Constipation - Liver Doctor

A-Z Health Guide

Constipation

What exactly is constipation?

Constipation is not only irregularity of bowel actions. It also has to do with the hardness of the stool (bowel motion) and not only how often a bowel action is passed. In a healthy individual one to three motions per day is desirable.

Constipation can be due to not going to the toilet when nature calls! This results in the bowel reabsorbing water and therefore making the stool hard.

Eating large amounts of cooked and processed foods can contribute to sluggish bowels. Over a period of time, a layer of toxic waste products may build up on the lining of the sluggish bowel. This build-up can cause inflammation in the bowel, and the toxins are absorbed from the bowel and travel back to the liver via the portal vein. The liver has to work much harder to break down these internally produced toxins and symptoms of liver dysfunction may result. Thus constipation can lead to headaches, abdominal bloating, fatigue, allergies and skin problems.

Regular daily well-formed bowel movements passed without straining is desirable. This reduces the risk of conditions such as appendicitis, hiatus hernia, abdominal hernias, hemorrhoids and colon cancer. If the bowel moves as often as food is eaten, say 2 to 3 times a day, this can help prevent a build-up of toxic waste products in the bowel.

Common causes of constipation

Causes of constipation include –

a diet deficient in fiber and/or raw fruits and vegetables
food intolerance; most commonly to gluten and/or dairy products
lack of exercise
dehydration with inadequate intake of water
abuse of laxatives
Drug side effects
under activity of the thyroid gland
nervous tension
a structural abnormality of the bowel

Mechanical problems with the bowel are common, such as prolapsed bowel or extra loops of bowel or bowel pockets. These pockets form in the wall of the colon and this condition is called diverticulitis.

Megacolon

I remember a young woman who presented with severe constipation – she was only opening her bowels once every fortnight. A barium enema X ray revealed an extra loop of bowel as the underlying, albeit quite rare, cause of her problem. This redundant loop was removed surgically and she was cured! These extra loops of bowel are called “Megacolon”. This can be congenital or due to poor diet and laxative abuse. A special X ray called a barium enema is able to diagnose megacolon with extra loops of unwanted bowel. In extreme cases the extra loops of bowel become huge and great help is achieved by surgically removing them in expert hands.

Treatment and general recommendations

Try to establish a regular time for sitting on the toilet to train the bowel. Aerobic exercise like brisk walking is beneficial, preferably three to four times a week for a minimum of twenty minutes. Some specific abdominal exercises are also worth the effort. Sit in a straight backed chair and tighten the abdominal muscles for a few seconds then relax. Repeat ten times. Whilst lying, try some gentle massage of the colon – up the right side of the abdomen, across the top from right to left and down the left side. Learning to do some relaxation exercises or yoga will also help in those whose constipation is anxiety related. General exercise is also very helpful – aim for 20 – 30 minutes of exercise 3 – 4 times per week. Walking is ideal.
Chronic use of laxatives should be avoided – they can actually be the cause of ongoing constipation.

Diet

Good liver function is vitally important as bile is the body’s own laxative.
Include often – a good variety of high fiber foods such as raw vegetables, fruit, legumes, nuts and seeds.
It’s also vital to drink 8 to 12 glasses of water a day.
Linseeds (or flaxseeds) are excellent to assist with constipation as these have the action of lubricating the bowel. A good way to take linseed is in a mix called LSA – this is linseed, sunflower and almond meal – this can be purchased or you can make your own with a coffee grinder.
Avoid ALL margarines and hydrogenated oils.
Avoid deep fried foods.
Avoid processed foods.
Avoid gluten (found in wheat, rye, oats and barley) and all foods containing these. Gluten is a digestive irritant.
Avoid artificial sweeteners; see www.dorway.com

Other recommended books

Raw juicing

Here is an appropriate juicing recipe found in the “Raw Juices Can Save Your Life” book.

Constipation Smoothie

Ingredients

2 spinach or 2 dandelion or 2 cabbage leaves, well chopped
2 green apples, skin on
3.5 oz (100g) fresh prunes – stones removed
3.5 oz (100g) fresh figs
1.8 oz (50g) fresh rhubarb (remove leaves)
1.8 oz (50g) fresh cherries (stones removed) – optional

Method

Wash all fresh ingredients and chop.
Soak dried fruits in water overnight.
Blend in a blender and drink.
Add one tablespoon of chia seeds and stir.

Laxatives

Over the counter preparations like Senokot, Durolax and Cascara all produce strong stimulation of the bowel and long-term use should be avoided. Other laxatives include Coloxyl which is a faecal softening agent and “Agarol” which contains liquid paraffin that coats the faecal mass to allow easy transition through the bowel. Agarol should only be taken at bedtime as it can interfere with the absorption of the fat-soluble vitamins. Duphalac, Osmolax and Movicol work by osmosis, drawing water into the stool with resultant distension and softening of the stool. Normacol granules and Metamucil are known as bulk laxatives; that is they are forms of fibre that absorb water.

Tests for bowel and digestive function

If you believe that you may have a bowel problem, it is a good idea to see a specialist in gastrointestinal disorders, known as a gastroenterologist. The most serious problems to exclude are malignant tumors of the stomach and bowels, which become far more common as we age. This is why it is important to have thorough investigations early on if you develop any change in bowel actions, unexplained weight loss or abdominal pains.

Colonoscopy

This involves passing through the anus a thin flexible tube that visualizes the lining of the entire colon and rectum, and transmits the picture to a television screen. Samples (biopsies) can be taken from suspicious looking areas of the bowel to enable accurate diagnosis. It is done under mild intravenous sedation and takes around 30 minutes. The colon needs to be cleansed with laxatives beforehand to enable an accurate assessment. Colonoscopy is the most accurate way to diagnose the cause of bowel symptoms and to screen for cancer and bowel polyps. Bowel polyps can be removed via this procedure.

Barium enema X ray

This is an X-ray examination of the large bowel (colon and rectum) which enables the doctor to assess the shape, size and smoothness of the outline of your large bowel. The X-ray is performed after you receive an enema to insert barium (a chalky radio-opaque) liquid into the rectum which will contrast and outline the wall of the large bowel. A barium enema will show up enlargement of the large bowel and irregularities of the bowel wall and bowel pockets known as diverticula. It can also reveal muscular spasm (spastic colon) in the wall of the large bowel. In some cases of severe constipation a barium enema X ray will reveal a huge dilated colon with extra loops of unwanted bowel (redundant bowel), and this is known as a “megacolon”. A barium enema may show some types of bowel cancer, however, it can also miss small cancers, and for this reason a colonoscopy is a far more accurate way to exclude bowel cancer.

Recommended supplements for constipation

Livatone Plus Capsules
Take 1 teaspoon twice daily or 2 capsules twice daily with meals. Livatone Plus is the leading liver formula to improve liver function and bile production.
Magnesium Ultra-Potent Powder
Take one to two teaspoons daily in water or raw juice – A formula containing 4 different forms of magnesium is highly effective for reducing chronic constipation.
Super Digestive Enzymes
Take 1 – 2 capsules in the middle of meals if poor digestion is associated with constipation.