If you’ve ever had to deal with irregularity — and who hasn’t? — you know how uncomfortable it can be to discuss bowel problems. I understand it’s awkward to talk about such personal things. But we’re all here to make life better, so let’s put embarrassment aside and look at some simple solutions to these very real problems.

For some people, the primary issue with irregularity is constipation, usually described as difficult or infrequent bowel movements. For others, the watery, too-frequent bowel movements of diarrhea are causing problems. Sometimes these conditions are symptoms of more serious ailments, such as irritable bowel syndrome (IBS), which alternates between diarrhea and constipation. But today, I’d like to discuss constipation and diarrhea that occur without any complicating factors.

There are no hard-and-fast rules about the proper number of bowel movements. For some people, bowel movements are daily events. But others may be fine with a movement every few days. Personally, I think more frequent elimination is a good idea, since the whole point of bowel movements is to eliminate digestive waste and toxins, two things you don’t really want to store in your body for long periods of time.

Because constipation is so common, let’s look at what can be done about that issue first.

Correcting Constipation

Common factors that cause constipation include:

• Dehydration
• A poor diet
• A shortage of beneficial bacteria
• Too little fiber
• Lack of exercise
• Certain medications
• Low magnesium (but too much magnesium may cause diarrhea)

While laxatives are standard treatment for constipation, they are not a cure-all, and the side effects can be very uncomfortable, as my patient Gina discovered.

Get Proper Hydration

Pinch the skin on your hand. If it doesn’t return to normal immediately, you may be dehydrated. Fortunately, this is easily corrected by drinking more clean, filtered water.

Here’s a good guideline: You should be drinking the equivalent of half your body weight in ounces of water daily. In other words, if you weigh 160 pounds, you should be drinking 80 ounces of water — or ten 8-ounce glasses of water — every day. Drinking sufficient water helps keep stools soft and bulky, so they move through your system easily.

Eat Real Food

If you’re not eating fresh, whole, minimally processed food — in other words, foods your grandparents ate — this would be a good time to start. Your body knows what to do with things like vegetables, fruit, and meat. It has a much harder time dealing with bleached, processed ingredients that have been ground into pulp and mixed with heavy doses of sugar, fat, and salt. Do yourself a big favor and shop the supermarket perimeters, where real food is stocked, not the packaged goodies in the center aisles.

If you don’t read food labels, please start. Avoid foods made with high-fructose corn syrup (HFCS), which is used in everything from salad dressings to bread and cereals. Look for whole-grain foods, which contain more nutrients and naturally occurring fiber (see below) than less-nutritious multigrain choices. For fruits and vegetables, choose fresh first, frozen second, and canned only as a last resort.

Put Probiotics to Work

Question: What do your brain and intestinal tract have in common?

Answer: Much more than you might think. The intestinal tract relies on many of the same hormones and neurotransmitters as the brain — not surprising when you consider that the entire digestive process is a complex series of decisions about which substances go where. Probiotics, the beneficial bacteria essential for good digestion, help the intestinal tract implement those decisions about processing the food we eat. Probiotics also encourage healthy elimination, can relieve constipation, and help with diarrhea, which we’ll look at shortly.

If you’ve taken antibiotics in the past, as most of us have, your supply of probiotics could be low. Today’s broad-spectrum antibiotics kill all bacteria in the body, not just the bad ones. So any time a patient mentions problems involving regularity, digestion, or diarrhea, I recommend probiotic supplements containing at least 10 billion live organisms per dose.

Make Friends with Fiber

Let’s talk about the “F” word — fiber. Americans eat far too little fiber, which may be why laxatives are among the best-selling drugs in pharmacies. Fiber helps digested food stay bulky and soft, allowing it to pass through the colon easily. Your daily diet should include foods high in fiber, such as the following:

• Fruits, especially prunes
• Lentils
• Vegetables
• Beans, especially lima beans and soybeans
• Barley
• Oat bran
• Flax and chia seeds
• Oatmeal
• Nuts, like almonds and peanuts
• Buckwheat
• Whole grains

Eating plenty of fiber-rich foods not only encourages regularity, it also helps balance blood sugar and maintain healthy cholesterol levels. A recent study found that simply adding a little oat bran to an ordinary diet helped nearly 60 percent of the participants transition off laxatives. You can try this at home by adding one-half cup of oat bran to your breakfast cereal or smoothie each day. If you can’t tolerate the taste of oat bran, supplements are also available. Or you can add a form of fiber known as psyllium, available at health-food stores, to your daily regimen. No matter which option you prefer, be sure to drink plenty of water when taking fiber to encourage movement through the digestive tract.

Fiber has the added benefit of reducing the likelihood of developing hemorrhoids and diverticulitis, two conditions often made worse by constipation. So aim for 20 to 35 grams of fiber daily. An online search can help you find sites that provide the fiber content of many popular foods, so you can calculate your intake.

Move On

If you spend most of the day sitting, don’t be surprised if bodily functions aren’t functioning. The human body is designed to move, and studies show that increasing activity can help strengthen muscles while relieving constipation, shortening the amount of time it takes for feces to move through the colon.

Try 30 minutes of brisk walking daily, but don’t stop there. I suggest reviewing my earlier newsletter on exercise for more ideas on how to get the most from movement. Trust me, these go way beyond regularity and include heart health, lower blood pressure, better blood sugar management, less likelihood of depression, and much more.

Swap Medications

Let’s not overlook the possibility that medication is causing your constipation, since this is a common side effect of quite a few drugs. If you think your irregularity may have something to do with a drug you’re taking, discuss alternatives with your health-care provider or pharmacist.

Soak It Away

If constipation is making you so uncomfortable you can’t stand it another minute, pour a box of Epsom salts into the bathtub, fill it with water, and have a nice, long (20 minutes or so) soak. Your skin will absorb the magnesium in the Epsom salts and solve the problem within hours.

Dealing with Diarrhea

Diarrhea is usually described as loose stools passed frequently and/or urgently. Typical causes include:

• Food sensitivity
• Allergy
• Medication
• Food tainted with bacteria (i.e., food poisoning)
• Stress
• High doses of certain supplements, particularly vitamin C and magnesium

Most cases of ordinary diarrhea can be treated without medication by using the suggestions below. However, if you find that the condition is not improving after a few days, please consult a health-care professional. There’s a risk of dehydration and/or malnutrition with chronic diarrhea. It’s also possible that your diarrhea could be caused by a more serious condition, such as irritable bowel syndrome (IBS).

Track Your Diet

A food-allergy test can help identify what may be causing digestive problems. As an alternative, you can keep a food diary to help you determine the source of occasional diarrhea. Simply write down everything you eat and drink each day, and then record how your bowels react and how you feel.

The foods that cause most allergies and sensitivities include:

• Dairy products
• Wheat
• Eggs
• Peanuts and tree nuts, such as almonds, cashews, and walnuts
• Fish and shellfish
• Soy
• Celery
• Sesame seeds

Use the list to eliminate one food or food group at a time. For example, if you don’t feel different after a week without dairy products, resume eating dairy to see how your body reacts. Now you can move on to the next food and repeat the process. If you keep careful records, you’ll be able to tell which foods may be causing problems.

Eat like a BRAT

No, not like a spoiled child. BRAT is simply an acronym for bananas, rice, applesauce, and toast. This bland diet is one solution to temporary diarrhea. These foods firm up stools and provide important nutrients. Usually a few days on the BRAT diet is all it takes to get back to normal. For a little variety, you can also include plain boiled potatoes, saltine crackers, and clear liquids, such as broth.

Give Bacteria a Boost

As I noted in the section above on constipation, the good bacteria known as probiotics are very helpful for restoring regularity, and that includes combating diarrhea. I recommend patients with diarrhea take a probiotic supplement every hour on the hour while awake to relieve the symptoms.

Many times, people develop diarrhea while taking antibiotics. If that’s your situation, start taking the probiotics right away, but do not stop the antibiotics. Take the full course prescribed by your physician, and then continue the probiotics to regain regularity.

Of course, antibiotics are not the only medication that can cause diarrhea. You may have to discuss your prescriptions with your physician or pharmacist to determine which ones could be causing problems and what alternatives are available.

If you’re having problems with constipation or diarrhea, there are plenty of natural alternatives that can help. By encouraging and supporting your body’s own ability to heal, you’ll avoid the downsides of laxatives and antidiarrheal drugs. Targeted supplements, proper food, sufficient water, and moderate activity can restore regularity and put the spring back in your step in no time.

Last Updated: August 16, 2018
Originally Published: October 8, 2012