Constipation Management with Supplements

Many people wonder how dietary supplements can help with constipation. This video by Kelli Borgman, RD, consultant for the Vermont Continence Project describes the role of supplements in treating chronic constipation in children.

A full transcript of the video appears below.

Hello, I’m Kelli Borgman, a dietician consultant with the Vermont Continence Project. In this video, I’ll go over some basic options and information about common supplements used for constipation management. There are so many supplements marketed for GI Health and constipation these days. Of course, talk to your doctor or medical specialist about starting any supplement to make sure the timing is right and the dose is optimal for the stage of treatment your child is in.

Many supplement labels warn against using pediatric products with toddler and preschool-aged kids. If it’s really indicated or you would like to use supplements with your younger children, your medical team should be able to tell you if it’s safe for your younger child in particular. With your team’s support, you’d likely decrease the dose or frequency based on their smaller size or personalize the dose based on a medical condition.

Keep in mind the quality of supplements is critical for a good result. Because of the lack of regulation in the industry, cheaper supplements can have fillers, be contaminated, or not contain the product it says it does on the label. Buy from a company that’s transparent in their sourcing. Many reputable brands post third party testing data, or what quality assurance programs they participate in. You can also bring your supplements or ideas to your medical visits and ask your healthcare professional to check them out.

When you start thinking about constipation supplements, many times we start with fiber, which creates softer, easier to pass stools. It’s a good choice if a variety or quantity of higher fiber foods is a day-to-day struggle for your child. If you have a more selective eater and feel it will take six months or longer to make meaningful changes in their diet, absolutely consider a fiber supplement to fill in the gap for those six months, at least.

When you’re looking at supplements, there are many good options. Some are more highly processed themselves and will dissolve more easily in water, and others are more whole foods-based, where the texture and color can significantly change whatever food or drink you’re putting them into. You really want to look at how many grams are in a serving. Does it meet a significant enough amount to meet their needs compared to how much fiber they’re getting through their diet? This gives you a sense also if the fiber supplement you’re looking at is worth adding to their daily routine. When dosing a supplement, keep in mind the amount they can realistically tolerate. You can start with smaller amounts to test it out. Somewhere in the range of three to five grams per day might be a starting place.

Though many types of fiber supplements work, psyllium husk is a popular option because of its unique properties. It absorbs water really well. It’s also resistant to gut bacteria digesting and fermenting it, so it stays intact and functional all the way through the GI tract. That also means less gas in general, which is especially important for kids with bowel sensitivity or discomfort.

Probiotics temporarily support the gut if overall balance of good to bad bacteria is an issue or total populations of microbes are low, which is often related to antibiotic and medication use. When probiotic bacteria digest food, the byproducts they poop out include nutrients like B vitamins and easy to absorb fatty acids, which feed and support the intestinal lining, as well as get absorbed to be used by the entire body. Probiotic supplements will not change the balance of microbes permanently. Dietary and lifestyle factors, long-term fiber intake, and regular physical activity are needed to support the helpful microbes to stick around. Many strains of probiotics have also been shown to have positive immune boosting effects. It’s amazing to think that 70% of the immune system is found in our digestive tract. In addition, there are direct communication pathways between the gut and the brain via the nervous system, so the overall balance and amount of bacteria can affect the signaling and strength of communication to the brain. Research shows that gut bacteria even affect mood and cognition.

Prebiotics are types of fibers that work to give a home and fuel for helpful microorganisms in the gut, which also decreases unhealthier populations of microbes, and they’ve been shown to be anti-inflammatory. If you see the word symbiotic in a label, it simply means a mix of pre and probiotics. Overall, they can have beneficial, synergistic, whole body effects for a constipated child with immune or mood challenges. The limitation is that this is a long-term approach and should generally be used alongside other foundational supports for GI Health.

There are many other supplements that can be used and are very effective, but as I said earlier, quality matters and timing is crucial. Layering these supplements on top of medications that have similar effects like prescribed laxatives can be counterproductive. Herb formulations include herbs like burdock, yellow dock, dandelion, and fennel, and have a stimulant laxative type effect.

Vitamin C and magnesium are vitamins and minerals that can act as laxatives and also be a great option to consider. The cons to magnesium is that there is an upper limit of safety for children and adults as some of it’s absorbed into the system, so keep in mind what kids are getting from their food sources. Talk to your child’s provider if you need help choosing a type of magnesium in order to balance what they’re already getting from their diet. The scientific name for vitamin C is ascorbic acid. Having adequate vitamin C in your diet and through supplements helps aid digestion and promotes a healthy immune system barrier in the gut. While there’s little chance of overdose due to its water solubility, meaning whatever your body doesn’t need it can dump into urine and get rid of. If your child struggles with reflux or has a history of reflux, larger doses could increase reflux symptoms.

Thank you for taking the time to watch this. The information contained in this video is for informational purposes only. It is not a substitute for professional health or medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider.