Struggling with Irregularity? What You Need to Know to Help You Go!

Constipation is relatively common, affecting over 20% of the population each year[1]. The nature of a person's bowel movements is influenced by a variety of factors, including activity and eating habits, gender, age, and overall health status. There is no specific number of bowel movements that a person should have; what is normal for one person may be abnormal for another. Most people have their own routine, and deviating significantly from their regular pattern can indicate something is wrong. 

The following are several tips that I would recommend to a client/patient suffering from constipation:

1. Hydrate. Throughout the day, drink lots of water or other non-sweetened liquids. Fluids aid in the softening of your stool, making it easier to pass. Including prune juice in your daily diet may also help you maintain your regularity. Starting the day with a hot beverage might also be beneficial. High fiber diets may raise your risk of constipation if you don't drink enough water.
2. Eat regularly. Even if that morning meal brought some relief, plan on putting something in your belly every few hours throughout the rest of the day. Eating meals regularly and consistently can help encourage your system to keep moving along in a smoother way.
3. Up the fiber. Add fiber-rich foods to your diet, such as raw fruits and vegetables, whole grains, beans, prunes, or bran cereal. Your daily intake of fiber should be between 20 and 35 grams. Psyllium husk is a fiber supplement that has some of the best evidence to support its use[2]. Partially hydrolyzed guar gum (PHGG), a water-soluble fiber with prebiotic activity, also has some of the best research supporting its use to relieve constipation, as it improves transit time and stool consistency and stimulates growth of beneficial gut microbes, such as Bifidobacteria and butyrate-producing flora[3,4].
4. Add exercise. Walking and other types of exercise that add weight-bearing, jarring movements to the body may stimulate motility. Aim for about 150 minutes of moderate exercise every week, with a goal of 30 minutes per day at least five times per week. 

Metamucil (psyllium husk) vs. citrucel (methylcellulose): 

Two of the most common fiber supplements are Citrucel and Metamucil. Both Citrucel and Metamucil are common bulk producing fiber laxatives that absorb liquid in the intestines to form a soft, bulky stool. The active ingredient in Citrucel is Methylcellulose, a chemical compound derived from cellulose and a gelling agent that increases the amount of water in stool making it softer and easier to pass[5]. Metamucil is the only leading brand to contain a 100 percent plant-based natural fiber called Psyllium Fiber, which is derived from the seeds of an herb called Plantago ovate that is grown mainly in India5. Citrucel (methylcellulose) is mainly insoluble fibers that are nonfermentable, so it’s less likely to contribute to bloating and gas. Psyllium husk (Metamucil and Konsyl) is rich in both soluble and insoluble fiber and can be gassier than other types of fiber supplements. Generally, fiber supplements with mainly insoluble fiber may be a better option for constipation.

What does the research say about magnesium? 

Magnesium for constipation is simple, cost effective, time tested and efficient. Magnesium citrate is a form of magnesium that’s bound with citric acid and is found naturally in citrus fruits and gives them their tart, sour flavor. This supplement is an osmotic laxative, which means it relaxes your bowels and pulls water into your intestines. The water helps soften and bulk up your stool, which makes it easier to pass. Magnesium citrate is relatively gentle. It shouldn’t cause urgency or emergency bathroom trips, unless you take too much of it. You can find it at many drug stores, and you don’t need a prescription to purchase it. In addition, some research suggests that this type is among the most bioavailable forms of magnesium, meaning that it’s more easily absorbed in your digestive tract than other forms and therefore is often used to treat magnesium deficiency[6].

Another popular magnesium supplement is magnesium oxide which is a salt that combines magnesium and oxygen. This supplement is an osmotic laxative, and its key effect is the softening of hard stools. Magnesium oxide causes the intestines to release water into the stool, which softens the stool and relieves constipation and irregularity. In addition, this type isn’t typically used to prevent or treat magnesium deficiencies, as some studies report that it’s poorly absorbed by your digestive tract[7]. 

References: 

1. Constipation: What to do if you can’t poop. Cdhf.ca. Published July 23, 2021. Accessed August 14, 2021. https://cdhf.ca/health-lifestyle/constipation-what-to-do-if-you-cant-poop/
2. Eswaran S, Muir J, Chey WD. Fiber and functional gastrointestinal disorders. Am J Gastroenterol. 2013;108(5):718-727.
3. Polymeros D, Beintaris I, Gaglia A, et al. Partially hydrolyzed guar gum accelerates colonic transit time and improves symptoms in adults with chronic constipation. Dig Dis Sci. 2014;59(9):2207-2214.
4. Ohashi Y, Sumitani K, Tokunaga M, Ishihara N, Okubo T, Fujisawa T. Consumption of partially hydrolysed guar gum stimulates Bifidobacteria and butyrate-producing bacteria in the human large intestine. Benef Microbes. 2015;6(4):451-455.
5. Khillar S. Difference Between Citrucel and Metamucil. Differencebetween.net. Published January 22, 2021. Accessed August 14, 2021.
6. Marcin A. Using Magnesium Citrate for Constipation. Healthline.com. Published April 20, 2021. Accessed August 14, 2021. 
7. Hill A, RD, LD. 10 interesting types of magnesium (and what to use each for). Healthline.com. Published November 21, 2019. Accessed August 14, 2021.