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Constipation: What is it that we still do not Know about it?

Updated: Mar 25, 2023

Food, Medicines, and Lies The Health Talk series by Dr. Prritii


Have you gone “number two” today? Yesterday? The day before that? In conventional medicine, the baseline requirement for regularity is three bowel movements a week, but a better indication of a truly healthy gut is going one to three times a day. Regular bowel movements are a key indicator of a properly functioning digestive system.

The Gut Health Survey (2018) highlights the predicament of these 'silent sufferers', the cause of chronic constipation and the problems associated with it. Abbott partnered with IPSOS, global market research and consulting firm, that surveyed 4,133 respondents across 8 cities – Mumbai, Delhi, Kolkata, Hyderabad, Chennai, Patna, Ahmedabad, and Lucknow to understand the seriousness of the issue. It found the below-mentioned highlights:

  • Survey states a higher prevalence of constipation in metros. Constipation is not only a medical problem restricted to elders but is also seen amongst youth and middle-aged population

  • City trends - Kolkata, at 28% has the highest number of constipation sufferers followed by Chennai at 26% as per survey findings

The condition of constipation sufferers in the country, as well as the association of Constipation with comorbidities such as Diabetes, Hypothyroidism, and Anorectal disorders. The findings suggest that 22% of the adult Indian population is suffering from the condition, with 13% complaining of severe constipation. 6% of the Indian population suffers from constipation associated with certain comorbidities.


  1. The eight-city survey highlights a higher percentage of constipation sufferers in metros (23%) as opposed to non-metros (19%). Kolkata has the highest number of sufferers at 28%, followed by Chennai at 26%.

  2. Various metabolic disorders are likely to cause constipation. For example, Diabetics are 2.2 times more prone to constipation vis-à-vis nondiabetics while patients with Hypothyroidism are 2.4 times more likely to develop constipation vs patients without hypothyroidism. Moreover, people with Anorectal disorders have more than 2.7 times the likelihood of associated constipation. Constipation tends to be more severe when associated with some of these comorbidities.

  3. Pregnancy was found to be a common cause of constipation in women, with every 1 in 4 pregnant females (25%) suffering from constipation. It has been observed that constipation is most common in the second trimester. The survey also highlights the fact that 18% of pregnant women developed anorectal disorders, thus making it imperative for medical practitioners to identify the condition in its early stage and begin treatment.

  4. Practices like irregular eating habits, consumption of junk food, and less water intake have been identified as key factors causing constipation. 21% of sufferers do not indulge in any physical activity, making a sedentary lifestyle an important factor associated with constipation.

  5. The survey also brought to light the fact that though 88% of the sufferers are concerned about the condition, very few are willing to discuss it with their immediate family or friends due to the "social taboo". According to the survey findings, 49% of the respondents have been shy about seeking medical help to solve their problems. In fact, on average, respondents admit to waiting for an average of four months before deciding on consulting a doctor.

  6. A glaring 33% of the sufferers have never treated constipation, while 48% have resorted to home remedies to treat the condition.

Speaking on the importance of Gut Health, Indian Cricketer, Virender Sehwag, who has been associated with Abbott on gut health awareness initiatives said, "Being an athlete, I know gastrointestinal issues can be the root cause for many other health issues including mental health. If we suffer from gastrointestinal issues, it becomes difficult to focus and perform well in the field and in life. Having a healthy gut is key as it allows the body to build a stronger immune system." In fact, the survey results state that after a common cold and cough, constipation is one of the most common self-claimed problems for Indians.

Our bodies are naturally very efficient machines, and when our systems are slowed down it can often be the cause or result of larger health problems.

Our elimination system is built to remove toxins and waste from our bodies. When you don’t eliminate them regularly, these toxins are stuck sitting in your intestines, potentially being absorbed back into the bloodstream via a leaky gut. The waste in your intestines sits idle, producing bacteria that can disrupt the balance of healthy flora in your gut and lead to inflammation.

Any of the following symptoms direct you towards being Constipated:

  • Straining during a bowel movement more than one-quarter of the time

  • Hard stools more than one-quarter of the time

  • Incomplete evacuation more than one-quarter of the time

  • Averaging less than one normal formed, but soft stool daily

Common causes of constipation include:

  • Inadequate water intake

  • Inadequate fiber in the diet

  • Low thyroid hormone

  • Magnesium Deficiency

  • Vitamin C Deficiency

  • Disruption of regular diet or routine

  • Traveling

  • Inadequate exercise or immobility

  • Food Allergies

  • Eating large amounts of gluten & dairy products

  • Stress

  • Resisting the urge to have a bowel movement too frequently

  • Overuse of laxatives (stool softeners)

  • Neurological conditions, like Parkinson’s disease or multiple sclerosis

  • Too much calcium in supplements or antacids

  • Certain medications, anti-depressants, pain killers, and iron supplements

  • Depression

  • Eating disorders

  • Irritable bowel syndrome

  • Pregnancy

  • Colon Cancer

  • Others…..

9 Things you can do to overcome Constipation:

  1. Follow a comprehensive elimination diet for 3 weeks and see if it is because of any food allergies or gluten or dairy insensitivities.

  2. Probiotics – When the wrong bacteria or yeast gain control of the bowels, they slow things down to ferment foods just how they like them. A good quality probiotic having, lactobacillus and bifidobacteria can help rejuvenate the gut microbiome. 20-40 Billion units to 100 billion units depending on the brand and severity of the problem will be helpful.

  3. Dehydration – Drinking a large glass of warm water upon waking improves bowel movements in most cases by initiating the gut movement. Without enough fluids to move things through the intestinal tract, the feces becomes hard and your digestion slows way down.

  4. Fiber – Human body needs 35 gms of our dietary intake to be from good fiber as per updated guidelines. Today we are only getting about 15-20 gms in our diets. Therefore I generally recommend Isabgol, Triphala 2tsp at night before sleeping or in breakfast 2 tsp of freshly ground flax seed powder or 1 tsp chia seeds.

  5. Balancing Thyroid Hormone – In cases of constipation, it is important to check T3 (active thyroid hormone) as it impacts intestinal motility. Adding bio-identical T3 has helped a lot of my patients benefit from long-standing constipation.

  6. Vitamin C – One symptom of vitamin C deficiency is constipation. Taking vitamin C in amounts just below bowel tolerance (gas, bloating, or diarrhea) can definitely improve bowel movements and regularity. Start slow with 1000 mg 3 times a day and every 2-3 days add another 1,000 mg to the regimen. When you reach bowel tolerance and stools loosen up, decrease the dose a little and maintain the dose that works for you

  7. Magnesium – if patients I see are complaining of difficulty with constipation, the first thing I usually recommend is adding magnesium citrate at bedtime. Many patients sleep better, have less muscle pain and their bowel function dramatically improves with a little magnesium. Doses typically range from 300-600mg but may go upwards of 1000mg daily.

  8. Avoid Junk Food – Having a lot of junk food during the day in the daily eating plan is an important reason for constipation.

  9. Stress management – Breathing right and doing meditation can really help decrease stress levels and hence improve gut motility and hence constipation.

Dr.Priti Nanda Sibal is CEO of Mediskool Health Services Pvt Ltd. She has experience of 25+ years and is a successful functional medicine practitioner in Gurugram. She practised with a philosophy that focused on human relationships and treating the whole person, rather than simply the disease. Such ideology was dubbed "Whole Life Health" by her. As the healthcare system made it more difficult for patients to receive this level of personalised treatment, Dr. Priti Nanda Sibal near Gurugram decided to bring change in lives of people. She gave priority to personal health of an individual and she is doing it by practicing dedicatedly entirely to Functional Medicine.

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