Let’s dive into a topic that almost no one talks about, but everyone thinks about and looks at: our poop. This is a critical topic to discuss with every one of your clients. After our fourth birthday, very few of us keep sharing details of our toilet trips with friends and family. But as it turns out, the status of your bowel movements is a powerful reflection of your overall health.
As a practitioner, I ask everyone about their bowel movements. Over the years, this means I have collected a rather amusing bunch of stories. Most typical is the exchange I have with first-time clients about BM frequency…
“So, John, let’s talk about your bowel movements. Are you regular?”
Silence. Throat clearing. Arms cross over his chest.
“Uhhhmmm. Yeah. I’m regular.”
“So what does that mean exactly, John?”
Silence – more fidgety this time.
“Well, you know – I go when I need to.”
“John, how many days a week do you have a regular, formed, complete bowel movement?”
Finally giving up on avoiding this conversation.
“I think my BMs are just fine. I very regularly go at least once a week – and sometimes even twice.”
Because we don’t talk about it, most of your clients don’t understand what makes up “regular” or “healthy” bowel movements. Sure, things like occasional sleep loss or airplane travel will be exceptions. But generally, we should all be having at least one, fully formed, complete bowel movement every day. We may even have 2 or even 3, essentially one for each meal (as is seen in studies of most indigenous cultures). Our stool should be easy to pass (no reading material required). You shouldn’t have to strain to pass a stool; that pressure can build up inside your colon and cause inflammation in the colon (diverticulosis). Healthy BMs should be light brown in color with no discernible food bits, indicating good strong stomach acid and efficient digestion. You want most of your BMs to be long, log-like pieces (or even the fully-formed letter S that Dr. Oz has made famous), not hard little marbles and ping pong balls. If these details don’t describe your client’s typical experience, they are not “regular”. If they have to take some kind of over-the-counter medication or fiber-in-a-cannister every day to get these results, they are certainly better off but are still not “regular”. Normal, perhaps. But not regular. And they need your help.
The average American is constipated. Chronically constipated. Early man ate a tremendous amount of fiber each day, drank plenty of water, slept well, exercised all the time, lived in a low-toxin environment, had healthy intestinal flora, and enjoyed a relatively low-stress lifestyle. Compared to the average American today, that sounds a bit like a spa experience. But here’s the truth: if your clients don’t have regular bowel movements, it is only a matter of time until they get sick. Plus, it’s really uncomfortable. Alleviating your client’s constipation will give you immediate credibility and probably earn you some sincere gratitude.
Here’s a great way to explain constipation to your clients: Not having daily BMs is like not taking out the trash from your kitchen when the can is full. Things start to spill over and get messy and smelly. Harmful bacteria flourish as your stool continues to ferment. Waste products continue to irritate and perhaps poison your gut lining. Worst of all, your body will eventually begin to reabsorb the trash. Yes, it’s like eating the kitchen trash all over again. This is an image your client will understand! Your stool is the primary exit pathway for waste in your body. I am not just talking about leftover fiber from your salad. A significant part of your body’s waste is toxins, things like pesticides, drugs, chemicals, plastic, heavy metals, damaged cholesterol, and excess estrogen.
Here is a list of key lifestyle changes that can get your clients’ bowels moving:
Your typical client probably eats few foods high in magnesium (e.g. halibut, almonds, spinach, cashews, seaweed). Even if they do, the magnesium content in many plant foods has plummeted rapidly since the mid-1900s due to over-farming of the same soil. If your clients are constipated and the fiber/water/fat/probiotics combination isn’t working, have them try 400-800 mg magnesium citrate each evening after dinner. Unlike medications which force your body to shove out a stool artificially, magnesium works for bowel movements because it’s what your body naturally uses to move them along in the first place (in a natural wave-like muscle movement all along the GI tract called peristalsis). Many times chronic constipation is just chronic magnesium deficiency. Magnesium is a particularly good idea if your client has other symptoms of being “bound up” or “tight” (e.g. high blood pressure, acid reflux, muscle spasms/soreness, frequent headaches, impatience).
For your clients who are adverse to taking supplement pills, I recommend magnesium powder that fully dissolves in hot water (my favorite brand is called Natural Calm). This allows them to enjoy a relaxing warm drink before bed that will work its peristalsis magic overnight. Note: I have never encountered a case of constipation that I cannot resolve for a client with sufficient magnesium. But warn them ahead of time that taking too much might just give a short-term case of loose stools or diarrhea; you’ll just need to cut back on the dose.
a. Soluble fiber helps to form a stool (adds bulking). So it’s key for fully-formed BMs and helpful for intermittent loose stools or diarrhea (think of rice, oatmeal, apples in particular) but not useful for constipation. Psyllium husks are a great natural soluble fiber supplements Mix them up in a smoothie, stir into yogurt, or blend with a protein shake. I also recommend you work with your clients to give up any “PseudoFiber” powders they might use as most of them contain artificial colors, flavors, and sweeteners (e.g. Metamucil). Be sure to read labels carefully.
b. Insoluble fiber helps to move a stool along for easy exit (think of all vegetables, especially leafy greens). This kind of fiber is particularly helpful for constipation. Flaxseed (especially whole) is an excellent insoluble fiber source as well.
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