This month we’ll be talking about constipation. I’ll talk about the causes, what tests you can do to resolve this problem when the usual culprits are not at play. Then next month I’ll give you a guide as to how to prevent constipation and, to resolve this uncomfortable situation. As well as, what you should not do, in regard to ‘medications’ that manage constipation. And, how our good old friend stress, can play a role in causing constipation.

To begin with, constipation is when you are having difficulty in going to the toilet when needing to open your bowels and/or, you do not go on a daily basis. That is, the stools are hard and you need to strain to pass the stool out. Sometimes, they can look like ‘pebbles’ instead of a long well-formed ‘sausage’. Young children tend to do this when being toilet trained.

Causes

I’m sure that most of you are aware of the main causes of constipation – poor water intake and low fibre in your daily diet. This is because fluid is absorbed in your colon. So, if you don’t drink enough water, this dries out the stool making it hard and difficult to pass. Fibre, adds bulk to the stools, as well as helping to maintain water content in your stools – making it easier to pass.

Other causes include –

• Lack of exercise
• Some medications – in particular, codeine which is in pain medication such as Panadeine, Panadeine Forte
• Surgery, especially abdominal
• Pregnancy
• Hypothyroidism – due to your metabolism slowing down
• Irritable Bowel Disease (IBD)
• Food intolerances – lactose and gluten, being the main suspects
• Illness/injury – due to reduced movement and food intake
• Holding off going to the toilet – you begin to ‘turn off’ your body’s response to opening your bowels
• Overuse of laxatives
• Intestinal microflora imbalance – caused by antibiotics, illness, food intolerances, poor diet
• Parasites
• Poor digestion – due to reduced gastric acid, enzymes or bile

Testing When You Are Experiencing Constipation

There are some tests that you can do to see what may be contributing to your constipation. This may be necessary if we have addressed the main causes – low water and fibre intake – and, you continue to experience constipation.

There are two main tests I use, I might get you to do is a stool test – Comprehensive Digestive Stool Analysis (CDSA) or microbiome mapping like the GI Map Test or a SIBO Test – after taking a comprehensive look at your diet, lifestyle and, general health. Especially if you have had a ‘stomach bug’, or been overseas, and prescribed medications or, natural medicines have not helped.

The GI Map test looks at many things that might affect your intestinal system, leading to constipation. It looks at –

• Your microbiome, to see if the ‘ecosystem’ is balanced – whether there is an overgrowth of pathological bacteria or yeast or a lack of good bacteria
• If you might have any parasites or worms
• It tests for inflammatory and immune markers
• Short Chain Fatty Acids – if there is enough of these or an imbalance
• Intestinal permeability – you might know this as ‘leaky gut’, measuring zonulin

A SIBO test is checking to see if you have an overgrowth of bacteria that produce hydrogen or methane in your small intestine. If you have an overgrowth of methanogens it’s likely you will experience constipation and so dealing with this will help get rid of your constipation.

You may need to have a colonoscopy and endoscopy done to see if you might have IBD or Coeliac disease. This is to rule these out if your symptoms and diet, really point in this direction.

You may have other symptoms that indicate that you have a slow thyroid. So a blood test looking at thyroid function would be indicated.

References

• Better Health Channel