Understanding Constipation: Causes, Solutions & When to Seek Further Testing

Constipation is one of the most common digestive complaints, yet it's often dismissed as a minor inconvenience. If you're experiencing irregular bowel movements, straining, or incomplete evacuation, understanding the underlying causes and exploring effective solutions can make a significant difference to your quality of life.

What is Constipation?

While constipation is medically defined as having fewer than three bowel movements per week, I like to see my clients having at least one bowel movement daily for optimal digestive health. Many people experience constipation symptoms even with more frequent movements. The key indicators include:

• Hard, dry stools that are difficult to pass

• Straining during bowel movements

• Feeling of incomplete evacuation

• Bloating and abdominal discomfort

• Needing to use manual maneuvers to facilitate bowel movements

It's important to note that 'normal' bowel frequency varies from person to person. However, optimal digestive health typically involves at least one complete, easy-to-pass bowel movement daily.

Common Causes of Constipation

Constipation rarely has a single cause. More often, it's the result of multiple factors working together:

1. Dietary Factors

• Low fibre intake - insufficient fruits, vegetables, and whole grains

• Inadequate fluid consumption

• Excessive consumption of processed foods

• Low intake of fermented foods and prebiotics

2. Lifestyle Factors

• Sedentary lifestyle and lack of physical activity

• Ignoring the urge to have a bowel movement

• Irregular meal times and rushed eating

• Chronic stress affecting the gut-brain axis

• Travel and changes in routine

3. Medical Conditions

• Hypothyroidism (underactive thyroid)

• Irritable Bowel Syndrome (IBS)

• Small Intestinal Bacterial Overgrowth (SIBO)

• Pelvic floor dysfunction

• Hormonal changes (pregnancy, menopause)

• Neurological conditions

4. Medications

• Opioid pain medications

• Certain antidepressants

• Iron supplements

• Antacids containing calcium or aluminum

• Some blood pressure medications

5. Gut Microbiome Imbalances

• Dysbiosis (imbalanced gut bacteria)

• Low microbial diversity

• Insufficient beneficial bacteria

• Overgrowth of problematic organisms

What You Can Do Initially

Before considering more advanced interventions, these foundational strategies can often provide significant relief:

1. Dietary Changes

• Gradually increase fibre intake to 25-35g daily through whole foods

• Drink at least 2-3 litres of water daily

• Include prunes, kiwifruit, and figs which have natural laxative properties

• Add fermented foods like sauerkraut, kimchi, and kefir

• Consider a magnesium supplement (particularly magnesium citrate or glycinate)

• Reduce processed foods and refined sugars

2. Lifestyle Modifications

• Establish a regular meal routine

• Don't ignore the urge to have a bowel movement

• Create a relaxed bathroom routine without time pressure

• Practice stress management techniques

• Exercise regularly - even a 20-minute daily walk can help

• Consider a squatting position or use a footstool to elevate your feet while on the toilet

3. Natural Support

• Herbal teas containing ginger, peppermint, or fennel

• Psyllium husk or chia seeds (with plenty of water)

• Vitamin C to bowel tolerance

• Castor oil packs over the abdomen

• Abdominal massage in a clockwise direction

When to Consider Further Testing

If you've implemented dietary and lifestyle changes for 4-6 weeks without significant improvement, or if your constipation is accompanied by concerning symptoms, further investigation may be warranted.

1. Red flags that require immediate medical attention:

• Blood in stools

• Unexplained weight loss

• Severe abdominal pain

• Sudden onset of constipation in someone over 50

• Constipation alternating with diarrhoea

2. Gut Testing: Understanding Your Gut Microbiome

For persistent constipation without clear cause, comprehensive gut microbiome testing can provide valuable insights. Microba is an advanced gut microbiome test that we use, that analyses the full spectrum of microorganisms in your digestive system.

What Gut Testing Reveals:

• Complete profile of bacteria, fungi, and other microorganisms

• Microbial diversity scores

• Beneficial bacteria levels

• Potentially problematic organisms

• Metabolic functions of your gut microbiome

• Comparison to healthy reference ranges

• Personalised dietary recommendations

How Gut Testing Can Help with Constipation:

The test can identify specific imbalances that may be contributing to your constipation:

• Low levels of butyrate-producing bacteria (important for colon motility)

• Reduced microbial diversity

• Insufficient fibre-degrading bacteria

• Presence of organisms associated with slow transit

• Metabolic dysfunctions affecting gut motility

This information allows for targeted interventions including:

• Specific probiotic strains tailored to your needs

• Prebiotic foods that feed beneficial bacteria

• Dietary modifications based on your unique microbiome

• Herbal antimicrobials if needed

• Personalised supplement protocols

The Testing Process:

Gut testing is simple and done from home:

1. Order your test kit

2. Collect a small stool sample at home

3. Mail it to the laboratory using the prepaid packaging

4. Receive comprehensive results within 4-6 weeks

5. Book a consultation to interpret results and create your personalized treatment plan

Taking the Next Step:

Constipation doesn't have to be a life sentence. While initial dietary and lifestyle changes provide relief for many people, persistent symptoms deserve deeper investigation.

If you're ready to understand the root cause of your constipation and receive personalised recommendations, Microba testing combined with naturopathic guidance can provide the answers you've been seeking.

Book a consultation to discuss whether gut testing is right for you and to develop a comprehensive treatment plan tailored to your unique needs. Together, we can restore your digestive health and improve your overall wellbeing.

Frequently Asked Questions

• How long should I try natural remedies before seeking further testing?

I typically recommend implementing dietary and lifestyle changes consistently for 4-6 weeks. If you're not seeing significant improvement after this time, or if your symptoms are severe or accompanied by red flags (blood in stools, unexplained weight loss, severe pain), it's time to consider further investigation such as Microba gut microbiome testing. However, if your constipation is significantly impacting your quality of life, you don't need to wait - we can discuss testing options during your initial consultation.

• Is gut testing covered by health insurance in Australia?

Gut testing is not typically covered by Medicare or private health insurance as it's considered a specialised functional test. However, some private health funds may provide a rebate under your extras cover (naturopathy or general treatment benefits). The investment is approximately $350-480 depending on the test panel selected. Many of my clients find the detailed insights invaluable for creating a targeted treatment plan, potentially saving money on trial-and-error approaches with supplements and treatments.

• Can constipation be a sign of a serious condition?

While most cases of constipation are related to diet, lifestyle, or functional gut issues, it can occasionally indicate more serious conditions. You should seek immediate medical attention if you experience: sudden onset constipation (especially if over 50), blood in stools, unexplained weight loss, severe abdominal pain, or constipation alternating with diarrhea. These could be signs of conditions requiring urgent medical investigation. As a naturopath, I work collaboratively with your GP and specialists when necessary to ensure comprehensive care.

• What's the difference between your chosen gut test and a regular stool test from my GP?

Standard stool tests from your GP typically check for parasites, blood, and pathogenic bacteria - they're excellent for diagnosing infections and acute problems. Microba gut testing goes much deeper, analysing your entire gut microbiome including beneficial bacteria, diversity scores, metabolic functions, and comparing your results to healthy reference ranges. It's like comparing a basic health check to a comprehensive functional assessment. For chronic digestive issues like constipation, Microba gut testing provides insights that standard testing simply can't offer.

• How quickly can I expect to see results from treatment?

This varies depending on the underlying cause and how long you've been experiencing constipation. Some people notice improvements within days of implementing dietary changes (especially increasing water and fibre), while others may take several weeks. If we're addressing gut microbiome imbalances, it typically takes 6-12 weeks to see significant changes as we work to restore healthy bacterial populations. The key is consistency with your treatment plan and regular communication so we can adjust your protocol as needed. Remember, sustainable change takes time, but it's worth it for long-term digestive health.