Learning to listen to those gut feelings

Cathryn Arndt

How often do you move in a day?

I’m not talking about the frequency of your exercise routine, but how often your gut compels you to go to the bathroom for a bowel movement.

There, I said it: How often do you poop?

For more than a year now, I’ve wanted to write about this, although – let’s face it – it’s not exactly a trendy or appealing topic. Before hastily finding another article, I encourage you to stay with me.

The surprising reality is that gut motility, or movement, problems and constipation are more nuanced and more common than people understand. Most folks don’t know that both issues can cause long-term health problems. Their underlying root causes and solutions are often more comprehensive than the advice to “eat more fiber and drink more water.”

What exactly is constipation? Depending on whom you ask, a definition can be hard to pin down. From my experience and in talking with other health care professionals, I consider constipation to be the difficulty having a regular bowel movement, or not having a minimum of one movement a day.  

Consider: If you eat three to five times a day, you ought to be “eliminating” at least once a day (kids under 12 months of age are different). We poop because our bodies need to get rid of the waste products we can’t (and shouldn’t) use. Our bowel movements consist of bacteria, fibers and byproducts of the hormones we’ve used up or the medications we’ve taken, just to name a few things. If we don’t excrete these, the body can reabsorb and recirculate certain compounds like those hormone byproducts. Even if you don’t exactly have “constipation” but feel like your digestive system is slow on a regular basis (we call this slow gut motility), you still can face health consequences down the road.

Also important is what your bowel movement looks like. I’ll spare the details, but the appearance can tell you a lot about what’s going on in your body.

A great resource is the Bristol stool chart, which lists several types of bowel movements, what is normal and what is not (types 3 and 4 are normal).  If you’re having somewhat regular bowel movements, but they don’t “appear” normal, you may still have something going on in your gut that should be addressed.  

So what’s the big deal about slow gut motility and how it “looks?” Think of a stagnant pond. It’s stinky and gross because things have stopped moving and bacteria (either good or bad) have overgrown. The same happens in your gut.  

The consequences of a stagnant gut vary in intensity and in short- or long-term effects. There can be a mild, uncomfortable feeling of “fullness” or a lack of appetite as well as gas and bloating. Extreme pain can also occur. (I’ve known people who’ve gone to the ER for what turned out to be significant constipation!). 

Long-term constipation actually can cause major bacterial overgrowth in both the large intestines (where bacteria should be present in the right amounts) and in the small intestines (where it isn’t supposed to be at all!). This can lead to nutrient deficiencies and their symptoms (low iron, low B vitamins etc.) in addition to more extremely uncomfortable GI symptoms and conditions.

So what causes this stagnation? Believe it or not, it isn’t “just” your diet.  You may have been told to drink more water and eat more fiber, whether from food or supplements.  Sometimes diet IS the culprit, especially in a world where we eat too much processed fats, sugars and meats. A poor diet will also lead to poor microbiome health, which in turn affects motility.  It’s always good to start by assessing your diet.

 However, you may feel as though you’re “doing it all right” and are still plagued with constipation.  There are so many other reasons why your gut might be slow that are not directly food-related (and in fact, all the “good” things you might have been doing were making it worse!) 

This is important: Ultimately, any condition that affects your nerve function or your hormones can cause constipation. Uncontrolled diabetes, Parkinson’s, multiple sclerosis (MS) or car-accident injuries can all damage nerve functions that direct your gut movement. Hormonal problems like low thyroid and estrogen dominance greatly affect the chemical signal that tells your gut to keep things going.  Menstruating and pregnant women will also experience temporary shifts in gut function as well. 

So if you find yourself suffering from slow motility and its discomforts (or long-term health consequences), it may be time to dig a little deeper into your problem’s root cause rather than brushing it off as your “normal.” You aren’t crazy for wondering why the “right” things don’t work for you. As you dig into the cause and begin to manage the real reason for your problems, you can also learn to manage the symptoms while you figure it out.

Below are some tips to get you started. 

Tips for Finding Your Root Cause and Managing Your Symptoms

— Start looking for your root cause, especially if you have medical conditions like diabetes, low thyroid function, multiple sclerosis, or Parkinson’s. Aim for better or complete management. Painkiller medications, hormone therapies, pregnancy or a woman’s menstrual cycle all slow gut motility.  If you have SIBO (small intestinal bacterial overgrowth), then you will need treatment to bring the bacterial count down and meds to keep it moving.  

— Drink hot water first thing in the morning and as needed any time your gut  feels “slow.”

— Give your bowels a break. Light fasting can be helpful here, making sure at a minimum that you’re leaving a 12-hour gap between your last and first meal (ex., 7 p.m. to 7 a.m).

— Visceral massage by a professional or abdominal self- massage. You can look this up on YouTube.  It’s easy to do and often very effective. A visceral massage therapist can check if the valves in your gut are locked up. The effects can be very helpful!

— Movement and specifically exercises that involve twists (such as yoga) increase blood flow and mechanically encourage flow in the right direction.  

— A Squatty Potty, which is a special stool that allows you to squat to poop. Anatomically, it puts everything in perfect alignment.  It’s not just a weird, catchy ad; it actually works wonders for the people who use it.  

— Eating a little lighter with smoothies (that include ginger) or well-cooked soups with herbs (no cream). When you feel most backed-up, consuming high fiber supplements or foods will likely NOT make you feel more comfortable.  Opt for easy-to-digest, lower fat and lower fiber options.  

Supplements & Foods

— Magnesium citrate, up to 1,200 milligrams daily.  Separate from food by two hours. Good results when taken before bed with a glass of water. Can be taken in a divided dose or all at once.  

— Kiwis, two a day. Research has shown it to be very effective.  

— Herbs like ginger and fennel, added to food  or eating after a meal.

— Motility supplements.  Herbal blends on the market help motility. Some have ginger and artichoke extract and apple cider vinegar. Iberogast and Motil Pro and two other types. Always check with your doctor before starting one of these.  

— Probiotics.  Use these with caution when constipated.  If you’re very backed up, you don’t want to add more bacteria to the mix! Once you get things going, this can help replenish the good gut bugs or keep things moving along.  

Cathryn Arndt is a Registered Dietitian Nutritionist (RDN).  She and her husband and daughters live in the McDowell Creek area.