Constipation - What's up with your Poop?

Updated: Jun 27, 2020

One of my favorite jokes: What's brown and sticky? A stick! Bet you thought it was something else, right?

This can be an uncomfortable topic to discuss - poop, but it's an important topic when discussing your health and well-being. It's also the "butt" of many jokes, and considering toilet paper is flying off the shelves these days, why not get a better understanding of it?

Poop is the waste products of what you eat, what can't be digested or absorbed completely. It's also made of bacteria, and metabolic waste, mostly from blood cell breakdown (bilirubin) and dead epithelial cells from the lining of the GI tract. Sometimes you might even see a little clear mucous, which is used by the GI tract to help lubricate its transport out of our bodies.

"You should poop at least once a day. Ideally, 3 times per day. Any less than one poop a day is considered constipation."
You want type 4 poop.

Constipation is the most common digestive complaint in the US. In 2000, 63 million people were diagnosed with chronic constipation. That accounted fro 5.3 million prescriptions and even 132 deaths (1)! Most gastroenterologists won't even diagnose you with chronic constipation unless you're pooping less than 3 times in a week. Can you imagine how many people are actually constipated in the US, meaning pooping less than once daily? I would say in the neighborhood of 1 in 3-5 people, just based off of how often patients are not pooping daily that come into the office. Even if you're having daily movements, they should be smooth and comfortable to pass. If you're having difficulty, or passing hard pebbles, that is also classified as constipation.

Not to mention the uncomfortable symptoms that can come without a daily movement, such as gas, bloating, low back pain and sometimes even anxiety and fatigue.

Daily movement is essential for a number of reasons:

  1. It's how we detoxify and eliminate toxins and other garbage: If we're not getting that "crap" out, it's staying behind in our systems to wreck havoc. Our digestive system accounts for a large percentage of our daily detoxification of metabolic wastes and toxins we're exposed to during daily life. If this system becomes backed-up, we then have to use other organs (namely the kidneys, skin and even lungs) to get stuff out. These systems can't eliminate nearly as much as the digestive system can, so they easily become over-burdened and then experience problems.

  2. It's how we process and metabolize hormones: Hormones such as estrogen are eliminated by the liver in a process called conjugation, where it's then expelled through the bile into the digestive system. Bacteria can then act on the hormones, unconjugate them, and the circulatory system picks them back up again to circulate around until we're able to eventually get rid of them. If your stool is allowed to sit in the GI for longer than it should, it would make sense that more hormones are unconjugated and picked back up by the circulation, creating unhealthy imbalances in these hormones. Learn more about your hormones here.

  3. It's where 70-80% of our immune system exists: Most of your immune system lives in your GI in the form of large patches of immune cells (gut associated lymphoid tissue) and mucous. You need most of your immune system here because this is where we take things from the outside world (food, water, etc.) and introduce them into the internal environment of our body, where we would be most susceptible to infection. So if your digestive system isn't functioning well, you can bet it could affect your immune system function. We see this commonly as allergies, food sensitivites and immune system hyperreactivity, even autoimmune disease (2).

  4. You liver function depends on it: All the blood from your digestive system, chalk full of macro- and micronutrients from your food goes straight to the liver where it's processed, packaged and shipped out to the rest of the body. Healthy liver function depends upon healthy, nutrient-dense blood from the digestive tract to be able to complete its many jobs including detoxification (conjugation of compounds, including hormones), fat processing, bile production, and energy metabolism.

Chronic constipation comes with risks as well:

  • Hemorrhoids

  • Fecal impaction

  • increased risk of colon cancer (especially if due to low fiber intake)

  • Anal fissures

  • Rectal prolapse (which comes with anal leakage)

So what's the cause?

Eating the wrong foods for your body: We are all intolerant to certain foods, and when we eat these foods, they are not easily broken down by our digestive system which creates fermentation, bacterial imbalances and slowed digestive movement. The easiest solution can be to remove these foods from the diet. Read more about food intolerances here.

Poor upper digestive function: Most common here is insufficient stomach acid production. Stomach acid's main role is to break down protein, and if there's poor breakdown early in the process, you can imagine this makes it harder for the lower digestive organs to breakdown foods. This can slow the transit through the GI. Another common symptom of insufficient stomach acid is actually heartburn - you can read more about that here.

Poor liver function and bile production: One of the stimuli to help create the urge for a bowel movement is a release of bile from the gallbladder and liver. If this bile release isn't happening normally, or if the liver is too congested to be producing good quality bile, you won't get sufficient emulsification of fats or the urge to go. Any time the upper digestive system doesn't get the job done, it puts more work on the lower digestive system and slows the system down. Read more about your liver here.

Insufficient fiber intake: Fiber is necessary to help with the movement of stool through the system as well as to provide some "bulk" to the stool as well. Fiber is also a lot like a "roto-rooter" for the digestive tube, helping to keep the system running clean. Most adults need about 35 gm of fiber daily, but most of us only get about 16 gm (3). Fiber also helps reduce our colon cancer risk, lowers cholesterol and reduces blood glucose levels and risk of developing type 2 diabetes. Eat more whole grains and veggies!

Chronic anxiety and stress: You can probably imagine that digesting your food is the last thing your body is thinking about when in "fight or flight" mode. When anxious or stressed, the body pumps hormones necessary to divert blood flow away from the digestive system in favor of organs such as the heart, lungs and muscles - the ones we need to fight or run. If we're not getting healthy periods of time that are stress free and relaxing (parasympathetic), we don't get the circulatory support needed to stay "moving". Here are some tips to help reduce chronic anxiety.

Certain medications: Opioids top the list here in drugs with side effects of constipation. But did you know chronic over-use of laxatives can also create constipation? The body actually "forgets" how to have a bowel movement after long term use of stimulating laxatives. Other common medications such as antidepressants, antacids, certain calcium and iron supplements, anticonvulsants and diuretics can all cause constipation as an unwanted side effect.

Hypothyroidism, Dehydration and Magnesium deficiency are also common causes which are easily addressed.

The best way to eliminate chronic constipation is through a complete evaluation and functional assessment by your naturopathic physician. We understand and love the digestive system! Chronic constipation is often easy to correct once the causes are eliminated and proper nutrition and function is restored. You don't have to struggle with chronic constipation, and you don't have to manage it with laxatives and stool softeners, "Smooth Move" tea and similar.

What did one fly say to the other? Is this stool taken?

Have you seen the new movie constipated? It hasn't come out yet.

Poop jokes aren't my favorite jokes, but they're a solid #2.

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