If you’re constipated and want to kick that condition to the curb, you’re in luck: There are actually a few things you can do to help out your situation.
Many people attempt to fix constipation by taking fiber or using laxatives, which can be helpful but cause a dependence on either substance. In order to get you on the right track, we have to talk about what constipation is and the underlying physiology that contributes to it.
This isn’t to say everyone who takes this information to heart will see their constipation gone in a flash. But over time, most people will see a dramatic improvement in the frequency and consistency of their #2s.
Typically, poor colonic motility is the cause of constipation. Fortunately, behavioral factors have a huge role in colonic motility; people just don’t know their behavior causes them to be constipated.
As a result, many people get kind of stuck believing they need to take laxatives or fiber supplements for successful #2s the rest of their life. This isn’t the case, and you’re about to learn why.
Key factors that regulate motility in the colon: Circadian rhythms and the gastrocolic reflex
The colon, also known as the large intestine, is the final stretch of the digestive tract leading from the ileum of the small intestine to the anus.
The colon is vastly different from the small intestine in structure and function. While the food bolus typically takes ~6 hours to move through the small intestine, its remains spend 24-48 hours in the colon.
Circadian rhythms, feeding patterns, and reflexes between the stomach, ileum, and colon regulate colonic motility. Let’s examine how each plays a role in constipation.
Circadian disruption makes you constipated
Circadian rhythms are physiological patterns and processes that take place over an approximate 24 hour period. The most common example of this is the sleep/wake cycle.
But colonic motility also follows a circadian rhythm, with greater motility in the morning than the evening. This is why most people don’t typically go #2 in the middle of the night.
Evidence notes disturbed circadian rhythms in colonic pressure of people with constipation. Whereas people with normal bowel habits see higher colonic pressures in the morning, those with constipation have higher pressures in the evening. Furthermore, constipation presents with blunted rhythms.
It’s important to note that behavioral factors drive circadian rhythms, and circadian rhythms drive behavioral patterns. These behavioral patterns help our body determine the “time”. As a result, our behaviors play an important role in our colonic motility.
This is true about most processes outside of our control such as immune function, sleep patterns, and digestion. Therefore, behavioral factors such as light exposure, feeding schedule, and activity patterns are important for regulating these processes.
To start building strong circadian rhythms, check out this video from our Facebook group.
An impaired gastrocolic reflex makes you constipated
In addition to circadian rhythms, there are reflexes that regulate motility in the colon. Two important reflexes that play a role in making us regular include the gastrocolic reflex and the gastroileal reflex.
Before we jump in here, it’s important to discuss the regulation of these reflexes. Within our gut, we have a nervous system distinctly dedicated to digestion known as the enteric nervous system(ENS). The ENS plays the biggest role in regulating these reflexes.
When we eat, food moves from our mouth to our stomach, causing distension of the stomach. This distension triggers sensory neurons of the ENS to stimulate motor neurons that increase motility in the ileum and colon. These are the gastroilieal and gastrocolic reflexes, respectively.
This enhanced motility causes the contents of our colon to move from the sigmoid colon into the rectum. This causes increased pressure in the rectum, which stimulates our urge to go.
This process occurs after every meal, with larger meals believed to create greater stimulation. The content of the meal may also matter, with a study showing that meals higher in fat producing more backwards propulsion, potentially delaying the urge to defecate.
How to stop being constipated
Now that we understand the 2 predominant factors driving our urge to go #2, let’s use this information to enhance that urge. We do this by lining up our circadian rhythms with the gastrocolic and gastroileal reflexes.
First and foremost, we need to build strong circadian rhythms. The circadian urge to defecate in the morning is only possible if our body knows when time morning is.
The time of the clock on the wall is irrelevant to our internal clock if they’re not aligned. As mentioned above, behavior drives our internal clock, so getting our light exposure and feeding rhythms right is at the top of our list.
Another useful strategy for improving constipation is the proper timing of laxative use, referred to as chrononutrition. Evidence indicates that bisacodyl, also known as Dulcolax, helps restore circadian colonic motility. To gain this benefit, take bisacodyl at night, 12 hours prior to your first meal the following morning.
Next, we want to stimulate the enteric reflexes in the morning to line up with the circadian urge to defecate. This means we want a bigger meal first thing in the morning to stimulate these reflexes. Skipping breakfast is not a good idea if you’re constipated. Additionally, if constipation is a problem for you, reducing fat intake in that first meal may be a good idea.
Finally, one factor not mentioned yet is the damaging effects of hyperglycemia. Hyperglycemia damages enteric neurons, preventing them from relaying their signals. Poor blood glucose regulation and overt type 2 diabetes impair the gastrocolic reflex, likely due to damage to enteric nerves.
Therefore, it’s important to correct Type 2 diabetes if you have it.
Being constipated has a dramatic impact on a person’s quality of life. Fortunately, addressing certain behavioral patterns often corrects constipation by strengthening colonic motility.
Addressing circadian rhythms, consuming a larger meal at breakfast, and correcting type 2 diabetes are essential behavioral factors that promote motility in the colon. Lining up your circadian rhythms with the enteric reflexes that stimulate defecation is a powerful tool to correct constipation.