Constipation is by far the most popular reason clients come to my office. Rather it be an occasional bout with constipation or if it has been a lifelong problem, it is important to get to the root of the cause. That is why I have put together this ebook “Constipation – Causes and Cures” to help you find the potential reasons for your constipation and an arsenal of natural remedies to help easy your discomfort. Hi, I'm Trisha DeHall and let me introduce myself. I have been in the colon cleansing and the body detoxing profession for more than 25 years and am a member of the International Association of Colon Hydrotherapy. I am also a Master Certified Personal Trainer and own several Fit Body Boot Camp Fitness Centers where I specialize in weight loss, exercise and fitness for all ages. I also have a Masters in Nutrition, and have an entire team devoted to helping clients achieve their health and fitness goals. www.cincinnatifitbodybootcamp.com

At our Colon Hydrotherapy Salon we offer colon cleansing, a gentle purified water washing of the large intestine to clean and remove built up fecal matter in addition to several other detoxing modality’s including Infrared Saunas. Our staff will do everything we can to make your visit with us as pleasant and effective as possible. You can find more about our cleansing, diagnostic testing and detoxing services at www.cincinnaticolonhydrotherapy.com

I hope you find this ebook helpful and educational. Constipation is a serious problem for many people, both young and old, and it’s important to your overall health to correct the issue as soon as possible. Yours In Health Trisha DeHall 513-291-3481

You must get your physician's approval before beginning any nutritional program. These recommendations are not medical guidelines but are for educational purposes only. You

must consult your physician prior to using the suggestions in this ebook or if you have any medical condition or injury that contraindicates physical activity or a change in your

nutritional habits. The information in this report is meant to supplement, not replace, proper exercise training or information from your primary care physician or health care specialist.

Constipation Constipation is one of the most common digestive complaints, accounting for about 2.5 million doctor visits every year. But it occurs much more frequently than this number indicates because the majority of people with constipation treat it at home with over-the-counter laxatives. Big mistake: Regular use of certain laxatives can make constipation worse by damaging the large intestine, making it "lazier" and even less efficient.

Constipation may be defined as infrequent or incomplete bowel movements often characterized by stools that are hard, dry and difficult to pass due to slow transit time through the gastrointestinal tract. Gut transit time is the amount of time that elapses between ingestion of food and its excretion in the form of stool. In conventional medical circles, it is considered normal to have a bowel movement as infrequently as three times a week. In contrast, most holistic practitioners would consider the normal range of bowel movements to be one to three per day. The thinking is that three movements are ideal because we generally eat three meals daily. Ideally, when food enters the stomach, a nerve impulse is sent to the colon prompting it to contract and release its contents. This gastrocolic reflex, when functioning properly, would cause us to empty our colons after each meal. Many people have just one bowel movement per day and think this is normal. A daily bowel movement may still be considered constipation especially when taking into consideration the amount of feces eliminated in the bowel movement. A daily bowel movement of approximately one and a half feet, which is about the size of the left side of the colon, would be considered normal by natural health practitioners. This may be broken up into two to three movements per day or, sometimes, in just one bowel movement.

Most people who experience constipation can prevent it permanently with dietary changes and other natural approaches. Even people who have had constipation for years often can restore normal bowel function within two weeks.

What's Normal?

In a healthy body, waste travels through the digestive tract in a predictable, regular cycle, over a period of six to 24 hours. Most people have one to three bowel movements daily. Others have as few as three bowel movements a week. There's a lot of individual variability - what's normal for you might not be normal for someone else. Red flag: Any change in your normal bowel habits. See a doctor if the frequency of bowel movements change ...you have blood in your stool ... or you are experiencing intense abdominal pain. Constipation by itself is rarely dangerous, but it may be a sign of other problems, including colon cancer. Stool in the intestine contains bacteria, fungi and metabolic by-products of digestion. If it remains in the colon for too long, these harmful substances cause a number of uncomfortable symptoms, such as bloating, painfully hard stools and a general sense of fatigue.

What Causes It? There are many possible causes of constipation ranging from simple to complex. Among them are:

Insufficient fiber in the diet

Too much fat in the diet and too many refined foods

Side effects of some medications (antidepressants ; tranquilizers; painkillers that contain codeine, morphine or opium ; some blood pressure and heart medications)

Lack of exercise

Travel (especially changing time zones)

Pregnancy (hormonal and mechanical problems presented)

Excessive use of laxatives or enemas (can damage nerve cells in the bowel interfering with its ability to contract)

Ignoring the urge to defecate

Surgery (such as hysterectomy or back surgery that may result in severance of nerves in the bowel)

Dehydration

Extreme stress/depression

Magnesium deficiency

Deficiency of peristalsis-inducing nutrients: vitamin BS, vitamin C, choline and arginine

Prolonged bed rest

Lack of sleep

Advanced age

Spinal cord injury

Insufficient levels of digestive enzymes

Constipation is common in diseases such as:

Parkinson's disease

Autoimmune diseases such as lupus and diabetes

Glucose intolerance

Hypercalcemia (too much calcium in the blood)

Hemorrhoids and anal fissures (produce spasms of the anal sphincter muscle, delaying bowel movements)

Scleroderma and other neuromuscular disorders

Multiple sclerosis

Kidney failure

Stroke

Colon cancer

Dysbiosis (imbalance in bowel bacteria, where bad bacteria outnumber the good)

Food allergies

Parasites

Hypothyroidism

Neurologic injuries such as spinal cord injuries

Liver disease Thyroid function is particularly important with regard to constipation. If the body were a car, then the thyroid would be considered the spark plug. If it is sluggish, eliminations will also be sluggish. Many people today have what has been called "subclinical hypothyroidism." This means that their depressed thyroid activity does not show up on standardized tests. Subclinical hypothyroidism occurs in up to 20 percent of women. Alternative laboratory tests may be employed by progressive physicians to detect such thyroid problems. Some may test for and treat Wilson's thyroid syndrome, characterized by chronically low body temperature . Identifying and treating a sluggish thyroid is important. A slow gut transit time (the time it takes for food to pass through the gastrointestinal tract-from mouth through rectum) is an underlying factor in many cases of constipation. The optimal transit time is 24 to 30 hours or less. However, in the U.S. , the normal transit time can be 48 hours or more. Another possible cause of constipation has to do with the position we assume when having a bowel movement. In Western "civilized " cultures, we sit on a toilet , whereas in more primitive cultures the squatting posture is used. Actually, the squatting posture makes a good deal more physiological sense in terms of bowel stimulation and support achieved when the thighs come in contact with the abdominal wall. Constipation is much more common in Western cultures than elsewhere, also due to our sedentary lifestyles and consumption of processed foods. Fiber (indigestible complex plant carbohydrates found in fruits, vegetables and whole grains) is removed from most processed foods because it decreases shelf life .

Mouth 1 minute

Esophagus 4 to 8 seconds Stomach 2 to 4 hours Small Intestines 3 to 5 hours Colon (large intestines) 10 hours to several days

Average transit time through the digestive system

When bowel transit time is slow, waste is not promptly eliminated from the body. It will consequently create prolonged bacterial fermentation of the retained fecal material which can produce harmful or poisonous chemicals. As toxins are reabsorbed into the body, the risk of developing colon diseases and other health problems increases. Excessive bowel transit time means increased exposure to waste and toxins. These toxins stress the gallbladder, pancreas and liver giving rise to fatigue and headaches. Toxins created in the constipated bowel damage digestive enzymes in the intestinal wall and cause digestive problems and nutrient deficiencies. The walls of the colon can weaken and herniate, giving rise to diverticulosis . Besides diverticulosis, the excessive bowel transit time associated with constipation can contribute to such bowel disorders as irritable bowel syndrome and colitis.

In addition, studies suggest that constipation may indirectly cause estrogen to be reabsorbed. With slow transit times, a low-fiber diet and low concentrations of beneficial Lactobacilh and Bifidobacteria , there will be reabsorption of estrogen . Elevated estrogen can give rise to many female problems including breast, ovarian and uterine cancer.

Constipation During Pregnancy It's bad enough that you're tired all the time, but now you can't poop either. As a result, you're bloated, gassy, majorly miserable, chronically cranky — and desperate for relief (and success on the toilet). Irregular bowel movements unfortunately plague some women during pregnancy but bypass others altogether.

What Causes Pregnancy Constipation?

Once again, it's your pregnancy hormones wreaking havoc as they cause the muscles in your bowels to relax on the job — making them sluggish and allowing food to hang around longer in the digestive tract. The upside: There's added time for nutrients to be absorbed into your bloodstream, allowing more of them to reach your baby. But you don’t want this to linger on too long. Hormones aren't the only culprits in your colon congestion. Your expanding uterus (which will continue to expand as the weeks go by) takes up valuable space normally occupied by your bowel, giving it less room to go about its business. What's more, the iron-containing prenatal vitamins you're faithfully taking might also be contributing to the clog – but stopping them is a bad idea, for you and your baby (in fact, your practitioner will likely advise that you

take an additional iron supplement once you hit the halfway mark of your pregnancy).

What You Need To Know This will soon pass – but you don't have to resign yourself to nine months of misery. There are plenty of tactics to try to ease the problem and in the effort, avoid the company of constipation's dreaded sidekick, hemorrhoids. The suggestions below should work just fine. Start with your diet, make sure you are getting at least 35 grams of fiber and drinking 8 glasses of purified water daily.

Constipation in Children

Constipation in children is a condition in which a child may have fewer than two bowel movements a week, which is a little under estimated is you ask me. You might want to be concerned if they go more than 2 days without having a bowel movement. Your child may also be considered constipated if the bowel movements are hard, dry, and small, making them painful or difficult to pass in most cases. Almost 5 percent of visits to pediatricians are for constipation. About 25 percent of the children who visit gastroenterologists are constipated. Unfortunately, constipation can lead to health problems such as fecal impaction, anal fissures, or rectal prolapse.

Fecal impaction happens when hard stool packs a

child’s intestine and rectum so tightly that the normal

pushing action of the colon is not enough to push the stool out.

Anal fissures are small tears in the anus that may cause itching, pain, or

bleeding.

Rectal prolapse happens when a child’s rectum slips so that it sticks out from his

or her anus. Rectal prolapse in children is not common in developed countries.

Rectal prolapse can happen if a child strains during bowel movements, among

other reasons. Rectal prolapse may cause mucus to leak from the child’s anus.

If a child is constipated, he or she may have the following symptoms:

Posturing or changing positions can show that a child is trying to hold in stool or

is constipated. When a child’s posture changes or they continue to change

positions, he or she may stand on tiptoes and then rock back on his or her heels

clench his or her buttocks muscles

do unusual, dancelike movements

Parents or caretakers often mistake these postures as ways to try and have a bowel movement. A child may feel pain or bloating in his or her abdomen. Stool in a child’s underwear

If a child delays having a bowel movement, he or she may develop a large

amount of stool in the rectum—something health care professionals call a fecal

impaction. Some of this stool may leak and soil a child’s underwear. Parents or

caretakers often mistake this soiling as a sign of diarrhea.

Urinary incontinence

Stool in a child’s colon can press against his or her bladder. This pressure may

cause daytime or nighttime wetting called urinary incontinence.

A child should see a doctor if his or her symptoms of constipation last for more than 2 weeks. You should take a child to see a doctor right away if he or she has one or more of the following symptoms:

fever

vomiting

blood in his or her stool

a swollen abdomen

weight loss

Causes of constipation in children may include the following:

Ignoring the urge to have a bowel movement

Children most often get constipated from holding in stool. When a child holds in

stool, the colon absorbs too much fluid and his or her stool becomes hard, dry,

and difficult to pass.

Children may hold in stool because:

they are feeling stressed about potty training

are embarrassed to use a public bathroom

do not want to interrupt playtime

are worried about having a painful or an unpleasant bowel movement

Diets low in fiber

Another common cause of constipation in children is a diet with too little fiber.

Fiber helps stool stay soft so that it moves smoothly through a child’s colon.

Liquids such as water and juice help fiber work better.

Some medicines that doctors prescribe to treat other health problems can cause constipation in children. Medicines that can cause constipation in children include:

antacids—used to neutralize stomach acid—that contain aluminum and calcium

anticholinergics—used to treat muscle spasms in the intestines

narcotics—used to treat severe pain

some medicines used to treat depression

Certain health problems can make stool move more slowly through a child’s colon, rectum, or anus, causing constipation:

Hirschsprung disease—a birth defect in which the large intestine lacks some

nerve cells. The signals that tell your muscles to push stool along are missing, so

stool stays in the large intestine and causes blockage.

obstructions that block part of the lower gastrointestinal (GI) tract

tumors or narrowing of the GI tract

Functional GI disorders happen when something changes the way a child’s GI tract works, yet doesn’t cause damage. Functional constipation happens when the muscles in a child’s colon or anus move stool more slowly, and it often happens during one of three times:

when infants transition from breast milk to formula or when they start eating solid

foods

when parents or caretakers are potty training toddlers, and toddlers are learning

how to control bowel movements

when children start school and avoid using the bathroom at school for bowel

movements

Parents or caretakers can most often treat a child at home. However, if a child does not respond to treatment, call the child’s doctor. Treatment for constipation in children may include changes in eating, diet, and nutrition; behavioral changes; and enemas and laxatives, the very same treatment you can use as an adult and the nutritional suggestions I have given you here in this ebook.

Constipation In Older Adults

Constipation is common in older adults and accounts for about 2.5 million physician office visits annually. The estimated prevalence of constipation varies from 22 to 28 percent, and the number of persons reporting constipation increases with age. Constipation is more common in women, blacks, persons from lower socioeconomic levels, and persons living in rural areas and northern states. Causes of Constipation Constipation is not a physiologic consequence of normal aging. Many age-related problems (e.g., decreased mobility, comorbid medical conditions, increased use of medications with a side effect profile that includes constipation, and changes in diet) may contribute to the increased prevalence of constipation in older adults. A thorough medical history

and physical examination are needed to exclude constipation secondary to an underlying condition. Constipation can be divided into primary and secondary causes.

PRIMARY CONSTIPATION Primary causes of constipation can be classified into three groups: normal transit constipation, slow transit constipation, and anorectal dysfunction. Normal transit constipation, also known as functional constipation, is the most common. In patients with functional constipation, stool passes through the colon at a normal rate. Slow transit constipation is characterized by prolonged delay in the passage of stool through the colon. Patients may complain of abdominal bloating and infrequent bowel movements. The causes for slow transit constipation are unclear; the postulated mechanisms include abnormalities of the myenteric plexus, defective cholinergic innervation, and anomalies of the noradrenergic neuro-muscular transmission system. Anorectal dysfunction is the inefficient coordination of the pelvic musculature in the evacuation mechanism. These patients are more likely to

complain of a feeling of incomplete evacuation, a sense of obstruction, or a need for digital manipulation. Anorectal dysfunction may be an acquired behavioral disorder, or the process of defecation may not have been learned in childhood.

SECONDARY CONSTIPATION Medical and psychiatric conditions could potentially be a cause of secondary constipation. These conditions may be excluded by a thorough history and physical examination. A consensus guideline from the American Gastroenterological Association (AGA) recommends that most patients have tests for a complete blood count and serum glucose, thyroid stimulating hormone, calcium, and creatinine levels. A sigmoidoscopy or colonoscopy to exclude colon cancer is indicated in patients older than 50 years who have not had a recent examination and in those with concomitant rectal bleeding or weight loss. An important secondary cause of constipation is the use of medications, especially those that affect the central nervous system, nerve conduction, and smooth muscle function. In a study of patients who considered themselves constipated, 40 percent were using medications known to cause constipation. Over-the-counter medications, such as calcium - or aluminum-containing antacids and iron supplements, may also cause constipation. Overview of Constipation Treatment If a medication or a medical condition is the cause of constipation, eliminating the offending medication or treating the underlying medical condition may relieve the constipation. However, certain conditions require the use of a medication despite its side effects. Although opioid therapy almost always causes some degree of constipation, individual opioids induce constipation to different degrees. One study found that fentanyl (Duragesic) was less likely to cause constipation than oral morphine. In most cases, a prophylactic laxative should be considered when prescribing chronic opioid therapy because tolerance to the constipating effects of opioids does not develop over time. When no secondary cause of constipation is identified, empiric treatment should be tried initially for functional constipation. Management should begin with nonpharmacologic methods to improve bowel regularity and should proceed to the use of laxatives if nonpharmacologic methods are not successful. If the constipation is refractory to medical treatment, the patient should be referred to a specialist for further diagnostic evaluation. This may include measurement of colonic transit time, anorectal manometry, defecography, or a balloon expulsion test to assess colonic transit and anorectal function. In rare cases, biofeedback therapy or surgery may be warranted.

It is very important as we reach the age of 50 to get a colonoscopy every 5 to 8 years or as your primary care physician recommends. Colonoscopy is a test that allows your doctor to look at the inner

lining of your large intestine (rectum and colon). He or she uses a thin, flexible tube called a colonoscopy to look at the colon. A

colonoscopy helps find ulcers, colon polyps, tumors, and areas of inflammation or bleeding.

Food Allergies & Sensitivities

Common allergy foods include wheat, dairy, nuts, shellfish and strawberries, so if you are allergic to a certain food, that alone could be causing your constipation. Then it is important you avoid it altogether. A food intolerance or sensitivity on the other hand is when certain foods cause a reaction within the digestive system as well as the immune system and causes issues such as constipation, bloating, cramps and nausea. Common foods include dairy, gluten (wheat, barley & rye) and are best avoided as much as possible in order to see any relief in the symptoms. You may already be aware or suspect that certain foods trigger your constipation but start keeping a food diary over the next two to four weeks, writing down everything you eat and drink and the digestive complaints that occur, and you should start to see a pattern whereby every time you’ve eaten a certain food there has been a reaction. Let’s say that you suspect dairy is causing your constipation. The next step is then to cut dairy out of your diet completely for at least two weeks – this is sometimes referred to as an elimination diet. This may seem like a long time but it’s really important that your body has the chance to adjust and get used to not having that particular food. After two weeks, slowly re-introduce dairy, about once every two to three days, back into your diet and see if your symptoms (or in this case constipation) returns or worsens. If there has been no effect then you are ok to eat dairy and it may be another food, such as wheat, causing the problem so you need to start the process again. Eliminate wheat from your diet for a minimum of two weeks and then slowly start to reintroduce it. It can be a question of trial and error, and seem a hassle, but it is worth it! This will really allow you to start listening to your body and understanding how you personally react to certain foods - as no two people are the same.

Can I be tested for a food intolerance or allergy? You can yes! Food Sensitivity blood tests are available and are quite effective. There are several different Labs that offer them, but they can also be quite expensive as well. If you are looking for a good company to get a food sensitivity test, then I would recommend Alletess. We have been using Alletess for many years and find their food sensitivity ELISA test to be very accurate. We can provide this test for you at a very reasonable price and will be happy to go over the results with you. For more information please check out our website: http://cincinnatifitbodybootcamp.com/food-sensitivity-blood-test

What Not To Eat When Constipated (and to avoid

Constipation in the future)

White flour is wheat that has had most of its gut-healthy fiber stripped away. A healthy intake of fiber is essential for keeping your bowels humming along smoothly. Therefore, to help to ease constipation now (and perhaps prevent it from coming back), avoid:

Bagels

Cake

Cookies

Donuts

Pepperoni

Pizza

Salami

Sandwiches made with white bread, toast or buns Processed meats are hard on the digestive system. You don't want to give it a new job, e.g. working hard on your last meal, when it hasn't finished up its original task - that of emptying out any prior meals. In addition, processed meats typically contain nitrates, substances that may increase constipation. Therefore, when constipated (and beyond!), avoid:

Bacon

Bologna

Hot dogs

Sausage Like processed meats, fried and other greasy foods are hard for the body to digest, slowing the process down and therefore possibly contributing to constipation. To ease constipation and perhaps prevent it from coming back, avoid:

Barbecued ribs

Fast food hamburgers

French fries

Fried chicken

Fried fish

Buffalo wings

Many people report that dairy products can make them constipated . This may be due to the effect of lactose or some of the various proteins found in dairy products. Avoid the foods on the following list when you are constipated.

Cheese of all types

Ice cream

Milk

Sour cream

Yogurt* *Once your constipation has eased, you may want to try to eat yogurt again. Yogurt has gut-healthy probiotics that may help to keep you from getting constipated in the first place.

Dietary Fiber

In the past few years fiber has received a great deal .of well justified attention from nutritional scientists throughout the world. In addition to its impressive known benefits, research - now underway - may shed light on its possible role in preventing certain types of cancer, heart disease and other ailments all too common in Western civilization. Yet few people really understand what fiber is and why it is so important to your health and well-being. So allow me to briefly explain fiber to you. WHAT IS DIETARY FIBER? There is more to fiber than crunch. What Grandma calls roughage, scientists know as fiber. Fiber is an indigestible complex carbohydrate found in plants. Fiber is not a single food or substance and in itself has no calories because the body cannot absorb it. Therefore, high fiber foods low in fat are low in calories such as fruits and vegetables. Fiber can be divided into two categories according to their physical characteristics and effects on the body: Water insoluble and water soluble. Each form functions differently and provides different health benefits. Insoluble fibers, such as cellulose, hemicellulose and lingnin, do not dissolve in water. Soluble fibers, such as gum and pectin, do dissolve in water. WHAT FOODS SUPPLY WHICH FIBER ? A misconception shared by most people is that all fiber is pretty much the same. In fact, there are a great many different fibers from different sources with individual characteristics. They all come from one of three natural sources: grain, vegetable and fruit.

Soluble Fiber Insoluble Fiber

oatmeal oatbran nuts and seeds

legumes

peas beans lentils

fruits

whole grains

whole wheat breads

wheat bran rye couscous brown rice bulgur barley breakfast cereals

seeds vegetables

“ But remember you must drink at least 32 to 64 ounces of water a day!”

HEALTH BENEFITS OF FIBER While fiber will solve most problems of constipation it is equally effective in controlling simple diarrhea because it maintains the proper pace and bulk required for digestive function. The less time odious substances spend lying around in your colon, the less time they have to disrupt cell functioning and create confused, dangerous, blind, self-serving cells (i.e. cancer). We hear a lot of talk about environment and pollution these days. Let's consider our intestinal environment that affects all our cells, tissues and, consequently our health and well-being. Fibers like ground flax seeds, and whole grains has the ability to scrub out all the convolutions in the intestines so that they are clean. It removes toxins and wastes deposited in the intestines from all the complex systems of your organism. Certain fibers have a way of trapping and removing many harmful bacteria in the intestines but, from the standpoint of detoxification, they can bind a lot of the toxic agents that are produced in our bodies.

Fiber does many good things:

• It helps keep blood sugar and insulin at a steady level. (sugar can be a carcinogen also) • Fiber helps keep your appetite satisfied. If your gut feels full, you don't feel the need for a couple of candy bars. (overeating and obesity can contribute to cancer.) • Fiber stimulates the body to produce substances that regulate the growth of cells in the colon lining. (regulated growth is good. It's unregulated growth that happens during cancer.) • Fiber collects and holds bile acids. Acids just running loose can wreak havoc of their own, even if they are good for digestion. Soaking them in fiber and letting them out a little at a time is a nice way to get their good effects without the bad. • Soluble fiber helps to lower cholesterol, better known for its link to heart disease but also something that just may feed cancer as well. Cholesterol clogs things up, and clogged things can stagnate. Things that stagnate can begin to lose their normal function.

If you have been doctoring your morning cereal with wheat bran in the hopes of getting fiber's benefits, what you are mostly getting are larger, softer stools. This kind of fiber "bulks up" waste and moves it through the colon more rapidly, preventing constipation and possibly colon cancer. The trickiest accomplishments of fiber may lie with the stickiest kinds, the gums and pectins, as they may keep cholesterol under control by removing bile acids that digest fat. The same types of fiber may regulate blood sugar as well. This is accomplished by coating the gut's lining and delaying stomach emptying. As a result, they can slow sugar absorption after a meal and may reduce the amount of insulin needed. Fiber is a weight watcher’s dream since fibers like cellulose and hemicelluloses take up space in the stomach, making us feel full, therefore food intake is less.

Fiber and heart disease - High intake of dietary fiber has been linked to a lower risk of heart disease in a number of large studies that followed people for many years In a Harvard study of over 40,000 male health professionals, researchers found that a high total dietary fiber intake was linked to a 40 percent lower risk of coronary heart disease, compared to a low fiber intake. Cereal fiber, the fiber found in grains, seemed particularly beneficial. A related Harvard study of female nurses produced quite similar findings.

Fiber intake has also been linked with the metabolic syndrome, a constellation of factors that increases the chances of developing heart disease and diabetes. These factors include high blood pressure, high insulin levels, excess weight (especially around the abdomen), high levels of triglycerides, the body's main fat-carrying particle, and low levels of HDL (good) cholesterol. Several studies suggest that higher intake of fiber may somehow ward off this increasingly common syndrome.

Fiber and type 2 diabetes - Type 2 diabetes is the most common form of diabetes. It is characterized by sustained high blood sugar levels. It tends to develop when the body can no longer produce enough of the hormone insulin to lower blood sugar to normal levels or cannot properly use the insulin that it does produce There are several important factors that may help lower your risk for type 2 diabetes, such as maintaining a healthy weight, being physically active, and not smoking. Researchers are also trying to pinpoint any relevant dietary factors, one of which seems to be a high-fiber diet. The studies of male health professionals and female nurses both found that a diet high in cereal fiber was linked to a lower risk of type 2 diabetes.

When it comes to factors that increase the risk of developing diabetes, a diet low in cereal fiber and rich in high glycemic index foods (which cause big spikes in blood sugar) seems particularly bad. Both Harvard studies - of nurses and of male health professionals - found that this sort of diet more than doubled the risk of type 2 diabetes when compared to a diet high in cereal fiber and low in high glycemic index foods.

Foods that have a high glycemic index include potatoes, refined foods such as white bread, white rice, refined cereals (corn flakes, Cheerios), white spaghetti, and sugar. Foods with a low glycemic index do not raise blood sugar levels as quickly and, therefore, are associated with a lower risk of type 2 diabetes. Low glycemic index foods include legumes, whole fruits, oats, bran, and whole-grain cereals. If you wish to find a complete list of the glycemic index values of foods the internet has many (and I mean many) sites that can help.

The Use of Fiber in the Irritable Bowel - Irritable bowel syndrome (IBS) is one of the most common disorders of the lower digestive tract. There is no disease present with IBS, but it creates bothersome symptoms such as altered bowel habits -- constipation, diarrhea, or both alternately. There may also be bloating, abdominal pain, cramping, and spasm. An attack of IBS can be triggered by emotional tension and anxiety, poor dietary habits, and certain medications. Increased amounts of fiber in the diet can help relieve the symptoms of irritable bowel syndrome by producing soft, bulky stools. This helps to normalize the time it takes for the stool to pass through the colon. Liquids help to soften the stool. Irritable bowel syndrome, if left untreated, may lead to diverticulosis of the colon.

Fiber and diverticular disease - Diverticulitis, an inflammation of the intestine that in Western society is one of the most common age-related disorders of the colon. In North America, this painful disease is estimated to occur in one-third of all those over age 45 and in two-thirds of those over age 85. Among male health professionals in a long-term follow-up study, eating dietary fiber, particularly insoluble fiber, was associated with about a 40 percent lower risk of diverticular disease.

Fiber and constipation - Constipation is the most common gastrointestinal complaint in the United States and is of particular concern to the elderly. The gastrointestinal tract is highly sensitive to dietary fiber, and consumption of fiber seems to relieve and prevent constipation. The fiber in wheat bran and oat bran seems to be more effective than similar amounts of fiber from fruits and vegetables. Experts recommend increasing fiber intake gradually rather than suddenly. The intake of water should also be increased, as fiber absorbs water. By the way, wondering how much water or other beverages you should drink a day? The Institute of Medicine's Food and Nutrition Board gives the following general recommendations for water consumption: Women generally need to consume 91 ounces of water each day from beverages and foods, while men generally need to consume 125 ounces each day. People typically obtain about 80 percent of their water from beverages (including beverages that contain caffeine) and 20 percent of their water from foods. So for women, that translates into drinking 9 8-oz. glasses of water or other beverages each day and obtaining another 18 ounces of water from foods; for men, that translates into drinking roughly 12 8-oz. glasses of water or other beverages each day, and obtaining another 25 ounces of water from foods.

ARE YOU GETTING ENOUGH FIBER? Although fiber is not considered an essential nutrient, the U.S. Surgeon General and many professional health organizations recommend a diet containing 20-35 grams of fiber a day. The average American diet barely consumes half of this amount with an intake of 10-15 grams daily if you are lucky. Increasing the consumption of complex carbohydrates is the best way to increase fiber intake. Now this does not give you a ticket to go out and eat all the carbs you can. Remember whole unprocessed grains (and no, donuts do not fall into this category), moderate amounts of nuts, fruit and beans per day with lots of vegetables should do the trick. A large increase in fiber over a short period of time may result in bloating, diarrhea, gas and general discomfort. So add fiber gradually over a period of time (3 weeks) to avoid abdominal problems.

Remember to increase the amount of both kinds of fiber. Below are some tips to help:

Choose fresh fruit or vegetables rather than juice. Eat the skin and membranes of cleaned fruits and vegetables. Choose bran and whole grain breads & cereals daily. An increase in fiber should be accompanied by an increase in water. Eat less processed foods and more fresh ones. It is better to get fiber from foods rather than fiber supplements as foods are

more nutritious. Substitute legumes for meat two to three times per week in chili and soups. Snack on raw vegetables instead of chips, crackers, or chocolate bars. Replace white rice, bread, and pasta with brown rice and whole-grain products.

Types of Laxatives

Bulk-forming Laxatives These increase the bulk and water content of the stools. Some commonly used bulk formers are psyllium, methylcellulose, calcium polycarbophil and bran (used as a food and in supplement form). The only downside of the regular use of these products is that they can interfere with absorption of some drugs. Osmotic Agents These contain salts or carbohydrates that draw water into the colon to facilitate the passage of stools. While safe for occasional use, dependency can result if used habitually, and minerals can be washed out of the body. Examples of osmotic agents are lactulose, sorbitol, milk of magnesia and Epsom salts. Stool Softeners These wetting agents, acting as a lubricant, moisten and soften the stool so that it passes through the intestines more easily. An example of this type of laxative is mineral oil. These products should not be used on a regular basis. Mineral oil reduces absorption of fat-soluble vitamins, and docusate sodium, found in the mineral oil, may increase the toxicity of other drugs taken at the same time causing liver damage to occur. Stimulant Laxatives These irritate the intestinal wall triggering muscular contractions (peristalsis). Prolonged use can lead to dependency, and can damage the bowel. Some examples of these are: bisacodyl, castor oil, casanthranol, senna, cascara sagrada, and phenolphthalein. It should be noted that phenolphthalein, which is actually the active ingredient in prune juice, was recently removed from the market. Overuse of this substance causes depletion of potassium in the blood and reduced absorption of vitamin D, calcium and other minerals.

Standard Medical Treatment

Because lack of dietary fiber in the diet is thought to be the most common cause of constipation, many doctors recommend the use of fiber supplements as well as the addition of more high-fiber foods (fruits, vegetables, whole grains) to the diet. Bran, prunes, figs and apricots are particularly high in fiber (please check the fiber section of this ebook). If this protocol is followed, bran should be added to the diet slowly because adding bran to the diet too rapidly can cause gas and bloating. Additional fiber may also be obtained through the use of dietary supplements. In addition to recommending the addition of more dietary fiber and possibly, another form of laxative, many doctors will recommend lifestyle changes such as increasing water intake and exercise. If medications are suspected as the cause of constipation, they may be discontinued or switched by the physician. If a disease such as hypothyroidism, malignant tumors, polyps or an inflammatory bowel condition is identified, appropriate treatment of that condition will be initiated. Drugs and surgery are the major tools of the medical doctor, so some form of these will likely be employed regardless of the cause of the constipation. In fact, the cause may not even be established. If the constipation problem is due to parasites, candidiasis or food sensitivities, the traditional medical doctors are unlikely to discover this, as these conditions generally lie outside their area of knowledge. One study showed that the majority of patients with slow transit times and defecation disorders did not benefit from fiber therapy. For patients like this, the issue of insufficient peristalsis must be addressed. Medically, this is done with prescription drugs used to enhance bowel motility (movement). Unfortunately one recent drug, Zelnorm, was used for this purpose, but was taken off the market when it was found to cause serious cardiovascular adverse events. Currently, Amitza is the drug of choice for increasing bowel motility. The three prescription-only medicines most recently used to treat constipation are lactulose (Enulose, Kristalose and generic), linaclotide (Linzess) and lubiprostone (Amitiza). Amitiza and Linzess and are relatively new drugs that cause the cells that line the intestines to secrete chloride, sodium and water to help soften stools.

You won’t believe this but there are currently over 172 either prescription or over the counter drugs being used now by

physicians and patients for constipation.

Supplements & Natural Remedies

Here are a few natural remedies and supplements that may help with constipation. Some can be taken on a daily basis as part of your daily meal plan, but others need only be taken when necessary.

Ground flaxseed - works great when added to your daily diet. It's a highly concentrated source of fiber, with the added benefit of supplying healthful omega-3 fatty acids. Have one to two tablespoons of ground flaxseed daily. You can sprinkle it on yogurt or cereal or just eat it plain. Don't eat whole flaxseed, it has a tough outer coating that is not broken down during digestion – just be sure to get “cracked or ground flax seeds”. This product can be taken daily as part of a healthy meal plan. Flax Oil - Some people take stool softeners. Common ones, such as docusate (Colace), are not laxatives and not habit forming, but you can get similar results with flaxseed oil. Take one to two table-spoons daily. The oil can go in a shake or on a salad. Flax oil must never be heated and should be kept in the refrigerator. Flax oil has so many health benefits I won’t go into them all now, just trust me on this and add it to your daily diet.

Magnesium - People with constipation often are deficient in this mineral. Magnesium helps in three ways - it increases the strength and regularity of the intestine's muscular contractions ...it relaxes the nervous system ...and at higher doses, it promotes the accumulation of water in the intestine, which boosts bowel function. Foods high in magnesium: Green, leafy vegetables (such as spinach), brown rice, avocado, berries, cabbage, broccoli and bananas. If you have acute constipation, take 250 mg of magnesium two to four times daily. Don't take supplemental magnesium if you are pregnant unless authorized by your doctor. Probiotic - People who eat sauerkraut, live-culture yogurt and/or kefir (a fermented milk) are less likely to experience constipation because fermented foods contain probiotics. These beneficial organisms crowd out harmful microbes that may impair digestion and elimination. Eat fermented foods daily, or take a probiotic supplement. Look for a product that provides at least 30 billion active organisms, preferably a combination of Lactobacillus acidophilus and bifidus bacteria. A probiotic can be taken every day as part of your supplement program.

Milk thistle (Silybum marianum). A traditional remedy for hepatitis, milk thistle improves the flow of bile, a digestive juice that breaks down fats in the intestinal tract. Bile improves the colon's motility (the ability of the colon to contract and eliminate wastes). Dose: 200 mg to 250 mg of a product standardized to 80% silymarin (the active ingredient) with meals twice daily for six to eight weeks. Don't take it if you are pregnant or breastfeeding.

Triphala, as it is called, is the most popular Ayurvedic herbal formula of India, since it is an effective laxative that also supports the body's strength. Because of its high nutritional value, Triphala uniquely cleanses and detoxifies at the deepest organic levels without depleting the body's reserves. This makes it one of the most valuable herbal preparations in the world. Because of its high nutritional content, Ayurvedic doctors generally do not regard Triphala as a mere laxative. Some of the scientific research and practical experience of people who have used it down through the ages has demonstrated that Triphala is an effective blood purifier that stimulates bile secretion as it detoxifies the liver, helps digestion and assimilation, and significantly reduces serum cholesterol and lipid levels throughout the body. As a result, it is regarded as a kind of universal panacea and is the most commonly prescribed herbal formula and should be taken as directed on the label.

Aloe Vera as a supplement, it is said to help digestion, blood and lymphatic circulation, and kidney, liver and gall bladder functions. It contains three anti-inflammatory fatty acids that are helpful for the stomach, small intestine and colon. It naturally alkalizes digestive juices to prevent over acidity - a common cause of indigestion. It also helps clean the digestive tract by exerting a soothing, balancing effect. This could be taken daily as part of your supplement program.

Smooth Move Tea provides gentle, overnight relief from occasional constipation. Senna leaf promotes bowel movement by direct action on the intestine. A single serving provides an effective dose of sennosides from senna leaf, which have proven stimulant laxative action. It includes additional digestive support with fennel, orange peel, cinnamon, coriander and ginger to ease discomfort and reduce cramping. Not meant to be taken long term.

B Vitamin - complex supplementation is also a must for people with constipation because these vitamins nourish the nervous system, which triggers the muscles to contract as needed for elimination. In today’s world, B vitamins can be depleted for a number of reasons, stress being a big one. Find a good multi-B complex vitamin to take daily and add it to your daily supplement program.

ColonMax - is a natural laxative formula made with herbs and magnesium hydroxide to help relieve occasional constipation. This unique formula combines the following natural ingredients: Magnesium helps increase stool hydration* Cape Aloe is a gentle laxative herb that assists peristalsis* Rhubarb is a gentle laxative herb that helps maintain stool hydration* Slippery Elm helps soothe the intestinal tract* Marshmallow supports a healthy intestinal lining* Triphala is an Ayurvedic blend of three fruits (Amalaki,

Bibhitaki,and Haritaki) that helps support peristalsis

Organic Fiber-Clear - is a clear-mixing natural fiber supplement made with only 100% acacia fiber. Acacia is a natural soluble fiber that dissolves completely in liquids and soft foods without changing their taste or texture. Unlike psyllium-based fiber products that can dehydrate the bowel and cause abdominal discomfort, Organic Fiber-Clear is psyllium-free. Whenever you want to increase your fiber intake, simply stir Organic Fiber-Clear into a glass of water or your favorite beverage, or sprinkle it into soups, stews, pasta sauces and more! The convenient fiber supplement won’t thicken or become gritty like some other products, and you can add it to any food without altering the original texture or flavor. This can be added

to your daily supplement plan.

This is by no means a complete list, remember as I said above there are over 172 either prescription or over the counter drugs being used now by physicians and patients for constipation. This is just a few natural suggestions that you can find at any health food store that can be added to your daily nutrition plan to help with constipation. But please try to find the root cause and correct with diet and exercise.

Natural Remedies That May Help With

Acute Constipation (not meant to be taken for long periods of time)

Castor Oil - used during the Early Time

Castor oil has long been used throughout history. It was

reportedly used for medicinal purposes in Ancient Egypt and in the

early middle Ages in Europe. It was then regarded as a folk

medicine.

Edgar Cayce, who authored the Encyclopedia of Healing, said that

castor oil supported the healing of the small intestines, particularly

the lymphatic tissue – this allowed for tissue growth and repair.

Modern Castor Oil Uses

In the recent centuries, however, natural castor oil (also sometimes

referred to as castor oil) was at first identified as a laxative and as

a lubricant. Mothers used to feed it to their children as a relief for

tummy aches. When taken orally, castor oil helped ease the pain

of constipation and mild diarrhea.

Milk of Magnesia - is a liquid used in medicinal applications as an antacid and a hydrating laxative. Also known as magnesium hydroxide or Mg(OH)2, the solution is taken orally. It is so named because it looks milky white and contains the naturally occurring mineral magnesium. The substance acts to work within six hours of a dose in adults and children to temporarily relieve occasional bouts of constipation. The original concentrated formula was concocted by a man named Charles Henry Phillips in 1880, and sold under the brand Phillips' Milk of Magnesia. Today, the rights to the name "milk of magnesia" appear to be owned by Bayer Corporation. Milk of magnesia is an alkaline suspension, meaning that it undergoes a neutralizing reaction when encountering anything acidic. This makes it an effective combatant of excess stomach acid when taken internally. Too much hydrochloric acid (HCl) excreted by the parietal cells in the stomach can lead to indigestion, heartburn, and stomach ulcers. Milk of magnesia in the form of an antacid is dosed from 500 mg-1.5 mg (0.02-0.05 oz) and readily enters the stomach, where the hydroxide ions in milk of magnesia combine with the hydrogen ions in HCl to calm overactivity in the stomach. As a laxative, milk of magnesia enters the stomach to stimulate intestinal motility, helping flush out the intestines. A dose measures 2-5 g (0.07-0.18 oz). While the hydroxide ions play less of a role in this process, the magnesium helps through the following steps:

1. Magnesium ions draw water from the surrounding body tissues into the intestinal tract by osmosis. 2. The higher quantity of water in the intestinal tract softens and increases the volume of feces, stimulating nerves in the intestines. 3. Magnesium ions also play a role in releasing the peptide hormone cholecystokinin, causing accumulation of water and electrolytes in the intestine and triggering intestinal motility.

Epsom Salt is the common name for the chemical magnesium sulfate. Epsom salt is often used as a natural remedy for numerous health conditions, including migraines, muscle pain, cramps and to flush toxins from the body. Additionally, some people use Epsom salt as a way to relieve constipation. Under the care of your physician, you can take Epsom salt for its effects as a laxative.

1 Purchase Epsom salt from any pharmacy. Some manufacturers that make Epsom salt include Rite Aid and Swan. Review the package instructions before using the product internally as a laxative.

2 Measure out four ounces of cold water. Dissolve one teaspoon of the Epsom salt into the water by mixing thoroughly.

3 Add a small amount of lemon juice to the solution. This will not change its effectiveness and can help improve the taste of the drink.

4 Consume the entire solution in one sitting. If needed, you can repeat the dose after four to six hours. However, it is recommended that you use Epsom salt only twice in a 24-hour period to treat constipation. If you find one teaspoon is ineffective, you can use as much as two teaspoons of Epsom salt per dose.

Cascara Sagrada - Cascara sagrada is a stimulant laxative. It works by causing muscle contractions in the intestines, which moves stool through the bowels. The bark contains chemicals called anthraquinones that give it its color and its laxative effect. These chemicals react with bacteria in the intestines to stimulate the bowels. Cascara sagrada is available on its own or as an ingredient in pill and liquid laxatives. Make sure you read label instructions carefully. For laxatives that contain other substances, doses depend on how much cascara sagrada is present. Cascara Sagrada is not meant to be taken long term.

Daily Exercise

What Are the Best Exercises for Constipation? Simply getting up and moving can help constipation. A regular walking regimen -- even 10 to 15 minutes several times a day -- can help the body and digestive system function optimally. Any flexibility form of exercise is especially helpful also. Yoga, Pilates, and Tai Chi are examples of flexibility activities. These programs keep your body supple and limber by leading you through a systematic range of movements, motions and postures geared to minimizing stiffness and rigidity. Also, flexibility training increases physical coordination and balance, and reduces the possibility of falls – a major concern for people of all ages. Mild-to-moderate exercise such as strength training and functional training - helps stimulate intestinal contractions also. It reduces stress and relaxes the nervous system, which improves muscle movements in the intestine and helps prevent or treat not only constipation, but several other health conditions. For more information on exercise please visit my website www.cincinnatifitbodybootcamp.com or give us a call at 513-291-3481.

“Regular exercise is the only fountain of youth."

Trisha DeHall

What Does Your Stool Say About You

Type 1: Separate hard lumps, like nuts

Typical for acute disbacteriosis. These stools lack a normal amorphous quality, because bacteria are missing and there is nothing to retain water. The lumps are hard and abrasive, the typical diameter ranges from 1 to 2 cm (0.4–0.8”), and they‘re painful to pass, because the lumps are hard and scratchy. There is a high likelihood of anorectal bleeding from mechanical laceration of the anal canal. Typical for post-antibiotic treatments and for people attempting fiber-free (low-carb) diets. Flatulence isn‘t likely, because fermentation of fiber isn‘t taking place.

Type 2: Sausage-like but lumpy

Represents a combination of Type 1 stools impacted into a single mass and lumped together by fiber components and some bacteria. Typical for organic constipation. The diameter is 3 to 4 cm (1.2–1.6”). This type is the most destructive by far because its size is near or exceeds the maximum opening of the anal canal‘s aperture (3.5 cm). It‘s bound to cause extreme straining during elimination, and most likely to cause anal canal laceration, hemorrhoidal prolapse, or diverticulosis. To attain this form, the stools must be in the colon for at least several weeks instead of the normal 72 hours. Anorectal pain, hemorrhoidal disease, anal fissures, withholding or delaying of defecation, and a history of chronic constipation are the most likely causes. Minor flatulence is probable. A person experiencing these stools is most likely to suffer from irritable bowel syndrome because of continuous pressure of large stools on the intestinal walls. The possibility of obstruction of the small intestine is high, because the large intestine is filled to capacity with stools. Adding supplemental fiber to expel these stools is dangerous, because the expanded fiber has no place to go, and may cause hernia, obstruction, or perforation of the small and large intestine alike.

Type 3: Like a sausage but with cracks in the surface

This form has all of the characteristics of Type 2 stools, but the transit time is faster, between one and two weeks. Typical for latent constipation. The diameter is 2 to 3.5 cm (0.8–1.4”). Irritable bowel syndrome is likely. Flatulence is minor, because of disbacteriosis. The fact that it hasn‘t become as enlarged as Type 2 suggests that the defecations are regular. Straining is required. All of the adverse effects typical for Type 2 stools are likely for type 3, especially the rapid deterioration of hemorrhoidal disease.

Type 4: Like a sausage or snake, smooth and soft

This form is normal for someone defecating once daily. The diameter is 1 to 2 cm (0.4–0.8”). The larger diameter suggests a longer transit time or a large amount of dietary fiber in the diet.

Type 5: Soft blobs with clear-cut edges

This would be considered an ideal form. It is typical for a person who has stools twice or three times daily, after major meals. The diameter is 1 to 1.5 cm (0.4–0.6”).

Type 6: Fluffy pieces with ragged edges, a mushy stool

This form is close to the margins of comfort in several respects. First, it may be difficult to control the urge, especially when you don‘t have immediate access to a bathroom. Second, it is a rather messy affair to manage with toilet paper alone, unless you have access to a flexible shower or bidet. Otherwise, this is considered borderline normal. These kind of stools may suggest a slightly hyperactive colon (fast motility), excess dietary potassium, or sudden dehydration or spike in blood pressure related to stress (both cause the rapid release of water and potassium from blood plasma into the intestinal cavity). It can also indicate a hypersensitive personality prone to stress, too many spices, drinking water with a high mineral content, or the use of osmotic (mineral salts) laxatives.

Type 7: Watery, no solid pieces

This, of course, is diarrhea, a subject outside the scope of this chapter with just one important and notable exception—so-called paradoxical diarrhea. It‘s typical for people (especially young children and infirm or convalescing adults) affected by fecal impaction—a condition that follows or accompanies type 1 stools. During paradoxical diarrhea the liquid contents of the small intestine (up to 1.5–2 liters/quarts daily) have no place to go but down, because the large intestine is stuffed with impacted stools throughout its entire length. Some water gets absorbed, the rest accumulates in the rectum. The reason this type of diarrhea is called paradoxical is not because its nature isn‘t known or understood, but because being severely constipated and experiencing diarrhea all at once, is, indeed, a paradoxical situation. Unfortunately, it‘s all too common.

Other Considerations and Conclusion

A New England Journal of Medicine study of 65 children with chronic constipation reported that cow's milk was the cause in two-thirds of cases. It contains the protein casein, which has been shown to cause constipation.

Also, reduce the amount of saturated fats in your diet. A diet high in saturated fat slows motility-and the longer the stool stays in the intestine, the more likely it is to harden and interfere with normal bowel movements.

Alcohol and Caffeine: Decrease alcohol intake and caffeinated beverages, including coffee, tea, or cola drinks. In general, it is a good idea to have an extra glass of water (over and above the 6 to 8 daily mentioned previously) for every cup of coffee, tea, or alcoholic drink.

Bowel Hygiene: Go to the toilet at the same time every day, preferably after meals, and allow enough time as not to strain while having a bowel movement.

Laxatives: Avoid using over-the-counter laxatives. Try to avoid laxatives containing senna (Senokot) or buckthorn (Rhamnus purshiana) because long-term intake may damage the lining of the bowel and injure nerve endings in the colon.

Try to find the root cause of your constipation with dietary changes, food sensitivity testing, exercise and proper water consumption.

Disclaimer: The information on this ebook is presented for informational and educational purposes only. It is not a substitute for diagnosis, treatment and advice of a qualified healthcare provider. We do not intend to diagnose, treat, cure or prevent any illness or disease. Consult with your healthcare provider prior to using any advice or product mentioned in this ebook. The reader of this ebook is highly recommended to

investigate the safety and efficacy of any natural or alternative therapy, diet, nutritional advice, supplement or health modification program before commencing.

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