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Natural Stool Softeners that May Help to Fight Constipation


Constipation is the single most common digestive complaint worldwide. It can cause a variety of intestinal symptoms and discomfort and interfere with an individual’s quality of life.

When food material builds up in the colon, the last part of the intestines, and cannot be excreted efficiently and frequently, constipation occurs. Constipation leads to pain, discomfort, bloating, gas, nausea, cramping, and heaviness. Natural stool softeners may be a helpful home remedy for those needing relief from dry, hard, difficult-to-pass stool. Stool softeners are also often among a doctor’s first recommendations for the management of constipation.

What is Constipation?

Constipation is characterized by one or more of the following:

  • Less than 3 bowel movements a week
  • Straining or pushing to evacuate
  • Passing hard, dry stool
  • Feeling as though there’s a blockage in your rectum
  • Feeling the sensation that you can’t completely empty your colon

What are Common Causes of Constipation?

The digestive tract is essentially a tube running from mouth to anus that is responsible for digestion, absorption and transportation of nutrients. This organ sustains our growth, development and health but its function can become easily compromised. The colon is the part of the intestines designed to temporarily store stool (remnants of digestion and detoxification). Emptying of the colon happens as the colon contracts to push the stool along the colon and out of the rectum and anus – a process known as peristalsis. A variety of factors can reduce the colon’s peristaltic activity which increases the likelihood of constipation. The most common causes are low water and/or low fiber intake, stress, sedentary lifestyle and certain medications.

Natural Stool Softener Options

Psyllium

Psyllium comes from the herb-like shrub Plantago ovata. It produces tiny soluble-fiber rich seeds that act as a gentle bulk-forming laxative by drawing more water into stool.

One randomized, double-blind, controlled trial reports that 5.1 grams psyllium (smooth Metamucil) twice a day for two weeks was superior to docusate sodium (Colace) in softening stool by increasing stool water content and better managing constipation.

Consider adding a serving of psyllium husk, seed or powder to 8-10 ounces of liquid and consuming daily to help soften stool.

Prunes/Dried Plums

Prunes or dried plums are rich in soluble, fermentable fibers and sorbitol (a sugar alcohol) that exert laxative effects in the colon by increasing water content, fibrous bulk, and stool frequency.

A randomized, controlled study found that 50g dried plums twice a day (6g fiber/day) beat a psyllium intervention (11g psyllium twice a day, 6g fiber) in improving stool frequency and consistency. The researchers reported that prunes/dried plums should be the first line treatment for constipation. Kiwi, mango and ficus (figs) have also been shown to soften stool.

Consider eating prunes, kiwi, mango or figs daily or several times a week to help keep stool soft and minimize constipation.

Senna

Senna alexandrina is a woody shrub with edible fruit and leaves that produce a stimulatory laxative effect when consumed. Senna is an FDA-approved over-the-counter laxative for short-term treatment of constipation or for bowel prep before surgery or a colonoscopy. Senna stimulates the nerves and colon to contract which helps to produce bowel movements. One randomized-controlled trial (STIMULAX trial) found that colorectal surgery patients receiving both stimulant (including senna) and osmotic laxatives recovered gastrointestinal function earlier with less post-surgery complications compared to those with placebo.

Senna may become habit-forming so do not use it long-term.

Consider drinking a cup of senna tea before bedtime for occasional hard stool or constipation.

Flaxseed

Flaxseed, commonly called linseed or flax, are small seeds rich in anti-inflammatory omega-3 fats, lignans, fibers and unique bioactive compounds that help to improve digestive function and reduce inflammation, especially for those with inflammatory bowel disease (IBD).

According to one randomized, controlled trial, those with constipation experienced improvements in frequency and straining of bowel movements with a 4-week intervention of 50g flaxseed flour (similar to ground flaxseed) daily.

Consider adding ground flaxseed or flaxseed oil to yogurt, smoothies, cooked grains, oatmeal, and salads.

Magnesium

Magnesium is an element and electrolyte that helps the colon retain water and also assists in smooth muscle relaxation. Research reports that while magnesium citrate is a commonly used supplement for constipation or bowel prep, magnesium oxide, hydroxide, or gluconate exert more gentle laxative effects.

One randomized, placebo-controlled trial found that those who consumed 1.0g senna /day or 1.5g magnesium oxide per day for 28 days versus placebo experienced greater improvements in bowel movement frequency and quality of life compared to placebo.

Consider starting magnesium at a conservative dose of 200 to 400mg per day and increase as needed to soften stool. Only dose up to 1500mg per day if directed by your physician to minimize the possibility of diarrhea from overdosing.

Ginger Root

Tea made from ginger root, a plant closely related to turmeric, is a caffeine and stimulant-free beverage. Ginger tea may also be consumed frequently for constipation-induced nausea or for slow intestinal motility that may lead to hardened stool. Randomized, double-blind, controlled trials find that 1.0-2.0 grams a day of ginger reduces nausea and vomiting, and improves gastric function over placebo. While research is less clear about ginger’s role in the colon, it may help to settle generalized intestinal discomfort and be a worthwhile experiment for constipation-related symptoms.

How Can I Prevent Constipation?

To help the colon function properly, make sure to drink about half your body weight in ounces. Dehydration contributes to the majority of constipation issues, so hydration is key in prevention. Other recommendations include eating the recommended amount of fiber (about 14g per 1000 calories), moving your body daily to avoid a sedentary lifestyle, and not ignoring the urge to go when you feel it. If you wait too long, your stool may be more difficult to pass.

Key takeaways

Psyllium is a soluble-fiber rich seed that helps the colon retain water, add bulk and soften stool.

Dried plums, and a few other fruits, add fiber and water to the colon, and increase stool frequency.

Senna is an edible woody plant that causes a stimulatory laxative effect in the colon which increases bowel movements. Take only short-term to avoid serious side effects.

Flaxseeds are anti-inflammatory seeds that exert gentle laxative properties. Daily consumption improves stool frequency and reduces straining.

Magnesium helps to retain water in the colon which softens stool. Excessive magnesium may lead to diarrhea.

Ginger root is closely related to the turmeric plant and contains two main bioactive compounds – gingerols and shogaols. These phytochemicals help to reduce inflammation and improve gastric and colonic motility, nausea and vomiting.

The majority of constipation issues can be prevented with adequate hydration, fiber intake, activity and not ignoring the urge to go.

Conclusion

Nearly everyone in the world experiences the discomfort of constipation – and the need for quick relief - at some point in life. Consider natural alternatives like psyllium, magnesium, prunes, flaxseed, senna, and ginger, as well as increased water and fiber intake and daily activity to help soften your stool and improve your colon’s function.

Resources:

Attaluri, A., Donahoe, R., Valestin, J., Brown, K., & Rao, S. S. (2011). Randomized clinical trial: dried plums (prunes) vs. psyllium for constipation. Alimentary pharmacology & therapeutics, 33(7), 822–828. https://doi.org/10.1111/j.1365-2036.2011.04594.x

Cornell Health. Laxative Use.

Dudi-Venkata, N. N., Kroon, H. M., Bedrikovetski, S., Lewis, M., Lawrence, M. J., Hunter, R. A., Moore, J. W., Thomas, M. L., & Sammour, T. (2021). Impact of STIMUlant and osmotic LAXatives (STIMULAX trial) on gastrointestinal recovery after colorectal surgery: randomized clinical trial. The British journal of surgery, 108(7), 797–803. https://doi.org/10.1093/bjs/znab140

Giacosa, A., Morazzoni, P., Bombardelli, E., Riva, A., Bianchi Porro, G., Rondanelli, M. (2015). Can nausea and vomiting be treated with ginger extract. European Review for Medical and Pharmacoholical Sciences, 19:1291-1296.

McRorie, J. W., Daggy, B. P., Morel, J. G., Diersing, P. S., Miner, P. B., & Robinson, M. (1998). Psyllium is superior to docusate sodium for treatment of chronic constipation. Alimentary pharmacology & therapeutics, 12(5), 491–497. https://doi.org/10.1046/j.1365-2036.1998.00336.x

Medline Plus. Senna.

Mount Sinai. Psyllium.

Morishita, D., Tomita, T., Mori, S., Kimura, T., Oshima, T., Fukui, H., & Miwa, H. (2021). Senna Versus Magnesium Oxide for the Treatment of Chronic Constipation: A Randomized, Placebo-Controlled Trial. The American journal of gastroenterology, 116(1), 152–161. https://doi.org/10.14309/ajg.0000000000000942

NIH. Symptoms and Causes of Constipation.

Rao, S., & Brenner, D. M. (2021). Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review. The American journal of gastroenterology, 116(6), 1156–1181. https://doi.org/10.14309/ajg.0000000000001222

Sun, J., Bai, H., Ma, J., Zhang, R., Xie, H., Zhang, Y., Guo, M., & Yao, J. (2020). Effects of flaxseed supplementation on functional constipation and quality of life in a Chinese population: A randomized trial. Asia Pacific journal of clinical nutrition, 29(1), 61–67. https://doi.org/10.6133/apjcn.202003_29(1).0009

van Gorkom, B. A., Karrenbeld, A., van Der Sluis, T., Koudstaal, J., de Vries, E. G., & Kleibeuker, J. H. (2000). Influence of a highly purified senna extract on colonic epithelium. Digestion, 61(2), 113–120. https://doi.org/10.1159/000007743

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