Have you gone “number two” today? Yesterday? The day before that? In conventional medicine, the baseline requirement for regularity is three bowel movements a week. However, a better sign of a truly healthy gut is pooping one to three times a day. 

Regular bowel movements are a key indicator of a properly functioning digestive system, yet roughly 12% to 19% of the population of North America, as many as 63 million people, suffer from constipation, resulting in about $235 million in medical costs a year.

What Constipation Can Cause

Our elimination system is built to remove toxins and waste from our bodies. When you don’t eliminate it regularly, these toxins are stuck sitting in your intestines, potentially being absorbed back into the bloodstream via a leaky gut. The waste in your intestines sits idle, producing bacteria that can disrupt the balance of healthy flora in your gut and lead to inflammation.

Although constipation symptoms are very easy to spot, the cause of your irregularity could be due to a number of factors including an underlying health condition, medications, or your diet and lifestyle. Let’s go more in-depth about what causes constipation and what you can do to get relief naturally. 

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What is Constipation?

When you think about constipation you likely describe it as the feeling of needing to go number two and not being able to empty your bowels. However, the medical definition of constipation is having fewer than three bowel movements in a week. 

Bowel patterns are different for everyone. Some people have bowel movements several times a day while others may only go once or two times a week.1 As long as you stay consistent with whatever your bowel pattern is, there’s nothing to worry about. Even the occasional constipation is very common and typically not serious. 2

Common Signs Of Constipation

Common signs of constipation include: 

  • Dry and hard stools
  • Painful bowel movements with stools difficult to pass
  • Feeling that you have not emptied your bowels

Chronic Constipation

Constipation becomes a problem when you go three months having less than three bowel movements per week. Other signs of chronic constipation include constipation that is disruptive to a person’s personal or work life and when it is not relieved by a change of diet or lifestyle changes.3

Women and people over the age of 65 are at a higher risk to experience chronic constipation. Pregnancy and lack of physical activity also increases the risk of chronic constipation. 

Poor diet and lack of exercise are common factors of short-term constipation. However, underlying health conditions such as autoimmune disease, hypothyroidism, small intestinal bacterial overgrowth (SIBO), Crohn’s disease, colon cancer and irritable bowel syndrome can cause chronic constipation. 

I will go more in-depth about the causes of constipation later. First, let’s dive into more specific symptoms of constipation. 

Symptoms of Constipation

As I mentioned, the most common sign of constipation is having less than three bowel movements in a week. More specific symptoms of constipation include:  

  • Difficulty passing stool
  • Painful bowel movements
  • Passing less stool than usual 
  • Lumpy, dry, or hard stool 
  • Cramping and pain in the abdomen
  • Feeling bloated
  • Nausea 
  • Loss of appetite

Conventional medicine will only treat the symptoms of constipation. As a functional medicine doctor, I get to the root cause of your constipation so you can take the necessary steps to eliminate it. 

Causes of Constipation

Now that you understand what constipation is and what the symptoms are, let’s talk about seven common causes of constipation.


Like the plumbing in your home, our internal flushing system requires adequate water to function properly. This is one of the most common causes of constipation and is easiest to avoid. Drinking coffee, soda, and alcohol can lead to dehydration if you aren’t drinking enough water. Providing your digestive tract with water is an easy and inexpensive step to support regularity.  

Not Eating Enough Dietary Fiber

Dietary fiber isn’t digested by your body. Instead, dietary fiber travels relatively intact through the stomach and intestines, absorbing water to add bulk to stool, and helps move waste through your system.4

Eating high-fiber foods such as prunes, beans and flax seeds can support a healthy bowel pattern. However, these foods are difficult to digest and/or high in sugar which could make a condition such as SIBO worse. Leafy green vegetables, cauliflower and zucchini are high fiber foods that can support a healthy digestive pattern. 

Disruption of the Gut Flora

Your digestive system is home to a rainforest of good bacteria that help break down and absorb food and then eliminate waste. Many factors such as taking antibiotics or oral contraceptives, stress, or inflammation can disrupt the natural gut flora leading to yeast overgrowth, SIBO, and leaky gut, all of which causes constipation.

Hypothyroidism and Hashimotos’s

Hypothyroidism, an underactive thyroid, slows down many of the body’s systems, including elimination. For your body to eliminate waste, your colon must contract, and slow or weak colon contractions can be a symptom of hypothyroidism. It’s estimated that 27 million Americans have an underactive thyroid and most have no idea that they do. 

Food Sensitivities

Constipation can be a common symptom of general digestive mayhem related to food sensitivity as the body struggles to digest and eliminate the foods at the root of inflammation. Although food sensitivity can be triggered by a wide range of foods, gluten and dairy are the most common culprits.

Autoimmune Disease 

Autoimmune diseases are born when your body is working hard to defend itself against something potentially dangerous, such as an allergen, a toxin, an infection, or even a food, and it fails to differentiate between the intruder and parts of your own body. This leads your immune system to attack your own organs. Autoimmune diseases can affect many different systems in your body; they include neurological conditions such as Multiple Sclerosis or Parkinson’s Disease, thyroid diseases such as Hashimoto’s, and multiple-system conditions such as Lupus. All of these diseases can cause constipation because they attack the intestinal tissue itself and the intestines stop moving food properly through the digestive system. 

Bowel Obstruction

A more acute cause of constipation can be an obstruction in the small or large intestine that prevents stool from moving through. Common causes of intestinal obstructions are scar tissue or adhesions caused by abdominal surgery, hernias, tumors, Crohn’s disease (which can narrow or twist the intestine), or even cancer.

There are, of course, many other potential causes for constipation, such as not getting enough exercise, excessive stress, or taking harmful over-the-counter painkillers. It is best to take a comprehensive view of your health and what factors might be contributing to your constipation. Once you understand what is causing your constipation you can properly treat it.

How To Relieve Constipation Naturally – Infographic – Amy Myers MD®How To Relieve Constipation Naturally - Infographic - Amy Myers MD® https://content.amymyersmd.com/article/causes-constipation/How To Relieve Constipation Naturally – Infographic – Amy Myers MD®

How to Relieve Constipation Naturally

As I mentioned earlier, the easiest way to relieve constipation is to drink plenty of water.  You use water in all of your body’s processes. In fact, this fluid makes up 60% of your body. That’s why staying hydrated is essential to keeping all your systems functioning optimally, including your bowels. There are several ways you can support your digestive system and find natural relief from constipation. 

Increase Water Intake

As the saying goes, keep your pipes flushing by staying hydrated. Tap water and bottled water contain toxins and are filled with harmful chemicals. When it comes to hydration, pure, clean water is the best choice. Recent research has shown the optimal water intake averages 15.5 cups per day for men and 11.5 cups per day for women. It could be more or less depending on the weather and how much you exercise. 

Eat Enough Dietary Fiber

Dietary fiber absorbs water and can support a softer stool to alleviate the causes of constipation. Eating foods rich in dietary fiber is a staple for regularity. Good sources of fiber include avocados, strawberries, raspberries, carrots, beets, broccoli, brussels sprouts and leafy greens.5 It is recommended that men consume 30-38 grams of dietary fiber per day and women consume 21-25 grams per day.6

Eliminate Inflammatory Foods

While you’re reaching for high-fiber foods, stay away from the foods that lead to inflammation, particularly gluten, dairy, corn, soy, and sugar. Food sensitivity and inflammation triggers are unique to each person, so I recommend doing an elimination diet to identify any food sensitivities.

Heal Your Gut

In functional medicine, we use a simple approach called the 4R protocol to repair your gut. 

  • Remove: Removing the bad, such as eliminating inflammatory foods such as gluten, sugar and dairy, along with toxic foods like alcohol and caffeine.
  • Restore:  Restore what’s missing to support proper digestion and absorptions such as digestive enzymes and acids.
  • Reinoculate: Restore the beneficial bacteria to re-establish a healthy balance of good bacteria. I recommend a probiotic that contains beneficial bacteria such as bifidobacteria and lactobacillus species from 30- to 100-billion units per day. If you have SIBO, I recommend you only take a soil-based probiotic to avoid feeding bad bacteria with the good.
  • Repair: Providing the nutrients necessary to help the gut repair itself is essential. My most comprehensive weapon against leaky gut is Leaky Gut Revive®, which contains powerful gut-repairing ingredients l-glutamine, aloe, deglycyrrhizinated licorice, arabinogalactan, slippery elm and marshmallow root.

Having a healthy gut is a great way to stop constipation and ensure regularity. 

Supplement with Magnesium Citrate

While you are treating the root cause of your constipation, you can relieve your immediate symptoms with a magnesium citrate supplement, which plays a vital role in metabolic functions and aids bowel movements by attracting water in the intestine.

In my clinic, after ruling out all of the above causes for constipation I recommend my patients try Magnesium Citrate. Magnesium Citrate is the perfect form of magnesium to support healthy bowel movements.

You don’t need to accept constipation as a regular part of life. If you continue to struggle with constipation, evaluate your diet, your environment, and your activity level to uncover the root cause of your constipation and discover the right solution to get regular!


Article Sources

  1. Constipation. Cleveland Clinic. 2019.
  2. Constipation. Mayo Clinic Staff. Mayo Clinic. 2021.
  3. What Does It Mean to Have Chronic Constipation?. Jacquelyn Cafasso. Healthline. 2020.
  4. Dietary fiber: Essential for a healthy diet. Mayo Clinic Staff. Mayo Clinic. 2021.
  5. 22 High Fiber Foods You Should Eat. Kris Gunnars, BSc. Healthline. 2020.
  6. Dietary fiber: Essential for a healthy diet. Mayo Clinic Staff. Mayo Clinic. 2021.