Are You Constipated?

Hey Nourish Community,

Dr. Starr here!

I define constipation as less than 1-3 complete bowel movements daily. When waste sits in the colon for an extended time, toxins and excess hormones may be reabsorbed. This becomes an obstacle to achieving optimal health and healing.

When evaluating constipation in a patient, I always ask the following questions:

  1. Do you feel the urge to pass stool and how often?
  2. Do you have to strain?
  3. What is the consistency, shape and color of the stool?

Types of constipation:

Type I : "Urge constipation"

You feel the urge to move your bowels but have to strain. Stool may be hard pellets or soft and sticky. You may have multiple bowel movements daily but never feel completely empty.

Causes: factors that affect the ability of the colon to contract to propel waste into the rectum

  • Hypothyroidism
  • Certain medications
  • Dietary factors such as low fiber diet
  • Dehydration
  • Pelvic floor dysfunction or spasm
  • Physical obstruction or stricture due too surgical scars, endometriosis, organ prolapse or polyps
  • Stool impaction
  • Methane gas production or other irritants in the large or small bowel
  • Poor secretion of digestive juices such as bile, enzymes and stomach acid
  • Stress/trauma inhibits the parasympathetic nervous system

Type II : "No-urge constipation"

You can go days without the urge to go.

Causes: damage to the neurological circuit that stimulates the defecation reflex

  • Nervous system damage: MS, Parkinson’s, spinal cord injury, diabetic neuropathy, B12 or thiamine deficiency
  • Sacral inflammation or misalignment
  • Rectal dilation from chronic constipation
  • Stress/trauma inhibits the parasympathetic nervous system

Here are my top 6 natural interventions for constipation:


  • Squatting with knees above the hips straightens the rectum, try sitting with a stool at the base of the toilet


  • Don’t hold your breath! Your throat, diaphragm and pelvic floor share control centers. Actively relaxing the base of your tongue to widen the throat while simultaneously breathing out relaxes the pelvic floor to allow the bowel movement to pass easier.


  • Eat 1/2-1 cup of high fiber food with each meal: beans, artichokes, squash, berries, avocado, apples, broccoli, chia seeds, oatmeal and prunes
  • Try 1 tablespoon of psyllium seed husk powder in 12 ounces of water in the morning


  • Drink ½ of your body weight in ounces of filtered water daily.

Herbs to help with GI contractility:

Take a dropper-full of an herbal blend before meals or capsules containing one or more of these herbal extracts twice per day before meals:

  • Ginger
  • Artichoke
  • Aloe vera
  • Bitter herbs including gentian, burdock and dandelion root
  • Triphala

Nutrients to soften the stool:

These work by pulling water into the bowels, take enough to create a soft-formed stool:

  • Magnesium: citrate, oxide or ozonated magnesium
  • Vitamin C

Lab testing for constipation:

If you implement all of the interventions outlined above and still struggle to have a daily bowel movement, there may be a more complex cause to identify. Call your doctor to discuss functional testing to identify what is out of balance in your case. Be aware that there are often multiple factors to consider.

  • Comprehensive thyroid panel
  • Comprehensive stool analysis
  • 3 hour breath test for hydrogen, methane and possibly hydrogen sulfide
  • Urinary organic acid test for candida
  • Pyruvate and lactate level and serum B1 for thiamine deficiency
  • Serum B12 level
  • Comprehensive metabolic panel to evaluate electrolytes and liver enzymes
  • Imaging and evaluation through a chiropractor, pelvic floor PT or neurologist

I truly hope you find relief with these therapies and feel empowered to uncover the root cause of your chronic constipation. Your body can heal!

With care,
Dr. Starr

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