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My constipation protocol

SwanRonson

Senior Member
Messages
300
Location
Alabama
I've had severe constipation for as long as I can remember. My mother had it, and her mother had it too. I have no idea what causes/caused it. I've given up trying to understand it. All I know is that mine responds very well to osmotic laxatives. Miralax works very well. But, if I don't take it every few days I go right back to straining my eyes out.

I'm currently having sustained success for the first time in my life however. The success began when I did a 14 day course of Xifaxan-550 to treat SIBO (if you have chronic constipation, SIBO is pretty much a slam dunk).

The day before starting the Xifaxan I took 3 caps of Miralax, and really got things moving. I then started the Xifaxan and switched my diet to incorporate more "low fodmap" veggies and fruit. In the past I always avoided high fiber foods because they made my constipation worse. I also switched to Magnesium Oxide and switched to squatting on the rim of the toilet rather than sitting. It's like a poor man's squatty potty. :)

So here is what my daily routine looks like now:

Wake: 7am - Drink 16 ounces of mineral water (Grolsteiner or a brand with plenty of sodium and magnesium) and a cup of black decaf coffee. Go squat on the rim of the potty until I have at least a small BM. I give it plenty of time. I usually have a pretty decent size BM after a few minutes, but not always. You just want to get something going. Anything. Even if it's very small.

Breakfast: Vitamin C (1000mg), 4 bacon, 2 eggs w/diced tomatos, slice of papaya, grapes, 1 navel orang

[After breakfast I usually now have a large BM. Sometimes 2.]

Lunch: Vitamin C (1000mg), kale/cucumber smoothie (kale, skinned cucumber, 3 ounces of aloe, fresh pineapple, 1/2 cup of cocounut water in blender on high for a few minutes. Needs to be liquid smooth.), 4-5 ounces of chicken, white rice with ghee, 1 naval orange, canteloupe

Dinner: 1/2 pound of ground beef with diced tomatos, green beans, romaine salad with sesame seeds, olive oil, raisins, and red wine vinegar, yellow squash fried in grapeseed oil with good mineral salt, 1 naval orange, papaya

Bed time: 400mg of Magnesium Oxide, bowl of strawberries, canteloupe or watermelon​

Things to point out:

The Xifaxan clears the initial SIBO that exacerbates the motility problems, but I think taking the miralax to get things moving initially really helps the Xifaxan to work. I also drank a lot of high fat, homemade chicken bone broth during the Xifaxan treatment. Sometimes I would just have that for dinner instead of a meal. Slowly transition to more veggies as the 14 days pass. A little more each day.

You'll also notice that this diet is gluten free, dairy free, nut free and low fodmap. I throw in some restistant starch foods like white potato every now and then in tiny amounts just to test the waters and keep those RS loving bacteria kicking a bit. Not sure if it even helps or not. I just do it. :-/

Having plenty of vitamin C and citrus fruits throughout the day helps things a lot and won't trigger SIBO symptoms. Plus, eating the whole fruit doesn't spike your blood sugar like just the juice would since the fiber is still there.

I try to have at least one smoothie per day with aloe. Sometimes I have two. It really seems to help things keep moving and give digestion a breather.

Eat papaya and pineapple with every meat containing meal since they contain a ton of natural enzymes and will really help keep the food from sitting in your stomach/duodenum for hours.

Only drink good, high content mineral water and keep it around 24 ounces a day. If you drink too much you pee out your electrolytes. If you drink to little you get dehydrated. I found that 16 ounces upon waking, and another 8 ounces between meals is all I really need. Just don't drink too much and keep it high quality. No tap water.

The magnesium oxide before bed works well. Right now 400mg is working ok for me. You may benefit from more or less.

I keep an extensive daily food journal so that I if I have trouble getting a BM going in the morning I can turn back a page or two and see what may have caused it. This is also helpful with the smoothies. WHen you make a smoothie that's heavily loaded with kale it will turn your poop spinach green. You can use this as a natural way to track your transit time. Drink a big kale smoothie for breakfast and dinner one day and then see how many days it takes for your BM to come out green. This tells you your transit time. Then, you can use the transit time going forward to figure out which foods you ate might have brought back your constipation. You'll know how many pages back to turn in your food journal.

On the occasion that I do have a hard time getting a decent BM, the next two mornings I'll use 1/2 a teaspoon of Effer-C mixed well in 8 ounces of clear water (spring water, not tap). Then chase it with another 8 ounces of clear water. By the second morning of this I'll have a large BM and be back to regular. Then just go look up in your food journal what may have been the culprit.

A note on low fodmap food lists:

Most low fodmap food lists out there are a little off. I'm not sure why, but they include foods that are pretty highly fermentable. The list I use is from this book. I choose foods from the appendices that are listed as "low" on the symptoms chart.
 
Last edited:

perchance dreamer

Senior Member
Messages
1,699
What works for me is to soak 2 TBS of chia seeds in water and drink the gel every day. Also, eating fennel and jicama help a lot.

I slice jicama into french-fry size and add a little lime or orange juice, salt, and cayenne or chipotle powder. Jicama is pretty low carb,11g per cup. I either roast fennel or just slice it very thinly and eat it raw.

Moringa powder also helps my bowel function.
 

helen1

Senior Member
Messages
1,033
Location
Canada
@SwanRonson Thanks for the entertaining post. It was fun to imagine you perched on your toilet seat. Well okay maybe not exactly fun but at least weirdly amusing let's say.

Chlorella really helps me, a heaping teaspoon a day. I've also been taking magn oxide for years and I think I win the record for taking/needing the most: 2500 every night. I know. But get this, before treating my gut for SIBO and yeast I used to have to take 8000 mg and that's not a typo. Still have a ways to go, 2500 is a lot so there must be something wrong in there. I too have been constipated my entire adult life.
 

Gondwanaland

Senior Member
Messages
5,094
WOW @helen1 don't you get increased urination from that?

I know that dairy is off limits for a lot of people, but I ate A2 dairy for 3 years and never had a single day of constipation during that time. Unfortunately that was in Europe and here where I live now I have no access to A2 dairy products, except for mozzarella di buffala.

I know there could be several other factors contributing for a constipation-free life in Europe (including a magnesium-rich soil) and this has been my holy grail for several years now, but the A2 dairy makes so much sense. In 2013 I had acces to one carton of A2 milk (imported, pasteurized!) and experienced no constipation during that period of time.

About A1 and A2 dairy
Mercola's articles are always biased in some way, but this could perfectly explain my n=1 observation.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
Some of the things I read you are doing there, dont sound healthy.

Its probably not a good idea to try to do that first thing in morning before even eatting as eatting stimulates the bowels.

Only drink good, high content mineral water and keep it around 24 ounces a day. If you drink too much you pee out your electrolytes. If you drink to little you get dehydrated. I found that 16 ounces upon waking, and another 8 ounces between meals is all I really need. Just don't drink too much and keep it high quality. No tap water.

I had to look up what that is in mls as I dont know ounces.. 24 US fluid oz = 710ml.

That is far too low a fluid intake for someone with constipation and ME. Normal healthy people should be drinking 1-2 Litres per day (in mls that would be 1000ml to 2000ml) and ME people can need more due to low blood volume issues and dysautonomia. Fluid also should be increased with constiption.

Boosting fibre will never work to help constipation if the person isnt drinking enough water.
 

Beyond

Juice Me Up, Scotty!!!
Messages
1,122
Location
Murcia, Spain
@SwanRonson Thanks for the entertaining post. It was fun to imagine you perched on your toilet seat. Well okay maybe not exactly fun but at least weirdly amusing let's say.

Chlorella really helps me, a heaping teaspoon a day. I've also been taking magn oxide for years and I think I win the record for taking/needing the most: 2500 every night. I know. But get this, before treating my gut for SIBO and yeast I used to have to take 8000 mg and that's not a typo. Still have a ways to go, 2500 is a lot so there must be something wrong in there. I too have been constipated my entire adult life.
Hands up for chlorella as the most significant gut healer (noticeably improves elimination as well as inflammation) I have tried and for the perched toiled seat comment hehe. About chlorella, it wins the contest for the best shaped, most healthy looking poop (yuckkk). Also, kefir and kefir grains (yeah I eat kefir grains) will get things moving and stay moving.
 

helen1

Senior Member
Messages
1,033
Location
Canada
@Gondwanaland I don't eat dairy products, except rarely some goat yogurt as it flares my rosacea. Raw A2 dairy seems healthy if people can find it. About urination, it's true I have to get up in the night to pee once or twice. Thanks for reminding me about that. I think I'll experiment with increasing chlorella and reducing magn oxide. And drinking more water and looking into moringa and jicama.

@SwanRonson You've got a lot of good ideas there, thanks for posting them!
 

SwanRonson

Senior Member
Messages
300
Location
Alabama
Chlorella really helps me, a heaping teaspoon a day.

Why do you think the Chlorella helps you? Any theory?

You've got a lot of good ideas there, thanks for posting them!

Thank you. :) Unless someone has lived with eye-popping, headache inducing constipation they really have no idea what hell it can be. It makes every other health problem so much harder to deal with. And, we all know that "more fiber, more water" is absolutely useless advice.
 

SwanRonson

Senior Member
Messages
300
Location
Alabama
the next two mornings I'll use 1/2 a teaspoon of Effer-C mixed well in 8 ounces of clear water (spring water, not tap). Then chase it with another 8 ounces of clear water.

As a follow-up note, Effer-C by Douglas Labratories really works well if you haven't tried it. Just don't use it every day. Only use it when you need to and it remains effective. I just let it replace my morning 1000mg C dose on the mornings I take it. Take it first thing on an empty stomach and wait at least 30 minutes before eating any food. It usually produces a good BM by the second morning of taking it. If you're not averse to larger doses of C, you can double up and take a full teaspoon instead and it'll produce a BM within 1-2 hours. I just like to keep my C at 2000mg per day personally.
 

maryb

iherb code TAK122
Messages
3,602
Location
UK
Lot of good info here, I'll have to come back to read it thoroughly, been constipated all my adult life and even more so since getting sick. Really need to get onto some sort of regime.
 

SwanRonson

Senior Member
Messages
300
Location
Alabama
low blood volume issues and dysautonomia.

Of course. If you have those then do what your doc says, not me. :)

Its probably not a good idea to try to do that first thing in morning before even eatting as eatting stimulates the bowels.

Not sure I'm following your reasoning there. After 8-10 hours of not drinking anything during sleep I think it's pretty healthy to drink a lot when waking up. And then eat a little while later.

Normal healthy people should be drinking 1-2 Litres per day

I disagree. If you find any studies proving that more than 24 ounces a day is necessary for proper health (in normal people) I'd love to go over them. The more water I drink, the worse my constipation is. It's always been that way. And, everyone I know with severe constipation has tried drinking tons of water and it never helps. It just gives your kidney's and bladder some exercise. I pee about 4 or 5 times a day and it's always a normal clear, pale yellow color.

Remember, your food is loaded with water as well. Even meat has a lot of water by weight. And, if you're eating plenty of fruits and veggies, those are loaded as well.

Boosting fibre will never work to help constipation if the person isnt drinking enough water.

I wouldn't describe this as "boosting fiber". I added it up today and I'm on target to eat about 25 grams. That's 13 less than the RDA for adult men. If you are supplementing fiber then yes, you need to drink more. But supplementing with fiber is frought with problems anyway. My G.I. doc said he never recommends people supplement fiber. Just eat whole foods.

Also, if you're thirsty, drink something. :) 24 ounces is not a magic number. It's just what I aim for after much trial and error with my own body, so I think it's a good, safe place to start. By all means, adjust as you go along. I promise you that if I'm thirsty at 3:00 in the afternoon I drink some mineral water and don't think twice about it. Just drink it away from meals since it slows down stomach emptying.

I think the quality of the water you're drinking matters a lot more than the amount as well. 1 liter of tap water is going to make your chronic constipation worse. I can guarantee it. 1 liter of mineral water with plenty of sodium might be ok. It depends a lot on the mineral content of what you're eating. Remember that osmotic movement of water into and out of the colon is dependent on sodium/electrolyte balance largely. The water follows the electrolytes.

So, if someone with chronic constipation drinks tons of clear water all the time, they're going to really disrupt things by drawing water out of the colon as they pee off their electrolytes. Fluid intake is about balance. Too much or too little is bad. But, again remember that food has lots of water in it too. It's not all about what's in your cup. I drink 1 or 2 smoothies a day. Put pineapple, canteloupe, kale, aloe and cucumber in the blender and watch how much water comes out. It's a ton.
 

Gondwanaland

Senior Member
Messages
5,094
@Gondwanaland I don't eat dairy products, except rarely some goat yogurt as it flares my rosacea. Raw A2 dairy seems healthy if people can find it. About urination, it's true I have to get up in the night to pee once or twice. Thanks for reminding me about that. I think I'll experiment with increasing chlorella and reducing magn oxide. And drinking more water and looking into moringa and jicama.
About rosacea, going grain free and limiting fruit intake reduced my rosacea by 70%. Then a round of Flagyl took care of the remaining 30%. That was in September 2013 and it didn't come back.

If you get increased urination from magnesium it is time to really back off and increase your intake of calcium-rich foods. No, this will not help with constipation, but your kidneys need a break. That is why I reintroduced dairy into my diet. Unfortunately my yogurt and curd are A1 and my gut flora gets no benefits.

I have read that chlorella really helps with BMs, but it is off limits for me due to iodine content (Hashimoto's).

Drinking more water ruined my electrolyte balance years ago.

I will have to look up moringa and jicama, no idea about them.
 

SwanRonson

Senior Member
Messages
300
Location
Alabama
thanks Swan, this is good info. Do probiotics not help?

Probiotics are very risky with constipation since motility is slowed. You'll end up worsening SIBO, which is what's at the root of the constipation most of the time anyway. When peristalsis is retarded the bacteria just stay too long in the small bowel. It might take a few months to develop but eventually if you take them long enough you'll have some serious SIBO problems. Especially if you take a high quality multi strain formula like mercola complete or similar.

Look at John Brisson's work on this. He's warned about probiotics for a while now.

What helps most constipation is antibiotics and pro kinetics. Not probiotics.
 

helen1

Senior Member
Messages
1,033
Location
Canada
@Gondwanaland Glad to hear that about your rosacea. Going grain and dairy free has really really helped me too. Still can't touch vinegar, coffee, chocolate, tomatoes and any friction on my face also breaks it out.

Sorry @SwanRonson got off topic there... Back to bowels... One probiotic that helped me a lot with constipation was s.boulardii for 3 months. Have you used that one?
 

Crux

Senior Member
Messages
1,441
Location
USA
Probiotics are very risky with constipation since motility is slowed. You'll end up worsening SIBO, which is what's at the root of the constipation most of the time anyway. When peristalsis is retarded the bacteria just stay too long in the small bowel. It might take a few months to develop but eventually if you take them long enough you'll have some serious SIBO problems. Especially if you take a high quality multi strain formula like mercola complete or similar.

Look at John Brisson's work on this. He's warned about probiotics for a while now.

What helps most constipation is antibiotics and pro kinetics. Not probiotics.

I wonder if you've tried neomycin. I've read that it's usually prescribed along with rifaximin for SIBO with constipation. I tried some neomycin alone, and it really worked against constipation. I also found that a really low dose of metronidazole worked well.

I tried many other means of dealing with SIBO/ constipation, the antibiotics, low FODMAPS, and other dietary limitations have worked the best. ( I also supplement with potassium - good for regularity)

btw, I've been giving my cats some aloe vera juice. ( recommended for kidney problems) They are pooping like champs!)
 

maryb

iherb code TAK122
Messages
3,602
Location
UK
@SwanRonson thanks for starting this thread very timely for me.
did your doc prescribe the xifaxan, what was the dose? if not where did you get it?
This current episode started after IV abx treatment for Lyme, was taking probiotics and had
more regular BM than I've ever had, since then sick stomach symptoms and feeling really ill, unable to tolerate masses of food stuff again, when on the abx I was eating food I hadn't eaten for years (such as sweetcorn, squash etc.), drinking masses of mineral water, but something as simple as an enema wipes me out, showing my electrolytes are not balanced.. So the SIBO - leaky gut/too much water all fits.
I had xifaxan prescribed a few years ago and was much better that year looking back.
Are you feeling better in yourself for having sorted this problem out?
Just to add, I'm already gluten, sugar, dairy, legume free, and have been for years.