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While constipation can be caused by many things, there are natural alternatives to relieve this uncomfortable and sometimes painful condition
Constipation is generally described as having fewer than three bowel movements per week or the passage of hard, dry stools. It affects nearly 16% of adults and 30% of those over 65.[i] The top 10 causes of constipation are:[ii]
Lack of fiber
Too much dairy
Antacid medicines with aluminum hydroxide or calcium
Other medications such as antidepressants and blood pressure drugs
Overuse of laxatives and pain-relieving opioids
The medical community agrees that the first treatments for alleviating constipation should be lifestyle changes -- plenty of water, exercise and fiber.[iii],[iv] Certain fiber-rich foods -- flaxseed, kiwi, psyllium and figs -- as well as probiotics and prebiotics have been found to be among the best natural laxatives.
1. Stay Hydrated
Water is essential to your body's natural functions. Dehydration can cause chronic constipation because if you don't have enough water in your body, the large intestine soaks up water from your food waste, which gives you hard stools that are difficult to pass.[v] In general, drink eight cups of water per day, but increase liquids during exercise and hot weather since you can easily get dehydrated.[vi]
2. Be Active
People who exercise regularly generally don't typically develop constipation. Exercise helps constipation by decreasing the time it takes food to move through the large intestine and lowers the amount of water your body absorbs from the stool, which affects the hardness of your stools.
Aerobic exercise accelerates your breathing and heart rate, which stimulates the natural squeezing of your intestinal muscles. So add a regular walking plan to help your digestive system function at its best and then consider aerobic exercises like running, jogging, swimming or bicycling and weight training to keep your muscles strong.[vii]
A total of nine randomized controlled trials involving 680 participants engaging inqigong, walking and physical movement exercises were reviewed and the results showed significant benefits of exercise for improving constipation symptoms.[viii] Increasing exercise to improve constipation may be more effective in older people, who tend to be more sedentary, than in younger people.[ix]
3. Eat High Fiber Foods
Nearly 95% of adults in America eat a low fiber diet.[x] One of the best and easiest ways to increase fiber is to be sure to have lots of whole fruits and vegetables in your diet. Typically, adults need between 20 and 25 grams of fiber a day depending on their age for their health.[xi]
Legumes such as chickpeas, lentils and beans are fiber-rich vegetables that help prevent constipation.[xii] Leafy greens like spinach, kale and cabbage are fiber-dense foods that also add magnesium, which keeps water in your stool, softening it and enabling quick movement through your system.[xiii] Fruit fiber found in berries, mango,[xiv] mulberry,[xv] peaches, apricots, prunes and raisins[xvi] increases your regularity and prevents constipation.[xvii]
Flaxseed is a strong fiber that's a highly effective natural laxative. In a study of 53 constipated Type 2 diabetes patients who received 10 grams of flaxseed pre-mixed in cookies twice per day or placebo cookies for 12 weeks, the group eating flaxseed had improved constipation symptoms, weight and glycemic and lipid levels compared to the control group.[xviii]
In another study using either 10 grams of flaxseed or psyllium or a placebo in cookies, 77 constipated patients with Type 2 diabetes ate the cookies two times a day for 12 weeks. Both fiber groups --flaxseed and psyllium -- performed better than the placebo but flaxseed was superior in improving constipation, weight and glycemic and lipid control than the psyllium.[xix]
Randomly assigning 90 constipated subjects to either 50 grams per day of flaxseed flour with meals or 15 milliliters per day of a lactulose solution every morning for four weeks, the bowel habits in both groups significantly improved, but the flaxseed was more effective than the lactulose at improving bowel frequency, bowel movements and life quality for those with chronic functional constipation.[xx]
5. Kiwi Fruit
Recruiting 33 constipated patients and 20 healthy volunteers for a four-week treatment of kiwi fruit twice daily, kiwi fiber was found to effectively relieve chronic constipation, improve bowel habits and decrease the number of days laxatives were used.[xxi] A total of 32 participants were enrolled in a 16-week study with subjects receiving either three kiwifruits or 14.75 grams of Metamucil (five grams of dietary fiber) per day for four weeks followed by a four-week washout (baseline) between treatments.
The number of bowel movements per week was significantly greater during daily consumption of three kiwifruit compared with the baseline and the Metamucil treatments. Kiwifruit produced softer stools and less straining, abdominal pain, constipation and indigestion.[xxii]
Fifty-eight moderately constipated participants were randomized to kiwifruit extract or placebo for a three-week period with results showing significant increases in defecation frequency, improvements in fecal score and less defecation/abdominal pain in the kiwi treated group with no side effects of diarrhea, urgency or abdominal pain -- symptoms of irritable bowel syndrome.[xxiii]
In another study of 28 participants, healthy and constipated groups all used two kiwifruit-derived nutritional treatments as well as a placebo and results showed the kiwi interventions significantly increased the mean daily bowel movements compared with the placebo.[xxiv]
In a recent study comparing prunes, psyllium and kiwifruit in 78 patients with chronic constipation, psyllium and prunes were more effective than kiwifruit in terms of alleviating symptoms related to constipation, but patients were not able to tolerate them as well as kiwifruit, and kiwi was effective in over 40% of the patients.[xxv]
In a trial of 40 subjects with functional constipation -- less than three bowel movements a week, hard stools and difficulty passing stools -- patients received either a fig paste -- approximately three figs -- or a placebo paste for eight weeks. The fig group experienced a significant reduction in colon transit time -- from 63 to 38 hours -- and softer stools versus the placebo.[xxvi]
In research of 24 healthy and constipated patients, psyllium supplementation increased stool water and was associated with significant changes in microbiota, most notably in constipated patients.[xxvii] In a trial of 132 gastroesophageal reflux disease patients with functional constipation, psyllium alleviated constipation, which improved the reflux disease and its recurrences comparably to those given omeprazole, a common treatment drug with significant side effects.[xxviii],[xxix]
In patients with chronic idiopathic constipation, a comprehensive literature review of psyllium versus wheat bran research showed that psyllium was 3.4 times more effective than insoluble wheat bran for increasing stool output.[xxx] Psyllium husk treatment was compared to a placebo in 54 constipated women of reproductive age and psyllium effectively alleviated constipation symptoms by altering gut microbiota.[xxxi]
Probiotics add different strains of bacteria to your gut, which help make you healthier and are linked to improvements in constipation. Probiotics can be found in the food you eat like yogurt, fermented milk (kefir), sauerkraut, kombucha, tempeh and pickles or in supplements.[xxxii]
In a study of 135 constipated adult women taking 100 grams of kefir versus a control for one and two weeks, the kefir treatment was highly effective compared to the control for stool frequency, defecation condition and stool consistency in adult women with constipation for both periods of consumption.[xxxiii]
The probiotic Lactobacillus reuteri and magnesium were compared against a placebo in 60 children, who were 6 months to 6 years old, and both treatments were significantly more effective than the placebo in managing functional constipation. However, the probiotic was easier on the microbiome, or gut microbes.[xxxiv] A mixture of probiotics -- bifidobacteria and lactobacilli -- were given to constipated children ages 4 to 16 years for four weeks with very positive effects on constipation too.[xxxv]
A total of 11 clinical trials with 13 probiotic treatments including 464 subjects were meta-analyzed and showed probiotics decreased intestinal transit time, with greater effects in constipated or older adults and with certain probiotic strains compared to controls.[xxxvi] Similarly, in a meta-analysis of 14 studies representing 1,182 patients, probiotics significantly improved whole gut transit time, stool frequency and stool consistency.[xxxvii]
9. Prebiotics and Synbiotics
Prebiotics serve as food for the healthy bacteria in your gut and are found in onions, garlic, leeks, chicory root, honey, apples, asparagus, bananas and Jerusalem artichokes. Synbiotic means a combination of prebiotics and probiotics.[xxxviii],[xxxix]
In a meta-analysis of five trials involving 199 patients who were administered prebiotics and eight studies involving 825 patients administered synbiotics, prebiotics increased weekly stool frequency and improved stool consistency. Synbiotics significantly improved stool frequency, consistency and whole-gut transit time as well.
Galacto-oligosaccharides and fructo-oligosaccharides with probiotic combinations (synbiotics) had the strongest effects on symptoms related to constipation.[xl] In a study of 297 obese patients experiencing constipation during a weight loss program, those using synbiotics improved constipation, whereas those who used drug laxatives once a week had a worsening of constipation symptoms.[xli]
A synbiotic -- fermented milk with multiple probiotic strains and prebiotic fiber -- or a placebo was given for four weeks to 120 Parkinson's disease patients with constipation and the synbiotic was superior to the placebo in improving constipation.[xlii]
Choosing Natural Laxatives and Healthy Lifestyles
The first lines of defense for constipation are simple lifestyle changes -- staying hydrated, exercising and eating more fiber-rich foods. Certain natural fibers, probiotics, prebiotics and synbiotics are strong natural alternatives for those suffering from chronic constipation and stubborn symptoms. Please see GreenMedInfo.com for more research on natural laxatives and treatments for constipation.
[i] American Gastroenterological Association, Bharucha AE, Dorn SD, Lembo A, Pressman A. American Gastroenterological Association medical position statement on constipation. Gastroenterology. 2013 Jan;144(1):211-7. doi: 10.1053/j.gastro.2012.10.029. PMID: 23261064.
[ii] Facty.com, Ailments, Constipation, 10 Causes of Constipation. https://facty.com/ailments/constipation/10-causes-of-constipation/
[iii] My Cleveland Clinic.org, Health, Diseases, Constipation. https://my.clevelandclinic.org/health/diseases/4059-constipation
[iv] Mayo Clinic.org, Diseases-Conditions, Constipation, In-depth, Laxatives. https://www.mayoclinic.org/diseases-conditions/constipation/in-depth/laxatives/art-20045906
[v] Müller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005 Jan;100(1):232-42. doi: 10.1111/j.1572-0241.2005.40885.x. PMID: 15654804.
[vi] Web Md.com, Digestive Disorders, Water - A Fluid Way to Manage Constipation. https://www.webmd.com/digestive-disorders/water-a-fluid-way-to-manage-constipation
[vii] Web Md.com, Digestive Disorders, Exercise Curing Constipation Via Movement, https://www.webmd.com/digestive-disorders/exercise-curing-constipation-via-movement
[viii] Gao R, Tao Y, Zhou C, Li J, Wang X, Chen L, Li F, Guo L. Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials. Scand J Gastroenterol. 2019 Feb;54(2):169-177. doi: 10.1080/00365521.2019.1568544. Epub 2019 Mar 7. PMID: 30843436.
[ix] Health Harvard.edu, Diseases and Conditions, Common Causes of Constipation. https://www.health.harvard.edu/diseases-and-conditions/common-causes-of-constipation
[x] Quagliani D, Felt-Gunderson P. Closing America's Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. Am J Lifestyle Med. 2016 Jul 7;11(1):80-85. doi: 10.1177/1559827615588079. PMID: 30202317,PMCID: PMC6124841.
[xi] Fathallah N, Bouchard D, de Parades V. Diet and lifestyle rules in chronic constipation in adults: From fantasy to reality… La Presse Médicale. 2017;46(1):23-30. doi:10.1016/j.lpm.2016.03.019
[xii] Pituch A, Walkowiak J, Banaszkiewicz A. Butyric acid in functional constipation. Prz Gastroenterol. 2013;8(5):295-8. doi: 10.5114/pg.2013.38731. Epub 2013 Oct 28. PMID: 24868272; PMCID: PMC4027827.
[xiii] Izzo AA, Gaginella TS, Capasso F. The osmotic and intrinsic mechanisms of the pharmacological laxative action of oral high doses of magnesium sulphate. Importance of the release of digestive polypeptides and nitric oxide. Magnes Res. 1996 Jun; 9(2):133-.8. PMID: 8878010.
[xiv] Vinicius P Venancio, Hyemee Kim, Maritza A Sirven, Carmen D Tekwe, Gilson Honvoh, Stephen T Talcott, Susanne U Mertens-Talcott. Mango (Mangifera indica L.) Polyphenols Ameliorate Functional Constipation Symptoms in Humans Beyond Equivalent Amount of Fiber. Mol Nutr Food Res. 2018 May 7:e1701034. Epub 2018 May 7. PMID: 29733520
[xv] Teng-Gen Hu, Peng Wen, Hui-Zhan Fu, Guang-Yue Lin, Sen-Tai Liao, Yu-Xiao Zou. Protective effect of mulberry (Morus atropurpurea) fruit against diphenoxylate-induced constipation in mice through the modulation of gut microbiota. Food Funct. 2019 Mar 20 ;10(3):1513-1528. PMID: 30785176
[xvi] Very Well Health.com, Foods to Ease Constipation. https://www.verywellhealth.ceom/foods-to-ease-constipation-4143121
[xvii] Mark L Dreher. Whole Fruits and Fruit Fiber Emerging Health Effects. Nutrients. 2018 Nov 28 ;10(12). Epub 2018 Nov 28. PMID: 30487459
[xviii] Noureddin Soltanian, Mohsen Janghorbani. A randomized trial of the effects of flaxseed to manage constipation, weight, glycemia, and lipids in constipated patients with type 2 diabetes. Nutr Metab (Lond). 2018 ;15:36. Epub 2018 May 9. PMID: 29760761
[xix] Noureddin Soltanian, Mohsen Janghorbani. Effect of flaxseed or psyllium vs. placebo on management of constipation, weight, glycemia, and lipids: A randomized trial in constipated patients with type 2 diabetes. Clin Nutr ESPEN. 2019 Feb ;29:41-48. Epub 2018 Nov 17. PMID: 30661699
[xx] Sun J, Bai H, Ma J, Zhang R, Xie H, Zhang Y, Guo M, Yao J. Effects of flaxseed supplementation on functional constipation and quality of life in a Chinese population: A randomized trial. Asia Pac J Clin Nutr. 2020;29(1):61-67. doi: 10.6133/apjcn.202003_29(1).0009. PMID: 32229443
[xxi] Annie-On-On Chan, Gigi Leung, Teresa Tong, Nina-Yh Wong. Increasing dietary fiber intake in terms of kiwifruit improves constipation in Chinese patients. Eur J Pharmacol. 2008 Jun 10;587(1-3):273-80. Epub 2008 Apr 4. PMID: 17729399
[xxii] Sarah L Eady, Alison J Wallace, Christine A Butts, Duncan Hedderley, Lynley Drummond, Juliet Ansell, Richard B Gearry. The effect of 'Zesy002' kiwifruit (var.) on gut health function: a randomised cross-over clinical trial. J Nutr Sci. 2019 ;8:e18. Epub 2019 May 3. PMID: 31080591
[xxiii] Iona Weir, Quan Shu, Nengding Wei, Chengkai Wei, Yi Zhu. Efficacy of actinidin-containing kiwifruit extract Zyactinase on constipation: a randomised double-blinded placebo-controlled clinical trial. Asia Pac J Clin Nutr. 2018 ;27(3):564-571. PMID: 29737803
[xxiv] Juliet Ansell, Christine A Butts, Gunaranjan Paturi, Sarah L Eady, Alison J Wallace, Duncan Hedderley, Richard B Gearry. Kiwifruit-derived supplements increase stool frequency in healthy adults: a randomized, double-blind, placebo-controlled study. Nutr Res. 2015 Apr 11. Epub 2015 Apr 11. PMID: 25931419
[xxv] Chey SW, Chey WD, Jackson K, Eswaran S. Exploratory Comparative Effectiveness Trial of Green Kiwifruit, Psyllium, or Prunes in US Patients With Chronic Constipation. Am J Gastroenterol. 2021 Jun 1;116(6):1304-1312. doi: 10.14309/ajg.0000000000001149. PMID: 34074830.
[xxvi] Baek HI, Ha KC, Kim HM, Choi EK, Park EO, Park BH, Yang HJ, Kim MJ, Kang HJ, Chae SW. Randomized, double-blind, placebo-controlled trial of Ficus carica paste for the management of functional constipation. Asia Pac J Clin Nutr. 2016;25(3):487-96. doi: 10.6133/apjcn.092015.06. PMID: 27440682.
[xxvii] Jonna Jalanka, Giles Major, Kathryn Murray, Gulzar Singh, Adam Nowak, Caroline Kurtz, Inmaculada Silos-Santiago, Jeffrey M Johnston, Willem M de Vos, Robin Spiller. The Effect of Psyllium Husk on Intestinal Microbiota in Constipated Patients and Healthy Controls. Int J Mol Sci. 2019 Jan 20 ;20(2). Epub 2019 Jan 20. PMID: 30669509
[xxviii] Mousalreza Hosseini, Roshanak Salari, Mina Akbari Rad, Maryam Salehi, Batul Birjandi, Masoumeh Salari. Comparing the Effect of Psyllium Seed on Gastroesophageal Reflux Disease With Oral Omeprazole in Patients With Functional Constipation. J Evid Based Integr Med. 2018 Jan-Dec;23:2515690X18763294. PMID: 29607676
[xxix] RX List.com, Consumer Omeprazole Prilosec, Drugs Condition, What Are Side Effects Associated With Using Omeprazole. https://www.rxlist.com/consumer_omeprazole_prilosec/drugs-condition.htm#what_are_side_effects_associated_with_using_omeprazole
[xxx] Johnson W McRorie, George C Fahey, Roger D Gibb, William D Chey. Laxative effects of wheat bran and psyllium: Resolving enduring misconceptions about fiber in treatment guidelines for chronic idiopathic constipation. J Am Assoc Nurse Pract. 2020 Jan ;32(1):15-23. PMID: 31764399
[xxxi] Yang C, Liu S, Li H, Bai X, Shan S, Gao P, Dong X. The effects of psyllium husk on gut microbiota composition and function in chronically constipated women of reproductive age using 16S rRNA gene sequencing analysis. Aging (Albany NY). 2021 Jun 3;13(11):15366-15383. doi: 10.18632/aging.203095. Epub 2021 Jun 3. PMID: 34081625; PMCID: PMC8221300.
[xxxii] Healthline.com, Nutrition, 11 Super Healthy Probiotic Foods, https://www.healthline.com/nutrition/11-super-healthy-probiotic-foods
[xxxiii] Yue-Xin Yang, Mei He, Gang Hu, Jie Wei, Philippe Pages, Xian-Hua Yang, Sophie Bourdu-Naturel. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women. World J Gastroenterol. 2008 Oct 28;14(40):6237-43. PMID: 18985817
[xxxiv] Megumi Kubota, Kazuya Ito, Kazuhiko Tomimoto, Mitsuharu Kanazaki, Kei Tsukiyama, Akio Kubota, Haruo Kuroki, Mitsugu Fujita, Yvan Vandenplas. Lactobacillus reuteri DSM 17938 and Magnesium Oxide in Children with Functional Chronic Constipation: A Double-Blind and Randomized Clinical Trial. Nutrients. 2020 Jan 15 ;12(1). Epub 2020 Jan 15. PMID: 31952280
[xxxv] Noor-L-Houda Bekkali, Marloes Ej Bongers, Maartje M Van den Berg, Olivia Liem, Marc A Benninga. The role of a probiotics mixture in the treatment of childhood constipation: a pilot study. Nutr J. 2007;6:17. Epub 2007 Aug 4. PMID: 17683583
[xxxvi] Larry E Miller, Arthur C Ouwehand. Probiotic supplementation decreases intestinal transit time: Meta-analysis of randomized controlled trials. World J Gastroenterol. 2013 Aug 7 ;19(29):4718-25. PMID: 23922468
[xxxvii] Eirini Dimidi, Stephanos Christodoulides, Konstantinos C Fragkos, S Mark Scott, Kevin Whelan. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014 Oct ;100(4):1075-84. Epub 2014 Aug 6. PMID: 25099542
[xxxviii] Amy Myers Md.com, Article, Prebiotic Foods, https://www.amymyersmd.com/article/prebiotic-foods/
[xxxix] Veestro.com, Blogs. Food For Thought, 11 Plant Based Prebiotic Foods That Create A Healthy Gut. https://www.veestro.com/blogs/food-for-thought/11-plant-based-prebiotic-foods-that-create-a-healthy-gut?/
[xl] Ting Yu, Yong-Ping Zheng, Jia-Cheng Tan, Wen-Jie Xiong, Yun Wang, Lin Lin. Effects of Prebiotics and Synbiotics on Functional Constipation. Am J Med Sci. 2017 03 ;353(3):282-292. Epub 2016 Oct 4. PMID: 28262216
[xli] Michele Amenta, Maria Teresa Cascio, Pietro Di Fiore, Ivo Venturini. Diet and chronic constipation. Benefits of oral supplementation with symbiotic zir fos (Bifidobacterium longum W11 + FOS Actilight). Acta Biomed. 2006 Dec;77(3):157-62. PMID: 17312986
[xlii] Michela Barichella, Claudio Pacchetti, Carlotta Bolliri, Erica Cassani, Laura Iorio, Chiara Pusani, Giovanna Pinelli, Giulia Privitera, Ilaria Cesari, Samanta Andrea Faierman, Riccardo Caccialanza, Gianni Pezzoli, Emanuele Cereda. Probiotics and prebiotic fiber for constipation associated with Parkinson disease: An RCT. Neurology. 2016 Aug 19. Epub 2016 Aug 19. PMID: 27543643