Constipation Protocol

Having a daily bowel movement is so important to overall health and our poop can tell us so much about digestion, absorption, bacterial overgrowth and inflammatory status in the body! In the Naturally Nourished Clinic, there is an entire section of a new client intake dedicated to digestion and 10+ questions about poop!

Beyond conditions like IBS and IBD, bowel regularity is an essential part of feeling your best and detoxifying the body and when off can give us insights into what is going on beyond the surface. 

What exactly is poop?

50 to 80 percent of your poop (excluding water) is actually bacteria that had been living in your intestines and was then ejected as food passed through. Many of the bacteria in poop are still alive, but some are dead — carcasses of species that bloomed as they fed on the indigestible plant matter you consumed, then died shortly afterward. But it’s not all bacteria. Your poop also includes some of this indigestible plant matter — like the cellulose in vegetables — small amounts of your own tissue: intestinal lining cells that were sloughed off during digestion. 

What should my poop look like?!

Ideally we want to see one long, uniform movement that is easy to pass. Ideally there should be no undigested particles, mucus or oily sheen and you shouldn’t have to strain to have a bowel movement. Hard to pass stools or stools that come out in smaller “pebbles” are considered constipation. 

The Bristol Stool Scale is a great place to start for a visual of what “normal” looks like, and you are aiming for a type 4! 

How often should I be pooping?

You want to have at least one well formed bowel movement daily, up to three times daily. Skipping days can lead to buildup of toxins and over-fermentation by colonic bacteria as well as estrogen dominance as the bowels are a primary detoxifier of the body. 

Why does constipation occur? 

  • Not enough probiotics, dysbiosis, or suboptimal prebiotics to feed good bacteria! 
  • Lack of fiber in the diet
  • Stress! Sympathetic overdrive can slow peristalsis or movement of fecal matter through the intestines 
  • Inflammation of the bowel can drive constipation
  • Nutrient deficiency including B vitamins and Magnesium 
  • Medication use: opioids, antidepressants, birth control
  • Foods that drive constipation: unripe bananas and persimmons (high in tannins which reduce transit time), dairy, gluten and grains
  • Dehydration or electrolyte imbalance: the colon is a major regulator of electrolytes in the body

Why Does Constipation Impact More Women Than Men?

Women have wider pelvises than men, as well as extra internal organs (such as the uterus and ovaries) in the region. As a result, their colons hang a bit lower than men’s, and are a bit longer: on average, by ten centimeters. Finally, men have more rigid abdominal walls that help push food through the GI tract more effectively. Endometriosis can further complicate things as there may be adhesions that make it physically difficult to move stool along. Estrogen is also detoxified by the bowels and excessive estrogen can slow colon motility! We recommend EPA-DHA Extra, Super Turmeric and/or Inflammazyme at cycle time to reduce inflammation, cramping and keep you going! 

Traveling and Constipation

No, it’s not just you! Constipation during travel is incredibly common due to the change in ritual/environment, electrolyte and hydration shifts, changes in food etc. We can also see decreased peristalsis with the stress of travel. Check out this episode on travel where we address constipation and be sure to pack Relax and Regulate and Targeted Strength Probiotic!

The Issue with Over the Counters

Many of the over the counter drugs for constipation work to soften stool or bring water into the colon. If you look at ANY of these drugs they are not recommended for long term use!

Miralax in particular is a hyperosmotic laxative that is often used off-label for children, though it is only approved by the FDA for age 17 or older. It has a  whole bunch of scary side effects like behavioral issues, speech problems, anxiety, and depression!  

An FDA grant was awarded to the Children’s Hospital of Pennsylvania in 2014. So far, the study has found 167 cases of adverse side effects in children who took the laxative, including 37 kids who displayed neurological or psychiatric symptoms. And the FDA also disclosed that MiraLax powder was found to contain small amounts of the same toxic ingredients found in antifreeze called polyethylene glycol (PEG) 3350. 

Colace is an emollient laxative (also known as a stool softener) can cause bloating, cramping, diarrhea, gas, rectal irritation and throat irritation. Dulcolax is the brand name of the drug bisacodyl, used to treat constipation and falls into the category of stimulant laxatives, which work by increasing the motions of tiny, finger-like tissues on the intestinal wall called villi. This can cause cramping, sodium/potassium fluctuations, impaired kidney function, muscle loss and loss of colon function. Stimulant laxatives like Senokot, Ex-lax and bisacodyl can drive dependence as well as cramping, bloating and diarrhea.

3 F’s for Prevention and Treatment of Constipation

Fiber: aim for 25g daily 

Prunes, carrot fiber, flax, chia seeds, psyllium husk and beta-glucans are best choices but be mindful of overchelation! Use PhytoFiber as supplementation and include chia seeds, brussels, broccoli and fiber containing fruits and veggies daily as well as 2-3 cups leafy greens/day.


Too much fiber without enough fluid can act like a brick instead of a broom! Ensure at least 1/2 of body weight in fluid ounces and work in Water Infusions! Of course, water alone is not all that hydrating and as mentioned above, electrolyte imbalance can be a major driver of constipation. 

Our Electrolyte Limeade is a fabulous tool for rehydrating the body and improving bowel regularity. Check out thai video to get the recipe as well as other tried and true electrolyte solutions (INSERT VIDEO)

(F)Physical Activity 

Work in walking, stretching, yoga and light resistance training and aim to move your body every day!

More of an auditory learner? Check out this podcast episode on Perfecting Your Poop!

Supplement Support for Regularity

Relax and Regulate  1-2 scoops at bed, additional 1-2 scoops at rise to aid in daily motility as needed

A Probiotic Challenge is a very effective tool in determining whether your constipation is caused by lack to good bacteria (you will see improvement as you increase the number of capsules of Restore Baseline Probiotic over the course of the challenge), or whether dysbiosis is a contributing factor in your symptoms (you will likely see an increase in gas or bloating or an unfavorable shift in bowels). If this sounds like too much effort, you can simply start with Targeted Strength Probiotic 1 at bed which should provide necessary relief! 

Digestaid can help to support bowel motility by driving bile flow and enzyme activity and aiding in breaking down large food particles. Use 1-2 at all meals if dealing with constipation. 

PhytoFiber 1-2 tsp daily in a shake or smoothie or mixed with yogurt or nut butter. This provides both soluble and insoluble fiber in whole food forms to promote bowel regularity.

Also consider: 

Bio-C Plus 1-2 capsules three times daily or to bowel tolerance (when this causes a bowel movement). Vitamin C can increase gastric motility and cause a “flush” once the body is saturated with this nutrient. Due to this, it can have a laxative effect. 

EPA DHA Extra 1-2 twice daily with food can aid in optimizing fat intake, lubrication of the bowels and will also reduce inflammation that may hinder bowel function.

B12 Boost 1 at rise as this supports neurological impulse and peristalsis, B-12 deficiency is a driver of chronic constipation

Magnesium Citrate 200-400mg can be used as a laxative and stool softener occasionally (once you have tried up to 4 scoops Relax and Regulate)

If symptoms are severe or you do not see relief after 4-6 weeks of the above protocol, you may want to consider a Stool Test to assess bacterial, yeast and parasite influence, markers of digestion and absorption, inflammatory influence and more. 

Food As Medicine Solutions

Here are a few favorite recipes and products to aid in increasing fiber in the diet and providing gut supporting compounds.

This Coconut Oil Prune Puree is a great option for adding more fiber to the diet and is combined with coconut oil to lubricate the bowel! Can be used at 2 Tbsp daily to support regularity.

Maca Cacao Chia Pudding chia seeds provide soluble fiber to help drive bowel formation. 

Low Carb Collagen Zucchini Muffins are packed with fiber from almond flour as well as shredded zucchini.