Constipation Equation: It’s No Joke When the End of the GI Tract Needs a Little Help


by Jason Gourlas, PA-C

This is not the most pleasant subject, but we’ve all been there. Constipation affects millions of Americans each year. We spend over $700 million a year on laxatives alone, and more than a million prescriptions are written annually for medications to treat constipation.

People are considered constipated when they have infrequent bowel movements (two or less per week), have hard stools, strain to have a BM or feel like they have incomplete emptying. Some of the symptoms of constipation may include a swollen abdomen, abdominal pain/discomfort, and nausea and vomiting.

Colon Primer

The end of the line in the gastrointestinal (GI) tract is the colon. Some of its functions are the absorption of water, salt and some nutrients. What is left is called stool. Stool is a waste product that needs to be disposed of. The colon is a muscular tube that propels this waste along and eventually expels it from the body.

The gastrocolic (stomach/colon) reflex happens when food distends the stomach and when the byproducts of gastric digestion enter the small intestine. This reflex is responsible for the urge to “go” (have a bowel movement) after eating. Given the fact that we were designed with this reflex, it stands to reason that we should have a BM after almost every meal. This debunks the myth that it is okay to have only three BMs per week. At the bare minimum I recommend a daily bowel movement. When our BMs become too infrequent, we start to reabsorb the toxins excreted into the GI tract that were meant to leave the body.

Show Stoppers

Constipation can have many causes. The most common are dehydration, lack of physical activity and too little fiber. Other causes of constipation include:

  •  Ignoring the need to have a BM
  •  Stress
  • Electrolyte abnormalities like magnesium or potassium deficiency and too much or too little calcium
  • Hypothyroidism (low thyroid hormone), depression, diabetes, inflammatory bowel disease (ulcerative colitis or Crohn’s), irritable bowel syndrome or cancer
  • Medications
  • Pregnancy
  • Food sensitivities Treatment of these underlying causes will help relieve the constipation.

Treatment of these underlying causes will help relieve the constipation.

Moving Things Along

If you have to go, you should. Don’t hold it. Hover if you must. To avoid dehydration, it is advised that most people drink half their weight in ounces of water per day. For example, if you weigh 100 pounds, you should drink 50 ounces of water daily. You should also engage in 150 minutes of physical activity per week and to eat at least 5-9 servings of vegetables and fruits daily to ensure adequate fiber intake.

Vegetables and fruits provide antioxidants to nourish the lining of the colon as well as adequate amounts of potassium. Fiber feeds the good bacteria, known as probiotics, in our colon. Fermentation of fiber by these probiotics provides short chain fatty acids which are the main fuel source for the cells in our colon. These probiotics also influence the movement of the gastrointestinal tract. You should eat fermented foods with each meal and/or take a good quality probiotic.

Jason GourlasJason Gourlas offers free lectures on “Raising Your GIQ!” once a month at Vital Life Wellness Center, located at 2520 Broadway, Suite 100, in San Antonio. Call 210- 595-1019 for more information and to RSVP. Gourlas has 22 years of experience in medicine, which includes primary care, emergency medicine, neurotology and surgical critical care in hospital, clinic and military settings. He is board certified through the National Commission on Certification of Physician Assistants, a member of The Institute of Functional Medicine and is a diplomat of the American Academy of Anti-Aging Medicine. Gourlas also served 15 years in the United States Army. For more information about Vital Life Wellness Center, including information on free seminars, visit

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