Constipation: Remedies, Hormones, and Fibers to Restore Your Bowel Transit

Hello, I am Dr. Isabel Viña Bas, a physician and Scientific Director of IVB Wellness Lab. There are few things that cause as much daily frustration as feeling like your gut has come to a standstill.You start counting the days, trying seeds, herbal teas, or laxatives, and thinking that if you don't go to the bathroom every day, something is wrong.

But the gut is not a Swiss watch, and there is no perfect frequency that everyone must meet.The important thing is not to compare yourself to anyone, but to recognize your usual rhythm and detect when it has changed without a clear explanation.

Furthermore, constipation does not depend solely on eating more fiber. To move more than eight meters of intestine, you need active thyroid hormones, water, food volume, physical movement, and a nervous system that doesn't think we are living in danger. Understanding these pieces is what allows you to stop accumulating random remedies and start acting with criteria.

When do we talk about constipation and when is your rhythm normal?

Medically, the normal range is much wider than we usually imagine. One person can go to the bathroom up to three times a day (21 times per week) and another only three times per week.If that has always been their rhythm and there is no pain, bloating, or difficulty, both can be perfectly healthy.

That is why we should not diagnose constipation by looking only at the calendar.The real warning sign is a sudden change from your usual pattern without an obvious trigger. For example, going from going daily to doing it once a week without changing your diet, starting a medication, or going on a trip.

In that case, it is not time to normalize it or cover it up indefinitely with laxatives.It is time to consult with a digestive system specialist to understand what has changed and why.

Thyroid and constipation: the hormone that moves eight meters of intestine

For intestinal content to advance, the musculature of the entire digestive tract must contract in a coordinated manner.And for that contraction to occur, we need an adequate amount of active thyroid hormone.

When there is hypothyroidism, everything goes slower, including the gut. In hyperthyroidism, the opposite happens, and the frequency of bowel movements can skyrocket, and diarrhea may even appear.The speed of your gut closely follows your thyroid.

There is an important nuance here. Many people take levothyroxine, which provides inactive T4 hormone, and remain constipated. The reason may be that this T4 is not converted well into active T3 within the intestinal cells.It's like having fuel stored but not being able to start the engine.

In the episode, I explain that I have seen many patients' transit improve by optimizing that thyroid function. That is why we formulated TyroEnergy as support for thyroid activation and function.It is not about using it as a laxative, but about working on one of the hormonal causes that may be slowing down the gut.

Progesterone, period, and stress: why your transit changes during the month

The gut also responds to the hormones of the menstrual cycle. After ovulation, more or less between days 14 and 27, progesterone rises. Its function is to relax the musculature and prepare the body, but that relaxation does not happen only in the uterus: it also reaches the gut.The progesterone that relaxes the uterus also slows down transit.

That is why many women notice that, in the second half of the cycle, transit slows down and constipation appears. Just before the period, progesterone drops suddenly, and the opposite can happen: sudden diarrhea.These are not two different problems: it is the same gut responding to two hormonal moments.

Stress also hits the brakes. Adrenaline and noradrenaline act in the face of immediate danger, and cortisol maintains the response when stress is prolonged. It has complete evolutionary logic: if you are fleeing a threat, missing a flight, or about to get married, your body understands that it is not the time to have a bowel movement.Under stress, the gut receives the order to wait.

The problem comes when that alert becomes your usual state.The gut receives the order to wait every day, even if you are just sitting in front of the computer.

Eating very little also causes constipation: without volume, there is nothing to push

One of the most frequent mistakes is trying to solve constipation while following a very restrictive diet. If you eat a volume equivalent to a yogurt lid and your diet is based almost only on protein and fat, the gut does not have enough mass with which to form stool.

This is common in keto or very low-carb diets. In addition to reducing fecal volume, restricting carbohydrates too much can lower insulin sensitivity and reduce thyroid function in just 72 hours, and that slows down transit again.Removing too many carbohydrates also slows down the gut.

Constipation does not always mean you need to add something.Sometimes it means you have removed too much: food, carbohydrates, fiber, and volume.

Water and movement: two remedies for constipation that we underestimate

Fiber without water cannot do its job. If you drink little, food becomes a dry lump that the gut can barely transport along its more than eight meters.Without water, fiber gets stuck instead of helping.

In people who use injectable drugs to lose weight and have nausea, I recommend spreading out water intake before or after meals instead of drinking a lot while eating.The goal remains to hydrate the intestinal content without worsening the feeling of fullness.

And then there is gravity. The mouth is above the anus for a very practical reason: the body is made to move vertically.Spending all day sitting makes the colon sedentary as well.

I always tell the story of my grandfather Pepe, who at 94 walks ten times a day down the hallway, five in the morning and five in the afternoon. It seems like a minimal gesture, but that movement keeps his bones and gut active, and prevents urine and pulmonary mucus from stagnating, something key at that age to prevent urinary infections and pneumonia.Small, repeated movement is medicine for the gut.

You don't need to go out and run ten kilometers.For an immobile gut, getting up and walking several times a day is already a powerful biological signal.

Soluble and insoluble fiber: the sponge and the brush of your gut

Talking about fiber as if it were one thing causes a lot of confusion.In reality, there are two main types, and each fulfills a different function.

Soluble fiber: the sponge. It dissolves in water and forms a viscous gel. That gel increases stool volume, helps drag heavy metals, and contributes to lowering cholesterol and sugar. We find it in oats, especially for their beta-glucans, in legumes, apples, and carrots.

Within soluble fiber, there is a fermentable part, such as the inulin in garlic, onion, and leek, or FOS. This feeds the microbiota, which produces short-chain fatty acids with anti-inflammatory action.It is very beneficial, but in sensitive people, it can cause gas and bloating.

There is also non-fermentable soluble fiber. It makes the same gel, but bacteria do not use it, so it is usually better tolerated when there is irritable bowel.The most useful example is psyllium husk or plantago, with a suggested dose of 10 to 20 grams per day.

Insoluble fiber: the brush. It does not dissolve in water. It advances through the gut, sweeping and rubbing its walls, which helps push the fecal mass downward. We find it in wheat bran, broccoli, and fruit peels.

One is not better than the other. The sponge provides volume and water; the brush provides dragging.Knowing what you need avoids swallowing large amounts of a fiber that perhaps only bloats you without solving the problem.

Chia and flax for constipation: how to take them so they work

Seeds can be a simple tool, but how you take them completely changes their effect.With chia and flax, the how matters as much as the what.

Flax or linseed. When it is ground, it is digested and loses much of its mechanical function as fiber. If what you are looking for is to promote transit, in the episode I recommend taking it whole, so that it acts as a small brush of non-fermentable insoluble fiber.

Chia. If you leave it hydrating all night, it swells outside the body and part of the effect has already occurred before taking it. To use it as occasional support for transit, I explain a very specific guideline: take a tablespoon of dry chia and drink a glass of water right after. This way, it forms the sponge inside the gut.

Here, water is not optional.Taking dry seeds without enough liquid goes directly against the goal.

Why should laxatives with senna or bisacodyl not be a routine?

When you haven't gone to the bathroom for several days, a stimulant laxative seems like the quick fix. The problem is that the gut learns. Products with senna leaves, bisacodyl (like Dulcolax), or sodium picosulfate force the contraction of the intestinal wall, but their regular use generates tolerance, dependence, dehydration, and rebound constipation.The quick stimulant laxative, used daily, ends up ruining the gut it wanted to help.

During my shifts at the hospital, I treated two women with severe cardiac arrhythmias caused by hypokalemia, that is, a drastic drop in blood potassium.In both cases, the continued consumption of food supplements with senna leaves was behind it.

Potassium is essential for the heart to maintain its rhythm. Losing it over and over again due to the laxative effect is not a minor digestive annoyance.It can become a medical emergency.

That is why these stimulant laxatives should be reserved for one or two specific days.They are not the tea to go to the bathroom every night.

Probiotics for transit: the strain matters, not just the name

When we choose a probiotic, saying it contains Lactobacillus is not enough. The genus is the name, but the strain is the surname and determines what specific function it can fulfill.In probiotics, the surname changes everything.

To help regulate transit, in the episode I recommend looking for Lactobacillus reuteri DSM 17938 and Bifidobacterium lactis.The regimen must be maintained for at least three to four months to give time to restore the intestinal flora.

I also advise against buying probiotics mixed inside a multivitamin. The minerals in the same capsule can damage the bacteria before they reach the gut.A formula with many ingredients is not always a better formula.

Three safe options for chronic constipation without dependence

When diet, water, movement, and fiber are not enough, there are alternatives that can be used chronically without the tolerance, dehydration, or electrolyte alterations of stimulant laxatives.For chronic constipation, the key is to choose options that do not force the gut to contract by force.

Lactulose. It is an osmotic laxative derived from galactose and fructose. It attracts water to the gut to soften and increase stool volume. The dose in the episode is 5 to 10 grams per day in syrup.

Lactitol. It also acts by osmosis and is derived from lactose, although it can be used in intolerant people. The regimen is also 5 to 10 grams per day.

Liquid paraffin. It is a mineral oil that lubricates the colon, like an oral suppository. A tablespoon can be taken in the morning and another at night. Its drawback is that it can drag and reduce the absorption of fat-soluble vitamins A, D, E, and K.

These options can be combined, for example, lactulose in the morning and paraffin at night.And an important check: always check the syrup label at the pharmacy to make sure it does not contain added sugar or fructose.

How to choose the remedy for constipation without living from trial to trial?

Before buying another product, go back to the beginning. Ask yourself if your frequency has really changed, if you eat enough volume, how much water you drink, how much you move, and what point of the cycle you are in. Also check if there are symptoms of hypothyroidism or if stress keeps your body on alert.Most of the time, the clue is in one of these pieces, not in a new product.

Then choose the tool according to the problem. If volume is missing, you need food and fiber. If fermentable fibers bloat you, psyllium fits better. If the content is dry, you need water. If the colon has been sitting all day, you need to walk.And if the constipation is new and sudden, what you need is a medical assessment.

If you need continued support, prioritize osmotic or lubricant options, which do not force the gut. The goal is not a spectacular bowel movement tomorrow, but to recover a bowel transit that is sustained without dependence and without putting your fluid and mineral balance at risk.We are looking for stable regularity, not a shock effect.

Transforming your health is a matter of applying science with consistency, day by day.You have in your hands the knowledge to understand why your gut has slowed down and choose solutions that accompany it, instead of punishing it.

Author: Dr. Isabel Viña Bas 

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