EP.186/ Four Easy Home Remedies for Constipation with Endo Belly
Today we’re talking about the endo belly, but more specifically, constipation.
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Firstly, let’s quickly look at what the endo belly is.
The ‘endo belly’ is not actually a medical term, but instead is a name the community has coined in reference to the severe bloating we often experience. So, there isn’t technically a set definition, but it is generally thought to be severe bloating/swelling that tends to be attributed to endometriosis and is sometimes accompanied by pain. Some experts, articles and endo patients also include gut problems within this term too, but not always.
My definition, from my training and from seeing so many clients with these symptoms is that the endo belly is exaggerated/severe bloating, often accompanied by gut symptoms, pain or discomfort - but it is not always caused by endometriosis directly (there are normally contributing factors behind the endo belly).
Many people with endo suffer with this bloating or distension plus IBS issues like constipation, and often these can be caused by issues like gut dysbiosis (which is common with endo), small intestine bacterial overgrowth (which according to research could be affecting 80% of us with endo), adhesions from surgery and bowel endometriosis, to name just a few of the contributing factors. So, constipation can result from one or all of these issues, and the bloating itself could also come from one or all of these causes (and the many others not listed here), but the constipation itself could also be worsening your bloating.
When you’re constipated, you’re going to get a build-up of waste, gas and bacteria in your intestines, and the bacteria will also have longer to ferment the food you’ve eaten, resulting in more gas being produced than usual.
So, what can we do about it? Ideally and in the long-term, we want to address the root cause of your constipation, because at home remedies are unlikely to solve the root cause alone, however, whilst you’re on that journey, at home remedies can make a real difference.
Full credit to my tutors Dr. Allison Siebecker and Dr. Nirala Jacobi for these great tools.
Drink hot water in the morning
Yep, it’s that simple. Drinking hot or warm water, like a herbal tea, and making a chewing movement as you drink it, can actually trigger motility (which basically means movement) in the large intestine. It works best if you drink it slowly, though experiment with what works for you.
I wouldn’t necessarily wait for constipation to happen to try this but bring it into your daily routine, so you start to build a habit of a morning bowel movement.
Try flax or chia seeds
Both flax and chia seeds help to create a bowel movement, but which one you use really depends on your personal reactions to the seeds.
Chia is low FODMAP at serving sizes up to 24 grams, so as a result, chia is often safe for people with IBS and even, in many cases, people with SIBO. Chia seeds provide a large amount of fibre, and whilst many people with IBS and SIBO can’t tolerate a lot of fibre, chia seeds are often well tolerated so it’s a great way to top up your fibre content without a flare – and we all know how important fibre is!
You may have noticed that chia seeds absorb a lot of water, and so as a result, they can soften a stool by adding a gel-like consistency to food in your intestinal tract and by adding bulk, which can help form a stool and move it along.
Now, be guided by your personal reaction because with SIBO, adding fibre often makes things worse and because everyone is unique, even though chia is generally thought to be safe for SIBO, some people still react – which means their constipation could get worse.
So, start slowly with a small amount, like a tablespoon and increase to two if you find you don’t have any adverse reactions – just don’t exceed 24 g to be safe, although 24g of chia in one sitting is a huge amount, so I doubt you will!
Always add a liquid to your chia first, to create the gel-like consistency. You could make a chia pudding with almond milk, add them to oats or add them to a smoothie.
Now, with flax, I tend to see that’s less well tolerated with people who have SIBO due to the fibre content but see how you respond. To be on the safe side, a low FODMAP serving of flax is 15 grams, or one tablespoon, so start there, though you may personally be able to tolerate more. The serving size found to be effective for constipation in research is 20g.
Some of you may be wondering if flax is safe for endo. Flax contains plant compounds known as phytoestrogens, which mimic oestrogen in the body. Lots of studies show flaxseeds as being beneficial for people who have low levels of oestrogen as it raises them (just like soy) and yet because like soy, phytoestrogens are weaker than our own oestrogen, it should in theory help to lower oestrogen dominance and certainly has shown that with many people. But it seems to depend on the individual response as I’ve personally experienced worsening endometriosis symptoms with flax and I know my tutors Dr Jessica Drummond and Nicole Jardim have observed similar reactions too.
One factor to consider is that the issue isn’t the phytoestrogens in the flax but potentially the state of the flax. Flax is very vulnerable to going rancid and becoming inflammatory. It’s better to store whole flaxseeds in an airtight container in the fridge, for shorter periods of time and then grind flax seeds fresh (if required to be ground), rather than storing them in a cupboard, in a bag, already ground. So, experiment and see how you feel!
You can add flax to oats and smoothies, or you could stir it into yoghurt or a chia pudding.
Eat more fat
Adequate levels of fat can aid with constipation, as fat triggers large intestine motility.
Now, you do have to be careful because too much fat can sometimes cause gastro issues in people with IBS, but generally with my clients and students, we focus on two golf ball sized servings of fat with each meal, to support blood sugar levels, and that amount is often well tolerated. If you’re not sure, try a lesser serving size and also try fats that are lower in FODMAPs to avoid aggravating your symptoms.
Now, just to be clear, I am in no way telling you to start a low FDOMAP diet, that has to be prescribed by a doctor or dietician and should only be done with a diagnosis of IBS, but to avoid flaring your symptoms with these strategies, you could try low FODMAP options for these.
Some good fats include eggs, coconut oil, olive oil and low FODMAP nut butters. A great combination could be to combine one of these fats with your chia or flax at breakfast, after you’ve drunk some warm water, for maximum effect.
Try the ‘I Love You’ massage
The I Love You Massage is an easy abdominal massage that you can do on yourself at home, and is designed specifically for IBS problems like bloating, gas, constipation, etc. I’ve linked to a free video tutorial in the show notes.
In my experience, it’s best performed at night before bed, as it also helps to stimulate your migrating motor complex, which is a wave like motion in your small intestine, that cleans up the small intestine between meals and most of all, overnight. Whilst the MMC won’t directly help with constipation, it will help with SIBO and bloating occurring in the small intestine, and so this massage is targeting two issues at once – constipation through stimulating the large intestine and bloating/SIBO that’s occurring in the small intestine.
So that’s it! I hope one or a few of these at-home remedies help with your constipation. I would love to hear how you get on, so please do reach out on Instagram to let me know!
Show Notes
Water
https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf
Chia
https://link.springer.com/article/10.1007/s13197-015-1967-0
https://ift.onlinelibrary.wiley.com/doi/10.1111/1750-3841.12444
Flax
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944250/
https://pubmed.ncbi.nlm.nih.gov/8077314/
https://pubmed.ncbi.nlm.nih.gov/15702593/
https://www.annualreviews.org/doi/abs/10.1146/annurev.nutr.17.1.353?journalCode=nutr
Fat
https://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_symptomatic_relief_suggestions_jan_2020.pdf
https://www.sciencedirect.com/science/article/abs/pii/S1051227614001411
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460325/
I Love You Massage
https://www.youtube.com/watch?v=JTOkKVlBHzk&t=2s
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