Constipation:

of stool, hardness of stool, or a sense of incomplete bowel evacuation. Most people have at least three bowel movements in a week. There is no specific number as to how often a person should have bowel movements and it is extremely individualized.

In a constipated person, the one should always look for the signs and symptoms considered as red flags, and they are abdominal distention, vomiting, blood in stool, weight loss and severe chronic constipation.

Potential contributing factors:

1. Dietary factors:
   1. Low fiber.
   2. Low fluid intake.
   3. High calories intake.
   4. High protein diets.
   5. Magnesium deficiency.
2. Sedentary life style and lack of activities.
3. Pregnancy.
4. Chronic laxative abuse.
5. Iron supplements.
6. Medications: antihistamines, antidepressants, anti-Parkinson drugs, narcotics, calcium channel blockers, antacids containing calcium and aluminium, bismuth, antipsychotics, antispasmodics, and anticonvulsants.
7. Medical conditions: irritable bowel syndrome (IBS), colon cancer, anal fissure, painful hemorrhoids, hypothyroidism, diabetes mellitus, depression, eating disorders, Parkinson’s disease, multiple sclerosis (MS), stroke, spinal cord injuries, scleroderma, hypercalcemia (increased blood level of calcium), amyloidosis, and diverticulosis.

Nutritional Supports:

Restricted Foods:

1. Saturated and Trans fats. They slow down transit time through the intestines.
2. Processed foods.
3. Fried foods.
4. Foods that increase production of mucus: sugars, chocolate, dairy products, caffeine, bananas, eggs, wheat products, pastries, and beer. They slow intestinal travel time.
5. Gluten-containing grains.
6. Rice.
7. Pasta.
8. Potato.
9. Cakes.
10. Crackers.
11. Breads.
12. Carbonated beverages.
13. Food additives, preservatives, and colorings.

Recommended Foods:

1. Water: at least 2 – 3 liters a day. Insufficient water intake worsens constipation.
2. Whole grains:
3. Foods high in fiber: legumes, avocado, artichoke, pears, and prunes.
4. High fiber cereals.
5. Fresh fruits and vegetables, especially dark-green vegetables, berries, grapes, Bael fruit, guava, papaya, apple, persimmon, mango, pineapple, figs, rhubarb, and basil.
6. Flaxseeds.
7. Chai seeds.
8. Dried figs.
9. Dried apricots.
10. Rhubarb.

Recommended Supplements:

1. Psyllium: 5 – 20 grams a day. It is a bulk-forming laxative that contains insoluble fiber and mucilage. It is generally used for constipation, and it may reduce cholesterol and blood sugar levels as well.
2. Glucomannan: 4 – 10 grams a day. It is a water soluble fiber that helps control blood sugar and cholesterol. It may be used in weight management and constipation as well.
3. Aloe Vera Juice: ¼ – ½ cup three times a day. It has a stool-softening effect.
4. Ground Flaxseed or Chai Seed: 2 – 3 tablespoons a day.
5. Cascara Sagrada: as a tablet or capsule, 500 – 1000 mg a day, or as a tincture 3 – 5 ml day. Cascara bark contains cascaroides which have cathartic activities. Cascara should not be taken for more than 7 – 10 days.
6. Senna: 20 – 50 mg a day. The senna shrub contains sennosides, which have laxative effects. Senna should not be taken for more than 10 days.
7. Probiotics: a product with 15 – 20 billion organisms per serving.
8. Digestive Enzymes: A full spectrum product.
9. Magnesium: 400 – 1000 mg a day.
10. Alder Buckthorn: dried form as capsules, 20 – 30 mg a day, or as a tincture 5 ml once at bedtime. This shrub contains anthraquinone glycosides, which have cathartic activities. It should not be taken for more than 10 days.
11. Dandelion Root: as a dried form, 5 – 15 grams a day, or as a tincture 10 – 30 ml day. It contains taraxacin that improves digestion, increases bile production, and has a laxative effect. Dandelion root has appetite-stimulating and mild diuretic properties as well.

Miscellaneous Suggestions:

1. Liver detoxification.
2. Colon cleaning.