The Silent Epidemic No One Wants to Talk About

Woman sitting on a toilet with constipation, holding her belly in pain and toilet paper, bowels highlighted in red to show digestive discomfort.

Constipation is one of the most common digestive complaints, yet it often goes unspoken. Many people live with it for years, assuming it’s “normal” to struggle with bowel movements. In reality, constipation is a signal that your gut, diet, or lifestyle needs attention.

It affects an estimated 12–16% of the global population and up to 33% of adults over age 60 (1). In the U.S. alone, constipation accounts for 2.5 million physician visits each year. (2)

Despite often being dismissed as a “minor” problem, chronic constipation carries serious health consequences. It goes far beyond discomfort—long-term constipation can impair the body’s natural detoxification, disrupt the gut microbiome, alter hormone metabolism, and even affect mood through the gut-brain axis.

Research also links chronic constipation with a higher risk of colorectal cancer, as well as painful complications such as hemorrhoids and anal fissures. When stool remains in the colon too long, toxins and inflammatory byproducts can be reabsorbed into the bloodstream, contributing to systemic symptoms like fatigue, brain fog, and immune dysregulation. (3)

The real issue? Constipation is often treated as an isolated symptom—masked with laxatives—rather than as a signal of deeper imbalances in digestion, hormones, or nervous system regulation.

Why Standard Advice Doesn’t Always Work

Most conventional advice—“eat more fiber”—is too simplistic. Research shows constipation often persists despite adequate fiber intake. (4)

While fiber and hydration are important, constipation often arises from less obvious imbalances:

Dairy and gluten peptides – Certain proteins in dairy (beta-casomorphin) and gluten (gluten exorphins) act like opioids in the gut. They bind to opioid receptors in the intestinal wall, slowing peristalsis and prolonging stool transit. For sensitive individuals, removing these foods can dramatically improve regularity. (5,6)
Mineral deficiencies and dehydration – Healthy elimination depends on minerals that regulate muscle contractions. Magnesium relaxes intestinal smooth muscle, while potassium supports contraction. If either is low, the bowel’s natural rhythm stalls. Combine this with inadequate hydration, and stools become hard, dry, and painful to pass. (7,8)

Low stomach acid and disrupted microbiome – Stomach acid isn’t just about breaking down food — it’s the first signal in the digestive cascade. Adequate acid triggers the release of digestive enzymes and bile, ensuring that nutrients are properly broken down and absorbed.

When stomach acid is too low, food remains incompletely digested, leading to fermentation in the intestines and downstream imbalances in the gut microbiome. Over time, this can reduce the production of beneficial short-chain fatty acids (like butyrate), which normally help fuel colon cells and stimulate healthy peristalsis.

One of the most common reasons for suppressed stomach acid today is the widespread use of proton pump inhibitors (PPIs). While PPIs are effective for reflux, studies show that chronic use alters the gut environment, contributing to dysbiosis, small intestinal bacterial overgrowth (SIBO), and constipation in some patients. By blocking stomach acid, PPIs interfere with protein digestion, impair nutrient absorption (like magnesium and B12), and disrupt the gut’s natural signaling for motility. (9)

Low bile flow – Bile is essential not only for breaking down fats but also for maintaining proper gut motility. It helps lubricate stool and directly stimulates peristalsis in both the small and large intestine. When bile production or flow is sluggish, stools often become dry, hard, and more difficult to pass, leading to incomplete evacuation. (10)

Poor bile flow can be driven by several root causes, including:

Gallbladder sluggishness or bile stasis
Liver congestion from toxins or poor detoxification
Hypothyroidism, which reduces bile secretion
Estrogen dominance, which thickens bile and slows flow
Toxin overload from processed food, mold, heavy metals, mold toxins, or environmental chemicals

Supporting healthy bile flow — through targeted nutrition, hydration, liver support, and hormone balance — can dramatically improve constipation in patients who struggle with dry or difficult stools.

Poor eating hygiene – How we eat is just as important as what we eat. Eating too quickly, not chewing thoroughly, or eating while distracted prevents the nervous system from shifting into “rest and digest” mode. This weakens the entire digestive cascade — stomach acid release, bile flow, enzyme activity, and peristalsis — setting the stage for sluggish elimination.

Constant grazing/snacking – The gut has a built-in cleaning mechanism called the migrating motor complex (MMC) — waves of muscular contractions that sweep food residues and bacteria through the intestines. The MMC only activates during fasting states, typically 90–120 minutes after eating. Constant grazing or snacking keeps insulin and digestion “on,” suppressing the MMC and leaving the gut stagnant. Without these cleansing waves, motility slows, and constipation (along with bloating and bacterial overgrowth) is more likely. (11)
Sedentary lifestyle and poor posture – Movement is essential for gut motility. A sedentary lifestyle reduces intestinal stimulation, while prolonged sitting worsens stagnation. (12)

Even toilet posture matters: modern seated toilets kink the anorectal angle, making elimination harder. Elevating the feet (squat position) straightens the angle, allowing for more complete and effortless bowel movements. (13)

Chronic stress and gut-brain axis dysfunction – The nervous system directly controls the gut. Chronic stress elevates cortisol and shifts the body into “fight or flight” mode, suppressing the parasympathetic nervous system — the branch responsible for digestion and elimination. Over time, this disrupts vagus nerve signaling, leading to sluggish motility, incomplete evacuation, and worsening constipation. (14)

The Bigger Picture: Hidden Root Causes

Constipation is rarely just a matter of diet or water intake. In functional medicine, it’s seen as a signal of deeper systemic imbalances that affect the gut at multiple levels. Here are some of the most important hidden root causes:

Thyroid Dysfunction (Hypothyroidism)

Thyroid hormones regulate the body’s metabolic “speed.” When thyroid function is low, nearly every process slows down — including gut motility. Constipation is one of the hallmark symptoms of hypothyroidism and is often compounded by reduced bile secretion, which makes stools drier and harder to pass. Supporting thyroid health can be transformative for chronic constipation. (15)

HPA Axis Dysfunction (Chronic Stress & Adrenal Fatigue)

The hypothalamic-pituitary-adrenal (HPA) axis governs the body’s stress response. Elevated or dysregulated cortisol levels directly impair peristalsis, while long-term adrenal dysfunction can flatten the body’s natural daily rhythm, slowing bowel activity. Stress-management and vagus nerve support are often key in restoring balance. (16)

Sex Hormone Imbalances

Hormones like progesterone and estrogen strongly influence gut motility. Low progesterone or estrogen dominance (common in PMS, perimenopause, and menopause) can reduce peristalsis, explaining why many women experience worse constipation before their menstrual cycle. Balancing hormones can help normalize bowel patterns.(17)

Neurological Issues

The gut is governed by the enteric nervous system — often called the “second brain.” Diseases that damage nerve signaling, such as Parkinson’s disease, multiple sclerosis, or diabetic neuropathy, can impair intestinal contractions and lead to severe constipation. In these cases, addressing the neurological root is as important as treating the gut itself.

Medications

Certain medications are notorious for slowing digestion, including:

Opioids, which bind to gut receptors and paralyze peristalsis
Antidepressants (especially tricyclics and SSRIs)
Antacids containing calcium or aluminum
Iron supplements
Antihypertensives such as calcium channel blockers
Antihistamines such as benedryl
Anticholinergic drugs for urinary incontinence

If you are on these medications, constipation is not just likely — it’s expected — and may need to be counterbalanced with targeted therapies. (18)

Environmental Exposures

Hidden toxins in the environment, such as mold mycotoxins, heavy metals, pesticides, and industrial chemicals, disrupt the microbiome, liver detoxification, and bile flow. All of these pathways are essential for healthy elimination. In toxic exposures, constipation often occurs alongside brain fog, fatigue, and chemical sensitivities.

Gut–Brain Axis Dysfunction

The gut and brain communicate continuously via the vagus nerve. Chronic stress, unresolved trauma, or disrupted circadian rhythms can weaken this signaling. The result is impaired coordination of peristalsis, altered gut microbiota, and worsening constipation. Supporting vagus nerve tone through acupuncture, breathwork, or neuromodulation can help restore gut rhythm.

Natural Remedies for Relief

While constipation can have many root causes, the good news is that there are simple, drug-free strategies that support your body’s natural ability to restore healthy elimination. These align closely with both functional medicine and time-tested holistic practices:

Hydration
Aim for at least 2–3 liters of filtered water daily. Adding a pinch of mineral-rich salt or electrolytes can improve absorption, while herbal teas such as ginger, peppermint, or dandelion root provide gentle digestive support.
Fiber, Introduced Gradually
Both soluble fiber (oats, flax, apples) and insoluble fiber (leafy greens, whole grains, seeds) help regulate stool bulk and consistency. Introducing fiber slowly prevents bloating and allows the microbiome to adapt.
Movement and Physical Activity
Even light activity stimulates intestinal motility. Daily walking, gentle yoga postures, and abdominal massage can all activate peristalsis and ease elimination.
Routine and Toilet Posture
The bowels thrive on rhythm. Establishing a consistent morning routine and responding promptly to the urge to go helps retrain the gut. Using a small footstool to elevate the knees restores a more natural squat-like posture, which straightens the anorectal angle and makes bowel movements easier.
Mindful Eating and Fermented Foods
Eating slowly, chewing thoroughly, and avoiding distracted meals allows the nervous system to shift into “rest and digest” mode. Adding fermented foods like sauerkraut, kefir, kimchi, or miso provides beneficial microbes that support motility and gut balance.
Gentle Natural Aids
Time-tested remedies such as prunes, soaked flaxseeds, chia seeds, or warm lemon water in the morning can gently encourage bowel movements without dependency.
Stress Management and Relaxation

The gut and nervous system are inseparable. The gut-brain axis constantly communicates through the vagus nerve, a highway of signals that regulates digestion, motility, and inflammation. When stress is high, the body shifts into “fight or flight” mode, suppressing parasympathetic activity — the “rest and digest” state that is essential for healthy elimination. (19)

Chronic stress leads to elevated cortisol and adrenal dysregulation, which slow peristalsis, reduce stomach acid and bile secretion, and worsen constipation. Over time, this creates a feedback loop: the more stress disrupts digestion, the more uncomfortable the gut feels — which in turn fuels more stress.

Practical strategies to rebalance this system include:

Breathwork: Deep diaphragmatic breathing stimulates the vagus nerve and reduces cortisol, directly enhancing gut motility. Even a few minutes of slow breathing before meals helps the body shift into digestive mode. (20)
Meditation & Mindfulness: Regular practice lowers stress hormone levels, improves heart-rate variability (a marker of vagal tone), and enhances gut-brain communication. (21)
Acupuncture: Clinical studies show acupuncture can normalize autonomic nervous system balance, reduce stress response, and directly stimulate peristalsis. (22)
Vagus Nerve Stimulation (VNS): Gentle practices like humming, gargling, cold exposure, or auricular (ear) acupuncture activate vagal tone, improving bowel regularity by restoring parasympathetic dominance. (23,24)
Lifestyle rhythms: Adequate sleep, morning light exposure, and consistent meal timing strengthen circadian regulation of digestion, which is easily disrupted by stress.

By restoring nervous system balance and reducing the “fight or flight” overdrive, these practices not only improve bowel function but also support whole-body resilience and mood regulation.

These therapies address the root cause of sluggish motility: dysregulation of the gut-brain connection. They are especially effective in cases linked to stress, HPA axis dysfunction, or neurological conditions.

Final Thoughts: Natural Constipation Relief Through Root-Cause, Holistic Care

At Denver Sports and Holistic Medicine, we see constipation not as a minor inconvenience, but as a window into your whole-body health. While conventional advice often stops at “eat more fiber,” both clinical research and expert perspectives — like those of A Midwestern Doctor and Dr. Sehrawat — remind us that true healing lies in uncovering deeper imbalances.

By identifying hidden root causes — whether thyroid dysfunction, chronic stress, neurological changes, or environmental toxin exposure — and combining this with holistic therapies such as acupuncture, vagus nerve stimulation, nutrition, and lifestyle medicine, constipation can be resolved safely and naturally.

Constipation doesn’t have to control your life. With the right support, you can restore regularity, improve digestion, and reclaim the energy and vitality that come from a healthy gut.

If constipation is a recurring struggle for you, request a free 15-minute consultation with Dr. Martina Sturm at Denver Sports and Holistic Medicine, today.

Together, we’ll uncover your unique root cause and create a personalized plan to restore balance and long-term digestive health.

Frequently Asked Questions (FAQ) About Constipation

1. How often should I have a bowel movement?
A healthy range is typically 1–2 complete bowel movements per day. Some people naturally go less often, but fewer than three per week, or stools that are consistently hard, dry, or difficult to pass, are considered constipation.

2. Can constipation be a sign of something serious?
Yes. While occasional constipation is common, chronic constipation can signal deeper issues like hypothyroidism, hormone imbalances, neurological disorders, or environmental toxin exposure. It’s also linked to increased risk of hemorrhoids, anal fissures, and colorectal cancer if left untreated.

3. Do laxatives cure constipation?
No. Laxatives can provide temporary relief, but long-term use often leads to dependency, electrolyte imbalances, and further weakening of bowel function. Addressing the root cause — whether diet, hydration, stress, or underlying medical conditions — is a safer, more sustainable solution.

4. What foods are best for preventing constipation?
A diet rich in fiber (vegetables, fruits, flax, chia, and whole grains), hydrating foods (cucumbers, melon, leafy greens), and fermented foods (sauerkraut, kefir, kimchi) helps regulate motility. Adequate magnesium-rich foods (pumpkin seeds, spinach, avocado) also support healthy elimination.

5. Can stress really cause constipation?
Absolutely. The gut and brain are tightly connected via the vagus nerve. Chronic stress raises cortisol, suppressing digestive function and slowing peristalsis. Practices like breathwork, meditation, acupuncture, and vagus nerve stimulation can help restore balance.

6. When should I see a doctor about constipation?
Seek medical evaluation if constipation lasts more than two weeks, or if it’s accompanied by abdominal pain, blood in the stool, unexplained weight loss, or anemia. These may signal a more serious condition requiring prompt attention.

Resources

Constipation: More Than Just an Inconvenience