If the digestive system is healthy, a person should pass a well-formed stool one to two times a day. If stools are difficult or painful to pass, or bowel movements are occurring less than three times a week then this is called constipation. It’s an incredibly common condition that can affect anyone at any age.

There are many different factors that can contribute to constipation. These include:

• Fibre intake – Fibre is the indigestible part of plant foods. It acts like a brush inside the intestines helping to sweep waste matter through. A lack of fibre can lead to food moving more slowly through the digestive tract. In addition, when stools are not properly bulked out by fibre they’re less likely to stimulate the digestive systems evacuation mechanisms.
• Fluid intake – Water is another important component of a well-formed stool. Lack of fluid intake or consuming a lot of astringent fluids like tea can causes stools to become dry and more difficult to pass.
• Gut flora imbalances – About 30% of stool is bacteria and the balance of bacteria in the gut can have a significant effect on the consistency and frequency of bowel movements. An overgrowth of bad bacteria or yeast in the gut or an infection by parasites could lead to constipation.
• Reduced digestive function – Healthy digestion is a carefully coordinated process that relies on each stage working effectively before food passes on to the next. A lack of stomach acid, low levels of digestive enzymes, or lack of bile can result in improperly digested food in the intestines. This can slow transit time and contribute to constipation.
• Stress – During times of stress all of the digestive processes are reduced in order to prioritise resources for dealing with the immediate threat. Long-term stress can, therefore, impact on digestive function in a way that leads to or worsens constipation.
• Hormone imbalances – an underactive thyroid gland or an imbalance in the female hormones oestrogen and progesterone can both lead to constipation.

The side effects of medication – Many medications can cause constipation as a side effect. Examples include the painkiller codeine, antidepressants and anticonvulsants.

Medical conditions – Sometimes constipation is a symptom of another medical condition, such as multiple sclerosis or Parkinson’s disease.

Overuse of laxatives – One suspected cause of severe constipation is the over-use of laxatives, for example, senna, lactulose and Epsom salts. Chronic use of these products can damage the nerves or muscles of the colon compromising their function.

Medical treatment of constipation usually involves prescription laxatives. Initially, bulk-forming laxatives in the form of fibre drinks are offered. Stronger laxative or laxative suppositories may be recommended if these don’t work. In very severe cases a medical enema or procedure to remove stools from the digestive tract may be required.

How can functional medicine help with constipation?

Function medicine aims to understand why constipation exists and to restore normal bowel function naturally. A functional approach to constipation can include:

• Implementing a food plan that is rich in fibre and superfoods that assist proper bowel function
• Working on balancing fluid intake for optimum digestive function
• A comprehensive digestive analysis to assess digestive function, identify any bacterial imbalance and check for gut infections.
• Supplements and/or herbs to support optimal digestive function
• Stress management using lifestyle changes and herbs that support inner calm
• Hormonal assessment and where necessary a protocol to rebalance hormone levels naturally.