All the fibre in the world won’t make me poo!

“All the fibre in the world won’t make me poo” my patient told me. I often get patients who complain of chronic constipation. As a therapist, our first approach is to address diet to make sure that there is enough fibre in the diet.  That works in most cases, but for some, even a good diet seems to make no difference to their bowel systems.

I must admit that I never quite understood this, and like many therapists thought that the person is just not trying hard enough with their diet. Surely if they were eating the right foods, bowel movements should come easily and naturally? That is what I believed for a long time: until I struggled with my own daughter’s constipation.  She was on a pristine diet, absolutely no junk, plenty of vegetables, good quality fruit, the right amount of wholegrains.  However she could not have a natural bowel movement without using suppositories

How was this possible? I was gob-smacked! The worse her constipation got, the harder I tried to bring more fibre into her diet and that is when I learned, after plenty of research, that diet is not the only contributing factor to our bowel movements.

So, for those patients who struggle with their bowels even when they are on a very good diet, here are some of the findings that I found helpful:

1. Multiple neurotransmitters and hormones are involved in regulating gut function.  The most common being serotonin and acetylcholine.  That means that low mood or depression can contribute to constipation. More importantly, since these neurotransmitters are produced in the gut, if the gut isn’t working as it should, the production of these neurotransmitters is reduced leading to depression.  It is also the reason why anti-depressants can cause bowel changes.
2. Restrictions in the fascia around the bowels can also cause constipation. This was the case with my daughter.  Fascia is the sheath that surround our muscles and organs.  Sometimes this sheath wraps itself around the organs and becomes knotted.   Myofascial release is the technique used to unknot this sheath, giving more space for the intestine to function normally.  I couldn’t believe it when, just after 2 sessions, my daughter’s 5 years of constipation was over. We have never had to use a laxative again!
3. Organ dysfunction, such as stomach, liver or gall bladder problems can also greatly contribute to constipation.  A deficiency of bile can cause very severe constipation.    Low stomach acid is another contributor. Low thyroid function slows down the metabolism of the body and with it, the speed of bowel movements.
   

So, how can we differentiate the cause? The table below may offer some help:

There are other causes, so if you are not sure please talk to your practitioner.

In conclusion, although diet is very important in prevention, as you can see from the above, there are many other factors that could be contributing to constipation.  If you are unfortunately struggling with this problem please don’t hesitate to get in contact with us.