipation worse the good news is it is a very treatable condition I have a whole video dedicated to sibo where you can learn about treating the methane variety of sibo and I'm going to link that below next we have irritable bowel syndrome constipation predominant also known as ibsc but IBS is actually just a label for the symptoms so it doesn't tell us what's causing the symptoms and in 70 percent of cases it's often caused by sibo specifically the methane variety also known as the intestinal methane overgrowth another cause of constipation is dysbiosis so dysbiosis means there's an overgrowth of a bacteria or a fungus like Candida a lot of times this can be caused by antibiotics so a lot of patients will tell me that after a round of antibiotics their gut just wasn't the same now they have constipation that's because antibiotics can change your microbiome the reason the bacteria in your gut matter so much is that our stool is not simply the excrement of the food that we're eating it's actually byproducts made by the trillions of bacteria in our gut microbiome that's why healing the gut microbiome is a big part of treating constipation next we have chronic stress so if you're constantly in a state of fight or flight your sympathetic nervous system is going to be on overdrive and it's going to suppress your parasympathetic nervous system which is your vagus nerve so normally your vagus nerve promotes motility in the gut so if you're suppressing your parasympathetic nervous system due to all that stress it can cause constipation chronic stress can also raise your cortisol levels and that can change the bacteria that grow in your microbiome also leading to constipation next we have circadian rhythm dysfunction so if you travel a lot internationally and your sleep is disrupted or if you're a night shift worker this affects your circadian rhythm and that can also impact the motility in your gut leading to constipation another cause of secondary constipation is pelvic floor dysfunction this sometimes happens after childbirth where the pelvic floor muscles get traumatized so then they don't relax properly making it hard for the stool to get expelled the good news is it's a treatable condition with pelvic floor Physical Therapy finally there's a condition called dysenergic defecation and this is caused by impaired coordination between the rectal anal and pelvic floor muscles making it difficult to properly expel the stool again this is treatable with pelvic floor physical therapy and biofeedback [Music] so how can we treat constipation more naturally I mean nobody wants to end up on prescription medications for constipation and no one wants to take over-the-counter laxatives long term so usually most doctors will tell you to increase your fiber intake both in your diet and through supplements but interestingly that is not how I treat my patients because what I've learned is that universally most people who are constipated also have a lot of bloating and abdominal discomfort so if we increase fiber initially that actually worsens their bloating and discomfort and can worsen their symptoms and make them feel miserable so first I like to unclog the drain meaning let's get the bowels moving first this is going to help really alleviate your bloating so that you feel better and then we can start ramping up the fiber so the first thing I like to do to help my patients with constipation is to use three things and I found that these three things work incredibly well for the vast majority of my patients the first thing I like to use is magnesium so we use a chelated magnesium called essential magnesium and this magnesium is a combination of magnesium glycinate citrate and malate so it's gentle on the bowels and it works as an osmotic laxative what that means is it gently pulls water into the colon through the process of osmosis so I'll typically have patients take anywhere from two to four capsules at bedtime so that's anywhere from 250 to 500 milligrams at bedtime and the great news is magnesium is safe to use long term it doesn't create any dependency in the colon so it doesn't cause a lazy colon and most people are deficient in magnesium so it can also help you get a deep sleep it helps with Muscle Recovery anxiety it can help with your blood pressure it's also great for preventing migraine headaches and for preventing PMS we often refer to magnesium as the Miracle Mineral because it does so many amazing things in the body and it definitely helps to move your bowels the second thing I like to use is motility activator so this is a special Ginger formula that's really gentle on the gut it doesn't cause any Ginger burn and what it does is it helps to naturally promote the motility in your gut so if you take this at bedtime it's going to help promote those waves of peristalsis through your small intestine as you're sleeping so it's actually not a laxative it's just a natural prokinetic so it helps to activate your MMC which is the migrating Motor complex which controls the waves of peristalsis throughout your intestines so it really helps to alleviate all that bloating and discomfort that's often associated with constipation the third thing I like to use is a strong digestive enzyme so we use digestive enzyme Pro because remember most people with constipation have a lot of bloating so what enzymes do is they help to break down the food so that you can absorb the nutrients better so it really helps with bloating it can also help to break down biofilms so biofilms are created by bad criteria to hide from your immune system so enzymes can help to get rid of those bad bacteria and reduce inflammation in your body what I love about digestive enzyme Pro is it targets proteins fats and carbohydrates so it has Ox bile and pancreatin to Target fats it has B10 and pepsin to Target proteins and it has bromelain from Pineapple to Target carbs as well as papine from papaya to Target carbohydrates so I've found that this protocol of these three things which is the essential magnesium motility activator and digestive enzyme Pro can make a night and day difference in bloating and bowel movements and the great news is you don't have to really do any testing on your microbiome before starting these things so I'll typically have my patients start this at their initial consultation so that they can start feeling better I also remind my patients not to snack between meals so you only want to eat two or three meals a day that's because in between meals is when your my reading Motor complex which is those waves of peristalsis is able to clean out your small intestine so this can make a huge difference if you're having bloating so if you have a little bit of small intestine bacterial overgrowth or sibo going on just by cutting out the snacking and taking these three things you can feel significantly better of course I always ask my patients to clean up their diet so that means cutting out all their processed foods and refined sugar and eating more Whole Foods sometimes I'll ask them to do a trial off of gluten and dairy to see if they feel better and often they see significant improvements so they start losing weight they feel less inflammation they're less bloated they'll sometimes even notice other things like less joint pain their skin starts clearing up they have less migraine headaches and then typically their bowels will also start moving better so what if you're taking the Magnesium regularly but you're still not having a bowel movement every day well then you can try adding something called aloe Pro so this is the dried leaves of the aloe vera plant in capsule form and when you take this at bedtime along with your magnesium it helps activate contractions in the colon so it's a natural gentle stimulant laxative to get your bowels moving now let's talk about probiotics now remember dysbiosis and bacterial imbalance can be a big part of gut inflammation and constipation so to get the microbiome healthier I like to use probiotics so two of the most popular ones in my office are the probiotic 100 billion and the probiotic 225 billion and these both have several strains of lactobacillus and bifidobacterium and research shows that these strains of bacteria improve bowel frequency and make the stool softer so I'll typically have patients take this first thing in the morning on an empty stomach but if you're suffering from IBS symptoms there's one more probiotic to be aware of and that is saccharomyces boulardi also known as espolardi so it's actually a probiotic yeast and research shows that it's actually really helpful for IBS symptoms discomfort it promotes bowel regularity and it also helps to push out other badges from your body so if there's any baggies growing in your microbiome like candida it can help to push those out or if you have outward symptoms of yeast overgrowth like dandruff thrush or vaginal yeast espolarity can be really helpful now that we've gotten your bowels moving we can finally add in fiber so there's so many different fibers to choose from they're psyllium husk there's Acacia and in my practice we like to use Prebiotic fiber this is made from Green Banana flour so it's a resistant starch and it also has large arabino galactans from the large tree so this is a great Prebiotic fiber that helps to bulk up the stool and improve the softness of the stool so this Prebiotic fiber is really good for promoting the growth of good bacteria in your microbiome so you want to start slow and gradually titrate up the dough so that you don't experience any bloating or discomfort so I recommend start with a half a scoop a day and work your way up to two scoops a day the other great thing about this Prebiotic fiber is it's a resistant starch so it helps to improve your satiety and keep you full so it can be really great for those who are looking to lose weight or improve their insulin resistance pre-diabetes or diabetes so we've covered probiotics and we've covered prebiotics now let's talk about postbiotics so postbiotics are the end product when the bacteria in your gut metabolize the food that you eat so butyrate is one of the most important postbiotics in your gut and it actually is food for the cells lining your colon and butyrate is known to help promote motility in the colon reduce inflammation and can also reduce the risk of colon cancer finally I often use some natural herbs to help clean up the dysbiosis and bad bacteria in the microbiome so two of the most popular ones that I use are oregano oil and berberine Pro because what I've learned is that the majority of the time when I do a microbiome test for my patients any bad bacteria will be sensitive to these two herbs and these two herbs are typically very well tolerated they also help to break up biofilms which are those coatings on the bad bacteria that often make them resistant to treatment what's also great is that berberine and oregano they also work for fungal overgrowth like Candida so they work for both bacterial dysbiosis and fungal overgrowth and so I'll typically have patients take these twice a day after food for about one to two months and it can make a huge difference in their discomfort abdominal pain bloating and constipation over the years I've seen tremendous success in cleaning up an unhealthy microbiome with these two herbs berberine and oregano now let's talk about the diet once you're having a bowel movement regularly and you're feeling good Now's the Time to start ramping up fiber in your diet because remember fiber bulks up the stool and makes it softer and easier to pass the best way to get fiber in your diet is to eat lots of vegetables and fruit because these not only have fiber they also have phytonutrients and antioxidants they're good for your gut microbiome they also reduce inflammation in your body so these help to really reverse disease processes and keep you healthy so I'll often tell my patients to aim for one pound of vegetables a day now I know that sounds like a lot but it's actually very doable so that's 16 ounces so if you make that effort to have vegetables at every meal you can get to one pound next we have nuts and seeds for example you can use chia seeds Chia is great because it soaks up water so you can use it to bulk up your stool so some people like to make chia seed pudding which tastes delicious you can also use flax seeds either whole flax or ground flax and sprinkle that on your food or use it to bake some paleo muffins you can also use sunflower seeds and pumpkin seeds in your salads nuts are also a great source of fiber so there's so many to choose from some people like almonds or pistachios or pecans so choose whatever you enjoy next we have legumes which are lentils and beans the problem is that a lot of people don't digest these well and they suffer from gas and bloating so a lot of my patients with IBS do better when they avoid lentils and beans part of the reason is these legumes have resistant starches that are hard to break down so then they feed bacteria that produce gas the other issue is the outer coating of a bean has something called lectins so lectins are like the defense mechanism of the plant so if you think about a bean it doesn't really want to get digested it wants to travel through your intestines and become a plant somewhere so because of that defensive outer coating for some people this triggers abdominal pain and inflammation in the gut another source of fiber is whole grains like oatmeal brown rice or quinoa however I only recommend eating whole grains if you're not struggling with your weight or you don't have diabetes or insulin resistance because otherwise whole grains can increase insulin release they're also problematic if you have fatty liver disease so seeds whole grains nuts and legumes they all have some lectins so if you really enjoy these Foods you could try soaking them first or cooking them with a pressure cooker sometimes that makes it more digestible or take a digestive enzyme to help break things down one of the most popular diets that I recommend to my patients is the paleo diet and it works great for IBS as well as autoimmune disease so the paleo diet is grain free so it's typically lower in lectins it also takes away Dairy gluten and legumes which are big triggers for IBS in a lot of patients people typically feel less bloated on a Paleo diet and because they're eating less carbs they lose weight they feel less inflamed and we see Improvement in their blood sugar and insulin levels so I've seen a lot of success in reversing disease with a paleo diet which is also sometimes known as a Whole30 diet now let's talk about water how much water should you be drinking per day well you can calculate this by taking your body weight in pounds and divide by two so if you weigh 200 pounds you should be drinking a hundred ounces of water per day now caffeinated beverages don't count because when you drink one cup of coffee you actually urinate out two cups of water so you actually lose water so you need to drink more water to make up for caffeinated beverages now if you don't enjoy drinking plain water try adding some electrolyte powder so the electrolytes have all the minerals to give yourselves energy and it also tastes good so you end up drinking more now let's talk about fermented foods so this includes like sauerkraut kimchi pickled vegetables and non-dairy yogurt and these are great source of natural probiotics that can improve the diversity of your gut microbiome but if you eat these foods and feel worse then you may be histamine intolerant so I'll try to cover histamine intolerance in another video but typically it's an indication that there's something going on in your gut my microbiome that's not allowing you to break down histamines so you're getting symptoms like headaches rashes insomnia or nasal allergies so it's good to be aware that fermented foods although they're healthy for some people they're very high in histamines what about exercise well exercise is super important for the motility in your gut so by doing some cardiovascular exercise you're actually going to promote the MMC which is that migrating Motor complex promoting the waves of peristalsis through your small intestine and your colon so choose an exercise you enjoy whether it's brisk walking running cycling hiking or swimming and trying to do about 30 minutes every day what's fascinating is research actually shows that cardiovascular exercise actually promotes the growth of good bacteria in your gut microbiome so exercise does two things for your gut it promotes the motility and it enhances the growth of good bacteria next it's also really important to have a regular sleep schedule because having a healthy circadian rhythm can influence the motility in your gut it's also important that you create a regular bowel schedule so most people want to have their bowel movement first thing in the morning before they go to work so what I recommend is take your magnesium and motility activator at bedtime then when you wake up drink a nice big glass of water if you enjoy coffee go ahead and have one cup because coffee actually activates the gastrocolic reflex so it helps your get your colon moving just keep in mind that you want to avoid drinking multiple cups of coffee throughout the day because that can cause dehydration which can make constipation worse [Music] now I know a lot of you are just watching my video at home but when should you seek a doctor's attention well these are some things to look for if you're noticing blood in your stools if you're losing weight if you're having nausea or vomiting if you're just not getting better with over-the-counter treatments if you're age 50 you want to see your doctor because you're due for a colonoscopy so that's a procedure to screen for colon cancer and the other great thing is that they find any pre-cancerous polyps they can remove them and a lot of these polyps could potentially turn into cancer five to ten years later finally if you have persistent bloating that's not getting better you'll want to see your doctor or gastroenterologist to get a sibo breath test to learn more about sibo which is a big root cause of bloating I'm going to link my video below which covers this in great detail [Music] now let's return to that patient I mentioned at the beginning of the video who is only having a bowel movement once a month when I first met her I was astonished to hear that but I just walked her through this protocol step by step and I had her clean up her diet and what was amazing when I met her three months later she was having a bowel movement every day and it completely transformed her life she lost 20 pounds by cleaning up her diet she was no longer bloated she had so much more energy no more migraine headaches she also noticed that her skin completely cleared up she used to have acne and redness on her face and now her skin was glowing so this really shows how amazing healing the gut microbiome is and what an impact it can have on your overall health I get a lot of inquiries from people all over the country who are looking to schedule appointments with me but unfortunately my practice is now at full capacity so I'm not able to schedule any new patients so my hope is that these educational videos can help people and also we offer all of these supplements that I talked about today on my supplement store so I have a whole section dedicated to the gut microbiome where you can learn all about the things I described today in more detail how best to take them and we do ship throughout the United States now I want to share a little story the other day I received an email from a gentleman who I'd never met but who was ordering supplements from my store for a couple months and he wrote to me saying that he followed my protocol for sibo based on my video and based on the tips on my supplement store and got significantly better and it really improved his quality of life and prior to that he mentioned he had seen a gastroenterologist but wasn't really getting better with the conventional treatments so it was just so wonderful hearing and knowing that these educational videos and supplements are able to have a positive impact in people's lives now I want to hear from you have you suffered from constipation what helped did fiber make it better or worse please share your story by leaving a comment below thanks so much for watching this video If you enjoyed it please give it a thumbs up subscribe to my channel and don't forget to share it with your friends I hope you have a wonderful day and I'll see you next time [Music]

Channel: Rajsree Nambudripad, MD

Views: 124,170

Keywords: constipation treatment, how to cure constipation naturally, constipation dr berg, microbiome, dysbiosis, SIBO, probiotics, fiber, enzymes, heal gut, healthy, healthy gut, healthy gut microbiome, functional m, integrative medicine, magnesium benefits, diet for constipation, intestinal methane overgrowth, intestinal methanogen overgrowth vs sibo

Id: SQkLKi607Ac

Length: 32min 38sec (1958 seconds)

Published: Wed Oct 19 2022