conditions constipation



ICD-10 Codes:K59.0

Naturopathic Treatments

Acute constipation
• anthraquinones
- senna (Senna spp.)
- rhubarb (Rheum spp.)
- aloe resin (Aloe spp.)
- cascara (Rhamnus purshiana)
• castor oil

Lifestyle - to promote regularity
• stress management
• exercise
• routine

General Diet Recommendations:
• increase water intake: 2L/day
• increase fruit and vegetable intake
• increase fiber intake
• avoid foods with saturated fats
• avoid foods high in cholesterol, sugars, animal protein

Specific Foods
• apples
• kiwi
• prunes
• oatmeal
aloe gel

Fiber supplements - will act as a bulk laxative
• psyllium (Plantago spp.)
• ground flax seeds (Linum usitatissimum)
marshmallow (Althea officinalis)
slippery elm (Ulmus rubra)
• probiotics

• castor oil packs

bitter herbs - releases bile, which stimulates peristalsis & promotes regularly
vitamin C - osmotic laxative
• fish oil
• olive oil

Conventional Treatments

stimulant laxatives
• bulk forming laxatives
• lubricant laxatives
• stool softeners
• enemas
• suppositories

Signs & Symptoms

• infrequent bowel movement
• stools difficult to pass
• abdominal discomfort:
- fullness
- bloated
- pain
- colic


• dehydration
• fecal impaction
• diverticulitis
• hypercalcemia
• drug-Induced
• anorexia nervosa
• intestinal obstruction
• hypokalemia
• congenital megacolon
• lead poisoning


constipation occurs when peristalsis fails to move bowel contents at an adequate rate to have regular bowel movements

The following encourages effective peristalsis:
• nerve innervation
• parasympathetic system dominance
• bowel irritants (e.g. bile, insoluable fiber)
• stimulation of stretch receptors by voluminous stool (e.g. food, fiber, probiotics, water, etc)
• regular routine
• regular exercise massages the inner organs and keeps things moving

Causes of constipation:
• lack of fiber
• dehydration
• lack of exercise
• lack of routine
• laxative abuse
• sequelae of CNS condition
• metabolic conditions (e.g. hypothyroidism)
• chronic ignoring urge to have a bowel movement
• medications
- narcotics
- iron
- imipramine
- diuretics
- calcium channel blockers
- anticholinergics
- antacids
- decongestants
- anticonvulsants
- bismuth, lead


• >3 days without a BM
• physical exam: abdominal exam, bowel sounds, weight loss/gain
• rectal exam if need to r/o fecal impaction, fissures, hemorrhoids


"Show references"

"Hide references"

Dains J, Baumann, L, Scheibel P. Advanced Health Assessment and Clinical Diagnosis in Primary Care 2nd Ed. Mosby Elsevier Inc. USA. 2003.

Ferri Fred. 2008 Ferri's Clinical Advisor. Elsevier Inc.. USA. 2006.

El-Hashemy, Shehab. Naturopathic Standards of Primary Care. CCNM Press. Canada. 2007.

First Consult. Elsevier Inc. Taken from Natural Medicines Comprehensive Database. Taken from

Weiss R, Fintelmann. Herbal Medicine 2nd Ed. Thieme, New York 2000. p. 89

Barnes J, Anderson L, Phillipson J. Herbal Medicines 3rd Ed. Pharmaceutical Press, London UK. 2007

Sadeghzadeh M, Rabieefar A, Khoshnevisasl P, Mousavinasab N, Eftekhari K. The effect of probiotics on childhood constipation: a randomized controlled double
blind clinical trial. Int J Pediatr. 2014;2014:937212. doi: 10.1155/2014/937212.
Epub 2014 Apr 9. PubMed PMID: 24812563; PubMed Central PMCID: PMC4000641.

Quitadamo P, Coccorullo P, Giannetti E, Romano C, Chiaro A, Campanozzi A, Poli E, Cucchiara S, Di Nardo G, Staiano A. A Randomized, Prospective, Comparison Study of a Mixture of Acacia Fiber, Psyllium Fiber, and Fructose vs Polyethylene Glycol 3350 with Electrolytes for the Treatment of Chronic Functional Constipation in Childhood. J Pediatr. 2012 Jun 5. [Epub ahead of print] PubMed PMID: 22677568.

Halmos EP, Gibson PR. Dried plums, constipation and the irritable bowel syndrome. Aliment Pharmacol Ther. 2011 Aug;34(3):396-7; author reply 397-8. doi: 10.1111/j.1365-2036.2011.04719.x. PubMed PMID: 21726250.

McRorie JW. Prunes vs. psyllium for chronic idiopathic constipation. Aliment Pharmacol Ther. 2011 Jul;34(2):258-9. doi: 10.1111/j.1365-2036.2011.04713.x. PubMed PMID: 21679210.

Fleming V, Wade WE. A review of laxative therapies for treatment of chronic constipation in older adults. Am J Geriatr Pharmacother. 2010 Dec;8(6):514-50. Review. PubMed PMID: 21356503.

Attaluri A, Donahoe R, Valestin J, Brown K, Rao SS. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther. 2011 Apr;33(7):822-8. doi: 10.1111/j.1365-2036.2011.04594.x. Epub 2011 Feb 15. PubMed PMID: 21323688.

Chang CC, Lin YT, Lu YT, Liu YS, Liu JF. Kiwifruit improves bowel function in patients with irritable bowel syndrome with constipation. Asia Pac J Clin Nutr. 2010;19(4):451-7. PubMed PMID: 21147704.

Mehmood MH, Aziz N, Ghayur MN, Gilani AH. Pharmacological basis for the medicinal use of psyllium husk (Ispaghula) in constipation and diarrhea. Dig Dis Sci. 2011 May;56(5):1460-71. Epub 2010 Nov 17. PubMed PMID: 21082352.

Barish CF, Drossman D, Johanson JF, Ueno R. Efficacy and safety of lubiprostone in patients with chronic constipation. Dig Dis Sci. 2010 Apr;55(4):1090-7. Epub 2009 Dec 11. PubMed PMID: 20012484.

Walia R, Mahajan L, Steffen R. Recent advances in chronic constipation. Curr Opin Pediatr. 2009 Oct;21(5):661-6. Review. PubMed PMID: 19606041.

McCallum IJ, Ong S, Mercer-Jones M. Chronic constipation in adults. BMJ. 2009 Mar 20;338:b831. doi: 10.1136/bmj.b831. Review. PubMed PMID: 19304766.

Bolla G, Sartore G. [The psyllium fibre for the treatment of functional constipation in children]. Pediatr Med Chir. 2008 May-Jun;30(3):146-8. Italian. PubMed PMID: 19024858.

Candy D, Belsey J. Macrogol (polyethylene glycol) laxatives in children with functional constipation and faecal impaction: a systematic review. Arch Dis Child. 2009 Feb;94(2):156-60. Epub 2008 Nov 19. Review. PubMed PMID: 19019885; PubMed Central PMCID: PMC2614562.

Johanson JF. Review of the treatment options for chronic constipation. MedGenMed. 2007 May 2;9(2):25. Review. PubMed PMID: 17955081; PubMed Central PMCID: PMC1994829.

Chan AO, Leung G, Tong T, Wong NY. Increasing dietary fiber intake in terms of kiwifruit improves constipation in Chinese patients. World J Gastroenterol. 2007 Sep 21;13(35):4771-5. PubMed PMID: 17729399.

Leung FW. Etiologic factors of chronic constipation: review of the scientific evidence. Dig Dis Sci. 2007 Feb;52(2):313-6. Epub 2007 Jan 12. Review. PubMed PMID: 17219073.

Miles CL, Fellowes D, Goodman ML, Wilkinson S. Laxatives for the management of constipation in palliative care patients. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD003448. Review. Update in: Cochrane Database Syst Rev. 2011;(1):CD003448. PubMed PMID: 17054172.

Chang L, Toner BB, Fukudo S, Guthrie E, Locke GR, Norton NJ, Sperber AD. Gender, age, society, culture, and the patient's perspective in the functional gastrointestinal disorders. Gastroenterology. 2006 Apr;130(5):1435-46. Review. PubMed PMID: 16678557.

Hsieh C. Treatment of constipation in older adults. Am Fam Physician. 2005 Dec 1;72(11):2277-84. Review. PubMed PMID: 16342852.

Plantago ovata. (Psyllium). Altern Med Rev. 2002 Apr;7(2):155-9. Review. PubMed PMID: 11991795.

Schouten WR, Briel JW, Auwerda JJ, van Dam JH, Gosselink MJ, Ginai AZ, Hop WC. Anismus: fact or fiction? Dis Colon Rectum. 1997 Sep;40(9):1033-41. PubMed PMID: 9293931.

Sonnenberg A, Koch TR. Epidemiology of constipation in the United States. Dis Colon Rectum. 1989 Jan;32(1):1-8. PubMed PMID: 2910654.

Arslan GG, E er I. An examination of the effect of castor oil packs on constipation in the elderly. Complement Ther Clin Pract. 2011 Feb;17(1):58-62. Epub 2010 May 18. PubMed PMID: 21168117.

Higashikawa F, Noda M, Awaya T, Nomura K, Oku H, Sugiyama M. Improvement of
constipation and liver function by plant-derived lactic acid bacteria: a
double-blind, randomized trial. Nutrition. 2010 Apr;26(4):367-74. doi:
10.1016/j.nut.2009.05.008. Epub 2009 Jul 22. PubMed PMID: 19628371.

Disclaimer: This content is subject to change. The information is intended to inform and educate; it does not replace the medical evaluation, advice, diagnosis or treatment by a healthcare professional. © 2015 NDAssist Inc. and/or its affiliates. All rights reserved.