Today we’re talking about constipation and how to resolve it…

The kicker is that the answer may surprise you…but first of all, let’s cover what normal digestion and elimination are first, just so that we know what we’re actually shooting for!

Ideal digestion is…

No bloating…bloating is so common nowadays that tons of folks tend to think that it’s actually a normal part of eating because essentially every single time that they eat, they feel bloated…bloating is common, but it is not normal…super important distinction there!

It’s worth noting, you may have some minor distention in your abdomen if the volume of food that you ate was quite large, however this is different than bloating and in this case your stomach should be back to flat (relatively speaking depending on how much body fat you’re carrying) in no more than an hour or two I’d say.

Also, ideal digestion means minimal gas and so it is not normal to eat and become very gassy, that’s a sign that you did not tolerate something or somethings that you ate, even if they fall under the traditional ‘healthy food’ category for example…certain vegetables, fruits, beans, legumes etc.

In terms of elimination…

Bowel movement frequency and volume is going to depend largely on your specific diet and it can be perfectly normal to have a bowel movement anywhere from 2-3x per week up to 2-3x per day, there is huge variation in what is considered normal bowel movement frequency.

Another important point is that more frequency and larger volume does not necessarily mean better elimination…a lot of folks tend to think that larger bowel movements are better bowel movements and that is not necessarily the case.

Also, folks often believe that if they don’t have a bowel movement every single day, they are constipated, that’s not necessarily true either. There is a huge difference between expecting to have a bowel movement every day and actually being constipated, for example…

If you don’t have a bowel movement one day and you feel super backed up or in otherwards you feel like you have to go but you can’t, you’re probably constipated…however, if you don’t have a bowel movement one day, you don’t feel like you have to go and you don’t feel constipated…you’re probably not.

In terms of how healthy bowel movements should look, you can reference this ‘Bristol Stool Chart’ and what we’re after is a type 3 or 4.

As far as how your bowel movements should feel…it’s meant to be a very smooth process, meaning…you shouldn’t need to run to the bathroom as that would be considered diarrhea and you also shouldn’t need to strain in any sense of the word…you should feel the urge to go, walk to the bathroom and it should just happen!

Okay, now let’s dig further into constipation specifically…if you’re constipated you should eat more fiber, right!? Hmm not necessarily! There are 2 types of fiber, soluble and insoluble.

Soluble fiber is readily able to ferment in the gut, which produces gas and something called short chain fatty acids and then we have insoluble fiber which is a lot more resistant to being broken down and insoluble fiber adds bulk to our stool.

You can think about it this way…if there is a whole bunch of traffic merging into one narrow lane on a highway, is more cars going to create more traffic or less? Of course more cars is going to result in more traffic and so in terms of constipation not only do we typically not want more fiber, we actually want less i.e. want fewer cars on the road!

Insoluble fiber adds bulk to stool (more cars and therefore more traffic) and so if we’re already constipated, more fiber often leads to even more constipation and this may sound crazy because the mainstream advice is always, ‘more fiber, more fiber, more fiber,’ however…

Just from a purely physical standpoint, that actually doesn’t make sense being that fiber adds bulk to stool. Now you might be thinking…but what about soluble fiber and soluble fiber increases the likelihood for gas, which is also tied to specific carbohydrates called FODMAP’s, which we’ll talk more about in a minute.

Story time…a buddy of mine had been dealing with severe constipation for years and years and he kept adding more and more fiber to his diet in the form of primarily veggies and whole grains like brown rice and it just kept getting worse…

He didn’t know what to do and so he told me what he was eating and I actually recommended that he lower his fiber intake. The next time that I saw him he was almost in tears because he was so relieved and grateful to have found something that actually worked to get rid of his constipation…his bowel movements are now the best that they ever have been in his life, point being…

If you’re constipated and more fiber isn’t helping, it only makes sense to experiment with less especially because what you’re currently doing isn’t working and so what do you have to lose, right!?

What does the research say…?

You’d think that because the ‘add more fiber’ recommendation is essentially gospel in regards to relieving constipation that there would be a ton research to back this up and in terms of constipation specifically, it turns out that there actually isn’t, but…

I did come across a case controlled study that looked at 63 folks with constipation and within these people they had 3 groups that they gave differing fiber intakes. They looked at constipation and constipation-like symptoms such as strain, bloating, bleeding and pain.

Coming into the study every single person had both constipation and strain and a number of others also had bloating, bleeding and pain. Like I mentioned, they divided these folks into 3 groups…a high fiber group, a reduced fiber group and the zero fiber group.

The high fiber folks symptoms actually got noticeably worse, especially in regards to bloating. The reduced fiber group improved across the board in all of their symptoms and now what do you think happened with the folks on the zero fiber diet?

Not one of the folks had any symptoms at all meaning, there was a complete resolution of constipation, strain, bloating, bleeding and pain in every single person…and all of the zero fiber folks ended up having 1 bowel movement per day every day…

How did that compare with the high fiber group? The folks in the high fiber group had a bowel on average once every 6.8 days…that is highly statistically significant and if you want to comb through the study yourself, HERE is the link.

‘Wait, what…Marcus, you’re suggesting eating less fiber if I’m constipated? Isn’t fiber healthy, don’t we have to have it? Doesn’t it lower blood sugar, reduce cholesterol, improve gut health and feed the microbiome?’

First of all, fiber is not an essential nutrient meaning, we don’t need fiber to survive and we know this because there are groups of folks that eat zero fiber diets and have for years and they’re still very much alive and many of them are actually far healthier with no fiber than they were eating lots of fiber.

What about blood sugar? It is true that in the context of a high carb and/or sugar diet, consuming fiber may be conditionally beneficial to help with blood sugar management, however what if you’re not eating a ton of carbs and sugar? Well, it turns out that your blood sugar does an amazing job of regulating itself without the need for fiber!

I’m not going to dive into the cholesterol question just because this would turn into a novel if I did, what I will say is that there is a whole bunch of super exciting research being done right now on lean individuals with quote unquote high LDL, high HDL and low triglycerides.

It’s a very cool time in regards to what we’re learning about cholesterol and personally what I prioritize first and foremost before myopically focusing on cholesterol is…being objectively lean and healthy…wild concept, I know!

What about gut health and the microbiome? Well we just talked about how much we’re still learning about cholesterol, which is a single molecule and the microbiome has trillions of bacteria and so the truth is that we just don’t understand much of anything about the ins and outs of the microbiome specifically, but here’s how I see it…

A lean and healthy person with great digestion and elimination will have a healthy microbiome and if someone is unhealthy with poor digestion and elimination, they almost certainly will not have a healthy microbiome…kinda makes sense right!?

Now sometimes the hardest part about this whole thing around resolving constipation, bloating, gas etc. and actually improving gut health is that some folks have a super tough time releasing the idea or deeply engrained belief that the answer is potentially eating less fiber and therefore fewer vegetables and things like whole grains.

The more veggies the better right!? Oatmeal for breakfast it’s healthy right!? Well not necessarily…

I have worked with clients that do well with lots of vegetables and fiber in terms of their digestion and elimination and I’ve also worked with plenty of clients that actually improve their health like crazy with less veggies and fiber in their diets.

There is no one size fits all and this is why I talk about personalization and gearing all of my programs to the individual, meaning none of my clients are doing the exact same thing in terms of their nutrition, it’s case by case basis dealio!

As far as my personal experience goes, I actually follow what folks would consider to be a low fiber diet and have for years and my digestion is the best that it’s ever been and when I occasionally eat too much fiber…I don’t feel nearly as good!

Now, how would someone implement a lower fiber approach practically speaking? You can type into google ‘low fiber diet’ or just ‘low fiber foods’ and voila…or you could go about it the other way and type in ‘high fiber foods’ and steer clear of those for a bit…however, I would highly recommend that you still favour single ingredient whole foods regardless and so don’t sub out veggies for fiber-free crackers or some other processed bullsh*t…

Favour high quality animal protein so meat, fish, seafood, eggs and dairy if you tolerate it dairy.

In terms of carbohydrates, be careful with fruit, veggies and whole grains. If you’re going to have them, I would recommend low fiber options if you tolerate them and then in terms of fat you want to be mindful of things like avocado, nuts and seeds just because lot of them are quite high on the fiber front.

You most likely also want to keep an eye on FODMAP’s which are specific types of carbohydrates that tend to cause gas buildup, bloating and digestive issues in a lot of folks and there are tons of FODMAP food lists out there online, just type in ‘FODMAP’ and they’ll pop right up…and…

The coolest thing about this whole approach to constipation and your digestion as a whole is that it’s often a 2 birds, 1 stone situation in the sense that it tends to resolve not only constipation, but also massively reduce bloating as well!

Solving this is going to provide you with more energy because feeling constipated is such an energy drain and it often spills over into things like movement in the sense that, most folks don’t feel like moving all that much when they’re really backed up! It also lessens the need for stool looseners and/or laxatives, which create other issues in terms of hydration, electrolyte status etc.

As we wrap up, the key takeaway is…

If what you’ve been doing isn’t working, do something else…your digestion is improvable, I’ve experienced it personally and I’ve helped countless numbers of my clients dial it in as well!