Should You Really Eat if You’re Not Hungry And Have Constipation?

It’s 3 p.m. and I haven’t eaten since 8:30 a.m. But you’re constipated and not hungry. 

To eat or not to eat when you’re constipated? That is the question. 

The Constipation (& Eating) Struggle is Real

Constipation-induced loss of appetite is real. 

Any of these sound familiar? 

• You didn’t go #2 this morning…and all you can think about is how backed up and constipated you feel
• You wonder if eating another meal will help, or just make things worse—overcrowding your gut even more
• You debate what to eat when you’re constipated: A smoothie? Prunes? A regular sized meal? Or should you just fast—nothing at all?!

You are not alone. 

Constipation Statistics

In an ideal world, we’d poop at least once—if not two or three times—per day and move approximately a total of 12-inches of feces out of our body daily, without using coffee, supplements, laxatives, colonics, or any other methods.  

However, this is not the case.  

Approximately 1 in 2 of people experience constipation on a regular basis (Werth et al, 2019). 

Constipation is technically defined as a condition in which you have fewer than three bowel movements per week, or you experience hard, dry and small bowel movements that are painful or difficult to pass.

However, if you’re eating food on a daily basis, then you should be going #2 on a daily basis. If you’re not, you’re constipated. 

Constipation can entail other symptoms as well, including bloating, stomach cramps, low energy, anxiety, depression and…loss of appetite (Gurkan et al, 2013; Mosinka et al, 2017; Salhy et al, 2009). 

Constipation Physiology

Your body was born knowing how to poo. So why does your body forget, and why do you lose your appetite? 

In order to understand how constipation happens and why you’re not hungry, it’s important to understand the physiology of healthy digestion and hunger cues.

Healthy Digestion Physiology 

Step 1: Food Breakdown in Your Mouth
When you start chewing your food, it breaks down it into smaller, more manageable pieces. Your salivary glands simultaneously release saliva to help you form a food bolus— a mushy clump that can easily move down your throat. 

Step 2: Poop Signals
It’s important to note that the gastro-colonic response (contractions that prep your colon to poo) begins  within a few seconds after eating and may last for up to 2½ hours. Colonic contractions actually occur an average of 6 times per day, happening most frequently after awakening and after meals and account for the urge to eventually poo on a daily basis.

Step 3: Stomach Acid Breakdown
Food enters your stomach—stimulating stomach acid and the contraction of your stomach wall in order to break the food into even smaller pieces.

Step 4: Food Enters Your Small Intestine for the Next 6-8 Hours
Your food substances then move into your small intestine where the majority of digestion occurs (for 6-8 hours), as your body extracts all the nutrients it requires. Your liver, pancreas and gallbladder secrete digestive enzymes and bile to aid in digestion and prepare food for elimination. 

Step 5: On to the Large Intestine Recycler
After your small intestine has removed every bit of useful nutrients from your food, any indigestible leftovers move into your large intestine where it gets recycled and any leftover nutrients absorbed before turning the rest into feces (waste). As your colon converts the leftover material into feces, it also absorbs water and electrolytes from the material, used by the body to avoid dehydration and constipation. 

Step 6: The Golden Poo
Bye bye! Your leftover waste turns into the “golden poo”—ideally snake or sausage shaped and passing out the backdoor with ease. 

Constipation Physiology

If there is any backup or breakdown in the mechanics of healthy digestion, then you can say “hello” to constipation instead of the golden poo.

Constipation most often occurs when food is not fully broken down or digested and/or your waste or stool moves too slowly through the digestive tract or cannot be eliminated effectively from the colon, which causes the stool to become hard and dry. 

In conjunction, loss of appetite (not feeling hungry) may also occur because your body intuitively knows it’s not digesting well. 

7 Common Reasons Why Constipation Happens (That Most Doctors Won’t Tell You About)

Most doctors blame constipation on low fiber, dehydration, or slow motility. While all of these factors can certainly play a role, here are 7 other common reasons why constipation happens. 

Constipation Reason #1: Dysbiosis

Imbalanced gut microbiota exacerbate constipation. 

For example, studies in germ-free (no bacteria) mice colonized with the fecal microbiota from patients with constipation developed slow colonic transit, suggesting a certain (dysbiotic) bacteria profile is present in people who experience constipation regularly, More specifically, constipated gut types are often characterized by a decreased in Firmicutes bacteria species, increased Bacteroidetes, and lower amounts of  short-chain fatty acids and bile acids (Cao et al, 2017; Ge et al, 2017).

Dysbiosis—including low growth of beneficial species, high growth of pathogenic species, and/or low bacteria diversity—also regulates colonic motility and cell signaling that helps food move through the digestive system. Probiotics, such as lactobacillus plantarum, and bacterial reshifting has been shown to up regulate gut motility in research (Deng et al, 2018). And it is well documented that elevated methane gas—common in SIBO (small intestinal bacterial overgrowth)—is directly associated with constipation (Ghoshal et al, 2016). 

Constipation Reason #2: Low Ghrelin (Hunger & Motility Hormone)
Ghrelin, often called the “hunger hormone”, not only stimulates your hunger cues, but also stimulates GI motility—a lesser known characteristic. In constipation, ghrelin levels (hunger hormone and motility hormone) are often lower, while inversely leptin (fullness hormone) levels may be higher (Mosinka et al, 2017). What causes low ghrelin? One word: stress—both mental and physical (Spencer et al, 2012). 

Constipation Reason #3: Low Stomach Acids, Enzymes & Bile Salts
Stomach acid, digestive enzymes and bile salts help your gut do its job. Common triggers to suppressed function of these three things include:

• Eating too fast

• Not thoroughly chewing your food

• Nutrient deficiencies (low fat soluble vitamins, low B vitamins, zinc)

• Pancreatic insufficiency (from an imbalanced diet)

• Toxic burden (mold, cleaning/health products, pesticdies, poor diet)

• Eating out often (canola oil, hydrogenated oils)

• Chronic stress (see Reason #4)

Constipation Reason #4: Overtraining
Chronic stress and constipation go hand-in-hand. 

Contrary to popular belief, stress goes far beyond mental stress. Physiological stress upsets the digestive process and microbial balance, easily inviting constipation to have a place. Even seemingly “harmless” or “healthy” habits—like HIIT training and marathon running can add up as a compounded stress “load” for your body. While exercise in particular can be therapeutic tools for a healthy gut, it can also become a trigger for constipation if they push your body overboard. 

Studies in endurance athletes who maintain intense, frequent training schedules reveal an overwhelming amount suffer from gastrointestinal conditions, including dysbiosis, leaky gut, IBS and constipation. One 6 week trial, comparing “voluntary” treadmill runners versus “forced” treadmill runners found that the forced running group developed leaky gut and increased levels of the gram-negative bacteria Turicibacter spp. (strongly associated with immune dysfunction and irritable bowel disease), whereas the voluntary runners did not (Allen et al, 2015). Another study in healthy fitness enthusiasts who regularly exercised at 70% of their maximum workload capacity reduced gastrointestinal blood flow by upwards of 60-70%—increasing intestinal permeability and damage to the intestinal mucosa (Holland et al, 2015).

Exercise is not necessarily a “bad thing”, but for these reasons, this is why proper recovery (rest) and nutrition are critical for all around wellness (gut health included). Since both diet and low stress conditions strongly influence gut microbiota composition and function—in as little as 3 days (David et al, 2014), modulation of the gut microbiota via nutritional and recovery strategies may improve the stress response in fitness enthusiasts and improve performance.

Constipation Reason #5: Accidental Under-Eating
Not eating enough, frequent fasting/intermittent fasting or “gut healing” restrictive diets—such as low carb, high fat diets; meat-free diets; or carnivore diets—can also trigger constipation, primarily because under-eating slows colonic transit and inhibits digestive juices from flowing—especially if followed for an extended period of time. 

Individuals who follow a low-carb, high fat diet for example often experience an increase of the Bacteroides, Dorea  and Enerobacteriaceae gut micorbiota species and a reduction of Faecalibacteriu (Murtaza et al, 2019; Paoli et al, 2019). Interestingly, patients with constipation predominant-irritable bowel syndrome (IBS-C) also often exhibit the same presentation—an increase of Bacteroides sp., Enterobacteriaceae (Simren et al. 2013), and decrease in Faecalibacterium too (Lopez et al, 2017). This is primarily because fiber (found in carbohydrates) is essential for a diverse and healthy gut microbiome—their #1 food of choice. Dietary fiber increases stool frequency in patients with constipation—as long as it is balanced. On the flip side, patients who eat very high fiber, high carb diets (ie. Vegan diets, FODMAP rich diets, high starch diets) can also experience idiopathic constipation too. Research show diets consisting of approximately 30-40% fiber is the sweet spot (Ho et al, 2012). 

Another study in 900 healthy Iranian adults, known for regularly practicing fasting or intermittent fasting, found those who fasted for at least 2 weeks reported experiencing severe constipation three times more than those who fasted for less than 2 weeks, suggesting a significant decrease in GI motility and bowel function the more often fasting is practiced (Keshteli et al, 2017). 

As for intermittent fasting or the “one meal a day” model—often touted as a healthy alternative to fasting and helpful for gut healing—these tactics can also trigger constipation. For one, if you are aiming to eat enough for your body’s daily needs and fitness levels, eating 1,500 to 3,000 calories, within one sitting or a short time window can be tough for your digestive system (Ganesan et al, 2018). Additionally, nutrient deficiencies—particularly B-12 and Vitamin D—are common in those who suffer both from constipation, chronic under-eating and accidental dieting, primarily because they aid in both absorption and assimilation of nutrients and also help regulate appetite (Panarese et al, 2019). . 

Women with anorexia—the queens of fasting and intermittent fasting—are another great population to study the effects of low calorie diets and undereating on bowel habits. Studies overwhelmingly show that women with anorexia regularly experience slowed colonic transit and constipation, often going three to four days without going #2. However, upon commencing a regular, balanced eating schedule aids in stimulating regular bowel transit (Chun et al, 1997).  And, while calorie restriction may aid in weight loss, constipation is a common side effect, whereas those who follow a balanced diet and exercise plan, can experience the attainment of both a healthy weight and normal bowel function (Racette et al, 2006). 

Above all, eating a balanced diet is most important for curbing constipation. Even if you are eating enough, if you are not eating a balanced diet, eating emotionally or over consuming food, constipation may still be a conundrum. For example, studies show that patients with bulimia—often associated with binge episodes and insatiable appetite—equally have a high incidence of constipation, bloating and other gut symptoms as those who under-eat (Sato & Fukudo, 2015). And, a low veggie-filled diet—common in the Western world, where only 1 in 10 Americans consume the daily recommended amount (3 to 5 servings per day) is notoriously responsible for constipation (CDC, 2017). 

What this means for you? Whether you’re under-eating, over-eating, or simply not eating a balanced diet, constipation (and lack of appetite) can happen. 

Constipation Reason #6: Under-sleeping
Sleep is a panacea for all things health. On the other hand, disturbed sleep equals disturbed bowel functions (Gwee, 2011). 

Morning constipation is increased when the quality of sleep poor the night before (Goldsmith et al, 1993)–even after just one night of bad sleep (Jarret et al, 2000). And for those who sleep less than 7 hours per night, constipation risk is increased by 40% according to data from Digestive Disease Week (Staller, et al. Abstract Sa1711. Presented at: Digestive Disease Week; May 2-5, 2020; Chicago).

Constipation from sleep deprivation happens for a few reasons. 

For one sleep disrupts your circadian rhythms—body’s biological clock—as well as your autonomic nervous system, specifically in your enteric nerves (nerves in your gut) that signal to your brain how to regulate and control your bowels (Khanijowet al, 2015). The connection between the brain and the gastrointestinal system is imperative to the regulation of the digestive tract. Your migrating motor complexes (MMCs) in particular are the waves of electrical activity that move food through the gastrointestinal tract in a regular cycle—and are regulated by your brain and gut nerves. During sleep, the function of your migrating motor complex speeds up and works most efficiently, however, if you are short circuiting your sleep, you’re also short circuiting your gut. Additionally, REM sleep (deep sleep), is associated with increased colonic pressure—meaning the deeper you sleep, the better your bowels will work to create feces. 

Lastly, poorer sleep also yields greater changes in the physiological structure of your large intestine—specifically your rectum or your “rectal compliance.” Rectal compliance is the ability of your large bowel wall to stretch and contract upon pressure stimulus. Studies show that increased rectal compliance (a large intestine that is stretched and needs more pressure) is a contributing mechanism underlying constipation (Liu et al, 2011). The implication is that poor sleep may predispose a previously healthy individual to constipation.

Constipation Reason #7: Coffee Dependence
Coffee is a natural “bitter” and bile stimulator in your gallbladder. Bile is a substance created in the liver and gallbladder for the purposes of emulsifying fats and carrying toxins out in your feces. Drinking both caffeinated and decade coffee also spurs both colonic and gallbladder contraction and elevates levels of cholecystokinin, a hormone that stimulates bile flow (Godos et al, 2017; Rao, 1998). 

However, if you start depending on coffee to go #2 (and find that you can’t really go to the bathroom unless you have it), then, Houston, we have a problem. Frequent consumption and high intakes of coffee can train your gut to “depend” on coffee as a stimulant laxative—a trigger for your intestines to contract and push out stool. The more coffee you consume, or more you begin to depend on coffee to go #2, the less your intestines have to work on their own to contract and push out stool on their own. This “conundrum” is similar to how folks with metabolic syndrome or hypo-hyperglycemia episodes can “train” your blood sugar levels and gut microbiome to depend on sugar, carbohydrates or other foods that you frequently eat—and how you may feel “off” if you don’t have them (Garg et al, 1992). 

Coffee, namely instant coffee, may also be cross-contaminated with gluten and mycotoxins. Gluten, mycotoxins and gut problems (both IBS and constipation) often go hand in hand (Vojdani & Trash, 2012; Shariff et al, 2017; Garcia-Moreleja et al, 2015). 

Constipation Reason #8: The (Birth Control) Pill
Your gut microbiome is your largest endocrine (hormone) organ. The gut microbiota regulates estrogens specifically through secretion of β-glucuronidase, an enzyme that turns estrogens into their active forms. If this process is impaired however through synthetic hormone use (birth control pill), this results in both a reduction of your body’s natural circulating estrogens and dysbiosis—throwing off your gut’s natural functions and job as a hormone balancer (Baker et al, 2017). Increased synthetic estrogen has also been shown to decrease GI motility and “bulk” in stool as well—making it slower and harder to have a bowel movement (Oh et al, 2013).

So Should You Eat if You’re Constipated?

The short answer: Yes.

Regular, balanced meals, in conjunction with a healing your gut, is the best bet for helping your body heal from GI “issues” over time.

Additionally, although you may not always feel like eating in your gut (such as a growling or an empty stomach), it’s also important to recognize other signs of hunger that can help point you to nourishing your body (even if you’re apathetic to the thought of food).

Common “hunger” cues beyond a tummy growl include: 

• Fatigue or sleepiness

• Increased thoughts about food, especially around meal times

• Mental or physical sluggishness

• Difficulty focusing, remembering or concentrating

• Shakiness

• Headaches or brain fog

• Feeling weepy or emotional

• Anxious thoughts 

• Chewing on objects (pencil, hair, ice)

• Drinking carbonated beverages, coffee or chewing gum (note: carbonation can also make you feel more bloated and constipated)

6 Constipation Meal Ideas: Simple Sips & Little Bites

If you’re constipated and not feeling up to eating 3 full meals per day, but know you still need to nourish yourself and keep a balanced in your diet, I often recommend a “simple sip” or “little bite” as one of your meals. Aim to consume at least two balanced meals per day, and a liquid-based or easy-to-digest snack somewhere in there as well. Here are 6 ideas: 

• Low Histamine Meat Broth 

• Gut Love Smoothie

• Gut Love Coffee

• Simple Chicken Salad

• Protein & Greens

• Gut Love Parfait

RECIPES (RECIPE POSTS TO LINK)

Low Histamine Meat Broth
Ingredients

• Boneless Skinless Chicken Breasts*
• Boneless Skinless Chicken Thighs*
• Fresh Herbs or Spices of choice (rosemary, thyme, sage, basil, oregano, parsley, ginger, majoram, etc.)
• Sea salt, generous pinch or two
• Filtered Water, 8 cups
• Add-ins (optional)
  • • collagen peptides 
    • Extra sea salt 
    • ghee or MCT oil

Directions

1. Fill up a pot with 8 cups of water
2. Place the chicken breasts and thighs in the pot
3. Put whatever herbs you have on hand in the pot. There is no precise measurement.
4. Cook on the stove on a low simmer, uncovered for an hour and a half. Let cool
5. Skim the fat off the top if you did not use organic chicken
6. Strain
7. Store in the fridge up to five days. If you don’t use it in five days, store it in the freezer for up to six months.

*Note: You can also use pre-made quality bone broth or make beef broth using 2-3 lbs boneless grass-fed chuck roast. For beef broth: Heat oil in a large pot or Dutch oven over medium-high heat. Place the roast in the pot, and quickly brown on all sides. Then, fill a pot with enough water to cover the roast. Add in onion, garlic, celery, basil, salt and pepper. Bring to a boil, then reduce heat to low and simmer for 2 hours and 15 minutes, adding water if needed to keep the roast covered. 

Gut Love Smoothie
Ingredients

• 1 cup kefir, unsweetened coconut milk, almond milk or water
• 1 scoop quality paleo beef protein or grass-fed whey
• organic kale, baby greens, mesclun or arugula, frozen or fresh
• 1/2 green tipped banana 
• 1 heaping spoonful sunflower seed butter 
• 1 tbsp MCT oil
• Himalayan sea salt, sprinkle
• Add-ins (optional)
  • • crushed ice (makes it thicker)
    • colostrum powder
    • collagen peptides
    • ginger
    • vanilla extract, alcohol free
    • cinnamon

Directions

1. Add all ingredients to your blender
2. Blend on high
3. Drink up

Gut Love “Coffee”
Ingredients

• 16 oz Rooibos tea or cacao “coffee”
• 1 scoop quality paleo beef protein or grass-fed whey or collagen peptides
• 1 tbsp MCT oil
• cinnamon
• Himalayan pink sea salt, pinch
• vanilla extract, alcohol free

Directions

1. Add all ingredients to your blender
2. Blend on high
3. Drink up

Chicken Salad
Organic pulled chicken or canned wild tuna + heaping spoonful avocado mayo + fresh dill + sea salt + side roasted summer squash

Ingredients

• 1 cup shredded chicken or canned organic chicken, wild caught tuna or salmon
• 1 heaping spoonful avocado mayo 
• fresh dill 
• sea salt
• seaweed, romaine or collard green lettuce wrap
• Add-ins (optional)
  • • diced grapes or apples
    • cucumber
    • celery

Directions

1. Add all ingredients together
2. Roll in a lettuce wrap
3. Bon apetite

Crispy Chicken Thighs & Sautéed Greens
Ingredients

• 1-2 lbs. boneless skinless chicken thighs* (*may also use wild caught salmon or halibut)
• 2 tbsp coconut aminos
• Herbs of choice (I like AIP Powder: garlic, sea salt, basil, oregano, sage)
• 1 head greens of choice (chard, kale, collards) 
• ghee
• sea salt
• 1/2 cup bone broth or filtered water

Directions

1. Heat oven to 400 degrees
2. Season chicken (or fish) with coconut aminos, pinch of sea salt and herbs of choice and place in a coconut or olive oil oil greased oven safe baking dish
3. Bake for 45-50 minutes (until no longer pink). (If cooking fish, bake for 15-18 minutes)
4. Heat spoonful of ghee in sauté pan. 
5. Wash and shred greens off stems. Add to pan.
6. Season with sea salt to taste. 
7. Add a splash of water or bone broth
8. Cover and sauté for 5-7 minutes; stirring occasionally. 

Gut Love Parfait
Ingredients

• coconut yogurt or plain grass-fed organic yogurt  

• Sliced green tipped banana, diced green apples or handful berries

• raw macadamia nuts, pumpkin seeds or heaping spoonful sunflower seed butter

• cinnamon

• Vanilla extract, alcohol free

• Optional :pinch manuka honey 

Directions
Mix all ingredients together. Enjoy. 

5 Essentials to Hack Constipation

Healing from chronic constipation in order to simulate your appetite again is not a one-size-fits-all-approach. However, here are a few starting points to address constipation so you can get your appetite back to eat enough. 

Constipation Hack #1: Digestive Bitters with Meals
1 to 2 drops with meals helps stimulate bile curation, enzyme production and elimination.
Recommendation: Iberogast

Constipation Hack #2: Swig Apple Cider Vinegar
Boost stomach acid and enzyme production to get your bowels flowing.
Tip: Combine 1 tbsp apple cider vinegar with 4-8 oz filtered water and 1 tsp manuka honey, if needed. Drink before or after meals. 

Constipation Hack #3: Stand Up

Take standing and walking breaks every 1 to 2 hours to keep your bowels from becoming stagnant during the day. Exercise or stay active daily—without overdoing it. Find your sweet spot 30-60 minutes of some sort of activity (walking, group fitness, weights, running, cycling, swimming, dancing, yoga, etc.) . Rebounding (jumping up and down in place) for 2 to 3 minutes, as if you were jumping rope or better, on a mini trampoline, can help jostle up constipated bowel movements. Also, when you’re trying to go #2, avoid hunching over—this constricts your bowel. Instead sit up straight, prop your feet up onto a step stool or squatty potty, and raise your hands over your head as if you were on a roller coaster to lengthen your torso. 

Constipation Hack #4: Colonic Massage (Assist Your Body for Better Digestion)
When you’re feeling stuck down there, kneed and massage your colon in a counter clockwise fashion. Start at your right hip bone and kneed up to right under your right rib cage, then move straight over to the left side, then down on the left side towards the left hip bone. Repeat. You can also try some “manuevering” with down dogs, up dogs, table top (all fours) and child’s pose yoga poses, as well as left side lying with knees tucked in the fetal position can further facilitate digestion. Sleeping on your left side lets gravity help waste get from the small intestine to the large intestine. The ileocecal valve separates the small and large intestines and sits on the lower right side of the body. By giving the ileocecal valve some room to move, waste can travel more freely and potentially reduce a number of digestive difficulties.

Constipation Hack #5: Chew, Sautee, Cook, Steam
Chew your food really well—until fully liquified. Cook, stew, sautee, steam, puree, blend your veggies and meats (crockpot, slow cook, shred meats) to aid in digestion.