Constipation 101: Causes, Red Flags, and Practical Solutions

Constipation can range from a mild annoyance to a painful medical emergency—yet most people suffering with it suffer in silence. The fact is that constipation sends tens of millions to doctors' offices and ERs every year. It remains one of the most ignored, misunderstood, and undertreated problems in medicine.

Together, Dr. McMinn and Coach Lindsay break the silence and take a clear, evidence-based deep dive into:

• What constipation really is (and what it isn’t)
• The red-flag symptoms you should never ignore
• Why constipation is often a motility problem, not just “lack of fiber”
• The powerful roles of lifestyle, diet, medications, stress, hormones, and the gut-brain connection
• Practical, real-world solutions—from food as medicine and hydration to supplements, pelvic floor therapy, and when prescription options are appropriate

Dr. McMinn also shares deeply personal clinical and family experiences that underscore why this topic is anything but trivial.

Most importantly, you’ll walk away with a clear, practical 10-step Constipation Jumpstart Plan designed to help you get things moving—and keep them moving—safely and effectively.

Call to Action

If you or someone you love struggles with constipation, this episode could make a real difference.

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🎧 Listen now, take charge of your gut health, and become a better captain of your health ship.

Chapters

• 0:00 Why Constipation Deserves Attention
• 3:20 Red Flags You Must Not Ignore
• 8:20 Root Causes: Lifestyle And Meds
• 13:00 Motility 101 And The MMC
• 18:30 Foundational Fixes: Diet And Fiber
• 24:00 Hydration, Mind–Body, And Probiotics
• 28:30 Supplements And Osmotic Support
• 33:00 Pelvic Floor, Sit And Chill, Squatty Potty

Transcript

SPEAKER_00: 0:00

Welcome to the Wellness Connection MD Podcast. I'm your host, Dr. Jim McMinn. Today we're tackling a problem that millions of people struggle with, but almost no one talks about, even with their doctor, and that is constipation. It may sound trivial, but constipation can cause real suffering, and in rare cases it can actually become dangerous. I've witnessed this many times with my own eyes in the ER and in the clinic. The good news is that in the vast majority of cases, constipation can be both prevented and treated. By the end of this episode, you'll know the most common causes of constipation, the red flag symptoms you should never ignore, a bit about gut physiology to help you make sense of it all, and a clear 10-step plan to get things moving. So let's break down the silence around this common but important condition. Your gut health matters more than you think.

SPEAKER_01: 0:43

Welcome to the Wellness Connection MD Podcast with Dr. McMinn and Coach Lindsay, where we bring you the latest up-to-date evidence-based information on a wide variety of health and wellness topics, along with practical take-home solutions. Dr. McMinn is an integrated functional MD. Lindsay Matthews is a registered nurse at IIN Certified Health Coach. Together, our goal is to help you optimize your health and wellness with mind, body, and spirit. See a list of all of our podcasts.com. Stay up to date on the latest topics. Be sure to subscribe to our podcast by your favorite podcast player so that you'll be notified when future episodes come out. Discussions continue this podcast for educational purposes only. Diagnose disease. And now, on to the show with Dr. McMinn and Coach Lindsay.

SPEAKER_00: 1:40

Hello and welcome to the Wellness Connection MD Podcast. Thank you so much for joining us today. I'm Dr. Jim McMinn, and I'm here with our very own Coach Lindsay Matthews. Together we bring you the evidence-based podcast with honest, commercial-free, and unbiased up-to-date information about functional integrated lifestyle and wellness medicine. Our goal is to empower you with practical solutions to optimize your wellness and to become a great captain of your ship when it comes to your health and wellness. Well, good morning, Coach. It's great to see you again.

SPEAKER_02: 2:08

Great to see you, Dr. Mack, and great to be back with all of you listeners on the show.

SPEAKER_00: 2:13

Well, coach, today we're going to take a deep dive into an important issue that most of us deal with from time to time, but we hardly ever talk about it, and it's the issue of constipation. At first glance, it may sound a little bit trivial, but in reality, constipation sends tens of millions of people to doctors' offices, emergency rooms, and hospitals every year. It remains one of the most ignored, underappreciated, and misunderstood problems in medicine. Unfortunately, it tends to be one of those issues like, well, sexual function, abuse, mental health issues that patients are embarrassed or reluctant to talk about with their providers, so it rarely gets adequately addressed. But our goal is by the end of this episode, you'll understand the main causes of constipation, the red flag symptoms that you should never ignore, and a practical step-by-step plan to get things moving again.

SPEAKER_02: 2:58

We want to hammer home the point that on a scale of one to ten, constipation can be just a mild annoyance, or it can be a major medical problem, making people feel absolutely miserable, and it can even be extremely painful and dangerous. For instance, extreme constipation can cause bowel rupture, which can lead to a swift and painful death. Although that would be rare, it is also very real. And goodness, not the way anybody wants to go.

SPEAKER_00: 3:27

Oh, that's for sure. And I've personally witnessed uh many unfortunate victims in the ER having their bowels manually disimpacted. And let me tell you, it's no fun for the patient or the disimpactor. And coach, uh, I'll just uh add a little bit of personal uh touch here, if you don't mind. My own dearly beloved mother died of leukemia back a few years ago. And the thing that really brought her the most pain on her deathbed was not cancer, it was the bowel obstruction. So I'm just saying, coach, it's not a trivial issue. So today we're going to break down what's really actually happening when our gut slows down. And as always, we're going to leave you with some practical solutions to help you get your bowels moving and to keep them moving.

SPEAKER_02: 4:03

Before we get going, I'd like to remind folks that our podcast is one of those rare podcasts these days that remains completely unbiased and commercial free. We've been bringing this to you now for eight years.

SPEAKER_00: 4:15

It's hard to believe it, isn't it, Coach?

SPEAKER_02: 4:17

I was thinking about that just the other day.

SPEAKER_00: 4:19

Yeah.

SPEAKER_02: 4:19

And you have never heard a single commercial on the show during all that time. However, it does cost us money to produce these. So consider making a contribution to help us keep it coming to you.

SPEAKER_00: 4:31

And I'll make this quick. There are a couple ways you can contribute. First, if you buy nutritional supplements and we're not asking you to buy anything you don't already take, then consider purchasing physician grade supplements at our full script dispensary at a 10% discount. You can see the link for full script below in the show notes, or you can go to McMenMD.com and the link will also appear at the bottom of the homepage under helpful links. It's quite simple. Just click on the link and they'll guide you through the process. It's a win-win. You get high quality supplements at a discount, and we get your support for the show, for which we are very grateful.

SPEAKER_02: 5:03

You could also make a contribution directly to the show via credit card or by PayPal at the Support the Show link, which is in the show notes. Please don't forget to subscribe to the show so that you won't miss an episode. And tell your friends and family about us so we can keep it growing. And thank you so much for your support. It means a lot to us. And now, on to the show.

SPEAKER_00: 5:25

All right, coach. Well, let's start with the basics. What exactly is constipation? In general, if you got it, then you kind of know what it is. It makes you feel kind of miserable. But just for the record, the Mayo Clinic defines constipation as passing fewer than three stools per week or having a difficult time passing stools.

SPEAKER_02: 5:42

Before we proceed further, let me point out that besides the number of stools per week or difficulty passing them, there are a few other serious red flag symptoms that call for prompt medical evaluation. And those would include severe or worsening abdominal pain, especially if constant or associated with guarding or rigidity of the abdomen, constipation with vomiting, significant bloating, or inability or difficulty passing gas, blood in the stool, black tari stool or rectal bleeding, beyond a one-off tiny streak, clearly due to say to hemorrhoids, unintentional weight loss or loss of appetite, fatigue, iron deficiency, anemia in the setting of constipation.

SPEAKER_00: 6:31

And here are a few more red flags, coach. A sudden unexplained change in bowel habits in a person who has been regular for years, constipation lasting more than two or three weeks, despite appropriate self-care measures like fiber, fluids, movement, and all the over-the-counter agents, and needing to use fingers to extract a stool or having difficulty evacuating an enema or a suppository.

SPEAKER_02: 6:50

And to wrap up those red flags, also see your doctor if you experience an inability to pass gas plus marked distension or rapidly increasing abdominal girth, pencil thin or progressively narrowing stools, particularly if that's a new thing, persistent fever with constipation, especially if you pair it with abdominal pain, palpable abdominal or rectal mass, or new onset constipation in older adults, people over 50, or anyone with a strong family history of colorectal cancer, polyps, or irritable bowel disease.

SPEAKER_00: 7:30

So there you have it, coach. Those are the red flags. And uh constipation is not always just constipation. Sometimes it's the tip of the iceberg suggesting more serious problems lurking underneath. So if you have any of those red flags, then please uh get checked out right away.

SPEAKER_02: 7:43

Causes of constipation are many. And it's important to note that for most patients, it's not just one big thing, but instead it's typically that combination of factors that contribute to the end result of being constipated.

SPEAKER_00: 7:55

And you know, coach, so we think uh it's important to take a look at these causes, since as functional practitioners, which you and I are, that's just the way we think about things and the way we look at medicine. But also, for instance, as a patient, you may be oblivious to the fact that the medications you're taking are causing your constipation. Or in the case of my very own family, we had no idea that my dad's severe constipation was an early sign of his Parkinson's disease.

SPEAKER_02: 8:19

So let's take some time to break those causes down for you, starting with lifestyle factors. There's many lifestyle factors that may contribute, but here's some of the really big ones. Diet with low fiber and highly processed foods, inadequate fluid intake, really sedentary lifestyle, not moving, stress, poor sleep, being out of sync with our circadian rhythms, alcohol, irregular eating patterns, and habitually ignoring the urge to defecate for whatever reason. For instance, sometimes we're too busy or we just don't like to use a public restroom. Ignoring that urge is a cause for long-term constipation.

SPEAKER_00: 9:04

Another very common cause of constipation is due to the side effects of certain medications. The main culprits include opioids, which are the narcotic pain medications, many antidepressants, anticholinergic drugs, which are things like antihistamines, some anti-convulsant medications, calcium channel blockers, which we often take for things like high blood pressure, aluminum and calcium-containing anti acids, iron supplements, and certain Parkinson's disease medications. And coach, it's important these days to mention the popular GLP1 weight loss drugs. These medications slow gastric emptying and intestinal transit, so constipation is a common side effect. And a proactive aggressive bowel support program is highly recommended for folks taking these drugs.

SPEAKER_02: 9:47

The next cause that we'll mention is structural or obstructive causes due to things like adhesions from surgery, severe diverticular disease, colorectal cancer, pelvic organ prolapse, and inflammatory bowel diseases, which can cause strict.

SPEAKER_00: 10:12

And coach, even uh nerve damage or nerve dysfunction, uh, such as folks with like a diabetic autonomic neuropathy, neurologic diseases like Parkinson's and MS, traumatic brain injury, uh, post-surgical nerve injury, and the post-infectious states can all contribute to constipation.

SPEAKER_02: 10:28

We also see constipation caused by hormonal imbalances, especially hypothyroidism, pelvic floor dysfunction, which causes impaired evacuation, long-term stibulant or laxative use, which may reduce colonic responsiveness over time, eating disorders or chronically restricted intake, which suppresses motility signals, electrolyte imbalances, mitochondrial dysfunction, hypercalcemia, which is often due to hyperparathyroidism, pregnancy, IBS.

SPEAKER_00: 11:04

By the way, coach, let me just mention IBS is irritable bowel syndrome.

SPEAKER_02: 11:07

And the aging process itself, which is associated with a gradual decline in gut and overall motility.

SPEAKER_00: 11:14

And we'll wrap up our causes discussion by alluding to the mind-gut connection. We often see constipation in association with things like depression, anxiety, high psychosocial stress, eating disorders, and various pain syndromes, including the fear of a painful bowel moment due to things like fissures or hemorrhoids.

SPEAKER_02: 11:31

One of the most important concepts to understand is that constipation often boils down to a problem of impaired gut motility. Normal bowel motility depends on several systems working well together. And those systems are healthy nerve signaling, healthy smooth muscle in the gut wall, coordinated gut and brain communication, adequate energy production, think your mitochondria, and then proper timing and reflexes. When any of those systems are disrupted, especially more than one at a time, intestinal transit slows, stool becomes harder, and then the evacuation becomes more difficult.

SPEAKER_00: 12:11

Now, coach, uh, let me uh talk just for a moment about something super interesting. It's called the migrating motor complex or MMC. I know this is a little bit geeky, but it's really kind of fascinating. This is sort of a cyclic, wave-like pattern of muscle activity that's that sweeps through the stomach and small intestines during fasting. Its job is to clean out leftover food, bacteria, and debris between meals.

SPEAKER_02: 12:33

Let me highlight the words during fasting. So that means that for us grazers, and I'm I can be very guilty of that, people who tend to snack between meals, we don't fully activate the migrating motor complex because we're not fasting. So this slows down our gut motility. So ideally, it's best to not eat anything for at least four hours between meals to activate that migrating motor complex.

SPEAKER_00: 13:00

The migrating motor complex is an incredibly complex phenomenon. The MMC is created by the enteric nervous system, carried out by the smooth muscle, paced by the interstitial cells of the gut, and regulated by hormones like motilin and gorillin, with modulation from the autonomic nervous system, the microbiome, and from immune signaling. Wow. That takes a lot of coordination, coach. It's kind of like this fine-tuned symphony of gut physiology. It's just amazing. Mother Nature and the human body never cease to amaze me, coach.

SPEAKER_02: 13:31

Agreed. And when things are going well, the symphony sounds fantastic. But then stuff happens, like viral infections, systemic illness, inflammation, major stress, or nerve injury, and all of those can disrupt the migrating motor complex symphony. It's like all of the instruments are playing in a different key. And as you can imagine, the results can be really disastrous for our gut.

SPEAKER_00: 13:56

Yeah, I bet that symphony doesn't sound too good, does it, Coach?

SPEAKER_02: 13:58

No.

SPEAKER_00: 13:59

Yeah. You know, it's kind of interesting when the MMC gets messed up, it can actually result in constipation or diarrhea. I've seen it both ways. But unfortunately, this uh disruption can persist for weeks, months, or even can last a lifetime after the acute illness resolves. And this explains why many people, and I've heard a lot time uh through the years, uh coach, uh, said I was fine, then I got sick, and my gut never recovered. I've heard this so many times, coach.

SPEAKER_02: 14:22

Yes. So let's move on to what you listeners are waiting for, and that's prevention and treatment. The good news.

SPEAKER_00: 14:30

And with just about everything else we talked about, it all starts with lifestyle medicine. These measures are foundational for keeping our balance regular.

SPEAKER_02: 14:39

So that includes proper diet and eating habits, also abundant hydration, daily movement, responding to the urge to go, and then proper toilet posture all support gutility. There are many other lifestyle measures that can make a difference too. We did an entire podcast on the awesome power of lifestyle medicine, and we have an excellent handout on that topic for you called Lifestyle Essentials, which you can find at McMinnMD.com in the documents section. So we won't repeat all of those concepts today.

SPEAKER_00: 15:12

However, uh, the most important lifestyle measure that we must talk about is diet. Admittedly, personalization matters. It's not just about rigid rules for everybody. However, let's focus on some general dietary concepts that apply to most folks. In a nutshell, a constipation prevention diet is simply a fiber-rich whole foods diet eaten on a regular schedule.

SPEAKER_02: 15:33

And then to keep breaking that down a bit further, you want to eat the foods which stimulate a bowel movement and support the gut microbiome, and that is fiber. And you want to avoid the foods that slow down the bowels and dry out the stool. And those foods include low fiber, high fat, high-processed food choices like cheese, red meat, white bread, fried foods, and fast food.

SPEAKER_00: 15:59

More specifically, uh aim for about 25 to 30 grams of uh fiber per day and include a mix of soluble and insoluble fiber that works best since they all act through a little slightly different mechanism.

SPEAKER_02: 16:10

And by the way, if you haven't been eating a lot of fiber, you may need to increase the fiber gradually over about one to three weeks so your body can adjust. And for sensitive guts like people with IBS C or irritable bowel syndrome with constipation, favor cooked over raw vegetables and consider spacing fiber-rich meals across the day to reduce gas.

SPEAKER_00: 16:35

And I know the issue of soluble fiber and insoluble fiber can be a bit confusing. So uh basically think of soluble fiber as fiber that dissolves in water and forms a gel, whereas insoluble fiber doesn't dissolve in water. It's that simple, Coach.

SPEAKER_02: 16:48

So as a result, the soluble fiber tends to soften the stool, keep it slippery, and assist with fermentation, binds cholesterol and bile acids, and provides microbiome support. Examples of soluble fiber include oats, barley, chia seeds, flax seed, psilium husk, apples, citrus fruits, pears, beans, lentils, peas, carrots, and brussels sprouts.

SPEAKER_00: 17:12

I'm proud to say, coach, this morning I had my oats, my chia seeds, and my flax seed all this morning. So I'm getting plenty of plenty of soluble fiber there. On the other hand, insoluble fiber tends to add bulk to the stool, improves motility, speeds up transit time, and helps the stool to retain water and acts as a gentle scrub brush to sweep away debris and prevent stagnation. Examples of this would include wheat bran, whole wheat bread, brown rice, nuts, seeds, cauliflower, potatoes, especially with the skin, celery, cucumbers, and zucchini.

SPEAKER_02: 17:42

The foods that you'll want to avoid are the low fiber, high-fat, ultra-processed foods like white rice, white bread, fast food, pastries, and chips, which are linked with slower stool transit and reduced stool bulk.

SPEAKER_00: 17:59

Now let's take a look at what we call the therapeutic foods for constipation. And it's back to the concept of food as medicine, which I think is really popular and important concept these days. We've talked about that a bit before. But these foods would include things like prunes, kiwi fruit, ground flax, chia seeds, pears, beans, lintils, psilium, which is what you'll find in Metamucil. However, be careful with the brand name Metamucil since it does contain a lot of sugar or artificial sugars. You can also get just plain psilium in brands like Consul and many others. And by the way, my sister Cindy has a great recipe for a high fiber muffin called Mufflax. I can testify they're mighty tasty, and they're definitely will get you going. I'll put the recipe in the document section at McMinMD.com entitled Sister Cindy's Muffalax Recipe.

SPEAKER_02: 18:44

I love things that come from Sister Cindy.

SPEAKER_00: 18:47

She's quite a cook, she really is. She really is.

SPEAKER_02: 18:49

Yes. Before we leave the diet portion of the podcast, I'd like to briefly shed some light on the issue of irritable bowel syndrome. People with irritable bowel syndrome can either have diarrhea, which would be called IBSD, or constipation, which is IBSC. With IBS C, this is not simply infrequent bowel movements. It's in addition to the constipation, those patients often have abdominal pain, bloating, and uncomfortable bowel movements.

SPEAKER_00: 19:21

So if your doctor has diagnosed you with IBS C, then it's probably best to focus on more of the soluble fibers like the oat, cilium, and chi and all the stuff we mentioned before, and consider trying a low FODMAP diet. These folks with IBS C also benefit from stress regulation, targeted supplements, and sometimes they may require prescription medication.

SPEAKER_02: 19:40

After diet, the next important general principle is adequate hydration, because the fiber can't do its job unless there's enough water to soften and add bulk to the stool. In fact, inadequate fluid with high fiber can actually worsen bloating and constipation. So the solution here is quite simple. Drink up.

SPEAKER_00: 20:00

And the next thing I'd like to mention is the mind-body connection. As alluded to above, things like anxiety, depression, and stress uh contribute mightily to constipation. So please don't forget to address these issues with your provider. You might also want to take a look at our stress management plan and stress toolbox that you'll find at McMinMD.com. And also check out our recent podcast on the causes of depression.

SPEAKER_02: 20:21

As we pointed out many times, there's a huge gut-brain connection. And as that old Chinese medicine proverb goes, the body is a puppet of the mind. So in this case, if the mind is not right, then the gut's not right.

SPEAKER_00: 20:35

You know, coach, the next step I recommend is try some probiotics. I've seen that work on lots of folks. It's one of the things that might help, uh, probably won't hurt. Probiotics can modestly ease constipation by improving stool frequency and supporting healthier gut motility, though the benefit does vary from person to person. I recommend you get a high-quality probiotic with a mixture of lactobacillus and bifidobacterium, or just a bifidobacterium dominant blend.

SPEAKER_02: 20:57

And I always love the probiotic foods, and these have been shown to be really helpful for many people. So that includes yogurt, kefir, kombucha, miso, sauerkraut, kimchi, other fermented veggies, and tempeh. You may also want to try some botanicals and other supplements such as trifala or aloe-based products, herbal motility blends, bitters, or branded products, even like atrantil.

SPEAKER_00: 21:27

Didn't you used to make your own kombucha?

SPEAKER_02: 21:29

Yes, we made our own kombucha. We've made our own uh sauerkraut, kimchi. I haven't done it in a little bit. I think just having kids has kept me busy, but we've actually got we have some kimchi and sauerkraut in the fridge right now that we've been eating with, like I've been eating it with eggs in the morning, and it's my favorite. I love it.

SPEAKER_00: 21:48

Do you get actually get your kids to eat that stuff or not?

SPEAKER_02: 21:51

My son Jojo will. My daughter, she's kind of turned up her nose at it right now, so we're working on it.

SPEAKER_00: 21:56

Yeah, I no, this has been like 10 years ago, but I remember a podcast looking at the number of CFUs of bacteria, called only 40 units of bacteria in sauerkraut. It was amazing. It would blow any uh store bought product off the off the map. It was just incredible how many uh bacteria there were, and they're good bacteria. So um, so yeah, things like sauerkraut are really excellent. You know, coach, over about my 40 years of medical practice, I always felt that I learned more from my patients than they learned from me. And over that period of time, I saw so many folks with constipation, and a lot of them would share with me some of their therapeutic measures that were working for them. And I always took notes. And so in my constipation protocol at McMinn.com, I share some of these uh patients' suggested therapies with you, and you'll find all sorts of remedies, including motility agents, therapeutic fiber formulas, herbs, and lots more. And what works for one person may not work for another, so it's a matter of trying this, that, and the other to find out what works for you. So check out some of those therapeutic options that you might find helpful.

SPEAKER_02: 22:50

If the above measures aren't doing the job, then the next step might be to add osmotic support. This just means pulling water into the gut from the surrounding tissues to help soften the stool and make it easier to pass. Some osmotic agents to consider would be, for example, polyethylene glycol or miralax, magnesium, lactulose, or a sorbital solution.

SPEAKER_00: 23:16

My preference would be to start with magnesium. Now, the magglycin is wonderful, it's good for things like heart health and stuff like that, but it's not going to work very well for this purpose. But instead, go with things like a mag citrate, mag hydroxide, or mag sulfate. Mag citrate is readily available in many forms, including an excellent product called calm magnesium, which you can find online or at many stores. And this can also, by the way, can also help with sleep. Maghydroxide is what you'll find in milk of magnesia, and mag sulfate is what you'll find in Epsom salts. One strategy is to take mag citrate, about 300 milligrams, once a day, and then start titrating up, maybe to go twice a day and then up to maybe four times a day, start trying to titrating up on uh dosage as well, until you get a normal bowel movement.

SPEAKER_02: 23:58

For particularly stubborn bowels or for a more aggressive approach, there's a product called oxy powder, which is an oxygen-based magnesium product that also works quite well. This can be used short term or intermittently when standard osmotic agents are insufficient. It's typically taken at night and titrated to produce one to two soft stools per day without producing ongoing diarrhea. And a word of caution there, if there is any issue of compromised kidney function, then all magnesium products, electrolyte solutions, and osmotic agents should only be used under physician and guide physician guidance.

SPEAKER_00: 24:36

Yeah, coach, I've heard some really good feedback on that uh oxymag. So for people who have stubborn bowels, that might be a good way to go. But if the mag's not working, then consider trying Muralax, which can work uh quite well for most patients. And this is over the counter. You know, coach, when it first came out, I I think there was the the buzz was uh to use it only intermittently, uh um short-term, but I think now it's considered pretty safe for long-term use.

SPEAKER_02: 24:59

And if you're still not getting the results that you need, then stimulant laxatives may have a role for short-term rescue, but should not be used chronically without supervision. Keep in mind that these can cause cramping, electrolyte imbalance, or dependence if overused. Examples of that would be senna tablets, senna containing teas like smooth move tea, products containing biscadil, like dolcalax or correctol.

SPEAKER_00: 25:27

Another trick, especially for those with large or dry stools, is to lubricate the anal canal. A little lubrication reduces friction, protects the tissue, and helps the stools slide out instead of ripping and tearing along the way, causing things like fissures and hemorrhoids. This can be done with a water-based lubricant or a mineral oil or preparation H ointment. One nice thing about the preparation H ointment, and and I have no stock in preparation H, it comes with an appropriate uh applicator to help you get it up inside the rectal canal. Another strategy is to apply a preparation H suppository at night before you go to bed. This will melt overnight and provide excellent lubrication the next day. Glycerin suppositories may also be used in the same way, and they not only lubricate the anal canal, but they also draw fluid into the area. This can be very helpful, especially for those with fissures or hemorrhoids. However, glycerin is intended only for short-term use.

SPEAKER_02: 26:18

Moving on, let's talk about pelvic floor therapy. This is one of the most underrecognized but powerful tools for people with chronic constipation. You can have perfect fiber intake, great hydration, and the right medications, but if the pelvic floor does not relax, stool simply can't pass. For many patients, this is the important missing piece. And we did an entire podcast a few years ago on pelvic floor therapy with the wonderful Nikki Woods, who I've personally gone and seen since then. She's wonderful. So we won't go into a great detail of that today, but if you're interested, then please reference back to that podcast. This pelvic floor therapy can really make a difference.

SPEAKER_00: 27:00

Yeah, coach, uh I want to give a shout out to Nikki. She's just a wonderful human being, and I think she's just super expert in what she does. Uh so if you live uh anywhere in this area, which of course is Birmingham, Alabama, then uh go see Nikki if you have any kind of pelvic floor issues, including constipation, you know, all kinds of stuff. Uh urine urinary leakage, whatever. You you you name it. She can deal with the whole thing. But anyway, both adults and kids get busy with our daily activities and we just don't take the time to poop. Coach, um we ignore the I need to go signals from the gut. One of the most powerful and low-tech methods to produce regular stool is just to sit and chill for a while. The best time to do this is in the morning after breakfast, since this is when the gastrocolic reflex kicks in the most. And for adults, a cup of coffee with breakfast might help jumpstart things.

SPEAKER_02: 27:46

Yeah, it's kind of fun to watch how kids, I think, tend to have a lot more intuition about bowel movements than we as adults do. Like I watch my son JoJo. Sometimes he just cannot sit down and eat dinner. And my tendency is to sit down and eat dinner. But usually on those nights when he is just so squirmy and so fidgety, he'll eventually, after about 30 minutes, get up and go have a bowel movement. And then he'll just come and eat all he wants. And I think, you know what? I need to have that intuition myself. We don't, I don't need to keep compounding the issue. I need to sit down and go.

SPEAKER_00: 28:21

Our our bodies are always giving us signals and messages, and we we usually ignore them, right? We need to pay attention to our body, especially to our gut, right? And uh so in this case, when your gut says you need to go, you need to go.

SPEAKER_02: 28:31

Yes, right? Yes. Studies have shown that relaxation techniques can be quite effective in these situations, especially biofeedback. I've seen studies showing a 70% success rate with children with chronic constipation using sit and chill method plus biofeedback. Again, a pelvic floor physical therapist can teach you all about this stuff. So check it out. The term biofeedback, y'all, that might sound fancy or high volutin, but it's really simple and effective. So check it out.

SPEAKER_00: 29:02

You know, coach, many, many, many years ago, gosh, probably 20 years ago, I saw this really fascinating study, I think it was from Scandinavia, about children with something called incaprices. Encopresis, it kind of looks like diarrhea because they they lose control of their stools, these children. But what's happening, they they have a big plug of poop in their bowels and they're squirting around that plug. And so it looks like diarrhea, but it's really constipation. And so they did the the sit and chill method along with biofeedback. They had a 90% success rate.

SPEAKER_02: 29:32

Wow.

SPEAKER_00: 29:32

Wow. No drugs.

SPEAKER_02: 29:33

Yeah.

SPEAKER_00: 29:34

It's amazing, right? They just made them sit for a while, or it's maybe some relaxing music, some whatever. And uh, it was amazing along with biofeedback. So, yeah, so check out uh check that out. And again, a good pelvic fluorotherapist can teach you all about that. So go see Nikki and learn about biofeedback. And let me also mention that many of our patients swear by a device called a squatty potty. Have you heard of that, Lindsay?

SPEAKER_02: 29:55

I have, yes.

SPEAKER_00: 29:56

And especially for those patients with a large poop or who strain to poop. And the evidence backs it up. Uh, studies show that the squatty potty properly aligns the analektal canal, reduces straining, and makes bowel movements easier and more complete. So there you go. Give the squatty potty a try.

SPEAKER_02: 30:12

And just one more quick comment for parents about constipation in kids. Glycerin suppositories can also be helpful under physician supervision for short-term use for infants and young children with hard stools. They help the kids poop by drawing water into the rectum, lubricating the rectal canal, and then gently triggering the natural reflex to push the stool out. To be clear, that's not a long-term solution, though.

SPEAKER_00: 30:38

And let's just wrap this up, coach, by briefly mentioning prescription options. And we're not going to go into them one by one, but these can be very helpful for refractory cases. There are many types of meds which work by different mechanisms, and uh, I'll have to leave it up to your provider to prescribe the one that is right for you. Uh while I do think it's usually best to solve this riddle with natural means, and that's usually successful, coach, uh, by addressing things like lifestyle issues and all the stuff we've talked about before. There is a time and a place for these meds, and please don't feel like it's a failure if you have to resort to these. Some people just have stubborn bowels, and it's okay if you have to use meds.

SPEAKER_02: 31:12

Prescription constipation meds require clinical evaluation and monitoring, especially in older adults and complex patients. However, they can be very effective for the right folks, and we fully support their use when needed.

SPEAKER_00: 31:26

So let's wrap this up for you, coach. Uh drum all, please. There you go. Uh, with our 10-step constipation jump start plan. Uh, first of all, again, listen to your bowels, and when they tell you it's time to go, then go. Take time to poop, use the sit-in-chill method if needed. Hydrate well, keep your body moving. This helps everything, including your bowels.

SPEAKER_02: 31:45

Address the mind-body connection by treating anxiety, depression, stress, and any other mental health issues, and by learning relaxation techniques to help you poop. Attend to other lifestyle measures that we've already mentioned here. Eat that high-fiber plant-centered diet and avoid processed food. Add therapeutic fiber, such as flax or psyllium if needed, as well as some of the other therapeutic foods that we mentioned above, like prunes or Sister Cindy's delicious muffalax muffins.

SPEAKER_00: 32:17

And if the above measures aren't doing the job, then add some herbal support, some osmotic support with magnesium and or muralax. And if needed, use stimulant meds or supplements like smooth moti for a brief period of time. Funny, there's a time and a place for serious prescription medications via your provider. Use them when you need to and do whatever you gotta do to get your bowels moving.

SPEAKER_02: 32:36

In summary, constipation is common. It is important and it should not be ignored by the patient or the provider. And the great news is that it's usually treatable. So please don't be afraid to bring it up to your provider.

SPEAKER_00: 32:50

As per usual, coach, it all starts with awareness, paying attention to our bowels, and then intention to do whatever we need to do to fix the problem. We've offered up uh to you many simple solutions, and we hope that these help you make friends with your gut. And coach, one more quick thing. I usually try to put a plug-in for my wife, Dr. Cheryl. And uh today on the podcast, I mentioned my mom, my dad, my sister Cindy, but Cheryl specifically asked us not to mention here on the podcast of constipation. So this was a purposeful admission. So if you go into Dr. Cheryl withdrawal, don't blame me, blame Dr. Cheryl.

SPEAKER_02: 33:23

Well, that about does it for this edition of the Wellness Connection MD. Thank you so much for listening. I hope that we were able to share something with you that was interesting and that helped you in some way.

SPEAKER_00: 33:35

If you like the show, then please help us out by taking a moment to rate us on iTunes. Uh these reviews really do make a difference for us. And by the way, coach, I I gotta say, we're one of the most highest-rated podcasts out there. Big higher than all the big shots. So thank you, listeners. Thank you, listeners. Yeah, pretty cool. That thank you, all my relatives, for for your good reviews. No, really, we really appreciate it because I think uh you know we get rated higher than you get higher up to totem pole, whatever. So anyway, uh thank you, thank you, thank you for those reviews. We really appreciate it. It means a lot to us.

SPEAKER_02: 34:08

So, listeners, if you like the podcast, then take a moment today to let a friend know about us. We're trying to build a tribe of people who are passionate about holistic lifestyle, integrative, and functional medicine, and we hope that you join the tribe.

SPEAKER_00: 34:22

If you'd like to reach out to me to comment on the show or to make recommendations for future topics, you may do so at drmcmin at yahoo.com. And if you'd like to see a complete transcript of the show, then go on over to McMin M D.buzzsprout.com. That's B-U-Z-Z-S-P-R-O-U-T dot com, and you'll find a transcript there. And now, coach, can you please leave us with one of your wonderful coach Lindsay Pearls of Wisdom?

SPEAKER_02: 34:47

Thanks, Dr. Mac. You know, if you're constipated and doing nothing about it, I just want to encourage people to take some action. Your body is essentially, if it's constipated, it's hitting that self-compost button. Stool that sits too long in the colon doesn't just disappear. It gets reabsorbed, and that means toxins, estrogen, inflammatory byproducts, all that re-enters circulation. So regular elimination isn't just about being comfortable. It's a critical detox pathway, and it's a foundational sign of your metabolic health and your gut health, too.

SPEAKER_00: 35:20

You know, coach, we talked about in the past how there's a gut everything connection, gut brain connection, gut heart connection, gut bone, you name it, gut everything. If your gut's not healthy, you're not healthy, right? And part of that being constipation. Well, coach, that'll do it. Until next time, stay curious, stay informed, keep it real, and remember small actions can lead to big changes. Take the first step towards better health.

SPEAKER_02: 35:40

This is Coach Lindsay, signing out.

SPEAKER_00: 35:42

And this is Dr. McMinn. Take care and be well.