July 2026

Constipation

• Why am I constipated?
• Dandelion – Move Your Shit
• Cascara Sagrada – A Stimulant Laxative
• Psyllium -Bulk Your Poop

Why am I constipated?

Constipation, however, is not just about the number of bowel movements but also about quality. If your poop looks like goat poop, small dry balls, if it is hard to pass, or if you don’t evacuate completely, then you are constipated, even if you empty on a daily basis.

What causes constipation?

The root causes of constipation can be divided into two categories: structural and functional.

Structural abnormalities leading to constipation

Structural abnormalities leading to constipation are physical blocking or narrowing of the colon and rectal passage that prevent stool passage.

They can happen because of a tumor blocking the anal passage. I had a friend who discovered her stage 4 colon cancer following a very painful bout of constipation.

Any trauma or surgery in the pelvic floor can result in rectal prolapse, adhesions, and constipation.

Rectocele is a condition in women where the wall of tissue between the rectum and vagina weakens and bulges, trapping stool and making complete evacuation difficult.

Hemorrhoids are swollen, blood-clotted veins in the lower rectum or anus that can physically obstruct the passage or make defecation severely painful. Constipation can cause hemorrhoids, but hemorrhoids can also worsen constipation.

The most effective treatment for structural constipation is pelvic floor physiotherapy.

Functional root cause of constipation

Most people are more familiar with the functional root cause of constipation. In the context of constipation, the term functional means that the physiology is healthy, but for some reason, it is not working well.

Functional root cause of inflammation might include:

• Insufficient digestive fire
• A diet low in fiber
• Dehydration
• Sedentary lifestyle
• Stress
• Hypothyroidisim
• Dysbiosis and SIBO
• IBS
• Hormonal imbalance
• Dysautonomia
• Insulin resistance
• Medications

Insufficient digestive fire

Insufficient digestive fire means that the digestive system is not producing enough digestive enzymes to break down, absorb, and move food through the system.

When enzymes and digestive juices are not produced, the body struggles to break down food and absorb nutrients. Low nutritional status can set the stage for deficiency in the building blocks of digestive enzymes.

Hypochlorhydria

Hypochlorhydria happens when the stomach does not produce enough stomach acid. Many people who struggle with GERD assume that they produce too much stomach acid, but in most cases, the opposite is true. Stomach acid is crucial for breaking down proteins into amino acids and for extracting B vitamins and zinc from the food you eat. If chyme, the soup of acids and food that your stomach “spits” into the small intestines, is not acidic enough, motility is stunted, pancreatic enzyme secretion is reduced, and SIBO can occur.

Bile

Bile production is another important factor in digestion and motility. It is produced by the liver, stored in the gallbladder, and released in response to food in the small intestines. Bile binds together undigested food, waste products, and cholesterol to create stool. When bile enters the colon, it promotes motility and water secretion. Bile gives the stool its color.

Bile production and secretion can be a result of a low caloric diet, a low fat diet, liver imbalance, gallbladder imbalance, or removal.

A diet low in fiber

“Eat more fiber” is advice most people with constipation have heard at some point. Fiber plays a dual role in preventing and treating constipation: it provides bulk that activates stretch receptors in the colon wall, triggering peristalsis; it feeds the microbiome, whose metabolic products, especially short-chain fatty acids like butyrate, directly stimulate colonocyte function and motility; and it holds water in the stool. Without adequate fiber, the colonic mucosa is understimulated, the microbiome is starved, butyrate production drops, and stool becomes hard and slow.

Dehydration

As the mix of undigested food, waste products, and digestive enzymes passes through the colon, it reabsorbs some of the fluids back into the body, which transforms the soup into formed stool.

At the same time, mucus membranes in the colon secrete fluid that lubricates the stool, making it easier to pass. In conditions of chronic dryness or when mucus membranes are not functioning well, stool becomes dry and hard to pass.

Sedentary lifestyle

I like to say that when you move, your digestion moves too. Physical movement directly stimulates gut motility through multiple pathways.

Movement increases blood flow to the pelvic floor, delivering nutrients to the tissue and removing waste products, leading to optimal tissue function.

Movement activates the vagal nerve, coordinating digestive secretion and motility. Low vagal tone is associated with dysbiosis and constipation.

Walking after every meal, and squatting can promote blood flow to the pelvic floor and improve vagal nerve tone.

Stress

Many people, especially women, hold stress and trauma in the pelvic floor. The longer you hold stress in the pelvic floor, the harder it will be to release the tension as it moves from functional tension to a holding pattern and can lead to ischemia, a condition where blood and lymph flow are stunted because the tension doesn’t allow free flow.

At the same time, muscle tension around the colon and rectum hampers peristalsis and narrows their lumens.

Stress also means less blood is diverted to the digestive system and less digestive enzyme production, which reduces overall digestive fire.

Hypothyroidism

The thyroid regulates all metabolic processes. In the digestive system, it refers to the amount of digestive juices produced, the rate of nutrient breakdown and absorption, and motility.

In hypothyroid conditions, all digestive functions, including motility, are slowed down.

Dysbiosis and SIBO

Dysbiosis is any condition that affects the composition or placement of gut bacteria. SIBO is a type of dysbiosis in which the numbers of gut bacteria in the small intestines are higher than normal, leading to nutrient deficiencies, bloating, and gas.

Gut bacteria in the colon ferment fiber and resistant starch, producing short chain fatty acids such as butyrate. These metabolites directly promote serotonin production. About 95% of the body’s serotonin is produced in the gut, where it functions as a signaling molecule that drives peristalsis.

A diet low in fiber and resistant starch means less short chain fatty acids are produced, but also alters gut bacteria strains and ecology. The end result is less serotonin production and reduced motility.

SIBO, an increase in the number of bacteria in the small intestine, can also lead to constipation. The excess bacteria in the small intestines compete with you for nutrients, they inhibit digestive enzyme production, leaving you with insufficient digestive fire, and slow motility, so they have access to the food longer.

IBS

IBS is a cluster of digestive symptoms resulting from dysfunction of the enteric nervous system. Some people experience IBS with constipation, while others struggle with diarrhea, and yet others might have alternating bouts of constipation and diarrhea.

The enteric nervous system contains about 500 million neurons that are embedded in the lumen of the digestive tract. IBS is a condition in which the sensory threshold in the enteric nervous system is dramatically lowered. The gut becomes hypersensitive; normal amounts of gas, normal peristaltic contractions, and normal luminal contents are perceived as pain or discomfort.

What is IBS-C?

In IBS-C (constipation), you get segmental contractions that do not propel the food downward but instead create pockets where food is churned.

In IBS, the gut brain axis is dysregulated in both directions. On the one hand, psychological stress directly worsens gut symptoms; on the other hand, gut dysfunction drives central nervous system changes, including dysbiosis, intestinal permeability, and gut inflammation, leading to stress, anxiety, depression, and cognitive changes.

People with IBS-C will benefit most from anti-spasmodic herbs to reduce spasms and restore coordinated motility. In addition, bitter herbs can stimulate serotonin production and help modulate visceral sensations.

Reproductive hormones imbalance

Constipation and reproductive hormones are linked in a mutual dance.

Reproductive hormones are conjugated by phase Ⅱ liver detoxification, bind to bile, and are excreted with the stool. When transit time is slow and conjugated estrogen sits in the colon, bacterial enzymes reverse the conjugate process, reactivating estrogen. Estrogen can be absorbed back into the blood through the colon wall. Constipation is a primary process of creating estrogen dominance.

Progesterone acts as a muscle relaxant in the body. In the luteal phase, when progesterone is the dominant reproductive hormone, women may experience transient constipation that resolves once progesterone drops.

Dysautonomia

In a healthy autonomic nervous system, the two branches, sympathetic (stress) and parasympathetic (digest and relax), are modulated. The nervous system adapts to internal and external inputs by shifting between branches.

In dysautonomia, the nervous system loses this flexible function and becomes stuck and dysregulated, leading to loss of peristalsis coordination, insufficient digestive fire, and a dramatic reduction in the urge to empty the bowel.

Constipation associated with dysautonomia will benefit from stimulating the vagal pathways. Breathwork, humming and singing, and washing your face with cold water. Bitter and aromatic herbs promote vagal tone.

Insulin resistance

Insulin resistance and constipation are bidirectional conditions. Chronically elevated blood glucose and insulin damage nerve cells in the periphery, including the nerve cells that are involved in the digestive system. Enteric neuropathy dysregulates peristalsis, slows down motility, and reduces rectal sensitivity, so the urge to evacuate is blunted.

Slow transit times disrupt the balance of your gut microbiome, promoting strains that compromise the intestinal barrier, allowing endotoxins such as LPS to leak into the bloodstream, triggering an immune response and low grade systemic inflammation, which directly interferes with insulin signaling and increases insulin resistance.

Medications

Many common prescription and over-the-counter medications can promote constipation by slowing down gut motility or altering fluid absorption.

To find out if a medication you are using gives you constipation, consider if your constipation issue began when you started using the medication. Also, read the side effects in the notes that came with the medication or find them on Google.

Never discontinue a medication that was prescribed to you by a medical professional without consulting them.

From cause to plan

There are so many root causes of constipation, and an effective treatment depends on identifying the root cause. This can be even more complex in people who struggle with more than one trigger. That’s where I come in. My special talent is asking the right questions that will unravel what triggers your constipation.

In the next couple of weeks, I am going to explore three herbs that help relieve different types of constipation.

Understanding why you are constipated is crucial to developing a strategy to relieve it.