15 Tips for Fixing Constipation (Without Miralax!)

Occasional mild constipation can happen to anyone - often it is due to a stressful event, interruptions to your routine, or diet (maybe you were traveling, or you just went a little crazy with the cheese plate). But generally, as long as you get back to you normal routine or diet, or the stress subsides - the constipation will resolve and you will be feeling normal in a day or so. If you have ever had occasional constipation, you know the feeling - discomfort, bloating, feeling full, gassy and sluggish. Now imagine what it would be like to feel that way most of the time. Chronic constipation is the #1 cause of kids' belly pain, and a common reason to miss school and activities. In addition - being constipated can impede the body's ability to detoxify. When constipation is ongoing or chronic, it generally is a signal that something is amiss somewhere in the diet, or perhaps with the digestion and elimination process - with the organs, the nerves, and anywhere along the gastrointestinal tract. In some cases, constipation can become a medical emergency. If chronic constipation goes on for a long time, it could leads to a blockage, also known as fecal impaction. According to an article by Dr. Mercola - Constipation Emergencies are on the Rise, "there was a 42 percent increase in ER visits for constipation in the US between 2006 and 2011." So it is important to not ignore constipation.

What is constipation? Look before you flush! Not everyone agrees on the definition of constipation - some experts say as long as you "go" 3 times a week, you are fine. But most natural & holistic health practitioners say anything less than 1 daily movement is constipation. You should look before you flush, because another way to identify constipation is by the quality of the stool - even if you are passing stool - if they are hard, little pebbles - it is considered constipation. (see below Bristol stool chart). Another consideration is when you are not completely emptying the bowel - incomplete evacuations are another sign of constipation. Also - if someone has to strain every time they go in order to pass the stool - this is another sign of constipation. The ideal situation is to have at least one complete evacuation of the bowel daily with a type 3 or 4 bowel movement on the Bristol Stool chart - which is a smooth and easy to pass stool. Some people may pass more than 1 daily.

Bristol Stool Chart

Underlying Causes of Constipation: Chronic constipation can be caused by a long list of issues including:

  • picky eating

  • highly processed diets

  • undiagnosed food sensitivities (dairy tends to be a common culprit)

  • being sedentary, lack of exercise

  • low fiber consumption (or oddly enough, in some cases too much fiber consumption)

  • insufficient fluid intake, chronic dehydration

  • behavioral issues (like "withholding" or ignoring the urge to go)

  • changes in routine or diet (like travel, or overindulging in a constipating food like cheese)

  • developmental issues

  • nerve damage or nerve disorders

  • gut dysbiosis (overgrowth of yeast or bacteria in the GI tract)

  • viral, bacterial, or parasitic infection in the gut

  • congestion in the liver, kidneys, or intestines

  • certain supplements can be constipating like calcium and iron.

  • medications (some medications like opiods and antacids can cause constipation)

  • medical conditions (like thyroid disease, cystic fibrosis, diabetes, Hirschsprung's disease, neurological disorders, untreated B12 deficiency, brain injury)

  • poorly managed stress

  • disease - if constipation is not resolved with diet and supplement changes, you should see a health practitioner to rule out more serious causes like colon cancer.

  • mineral and nutrient deficiencies, as well as heavy metal overload

Miralax Concerns: For constipation sufferers - the tasteless and odorless over the counter medication Miralax seemed to offer an easy solution to the problem - just stir it into a glass of water or juice, and drink it down - problem solved, right? Not so fast...although doctors have been recommending it as a safe solution for constipation in kids for years, prescribing Miralax is not FDA approved for use in children, so giving it to kids is an "off-label" use. And giving it to anyone of any age for longer than a week is also off-label. Miralax's label - says that it is for use in people age 17 and over, and not for more than 7 days (without a doctor's orders).

The research on the long-term safety of propylene glycol (PEG) use in kids is limited at best. And there have been concerns regarding the safety of Miralax's use in children for several years. According to the NY Times, "the Empire State Consumer Project, a New York consumer group, sent a citizen petition to the F.D.A. on behalf of parents concerned about the increase in so-called adverse events related to PEG that health professionals and consumers have reported to the F.D.A. over the past decade." According to this NY Times article, tests conducted by the F.D.A. in 2008 on eight batches of Miralax, found tiny amounts of ethylene glycol (EG) and diethylene glycol (DEG) in all of the samples - which are ingredients in antifreeze. Despite being conducted in 2008, the results of the tests were not disclosed to the public. The article also said that taking Miralax for long periods of time could lead to developing "acidic blood."

Since the start of 2017, a growing number of parents have come forward complaining of a myriad of psychological, behavorial, and neurological symptoms that they have been linked to the active ingredient propylene glycol (PEG) found in Miralax and some other laxatives - these side effect include tics, stuttering, anger/aggression, depression, anxiety, memory issues, obsessive-compulsive behavior, and more. There is a Facebook group called Parents Against Miralax that has grown from about 2,000 to over 18,000 members in just a few weeks time.

Many doctors are still recommending it as a safe option, while others are questioning the safety. “Every pediatric GI physician, I would guarantee you, has told a family this is a safe product,” said Dr. Kent C. Williams, a gastroenterologist at Nationwide Children’s Hospital in Columbus, Ohio. Now, he worries, “it may not be true.” According to the NY Times, "Scrutiny for Laxatives as a Childhood Remedy." Many kids and families have been using Miralax without being told of the potential risks, and having never been offered any natural alternatives to try first. Now with the possible side effect concerns - a lot of parents are scrambling to find a safe & natural alternative to Miralax - that works.

The good news is there are lots of natural alternatives that are safe, effective, and offer lots of positive health benefits.

15 Tips for Fixing Constipation Naturally: Note: Do not expect constipation to resolve overnight - take your time and implement changes very slowly and gradually to allow the body to adjust. Any major changes made to the diet or with supplements are best done on the weekend when the child is not rushing out of the house, and can be near a toilet in case they happen to get loose stools, and home relaxing in case there is any discomfort, gas, or bloating. Kids under the age of 4, or with a medical conditions (such as kidney disease), or currently taking medications - should speak to their pediatrician or specialist before implementing any of the below suggestion.

The content of this article is not to be construed as medical advice. - all information provided in this article is general and not specific to individuals. Contact your doctor or specialist with any questions about how this information pertains to you, your child.

1. Boost Hydration Studies show that most kids are not replenishing enough fluids each day, making them chronically dehydrated. Without proper hydration, the stools can become hard and difficult to pass (Type 1 and 2 on the Bristol chart). Overtime this situation can become chronic constipation. Just correcting hydration alone can potentially solve the constipation problem for certain kids!

  • Make sure kids are bringing water bottles to school, and that they are not coming back home full!

  • They should drink plenty of water and fluids spread out throughout the day. Try to not drink too much water with meals, it can dilute the digestive enzymes and work against digestion.

  • Avoiding sugary beverages is smart, as they can quickly lead to weight gain, cavities, and candida overgrowth (which can contribute to constipation). If you do choose juice - drink only unsweetened juice and dilute it with half water. Good juices for constipation are prune, pear, and freshly squeezed lemon.

  • Diets rich in plant-based foods are also very hydrating, and come paired with natural vitamins, minerals and fiber. Foods like melons, cucumbers, romaine lettuce, celery, and tomatoes, all contain a lot of water - which helps to lubricate and boost digestion.

  • Consider adding mineral drops and a small pinch of high quality Real Salt to 1-2 of your servings of water daily - this helps to boosts the magnesium, potassium, and trace mineral levels. Optimal minerals are very important for preventing constipation.

2. Identify & Remove Constipating Foods / Food Sensitivities: When constipation is chronic, going on an allergy elimination diet is a very good idea. Undiagnosed food allergies or sensitivities can cause inflammation, digestive troubles, problems absorbing nutrients, and constipation. It is also important to discover a food sensitivity because they can lead to damage in the small intestine, and many other very serious health issues overtime. I generally recommend keeping a food journal for a few days before starting the elimination diet, during the elimination period, and after. Download this Food Mood Journal for free. Almost any intolerance to a food could cause constipation, two of the most common culprits are dairy and gluten:

  • Dairy - one of the most constipating foods can be cows milk products. Only about 40% of the population has the ability to properly digest dairy, that means for the majority of the population (60%), dairy will interfere with digestion. For some, it can cause loose stools, while in others it can cause constipation. Cheese can be especially constipating. Removing dairy from the diet for a couple weeks can help to determine if that is the root of the problem. Substitute a non-dairy milk, and non-dairy cheese and see if the condition improves. After about 3 weeks of avoiding the food, you can reintroduce some dairy to "challenge" it. If there are symptoms (constipation, sneezing, etc) - continue to avoid for 2-3 more months. Try the challenge again. If there is a reaction - continue to avoid. If there is no reaction - then you may begin to incorporate small amounts of dairy, but remove it again if there are issues.

  • Gluten - Most people think that people with celiac disease or gluten intolerance will suffer from diarrhea, which many do. But celiac disease or a gluten sensitivity can also lead to constipation. Some patients with celiac disease are mistakenly diagnosed initially with irritable bowel syndrome, which has similar symptoms.

  • Test - Don't want to do an elimation diet, or would rather just test? A food intolerance panel can be run to identify food intolerances as well - such as the ALCAT test.

  • Cutting back on sugary and processed or "enriched" foods will not only benefit digestion - but it will benefit weight, energy, and overall health too. Processed foods lack enzymes, fiber and nutrients. Diets that are highly processed and sugary not only can lead to constipation, but can also lead to inflammation in the gut and an overgrowth of candida, which is a yeast. Also - the more sweet foods a child eats, the less they will enjoy unsweetened foods like vegetables, so getting rid of the sugar for a little while helps to reset the taste buds and metabolism. High sugar consumption also raises our triglycerides, blood sugar, and increases our risk of many diseases. Read: 20 Reasons to Break up with Sugar to learn more.

3. Eat more constipation-relieving foods

  • Slowly increasing foods that are naturally rich in fiber, vitamins and minerals like fruits and vegetables will help to get the digestion moving better. Add these foods slowly and gradually at first to not cause excessive gas and bloating. Some particularly good foods for constipation include:

  • prunes and other dried fruits

  • pears

  • kiwis

  • blueberries

  • cooked beets (beets are also good to determine "transit time" - eat a big serving of beets and notice when your stool is a pinkish color - that is how many days your "transit time" from eating to stool is. Ideal is 24-48 hours.

  • raw carrots

  • cooked oatmeal

  • (well hydrated) chia seeds.

4. Exercise If you want to get "things" moving - get moving!! Exercise is really important for overall health and digestion. Kids have more reasons than ever to be sedentary - lots of screentime, homework, etc. Kids who are not out being active can suffer from sluggish digestion. In addition to promoting regularity, exercise also benefits our mood, weight, energy, and sleep. So turn off the screens and get moving!

5. Get Healthy Fats Healthy fats help to lubricate the colon and keep things moving. My favorite fat for constipation is coconut oil. It is antiviral, antibacterial - so it will help to improve the bacterial balance in the colon, and it also does not require bile salts for digstion - so those with a sluggish gallbladder will still be able to digest it well. It is also metabolism-boosting and easily converted into energy. Any adult that has tried a Bulletproof coffee (which has 1-2 Tablespoons of coconut oil, plus 1-2 Tablespoons of grass fed butter in it) can attest to the fact that eating a lot of coconut oil and butter can make you "go!" Other healthy fats that benefit digestion and metabolism include grass fed butter, flax oil (not for cooking), olive oil, and avocado oil.

Some ways to get coconut oil into the diet are - adding it to smoothies, stir into oatmeal, cook with it, and making these "coconut oil chocolates":

Coconut oil chocolates: just melt 1/3 cup dark chocolate chips with 1/4 cup coconut oil (optional - add 2-4 drops of peppermint essential oil) - stir together all ingredients and then pour into the silicon ice cube tray - and put in freezer. Store in freezer so they do not melt. This makes 1 batch of mini chocolates - I used the square one of these silicon ice cube tray molds. If using a larger mold like this heart shaped one, then double the recipe.

6. Time. It is important to make sure your child has enough time each morning to sit and relax on the potty before going off to school. Even if you have to wake them up earlier in the morning - make sure they have plenty of time after breakfast to sit on the potty. Morning is one of the most optimal times to have a bowel movement. Sometimes kids will "hold it" at school, traveling, or if they are out in public. Some teachers might restrict bathroom breaks, to limit disruptions to the school day. If your child suffers from urinary tract, constipation or digestive troubles; make sure to inform the teacher so he knows to not to restrict your child's access to the bathroom. If the teacher does not agree, bring your issue to the principal, there is a disabilities act that prevents kids who have continence issues from being restricted from using the bathroom.