Natural Laxatives & Constipation Remedies
Tired of relying on laxatives and hoping to find effective home remedies for constipation?
FOOD SOURCES: Natural Laxatives & Constipation Remedies
In many cases, at least part of their laxative effect is related to their soluble and insoluble fibre content. Insoluble fibre acts like a bottle brush, preventing stool from adhering to the walls of the colon, while soluble fibre absorbs many times it’s weight in water to form a gel-like consistency that prevents stool from being too dense or hard. Both add bulk to stool.
Other constipation remedies have effects that relate to bacterial fermentation in the gut, a stimulating effect on the bowel, or the ability to draw water into the colon. Here’s the complete roundup! (Or scroll to the bottom for the BEST choices.)
1. High Fibre Fruit (i.e. berries, prunes, apples, pomegranate, kiwi): Generally speaking, high fibre fruits that contain a mixture of soluble & insoluble fibre can help to add bulk to stool, while simultaneously moistening and lubricating stool for smoother passage. Here are the top contenders:
- Kiwi & blackberries shown in studies to be especially effective. The pectin in kiwi may contribute to laxative effect via improved peristalsis & transit time.
- Prunes are high in fibre & also contain sorbitol, a poorly absorbed sugar alcohol that acts similarly to osmotic laxatives – that is, it draws water into the intestines to help stimulate a bowel movement. Prunes, in studies, yield similar improvements to straining & general symptoms of constipation when compared to psyllium, but showed a greater increase in the number of spontaneous weekly bowel movements than psyllium.
- Apples are high in fibre, contain pectin and show prebiotic activity; all of which contribute to improved transit time.
2. Chia, Flax, Psyllium, Oat Bran: These seeds contain plenty of soluble AND insoluble fibre to bulks AND lubricate stool, which effectively counters both constipation AND diarrhea. Bulking agents such as these may be particularly useful in those with primary constipation that alternates with occasional bouts of diarrhea. Soluble fibre is also shown to be of benefit in constipation occurring from IBS-C (Constipation Dominant Irritable Bowel Syndrome).
- Chia is quite high in soluble fibre, which likely accounts for it’s effect.
- Flax – many studies have demonstrated its effectiveness at treating and preventing both constipation & diarrhea. A 2004 study showed flax was significantly more effective than psyllium at relieving constipation and reducing bloating and abdominal pain scores. Even better? The longer flax is consumed, the greater the effect (symptoms were better after initial treatment period, but continued to improve after a further 3 month trial).
- This study showed psyllium to be more effective at treating constipation than the stool softener docusate sodium.
- A 2009 study involving frail geriatric patients showed that oat bran allowed almost 60% of subjects to stop using laxatives, while also benefitting their well-being and healthy weight management. Oat bran has also been shown in studies to be a colonic food (demonstrates the ability to promote the growth of beneficial bacteria in the colon), which promotes overall colonic health.
3. Resistant Starch/Butyrate: Foods like legumes (beans, lentils), cooked & cooled potatoes, green bananas and whole grains are examples. Aside from being high in fibre, these foods are particularly high in “resistant starch”, a type of carbohydrate, which through bacterial fermentation in the gut, produce short-chain fatty acids (SCFAs) – including butyrate. SCFAs, and especially butyrate, are important energy sources for the cells of the colon.
Butyrate may reduce symptoms of constipation in the following ways:
- shown to increase & strengthen peristalsis (the contactile motion that propels food down through the intestines)
- improves smooth muscle contractility in the gut
- supports regulation of the nerves that control peristalsis
- shown to decrease visceral hypersensitivity (increased pain perception commonly related to symptoms of gas and bloating)
- has an anti-inflammatory effect (decreases visceral hypersensitivity)
- SCFAs limit the movement of water out of the colon, potentially contributing to keeping stool moist.
4. Kefir: like natural yoghurt and other probiotic-rich foods (sauerkraut, kimchi, etc), the bacterial cultures in kefir may contribute to overall gut health, improved transit time and regularity of bowel movements.
A 2014 pilot study in functional constipation, using 500 ml/day of kefir for 4 weeks, showed an increase in stool frequency, improved stool consistency, and decreased use of laxatives. There was also improved transit time (movement of stool through the gut), and improved sense of satisfaction after a bowel movement. A pilot study granted – but it showed that further study was warranted. Another study showed kefir to bulk and moisten stool in rats. More study is required to be definitive, but because kefir has a variety of health benefits, it’s worth a try!
5. Coconut & Coconut Water: are both shown to elicit a laxative type effect. This may relate to the combination of fibre, electrolytes & fluids found in fresh coconut meat and coconut water – contributing to both bulking and moistening stool.
But be careful: over consumption can lead to diarrhea!
6. Coffee: has a stimulating effect on the muscles in your gut, speeding up transit time and promoting a bowel movement. While decaffeinated coffee has a similar effect, it is stronger with caffeinated coffee.
Keep in mind though, that coffee also has a diuretic effect (it draws water out of the body through the urine), which may ultimately contribute to constipation!
Also, relying on coffee to stimulate bowel movements may further the problem – creating a physical dependence on it, and lessening your colon’s natural ability to contract and stimulate passage of stool.
7. Olive Oil: In a study, olive oil was shown to be as effective as mineral oil in reducing constipation symptoms and increasing frequency of bowel movements.
So – all the benefits, without the anal seepage. Need I say more? (Just in case I do, consider that olive oil has myriad studies supporting its extensive health benefits – most notably regarding cardiovascular health and longevity.)
8. Water: Dehydration is a known contributor to constipation. Those who are under-hydrated are most likely to see improvements to constipation by increasing their water (fluid) intake. One group shown to be particularly likely to benefit is the elderly.
This study demonstrated that a high fibre diet (>25g/day) coupled with 2L water daily was more effective at improving constipation than a high fibre diet alone. Herbal teas and unsalted broth can also count towards water intake. Eating a diet high in fruits and vegetables also contributes.
Ready to tackle YOUR constipation? Let’s work together:
Or…read on for more info on “natural laxatives”…
OTHER SOURCES: Natural Laxatives & Constipation Remedies
There are a few other “natural laxatives” out there that get recommended frequently.
Here’s my expert opinion on these other natural laxatives and constipation home remedies:
9. Aloe Vera: The latex gel found in the leaves of the aloe vera plant may have an osmotic effect (draw water into the colon to stimulate a bowel movement) or contribute to lubricating stools. But a study on aloe and constipation showed it’s benefits only when used in conjunction with celandine (the herb Chelidonium majus) and psyllium, rather than alone.
While aloe may be part of a comprehensive approach to constipation treatment, there are likely better constipation remedies.
CAUTION: individuals with a latex allergy should avoid aloe.
10. Senna: Senna alexandrina is the herb found in common stimulant laxatives like Ex-Lax and Senekot. It exhibits a stimulant laxative type effect via sennosides – compounds that speed movement through the digestive system to stimulate a bowel movement. They also increase water absorption into the colon which helps pass stool.
Is it better or “more natural” to take the herb vs the pharmaceutical version?
While senna may help you avoid the milk, cocoa and confectioner’s sugar used to flavour Ex-Lax, and the hydrogenated palm kernel oil in it, the medication uses a standardized extract of sennosides – the amount of which can be highly variable when taking the herb. And ultimately, the concerns associated with the medication are the same as those when taking the herb (see below). That said, working with a licensed herbalist or naturopathic doctor is a good idea when considering laxative herbs. Anti-spasmodic herbs may be added to a formula to reduce side effects like cramps, and safety concerns can be addressed and monitored.
WARNING: These products are marketed for “occasional constipation” – but are often erroneously used or abused by sufferers of chronic or unrelenting constipation or those with disordered eating patterns. Over time, stimulant laxatives may decrease your colon’s ability to contract strongly – worsening constipation and resulting in dependence upon them. They also may cause cramps and diarrhea. Speeding transit time may lead to dehydration, electrolyte imbalance or impaired absorption of nutrients like calcium and vitamin D.
Want the benefits of senna with less side effects?
Eat some rhubarb! In addition to it’s high fibre content, rhubarb contains sennosides. Too bad it’s only in season briefly. But for a month or two in spring (or longer if you cook up some rhubarb-apple sauce to freeze or can) you can mix some in with your oatmeal & ground flax for a breakfast sure to “get you moving”!
11. Castor Oil: a compound in castor oil called ricinoleic acid, induces a strong laxative effect. However, it’s purgative effect often results in diarrhea, and possibly nausea and vomiting. While typically described as a stimulant or irritant type of laxative, the mechanism of action with castor oil is not clearly understood.
Furthermore, there are some concerns about the safe use of castor oil orally. The unpleasant taste, variability in quality of oil sold, likelihood of cramps, and danger of fluid and electrolyte imbalance with subsequent dehydration, make castor oil a remedy I do NOT recommend for oral use.
However, topical castor oil packs may be an option to consider. In a review of the uses, efficacy and mechanism of action of topical castor oil, the following was found: while the mechanism of action is not fully understood, a study of elderly subjects with chronic constipation showed that the use of castor oil packs did not necessarily impact frequency of bowel movements, but did significantly improve quality of stool and sensation of complete evacuation of stool, and also decreased the need to strain at stool. All positive outcomes.
WARNING: A test patch on a small area of skin should be done first to make sure there is no irritation or allergic reaction to the oil. While topical use of castor oil may produce the same side effects as oral use or other stimulant laxatives, the effects tend to be milder. Castor oil is a purgative – which means it can induce vomiting and diarrhea – and, for the same reasons above, is NOT on my recommended list for oral use.
12. Magnesium: Frequently touted as an effective natural laxative, magnesium is an essential nutrient with many functions. It works in tandem with calcium to control muscle contractility and relaxation by ensuring smooth nervous system communication. Thus, magnesium is required for healthy heart function, and any condition associated with muscle spasms or cramps such as leg and muscle cramps, eye twitching, headaches from muscle tension, menstrual cramps and constipation. Those with constipation who also suffer from leg cramps and/or sleeplessness may find magnesium effective.
A diet rich in magnesium may improve frequency & quality of stool. But supplemental magnesium may be required in moderate to severe constipation to elicit a laxative effect initially.
Some healthy food sources of magnesium include: whole grains, legumes such as black-eyed peas and kidney beans, molasses, nuts including almonds, hazelnuts & pecans as well as fresh produce such as Swiss chard, spinach & other leafy greens, bananas and avocados. Some mineral waters are higher in magnesium than others, and while they do not provide HUGE amounts, this study showed the effectiveness of Hepar brand mineral water at reducing symptoms of functional constipation.
WARNING: For individuals with kidney or heart/vascular conditions, magnesium & other saline type laxatives are advised against.
Bottom Line: Because of the potential dangers associated with saline type laxatives, long-term reliance on supplemental magnesium as a laxative is less desirable than dietary & lifestyle changes and other approaches wherever possible & effective. Including magnesium-rich food regularly in the diet is a safer option, especially for those with any history of kidney or cardiovascular problems.
13. Probiotics: Anyone who has ever had a digestive problem has likely been told at some point to try probiotics. This is great advice – probiotics are a major hot topic in research these days. Probiotics have been shown to be of benefit in a very broad range of conditions – including constipation.
The problem is that not all probiotics are created equal. Most people take this to mean you need to buy the most expensive one, or the brand with the highest number of bacteria present. Neither is true. Aside from good manufacturing practices (that keep the product stable and get the bugs where they need to go), the single most important feature of a probiotic is the STRAIN.
To give an example, Lactobacillus acidophilus is one of the most researched and recommended species of probiotic. In this instance, Lactobacillus is the family of bacteria, and acidophilus is the species. This is still a generic probiotic which may (or may not) prove useful. But when research is conducted, specific STRAINS of bacteria are being studied. For example, one of the most studied strains is Lactobacillus acidophilus LGG – where “LGG” is the specific strain.
Why is this important? Specific strains are what’s shown in studies to be effective at treating specific conditions. So, when I work with patients who are constipated, there are a handful of different strain-specific probiotics I consider, depending on their unique picture. Is there constipation primary or secondary? Is there an associated condition? In this way, I am better able to recommend a probiotic for constipation that will be effective.
Natural Laxatives & Constipation Remedies Round-Up
BEST NATURAL LAXATIVES & CONSTIPATION REMEDIES
1. Kiwi & Blackberries and other high fibre fruits
2. Ground Flax Seeds and other high fibre seeds and whole grains
3. Resistant Starch Foods like cooked & cooled potatoes, legumes, green bananas and whole grains
4. Water: 8-10 cups per day
5. Strain-Specific Probiotics
Supportive home remedies for constipation may include: magnesium-rich foods, olive oil, kefir, topical castor oil packs, moderate consumption of coconut meat or water.
Natural Laxatives to Avoid or Use in Moderation
Oral castor oil, magnesium supplements, senna, coffee
Over-rated Constipation Remedies
Psyllium is probably the most commonly recommended/purchased bulk fibre agent or natural laxative– but studies have shown ground flaxseed to be more effective.
Aloe vera may exert some laxative effect when used in combination with other herbs, but there is little evidence that it is especially effective. So I do not recommend it as an effective constipation home remedy.