Originally posted by Dr. Davis on 2015-07-30
on the Wheat Belly Blog, sourced from and currently found at: Infinite Health Blog.
PCM forum Index of WB Blog articles. There are any number of later blog posts, and a variety of Inner Circle resources, that expand on the insights here.

Eat, pray push?

I’ve previously expressed my reluctance to dwell very much on the issue of constipation, but this common issue is one of the defining problems with wheat and grains, despite widespread conventional advice that they are healthy sources of fiber.

Here’s an excerpt from chapter 4 of Wheat Belly Total Health, Your Bowels Have Been Fouled: Intestinal Indignities From Grains:

“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 be. Constipation remedies are like the 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 your mouth, and it should come out the other end, preferably that same day and 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, and 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 constipation’s most extreme forms, the remains of pancakes can stay in your colon for weeks. The combined effects of impaired CCK signaling, reduced bile release, insufficient pancreatic enzymes, and changes in bowel flora disrupt the orderly passage of digested foods.

“We are given advice to include more fiber, especially insoluble cellulose (wood) fibers from grains, in our diets. We then eat 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, yield bulk that people mistake for a healthy bowel movement. Never mind that all of the other disruptions of digestion, from your mouth on down, are not addressed by loading up your diet with wood fibers. What if sluggish bowel movements prove unresponsive to such fibers? That’s when health care comes to the rescue with laxatives in a variety of forms, some irritative (phenolphthalein and senna), some lubricating (dioctyl sodium sulfosuccinate), some osmotic (polyethylene glycol), some no different than spraying you down with a hose (enemas).”

We know that opiate drugs such as Oxycontin and morphine are commonly constipating. There’s even a new drug being widely advertised to “treat” the constipation side-effect of opiates, Relistor, or methylnaltrexone, an opiate-blocker that requires injection and costs around $700 per month. Recall that the gliadin protein of wheat and related proteins in other grains (e.g., secalin in rye) are partially digested to peptides that have opiate (“opioid”) properties, including binding to the opiate receptors in the human intestine. Wheat and grains therefore contain a disrupter of intestinal motility, partially solved by the bulk of cellulose fiber.

Remove wheat and grains and constipation, even obstipation, can be relieved within days because you have removed the opiates that slow intestinal passage of food. You will have removed a source of cellulose fiber, as well as the modest content of prebiotic fibers from grains, namely amylose and arabinoxylan, but these are easily replaced. This is part of the reason why I urge everyone to add sources of prebiotic fibers to their post-wheat/grain-removal regimen, as well as the fact that the majority of people begin this process with substantially disrupted bowel flora.

If there were a near foolproof approach to constipation/obstipation, it would contain:

• Eliminate all wheat and grains–thereby eliminating gliadin-derived opiates
   
• Cultivate the garden called bowel flora–by “seeding” with a high-potency probiotic, followed by “water and fertilizer” to nourish desired species with prebiotic fibers
   
• Hydrate well
   
• Supplement magnesium–Not only does virtually everyone begin with magnesium deficiency, but this deficiency adds to disrupted intestinal motility. This is reversed by supplementing magnesium. However, the degree of stool loosing varies among different preparations due to variation in their osmotic (water-imbibing) effects. Magnesium water and magnesium malate are among our preferred forms, as they are least likely to generate loose stools while softly helping out with regularity, while magnesium citrate can be used if you do indeed need a bit more stool softening and regularity (which can be due to delayed recovery of intestinal motility after removing wheat and grains).
   
• Supplement fiber–though this is not necessary for the majority of people on the Wheat Belly lifestyle. Just by adhering to the simple Wheat Belly strategies of consuming nuts; seeds such as pumpkin, sesame, chia, flaxseed, and sunflower; eating plenty of vegetable with limited servings of fruit and legumes like chickpeas, you obtain plentiful quantities of cellulose and other fibers. Additional flaxseed, chia, or psyllium are among the best choices.

You can see that the Wheat Belly approach does not rely on artificial means of reversing constipation and restoring normal gut motility. It does not load up on unnatural quantities of cellulose fiber, as you would by eating bran cereals and muffins, nor does it rely on intestinal irritants, softening agents, or opiate-blocking drugs. The Wheat Belly approach is to remove all disrupters of intestinal motility, restore bowel flora, and encourage the consumption of foods that naturally support bowel health. Doesn’t that make better sense?