Ask JJ: Eliminating Constipation

Let's talk poop. You want one to three bowel movements a day. They shouldn't be urgent, and you shouldn't have to run to the bathroom every time you eat, but you should be having them.
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Dear JJ: I'll keep this simple: I often struggle with constipation. I'm having a bowel movement maybe twice a week. My doctor recommended [brand-name fiber product], but I still struggle, literally. What do you suggest?

"One or two well-formed bowel movements every day is one of the best ways to give toxins a one-way ticket out of your body," writes Dr. Mark Hyman. "If that goal seems high you're not alone. As many as 20 percent of people struggle with constipation and, unfortunately, the problem can get more onerous with aging. But bowel function is something you have a lot of control over."

Let's talk poop. You want one to three bowel movements a day. They shouldn't be urgent, and you shouldn't have to run to the bathroom every time you eat, but you should be having them.

You're constipated when you move your bowels less than once a day, really struggling or creating poops that are tiny or don't easily come all the way out.

You want poops to be proud of (yeah, I said it). Those are well-formed poops you don't have to struggle with. They come out fully. They don't stop halfway through and leave you stuck, nor do they dive-bomb to the bottom of the bowl. A proud poop sinks to the bottom of the bowl. It doesn't mark things up.

Your poop reveals more than you might think. If you have an oily residue or slick slides, you aren't absorbing dietary fat well. If you have rabbit pellets or you're straining, you aren't getting enough fiber. If you have floating poops, it could be from excessive gas, produced by an overgrowth of bad bacteria lurking in your intestines.

Gross science lesson aside, if you don't eliminate properly, you'll be bloated, fat, and setting yourself up for a permanent problem with indigestion and obesity.

Hyman argues optimal fiber intake becomes among your strategies to stay regular, and studies support that strategy.

"Dietary fiber intake can obviously increase stool frequency in patients with constipation," concluded one study published in the World Journal of Gastroenterology.

When you work your way up to 50 grams of fiber daily, you usually eliminate constipation and other bathroom miseries. Please don't do this all at once. Add five grams incrementally until you reach your goal, and drink more water as you do so.

Most commercial fiber powder supplements come from psyllium husk. If you use a fiber supplement to meet your quota, look for one that combines fiber sources that mimic what we get from food.

Prunes become a great high-fiber food to blast constipation. Throwing two or three into your protein shake all but guarantee you get things moving down there.

Do fiber correctly, and ensure you're getting optimal amounts. If you're still having a little trouble "down there," here are four more strategies to get things moving and optimize poop quality and quantity.

1. Liquid up. "The body is very good at conserving water. Sometimes it's almost too good," writes Hyman. "When the walls of the colon suck too much moisture out of stool, it dries and hardens, which can lead to pebble-like poop and constipation. Drinking more water and other liquids during the day (aim for eight 8-ounce glasses) can make your BMs softer and easier to expel." To step things up, have some hot coffee or peppermint tea in the morning after a big glass of filtered water, but don't miss out on filtered water.

2. Supplement smartly. Studies show low-magnesium diets often contribute to constipation. Along with a magnesium supplement (start with 300 milligrams and increase as needed up to 1,000 milligrams), try vitamin C (start with one gram and increase as needed up to five grams). If your poop gets runny, back off those two supplements a bit. Iron and calcium are constipating, so if you are taking either of these, you may need some supplements to offset those effects. I use a vitamin C and magnesium powder at night to get things moving the following morning.

3. Get moving to get moving. In one study with patients diagnosed with irritable bowel syndrome (IBS), researchers found the exercise group reported significantly improved symptoms of constipation. High-intensity interval training and weight resistance become efficient, effective exercise to blast fat and alleviate constipation, but even 30 minutes of vigorous walking can help get things moving.

4. Bring out the big guns. If none of these strategies get things moving, try magnesium citrate or herbs like cascara sagrada, senna, Chinese rhubarb and/or frangula (I prefer herbal blends) on a short-term basis. These are also great to carry if you happen to get constipated while traveling. Only use them for a few days, as they could irritate the gastrointestinal lining with chronic use.

Keep in mind constipation and other bathroom problems can underlie more serious problem like thyroid imbalances. If you implement these strategies and you still struggle, please visit your doctor or integrative specialist because it could signify an underlying problem.

If you've dealt with constipation (and let's face it, most of us know its misery), what strategies helped moved things along? Share your thoughts below, and keep those great questions coming at