Constipation is a very common complaint. While doctors rarely become concerned about constipation unless the patient seems to have obstructed bowels, sufferers find that this problem really affects their quality of life. Sadly, some become dependent upon laxatives. Others want to avoid such medications and wish they had access to natural remedies for constipation. Luckily, there are a few that are neither risky nor expensive. One reader reports that protein shakes caused a constipation crisis.
Protein Shakes Led to Unbearable Constipation:
Q. My husband has had constipation for years, though it was mostly more annoying than scary. At times he had to drink magnesium citrate to get some relief. We are currently doing everything that we can, so he takes Miralax daily, eats prunes, drinks prune juice and uses supplements like fiber pills and stool softeners. I make nutritious meals with veggies, protein, starch and fruits.
To give him some extra energy, I bought protein shakes with 30 grams of protein. He loved them, so he began drinking them twice a day and it bound him up for three weeks.
We tried Fleet enema and magnesium citrate suppositories, but nothing worked. Finally, I took him to the ER where they administered an industrial-sized enema. That worked!
Why am I asking for your help? The drink gave him energy, but the constipation was awful. Is there something he could drink that would not cause unbearable constipation?
A. A person eating a normal diet won’t usually get energy from additional protein. But if you have a blender, you could make satisfying shakes or smoothies at home, using powdered whey, egg, soy or pea protein as the protein source. We like to add frozen banana (peel before freezing!) and frozen berries, which should provide a good amount of fiber. Fiber is critical for normal digestive function, and commercial protein shakes may have very little. Your homemade shakes might also include spinach or kale for extra fiber and nutrients.
One other note: When an older person like your husband develops severe constipation, he might ask his doctor to check if it is an early sign of Parkinson disease. That could call for treatment in addition to our ten tips for combating constipation, which you will find in our eGuide to Controlling Constipation. Be sure to consider the natural remedies discussed below as well.
What Natural Remedies for Constipation Might You Try?
Q. Are there any natural remedies for constipation in older people? I don’t want to take a laxative. My mother used to recommend prune juice. However, this raises my blood sugar. What can I do?
A. Usually, the first suggestion for overcoming constipation is to get more fiber. Often this could be in the form of prunes or possibly psyllium, the soluble fiber in Metamucil. Adding extra vegetables and fruit to the diet can be quite effective.
Fiber Is Effective Against Chronic Constipation:
A systematic review evaluated the efficacy of added fiber for adults with chronic constipation (American Journal of Clinical Nutrition, July 2022). The researchers found 16 studies including 1,251 volunteers.
Overall, 2/3 of those who consumed fiber had relief from their constipation, with greater stool frequency and better consistency. Two-fifths of those in the placebo group reported improvement.
The scientists found that certain fibers worked especially well. Psyllium was quite effective at doses of at least 10 grams a day. (That is about two teaspoons of psyllium powder.) In fact, psyllium increased the number of bowel movements as much as laxatives did, by about three per week.
Pectin also relieved constipation. The best results for both pectin and psyllium were achieved in studies that lasted at least four weeks. The downside, unsurprisingly, was an increase in flatulence among volunteers consuming fiber.
Kiwifruit as Natural Remedies for Constipation:
Scientists presented evidence at a virtual conference of the American College of Gastroenterology that eating two kiwifruit a day works about as well as psyllium or prunes. In addition, people eating kiwifruit were less likely to report bloating, pain or gas as a side effect. There were 79 middle-aged adults in the study who consumed kiwifruit, psyllium or prunes daily for four weeks. The participants ranked stool frequency, stool consistency and straining.
This kiwifruit study is not the only one. Research from New Zealand revealed similar results (Journal of Nutrition Science, May 2019). Moreover, previous research showed that kiwifruit could reduce symptoms of constipation among individuals with irritable bowel syndrome (Asia Pacific Journal of Clinical Nutrition, 2010). Presumably, the fiber in kiwifruit is partly responsible for its effectiveness. Fortunately, kiwifruit does not appear to speed the passage of gas through the digestive system (Neurogastroenterology and Motility, Sep. 2020).
Readers Endorse Kiwifruit in Testimonial:
Since writing about this research, we have heard from people who have put it into practice. One reader was pleased with the results.
Kiwifruit works against constipation:
Q. You wrote an article a while back about kiwifruit and constipation. It advised eating two a day to alleviate constipation.
So I started with one a day. I have never been so cleaned out in a good way. I’m almost afraid to eat two, but I love it.
A. You might be surprised to learn that there are several randomized controlled trials of kiwifruit to ease constipation. In the most recent, 24 adults with chronic constipation and 32 healthy controls consumed two gold kiwi fruit or 7.5 grams psyllium or placebo every day (Nutrients, October 6, 2022). According to the investigators, two gold kiwifruit daily are as effective as psyllium for treating constipation in adults.
Another reader agrees. In a comment on the article you read, they wrote: “Now that explains why I get diarrhea from kiwi fruit!”
An additional testimonial on the power of kiwifruit:
Q. The past few years I have tried several different products to avoid being constipated. In one of your articles, you suggested eating kiwifruit as a regulator.
I tried it and the results were amazing. I eat one at night, and by the morning all is back to normal. There are no cramps, gas or any of the usual uncomfortable side effects. My only problem is what happens when kiwifruit is not in season and I can’t find them in the store.
A. We are delighted that this simple, natural suggestion is working for you. A recent trial found that kiwifruit was as effective as the old standbys, prunes or psyllium, for increasing frequency, improving stool consistency and reducing straining (American Journal of Gastroenterology, June 1, 2021). In addition, volunteers reported fewer side effects, especially bloating.
Although kiwifruit are not as readily available in grocery stores as apples or bananas, they grow in both Northern and Southern hemispheres. Consequently, you should be able to purchase them throughout much of the year.
You can learn more about managing constipation and avoiding drugs that could make it worse in our eGuide to Controlling Constipation. Both this and the eGuide to Overcoming Digestive Disorders provide non-drug treatments as well as discussion of medication pros and cons.
Other Natural Remedies for Constipation:
Our readers have written about numerous other natural options for treating constipation. Some advocate consuming water in which they have simmered flaxseed. On the other hand, bran cereals or pumpkin bran muffins are popular natural remedies for constipation. We have a recipe for those muffins as well as for Power Pudding (wheat bran, prune juice and applesauce) in our eGuide to Overcoming Digestive Disorders.
Making Pumpkin-Bran Muffins to Overcome Constipation:
Q. You have offered a recipe for pumpkin bran muffins that calls for bran cereal. What kind of bran cereal do you mean? Would plain wheat bran work? What about oat bran?
A. The cereal we have used in this recipe is All-Bran. Bran Buds might work equally well, but raisin bran would not. Nor would plain wheat bran, though one might experiment with it or with oat bran. All should provide the insoluble fiber needed to accomplish the goal, overcoming constipation. Other interested readers can find this tasty recipe in our eGuide to Controlling Constipation.
An Old-Fashioned Laxative Recipe:
We recently received this letter from a reader with one of the classic natural remedies for constipation:
Q. I have a time-tested homemade laxative recipe I would like to share with your readers. Combine 1 cup chopped pitted prunes, 1 cup chopped pitted dates and 11/2 cups boiling water. Simmer until the water has evaporated. Store in the refrigerator and take 2 tablespoons per night.
A. Prunes are often used for their laxative properties. An analysis of four clinical trials found that prunes were better than psyllium (Metamucil) for increasing stool frequency (Alimentary Pharmacology & Therapeutics, Oct. 2014).
A more recent study compared “prune essence concentrates” (PEC) with a prune-flavored placebo drink. Not only did the PEC improve intestinal function, it also lowered total cholesterol and LDL-C (Pharmaceutical Biology, Dec. 2017).
Don’t Forget Psyllium:
If blood sugar is a concern, you should be checking yours regularly. Consequently, you may want to consider using psyllium for regularity. Beyond its effects promoting bowel evacuation, this fiber helps reduce both fasting blood sugar and HbA1c as well as triglycerides and LDL cholesterol (Phytotherapy Research, June 2020).
