Quit your pushing

I don’t like talking about it since it makes me wonder whether I’m starting down that inevitable decline towards the day when all I want to talk about is having a “good bowel movement.”

But the C word–constipation–has come up several times here when people go wheatless. “Won’t I lack fiber?” many ask. For example, in response to the Wheat Belly Blog post, The Wheat-free “Movement,” Janne posted this comment:

I am very happy on a no-wheat regimen but I wish I knew what I should do to add enough fiber to my diet. I am not quite on the verge of constipation. When I ate lots of whole grains (I haven’t touched refined grains in years), I would have easy daily bowel movements. I am still going daily but it’s not as ‘easy.’ I eat lots of vegetables, and sometimes a little brown rice. What am I doing wrong?

Granted: Wheat products are a convenient source of indigestible fiber. But the idea that you must have whole grains from wheat to obtain sufficient fiber is pure fiction. There are plenty of other foods that are rich in fiber.

Here are some ways to regulate regularity:

1) Add more raw nuts and seeds, more nut meals, including the recipes in the Wheat Belly book and here in this blog. It means that even treats like chocolate almond biscotti are rich in fiber.
2) More non-wheat fibers low in carbohydrates, especially flaxseed and chia. These are easy to sprinkle on foods, mix in with your wheat-free baked dishes, mix in with wheat-free granola. They do not have any effect on blood sugar.
3) A magnesium supplement–Magnesium provides an osmotic effect that increases stool moisture content. This is why many laxatives contain magnesium, like Milk of Magnesia (magnesium hydroxide). The majority of people are deficient in magnesium anyway, since modern water purification removes virtually all magnesium. The form of magnesium to choose depends on what you are trying to achieve. Strictly for purposes of regularity, magnesium citrate, 400 mg twice per day, will provide a modest boost. Those of you desiring better absorption of magnesium and less bowel softening, look for magnesium malate, 1200 mg twice per day.
4) A probiotic to help your poor wheat-damaged intestine to recover. While we need more data on these effects, wheat consumption changes the bacterial composition of your intestinal tract. Taking a probiotic for a few weeks can provide organisms like lactobacillus and bifidobacterium that help regain normal bacterial populations.
5) Hydrate–A helpful habit is to drink two 8 ounce glasses of water immediately upon awakening when you are substantially dehydrated. Do the same several more times per day and be sure that, whenever you urinate, urine is only lightly yellow, almost clear, never dark and concentrated.

So going wheat-free does not mean a lifetime of pushing and straining, then calling your surgeon to clip the hemorrhoids. For some, it can even mean reversal of incapacitating constipation to new-found regularity. It means intestinal health that is improved because it now avoids the most destructive of diet ingredients, wheat.

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Comments & Feedback...

  1. Firebird

    I’ve been using passion flower and dandelion root, taken at bed. That seems to help, but I feel I am “helping” things along, rather than allowing things to be normal. I’ve been low carb and virtually wheat free for several months but in the last 2 months have had issues with constipation to the point of using diabetic chocolates in an emergency. I feel that, should I stop the passion flower and dandelion, the issue may return.

    • Don’t forget vigorous hydration, exercise, and magnesium, Firebird.

      Also consider not overdoing the cheese and eggs, both of which can really constipate.

      • One of my blog friends who went paleo (which includes cutting out grains) said that she had perfect digestion for weeks, then a bout of constipation, and she discerned that cruciatus vegetables like cabbage and brussels sprouts were contributing to the problem. I have the same situation–when I was eating a lot of wheat, my digestion was really slow and chronically blocked up. Now, if I eat fiber-rich foods and drink a lot of fluids, I’m likely to get diarrhea. It goes back and forth and I’m having trouble finding a happy medium.

        It’s been on and off for me–meat/dairy and cabbage/brussels sprouts/cauliflower seem to be the biggest culprits causing constipation.

  2. RH

    Wow. My daughter had exactly the opposite problem when she ate wheat/gluten!!! She is now 12, and wheat free for 2 years, but for the first 10 years of her life she wouldn’t have a BM for 10+ days at a time! When she did, she would be in the bathroom for 3-4 HOURS CRYING. No Dr. could give us any direction or answers outside of the ridiculous “everyone is different…here, give her these meds…”

    Fortunately, I was gluten free, but unfortunately couldn’t convince my husband for 10 years that she may have a problem with wheat! He stubbornly INSISTED that “wheat was the staff of life” and told me not to put my health issues onto her…. I don’t know why he finally gave in and allowed me to TRY a wheat free diet on her, but within a week, ALL of her weird, painful, horrible symptoms were gone.

    I initially discovered my gluten intolerance through a book called “The Fat Flush” by Anne Louise Gittleman. She recommends psyllium twice a day in cran-water. Might want to give that a try?

    • HI, RH–

      I suspect this intractable constipation (“obstipation,” by the way is the “official” term) is more common than thought. And it is truly remarkable that it responds to wheat elimination.

      I’ve got to wonder why this effect develops? Some peculiar disabling of normal muscular action via lectins?

      • I know in my own case that wheat-containing foods seem to act like a sponge and cause me to retain huge amounts of water, causing swelling in my legs and also messing up my digestive system horribly. Now, this may be totally off-base medically, but that’s what it feels like. I used to have to drink enormous amounts of water just to keep my bowels moving at all, and I felt horribly bloated. Is it maybe possible that the grains dehydrate your digestive system in some way?

        • Yes, carbohydrates are hydrates of carbon, and guess what does the hydrating? Water! Most people do not know, and the others conveniently forget, that all carbohydrates reduce to glucose moleclues; from Wikipedia re fatty acids: “Breakdown of carbohydrates (e.g. starch) yields mono- and disaccharides, most of which is glucose.” http://goo.gl/Qzv8x

          Carbs cause bloating from increased water retention because “Carbohydrates, on the other hand, are more highly hydrated (than fats). For example, 1 g of glycogen can bind approximately 2 g of water.” http://goo.gl/6XrDf

    • Anita

      RH,
      My husband and I experienced the same resolution of constipation with the elimination of wheat. We have chosen to eat completely grain free. We were gluten free for a year, however I was still experiencing stomach pain, bloating and terrible digestive issues. So, I just gave them all up and have been following Paleo plan for about 2 months now. Finally experiencing some stomach relief and gaining back some energy. My children are grown, but I sooooo wish I’d known this when they were children, because all three have issues with dairy and I’m pretty certain wheat/grain as well.

    • Kathy

      Hi RH – I was very appreciative that you provided your post about your daughter and her intense constipation. My daughter is now 6 and is going through exactly the same thing: bouts of constipation where she hasn’t had a bowel movement for over a week to 10 days, and her belly starts looking distended, and she sits and tries to go and cries out in pain. I’d be so appreciative of hearing more details of how you weaned your daughter off of wheat products. Did you do it cold turkey, and just stopped completely giving her anything with wheat in it?

      My issue is that my daughter is a very picky eater, and her favorite foods at this point are mac-n-cheese, grilled cheese sandwiches, tacos and hamburgers. She does really like most fruits, and a few veggies – never any lettuce, cukes or what she calls “salad veggies”, but she will eat raw carrots. If you could share what your daughter’s wheat free daily diet consisted of, that would be so helpful. Thanks!

      • Kathy,
        I have a story and a daughter very similar to RH. She will be 10 this week and has spent her entire life with constipation issues, even as an exclusively breastfed infant. We went cold turkey gluten free 11 months ago and it was a life changing experience. Unfortunately it still did not entirely resolve her odd, auto-immune type issues and last month we found out that she lacks the enzyme to break down starch, via biopsy sent to the Mayo Clinic. We are now entirely grain/starch free and we are getting our daughter back! She has struggled with ADD symptoms, chronic pain, fatigue and so much more her entire life. Removing wheat improved this issues by at least 90% and I now have hope that she can recover fully.

        I would recommend at least two week wheat free trial. With a little planning, preparing meals is not that difficult. We eat lots of healthy, grass fed meats and tons of veggies. I also make smoothies and most recently bought a juicer and the entire family will drink very green juice. Snacks are hard now that we are grain free, but there are tons of options when simply gluten free. They are more spendy, so we do things like apple slices and peanut or almond butter. My kids eat tons of carrots. There is always some variety of kiwi, oranges or bananas on the counter. Most recently they have even started eating seaweed chips, much to my utter amazement. Tonight we had cold almond flour pancakes for dessert and they were the perfect treat.

        This week is very busy, so tomorrow I will make up lots of meatballs which will serve as our “fast food” for the meals that we will be on the go for. For so many years, it seemed too hard to attempt a massive elimination diet, but oh how I wish I would have done it YEARS ago!!

  3. PJ

    My absolutely favorite probiotic is Primal Defense by Garden of Life. Taking one first thing in the morning with a large glass of water resolved the issue of “C” I had after giving up wheat and grains. You can take up to three a day. I’ve tried every brand on the market and this is the only probiotic that I can actually feel making a difference. HUGE difference!

  4. Janne

    Wow, this is all very helpful. I also heard from my daughter-in-law-to-be that my step-grandson takes Aloe-vera juice daily to help him ‘go”. Has anyone tried that?

    • Marie

      Yes, I take 2 oz. of Aloe Vera Juice twice a day. I was having “problems” and found that the a.j. does help some. However, I wasn’t taking it for that reason. It was recommended for acid reflux. I’ve taken a prescription medication for 12 years to relieve that problem. Since being off wheat, the acid reflux problem has been so much better that I’ve quit taking the medicine. However, when I was told about the aloe vera juice I decided it wouldn’t hurt to drink it. It’s supposed to be good for lots of things. I bought a 32 oz. bottle at Sprouts and yesterday bought another one. It is 100% aloe vera juice and has no taste at all.

      • There’s something very special about aloe, Marie. I use it on my hands, since washing hands in cold Wisconsin winters can make them crack and bleed terribly. The aloe-containing creams are a hand-healing godsend.

  5. Linda Harris

    Aloe Vera juice works great. Hubby used it several years ago. Lately I have used the Acai Berry Cleanse or Colon Clenz. Only have to use them once or twice a week. I usually only use them when I feel like I am in a “retention with overfow” situation..I don’t drink enough water and don’t exercise so I am not sure going wheat free is my problem.

  6. Ruby

    I have cut my cord to wheat and am working on rebalancing my diet. Flax sounds like a good addition but what about its phytic content? Wouldn’t overdosing on flax contribute to impeding mineral absorption?

    • I’ve been skeptical, Ruby, that the phytate issue is a practical concern. I believe this falls into the category of picking your battles. There are aspects or imperfections in nearly all foods that, I believe, do not amount to practical problems. For example, there are potentially goitrogenic substances in cruciferous vegetables like broccoli, but they really don’t exert an effect, especially if you are obtaining healthy quantities of iodine. Likewise, phytates: potentially mineral absorption-blocking, but it never seems to result in real effects.

      • Anita

        @ Dr. Davis,
        Thank for your calming wisdom. So much stuff is thrown out there as “Oh, my Gosh! that will kill you/ cause Cancer/ Stop your heartbeat/ Mame your grandchildren etc, etc…” that the real concerns get lost in the drama. I have flax in some sort everyday. Keeps me quite happy in that department. I make breakfast bars and bread from elanaspantry.com and LOVE them. Check out her site.

  7. Sietac

    This is a timely topic. I am LCHF grain-free. I do not have a problem with constipation, but have noticed in the past several days that I am going more. I am wondering if it has anything to do with Vitamin D3, which I started taking just four days ago. It seems kind of odd, but maybe there is a connection. Personally, I think the whole fiber thing is overemphasized and overblown.

  8. I found that adding more fat into my diet helped with BM. I had mild problems before, none now and I don’t actually eat much fibre.

  9. I had more problems going when I ate grains, I fully agree with JJ eat plenty of fat. Fat is good for you and very satisfying. There are some days where I don’t consume any plant material and still have zero issues in the bowel department.
    Probiotics are very important too. Either through supplements or fermented foods.

  10. Anya

    I found a great product a few weeks ago that I have been drinking everyday now, and now I have no issues with constipation, which I was having from switching to the grain free diet. It is called Natural Calm and it is a powder that you put in water. I prefer in hot water like a tea. It is magnesium and works very well. I recommend it a lot for those with BM issues.

    For those above me in this post that talked about psyllium husk, I do not personally recommend that, although others may have a different opinion. If you have any form of colitis, let me tell you, it causes HORRIBLE pain and devastating symptoms. If you can believe it, my gastroenterologist recommended it to me on one of my many follow up visits when I complained of vague pain. I was doubled over from those husks and she still never thought it had to do with that or the wheat.

    My next apt. with her is in a few weeks and I am ify if I am going to tell her about how going wheat and grain free has basically gotten rid of that vague pain and other symptomsI still suffer from despite her meds. I am sure she will think I am crazy, which she already does. She does not get how her medications have still not completely resolved my painful colitis. Until reading Wheat Belly, I would cry on the way home from meeting with her, thinking that even this highly recommended doctor can’t help me, which was what I had been hoping for. I have seen her regularly every few months for over a year in hopes of remission.

    Last apt. in Sept. she said that she thinks I have IBS on top of colitis because of my continued complaints, and suggested in a sly approach it was emotionally based, which deeply hurt me. To hear your doctor think that of you, it is really horrible, especially when I know what I am feeling. I feel especially validated now going off grains how those symptoms she thought were emotionally based are virtually gone. I am hopeful that with more healing through this new wheat free lifestyle, they will be really gone.

    • Hi, Anya–

      You’ve encountered a phenomenon that plagues medicine: If you can’t make a diagnosis, blame the patient.

      Another sad inadequacy of the way physicians behave: Even if they witness cure–CURE–of a devastating, even life-threatening, condition, many will simply shrug their shoulders if the treatment (in this case wheat elimination) does not fit into their way of thinking. It doesn’t involve prescription drugs, snipping it out with a colonoscope, or surgical removal, then it must be a fluke and you’re nuts.

      Don’t fall for it.

    • I find that tea helps me rehydrate a lot better than just drinking water does. Heck, any water-with-something helps me rehydrate better, sometimes I’ll make lemonade with water, lemon juice, and some Truvia. I wonder if it’s similar to how if your skin is dried out, you don’t just soak it in water because that will actually draw moisture OUT of your skin. I suspect that in order for my gut to actually *absorb* the fluids, there has to be something in them that my digestive enzymes can hook on to and transport. When I just drink the water, I get bloated but nothing gets moving.

      I’ve been doing an experiment with cutting caffeine out of my diet (well, mostly, like 99% anyway) to see how my body reacts, so no coffee for me. It does seem to he helping with my overall malaise, but it’s subtle so I’m going another month and trying to be stricter (99.9% at least).

  11. Heidi

    Hello. I have been reading your blog and have ordered the book, although I have not read it yet. Due to suffering from a variety of the health issues mentioned, I am ready to try wheat free fora month. My question is about my kids-ages 3-9. Three of the four probably need to gain weight. If I take out wheat, should I keep gf carbs such as fruit and rice for the kids? I appreciate input on this! Thank you.

    • Yes, that sounds very reasonable, Heidi. Also, sweet potatoes, some quinoa, buckwheat, and millet. If their diet is based on vegetables, nuts, meats, eggs, some dairy, and these non-wheat carbohydrates, my prediction is that their weight will be perfect (though skinnier than other kids who, sadly, increasingly overweight) and their school performance will improve.

  12. MAC

    I also use Natural Calm. It is wonderful not only for stool regulation but also for muscle soreness. And because it is a powder, you can easily adjust the dose, as compared to capsules or tablets.

  13. mina

    Recommendation from the Dr. Campbell-McBride’s GAPS website:

    http://gaps.me/preview/?page_id=32

    Try to replace high-protein dairy with high-fat dairy. In my experience adding high-protein dairy: whey, yoghurt and kefir, does miracles for those who are prone to diarrhoea. Constipation, however, is a different matter. If you are prone to chronic constipation introduce high-fat dairy: ghee, butter and sour cream, but not high-protein dairy, such as yoghurt, whey, kefir and cheese: high protein dairy can aggravate constipation. High fat content of sour cream will lubricate the gut wall and soften the stool.

    • Mina, that’s really interesting, and actually parallels my experience really closely. I was considering cutting dairy out of my diet entirely, but it’s hard for me to get enough fat without it. However, this past week I’ve been eating almost exclusively high fat dairy (butter!) and I haven’t had any of my usual cheese/yogurt, and voila, major symptom resolution. I will stick with the butter and sour cream then!

      I think high-protein foods in general make my gut unhappy, because I have problems when I eat a bunch of meat, too.

  14. Sharon

    I take Calm at bedtime and also use enzymes. The enzymes and magnesium work together. We did a science experiment with enzymes. If you have enzymes you should be able to sprinkle them across a bowl of oatmeal and they will disolve. Pregest and Dr. Mercola’s enzymes worked wonderfully. We added magnesium and they worked even better.

  15. Boundless

    Looks like the site had a crash and was restored from a 3-day-old backup.
    Do you want replies to be reposted?

    • Hi, Boundless–

      Sure, if you have them saved somewhere.

      We’re still trying to figure out what happened. But at least we’re able to post and comment again. It’s odd that the activity of the last couple of days has not come back up.

      • Boundless

        Don’t forget the famous Goldfinger line:
        “Once is happenstance. Twice is coincidence. The third time it’s enemy action.”

        Track Your Plaque probably had no enemies.
        Wheatbellyblog needs to be prepared for the possibility.

        • Yes, Boundless, this certainly brought that message home.

          Thankfully, as oppressive regimes in the Middle East have discovered, social media has made it virtually impossible to squash a social movement.

  16. I had some problems with constipation during the first 10 days, but after that it’s been clear sailing. My movements are a lot smaller and solid whereas before I could still tell what I ate the day before. I attribute this to better nutrient absorption after eliminating the bowel irritant. I also have more control over when I go.

    • Boundless

      > Any suggestions to an alternative to Metamucil?

      Plain psyllium husk capsules. The Metamucil capsules are fine, but generic alternatives are dramatically cheaper.
      See:
      http://www.wheatbellyblog.com/2011/08/wheat-belly-explodes-into-bookstores/comment-page-1/#comment-1372

      The things to avoid with these products are wheat (in the wafers), sugars, possibly wheat-derived maltodextrin or questionable artificial sweeteners (in the powders), and wheat dextrin in the non-psyllium competitors. Inulin has issues of its own.

    • Brooks

      I have lost about 20# on the Dukan Diet. He recommends Oat bran—not oat meal for fiber. I put 1/3 cup in 1 cup water and boil with a tsp. cinnamon and a tsp. vanilla plus Equal.

  17. MTZ

    Yes, eggs are constipating. Metamucil is merely vegetable fiber – you can get it by eating veggies. Try some of the summer squash or even winter squash and you will find it works wonderfully. As suggested, something to drink upon rising – hot is best – and that will get the system going. I have taken a supplement called ‘Herb-Lax’ make by Shaklee for occasional irregularity. (organic and gluten free) I find I don’t need as much once I went wheat free. Frequent constipation can cause bladder issues as well. Keep the fluids – especially water – coming. About 8 glasses a day MINIMUM.

  18. Doris Johnson

    I have the same problem, have only been off of wheat for about 2 weeks. I’ve only lost five pounds. I feel like my bowels are full and I can’t seem to go enough. Also, I still eat a little bit of sugar. I walk anywhere from 1/2 mile to a mile every day on a areo glide machine. I have balance problems to it’s hard to walk outside. Will probiatics help?

    • Dr. Davis

      There are several very good products, Darla. But I have become comfortable with the Renew Life preparations. I know the owners of the company and they are incredibly meticulous people who pay attention to all aspects of production and formulation.

      • Donna Poirier Connerty

        Hi Dr. Davis,
        I went to their web site and they have quite a few products – I’m overwhelmed; I never taken anything like this…can you suggest the right product that’s wheat and gluten free?

        Thank you!

  19. Alisha

    I have noticed that I am not using the bathroom as regularly. I lost 10 lbs in 9 days but then its like I am gaining again because I am not eliminating as I should. My son even complained about constipation. I eat alot of green veggies and drink for the most part only water. I do eat eggs every day for breakfast. I think I need to incorporate more flax in my diet. Im not sure what to do!

    • Dr. Davis

      Think probiotic, Alisha.

      Minus the bowel flora-disrupting effects of the components of wheat, your gastrointestinal tract needs to repopulate with healthier organisms. Constipation is a common result in this transition. You can accelerate a return to normalcy by supplementing with a high-potency probiotic, e.g., 50 billion CFUs per day for 4-8 weeks. Also, others obtain further benefits by hydrating and considering a magnesium supplement, e.g., magnesium malate, 1200 mg twice a day.

  20. Suzanne Miller

    Hubby and myself have been taking first Benefiber for at least five years 2 tsp each meal. Now since Benefiber no longer available we use store-brand tasteless, quick-dissolving fiber powder made of wheat dextrin. Also, high fiber diet of veges – large salads lunches and dinner, low carb meals, also for years. We drink at least 64 oz or more of water daily, exercise 5 days a week. We wondered if the wheat dextrin fiber was the culprit in keeping the “wheat-belly?” because otherwise we have very very limited bread – no sandwhiches – just salads with our meals. Only have bread treats occasionally with guests. I see psyllium husks capsules are recommended. So we’ll head to store and get some. The question is mainly about getting off the wheat dextrin fiber powder… that might do the trick, you think?

    • Dr. Davis

      Yes, absolutely. Lose anything that might contain gliadin residues that amplify appetite and increase bowel permeability.

  21. Dr. Davis, I am persuaded by your arguments about eliminating (as much as possible) wheat from one’s diet. I am not, and never have been, overweight, primarily due to a lifetime of healthy eating and regular cardiovascular exercise. However, I am conflicted by another factor which has been helpful to my digestion for over thirty years: wheat bran, stripped from the rest of the wheat grain, which I have taken in its natural form for all these years. I prefer insoluble fibers to soluble fibers due to the gel produced by the latter, although my diet is rich in both, but I have ingested natural wheat bran for all this time without any noticeable negative health effects. So my question is: Is wheat bran in its natural form as bad as the whole wheat grain? Thanks for your guidance.

    • Dr. Davis

      No, the bran is simply a source of potential wheat protein contaminants at low level.

      Personally, would not chance it, but the risk is likely small.