Emerging insights from our gut microbiome and gut-brain pathways reveal that the real root cause for chronic constipation may lie deeper—in the brain, central and enteric nervous systems, including hormones.

While common advice suggests increasing fiber, drinking more water, or adding supplements like magnesium, these solutions often only address the symptoms, not the root cause.

This article explores how constipation is linked to brain function and provides a comprehensive approach to relief.

1. Understanding Digestion and Where Constipation Occurs

To fully grasp why constipation happens, it’s essential to understand the digestive process:

• The Digestive Journey: Food travels from the mouth to the stomach, where it is broken down by acids. It then moves into the small intestine for nutrient absorption and finally into the large intestine (colon) where water is absorbed, and stool is formed.
• Peristalsis: A Motor Function: The movement of food through the digestive tract relies on a process called peristalsis—wave-like muscle contractions controlled by the nervous system. When peristalsis slows down or becomes irregular, constipation can occur.

Constipation typically involves slow peristaltic activity in the colon, leading to infrequent or difficult bowel movements. But what’s causing this slowdown?

2. The Role of Nervous System Crosstalk

To fully grasp where digestion occurs and why constipation might happen, it’s essential to understand the intricate crosstalk between the enteric nervous system (ENS) and the central nervous system (CNS).

This interaction is mediated through a complex network of neurotransmitters, with serotonin and dopamine playing pivotal roles. Interestingly, a significant amount of these neurotransmitters—about 90% of the body’s serotonin and a substantial portion of dopamine—are found in the intestines.

Neurotransmitters made in the gut
Serotonin, for example, is critical in regulating gut motility and peristaltic activity, while dopamine is involved in controlling intestinal movement and modulating sensations like pain and discomfort.

The presence and balance of these neurotransmitters in the gut are not just vital for digestive processes but are also key areas of research in neurogastroenterology and psychiatry.

Digestive discomfort and mood
This connection helps explain why digestive issues like constipation are often linked with mental health conditions and why treatments targeting both the brain and gut can be effective.

3. The Real Root Cause: Brain and Nervous System Slowdown

While lifestyle factors like diet and hydration play a role, the root cause of constipation often lies in the brain and central nervous system:

• Brain-Gut Connection: The brain communicates with the gut via the nervous system to regulate peristalsis. This communication can slow down, leading to reduced motility in the intestines.
• Nervous System Fatigue: Factors such as stress, poor sleep, or hormonal imbalances can affect brain function, indirectly slowing down digestive processes.
• Medication Side Effects: One common issue for many patients on medication, particularly those in the SSRI or tricyclic categories, is constipation. Additionally, these can worsen constipation by causing dehydration.
• The Hormonal Interplay: Hormonal shifts may also affect the balance of neurotransmitters like serotonin in the gut, further influencing digestive function.

By understanding that constipation is often a result of slowed nervous system activity, we can approach treatment more effectively.

4. A Natural Approach to Relieving Constipation

Functional medicine looks beyond symptomatic relief to address the root cause—often focusing on enhancing brain and nervous system health to improve digestive function:

• Supporting Nervous System Health: Techniques to reduce nervous system fatigue, such as stress management, adequate sleep, and cognitive exercises, can help restore optimal brain-gut communication.
• Dietary Adjustments: A balanced diet rich in nutrients that support brain and nervous system function (like omega-3 fatty acids and B vitamins) can indirectly improve gut motility.
• Supplements and Natural Remedies: While magnesium and fiber supplements can help, incorporating enzymes, pro- and prebiotics, motility enhancements and herbal supplements like ginger, peppermint or fennel can support overall gut health and motility.
• Improved Circulation and Movement: Regular exercise stimulates the nervous system and promotes better peristaltic activity. Simple activities like walking or yoga can help keep both the brain and gut active.
• Hydration with Electrolytes: Drinking water with added electrolytes can better support cellular function and nerve signaling than water alone.

5. Constipation: Looking Deeper In Our Investigation

A functional approach to treating constipation goes beyond just addressing immediate symptoms. It involves a comprehensive evaluation to understand the underlying causes and the broader impact on overall health. When poor gut motility is identified, functional medicine practitioners, like Dr. Pucci, delve deeper into several key areas:

• Functional GI Analysis: This in-depth test assesses the digestive tract’s efficiency and can reveal issues such as malabsorption of essential nutrients and evaluate yeast overgrowths and whether the pancreas is producing sufficient enzymes necessary for digestion.
• Small Intestine and Stomach Acid Production: If there is deficiency in digestive enzymes or bile acids—essential for breaking down fats—food can remain partially undigested. This can also slow down transit time, leading to constipation.
• Thyroid Function: The thyroid gland plays a crucial role in metabolism, including digestive motility. Hypothyroidism (low thyroid function) can slow down many bodily processes, including peristalsis, contributing to constipation.
• Functional Hormone Analysis: Understanding the role of hormonal changes is crucial, especially for those experiencing these natural life transitions. For example, reduced estrogen levels can affect gut motility and microbiome composition, leading to changes in bowel habits.
• Stress Physiology: Elevated cortisol levels and changes in your body’s natural circadian rhythm are a leading cause of poor gut motility. During periods of high stress, the body diverts energy away from “non-essential” functions like digestion, causing constipation.
• Gallbladder and Liver Function: The gallbladder stores bile, which helps digest fats. If gallbladder function is impaired, it can affect fat digestion and contribute to constipation. Additionally, a fatty liver can indicate metabolic issues affecting digestion and overall gut health.

In functional medicine, we consider the interconnectedness of these systems.

If one area is compromised—like the thyroid or liver—it can impact gut health. This holistic approach is about giving serious consideration to all the potential factors contributing to constipation and addressing them through personalized treatment plans that may include dietary changes, supplements, lifestyle modifications, and stress management strategies.

By looking at the body as an integrated system, functional medicine provides a more comprehensive and effective strategy for treating constipation, focusing not just on symptom relief but on long-term health and wellness.

6. Conclusion

Overcoming frequent constipation requires more than just dietary changes or supplements; it involves understanding the deeper connections between the brain, gut, and hormones, and the related organ systems. By addressing the root causes through a comprehensive functional medicine work up, you can achieve long-lasting relief and improve your overall health and well-being. If you’re experiencing persistent constipation, consider exploring how optimizing brain health can help improve your digestive health.

Schedule a Conversation
Thank you for joining us on this enlightening journey through the role of your brain health, including key hormones and neurotransmitters, on digestion and chronic constipation . May your path be filled with balance, well-being, and the joy of embracing your authentic self.

If you have questions about your digestive health, or suffer from chronic constipation and want to find the root cause, schedule a conversation with our expert team. We’re here to answer your questions, provide guidance, and support you on your journey to optimal digestive health. Whether it’s assessing your gut-hormone-brain health status, helping you navigate your digestive health journey, or providing you a solution that includes a plan for optimal digestion, we’re here to help.