Here’s an excerpt from Wheat Belly Total Health about constipation. As uninteresting as it can seem at first glance, constipation can offer useful insights into diet and health, but not simple-minded insights like “get more fiber.”
A condition as pedestrian as constipation serves to perfectly illustrate many of the ways in which grains mess with normal body functions, as well as just how wrong conventional “solutions” can stray, Keystone Kops of health stumbling, fumbling, and bumping into each other, but never quite putting out the fire. Drop a rock from the top of a building and it predictably hits the ground—-not sometimes, not half the time, but every time. That’s how the bowels are programmed to work, as well: put food in the mouth, it should come out the other end, preferably that same day, certainly no later than tomorrow. People living primitive lives without grains, sugars, and soft drinks enjoy such predictable bowel behavior: Eat some turtle, fish, clams, mushrooms, coconut or mongongo nuts for breakfast, out it all comes that afternoon or evening, large, steamy, filled with undigested remains and prolific quantities of bacteria, no straining, laxatives, or stack of magazines required.
Live a modern life and have pancakes with maple syrup for breakfast instead. You’ll be lucky to pass that out by tomorrow or the next day. Or perhaps you will be constipated, not passing out your pancakes and syrup for days, passing it incompletely in hard, painful bits and pieces. In its most extreme forms, the remains of your pancakes can stay in the colon for weeks. The combined effects of impaired CCK [cholecystokinin] signaling, reduced bile release, insufficient pancreatic enzymes, and changes in bowel flora disrupt the orderly passage of digested foods. We therefore receive advice to include more fibers, especially insoluble cellulose—-wood-—fibers from grains, in our diet. We then convert our breakfasts to that of breakfast cereals or other grain-based foods rich in cellulose fibers and, lo and behold, it does work for some, as indigestible cellulose fibers, undigested by our own digestive apparatus as well as undigested by bowel flora, yields bulk that people mistake for a healthy bowel movement. Never mind that all the other disruptions of digestion, starting at the mouth on down, are not addressed by loading your diet up with wood fibers. What if sluggish bowel movements prove unresponsive to such wood fibers? That’s when healthcare comes to the rescue with laxatives in a variety of forms, some irritative (e.g., phenolphthalein, senna), some lubricating (dioctyl sodium sulfosuccinate), some osmotic (e.g., polyethylene glycol as in MiraLAX), some no different than spraying you down with a hose (enemas).
Perhaps, as a grain consuming human, you develop iron deficiency from grain phytates, necessitating prescription iron tablets that cause constipation. Perhaps you also develop high blood pressure, thereby prescribed thiazide diuretics and beta blockers, both of which add to constipation. Autoimmune thyroid disruption can develop from prolamin proteins of grains that slows bowel function down. When joints hurt from grain consumption, non-steroidal anti-inflammatory agents are typically taken, also resulting in slowed stool passage. If emotionally depressed from grain consumption, antidepressants can be prescribed that slow normal bowel reflexes that maintain motility. Get more fiber, drink more fluids, take a laxative.
The longer stool-in-progress stays in the distal small intestine and colon, the longer it has to putrefy. Just as food sitting out in the open rots, so can stool sitting too long in the bacteria-rich environment of the intestinal tract. Slowed passage of putrefied stool has been linked to increased cancer risk, especially of the rectum. Over time, constipation and its accompanying added work of evacuation can lead to hemorrhoids, anal fissures, prolapse of the uterus, vagina, and rectum, even bowel obstruction, a surgical emergency. Once again, the healthcare system, with its enthusiasm for procedures, has solutions for all of it. As banal, uninspiring, and ordinary as it is, constipation contains a world of important lessons to teach us about our relationship with the seeds of grasses. Yes, there is order and justice in the digestive world, but you won’t find it in that box of fiber-rich cereal.
Note that I barely make any mention of celiac disease or gluten sensitivity, as most of the gastrointestinal disruptions of grains are of neither variety. You can better appreciate just how much gastrointestinal distress and disruption is due to the various toxic components of grains. You can also appreciate why defenders of grains, such as the Whole Grain Council, try to minimize the problem by arguing that gluten is the only problem component in grains, a problem for a relative few. Nope: Grains are simply the innocent seeds of grasses, incompletely digestible just like the rest of grass plants, allowing persistence of toxins, intact and ready to block, irritate, and inflame the gastrointestinal tract of this species of primate, Homo sapiens, who never should have eaten the stuff in the first place. Insufficient bile and pancreatic enzymes, impaired digestion, gallstones, dysbiosis, effects coupled with intestinal inflammation—-the human gastrointestinal tract doesn’t stand a chance.
After a period of being free of grains, a re-exposure, inadvertent or intentional, can reactivate all of these intestinal phenomena. And it can do so with a vengeance, typically with intense symptoms of bloating, gas, diarrhea, as well as mind, emotional, joint, and inflammatory effects, that are worse upon re-exposure than they were during chronic grain consuming days, reflecting the partial (never complete) tolerance to their effects with frequent consumption.