.png)
Constipation is a common condition worldwide. It is typically characterized by difficulty passing stool, incomplete evacuation, hard or dry stools, and fewer than three bowel movements per week.
Approximately 16% of adults in the United States experience chronic constipation, and this number increases to 33% among those aged 60 and older. From a holistic perspective, the true prevalence may be higher, as many integrative practitioners consider at least one comfortable bowel movement per day to be normal.
Constipation often reflects that the body’s natural digestive system is not functioning optimally. There are several underlying causes, many of which are within an individual’s control.
Common contributing factors include:
- Low dietary fiber intake
- Inadequate fluid consumption
- Lack of physical activity
- Ignoring the urge to have a bowel movement
Certain medications are also known to contribute to constipation, including:
- Opioid pain medications
- Antidepressants
- Antihistamines
- Anti-Parkinson’s medications
- Antiseizure drugs
Additionally, some medical conditions may predispose individuals to constipation, such as:
- Diabetes
- Multiple sclerosis
- Parkinson’s disease
Long-term use of stimulant laxatives should be approached with caution, as it can lead to dependence and other side effects.
A first-line approach to improving constipation is increasing both water and fiber intake to support peristalsis—the wave-like muscle contractions that move stool through the digestive tract.
Recommended water intake: approximately 50–80 ounces daily, depending on activity level
Recommended fiber intake: 25–30 grams or more per day
Only about 5% of American adults meet recommended fiber intake levels.
Soluble fiber:
- Absorbs water and forms a gel
- Helps soften stool
- Found in: whole grains, nuts, seeds, beans, lentils, peas, fruits, and vegetables
Insoluble fiber:
- Adds bulk to stool
- Promotes regular bowel movements
- Found in: whole grains and vegetables
Note: Individuals with gluten sensitivity or allergy should use non-gluten grains.
Fiber Supplementation
For those unable to meet fiber needs through diet alone, supplements can be beneficial.
Psyllium husk is a commonly used option:
Typical dose: 10–15 grams daily, divided into doses
Take with approximately 10 ounces of water per dose
Start with 5 grams daily and gradually increase over several weeks
Other fiber supplements may also be used as alternatives.
Exercise
Regular physical activity is an often overlooked but effective strategy for improving constipation.
Aim for at least 30 minutes of daily exercise.
Triphala
A traditional herbal formulation made from three fruits:
- Terminalia chebula (black myrobalan)
- Terminalia bellerica (bastard myrobalan)
- Phyllanthus emblica (Indian gooseberry)
Triphala supports bowel regularity, is non-laxative, can be used long-term, and is widely available over the counter.
Probiotics
Probiotics may also help improve constipation. It is recommended to use products that are supported by clinical studies demonstrating effectiveness.
Constipation is a common but often manageable condition. In many cases, it reflects modifiable lifestyle factors such as diet, hydration, physical activity, and bowel habits. Addressing these foundational areas can significantly improve symptoms.
For persistent or severe cases, reviewing medications, underlying conditions, and incorporating targeted therapies such as fiber supplementation, probiotics, or herbal formulations can provide additional relief.
References
Dietary Guidelines for Americans. https://www.dietaryguidelines.gov/
Tarasiuk, A., Mosińska, P., & Fichna, J. (2018). Triphala: Current applications and new perspectives on the treatment of functional gastrointestinal disorders. Chinese Medicine, 13(1), 39. https://doi.org/10.1186/s13020-018-0197-6
