In last week’s post, I covered the first five steps you should take to avoid constipation without resorting to laxatives.

This week, we’ll dig a little deeper into the problem. Because sometimes, adding more fiber or drinking plenty of water just isn’t enough.

STEP 5: Have your thyroid checked

In addition to constipation, do you have cold hands and feet? Are you usually cold when everyone else in the room is comfortable? Are you tired or sluggish all the time, even after getting an adequate night’s rest? Do you gain weight easily? If any of these symptoms sound familiar, you may consider having your thyroid checked.

I’d start out with a routine blood test. But here’s a fair warning: they aren’t always accurate and can’t always detect a slightly underperforming thyroid.

If you have all the symptoms listed above and your blood test comes back normal, consider temperature testing at home. Test your temperature upon waking up each morning for five days. Keep very still while taking your temperature, as even modest activity can elevate your reading.

If you consistently get readings below 97.6 degrees, you may have an underactive thyroid and it’s probably what’s causing your bowels to stay sluggish. I suggest reading Broda Barnes’ book, Hyperthyroidism: The Unsuspected Illness. There are lots of steps you can take to correct an underactive thyroid, without resorting to thyroid medication.

STEP 6: Uncover hidden food allergies

Hidden food allergies can slow down or speed up peristalsis (the wave-like motion of your bowel). The most common food allergies are dairy, wheat, corn, soy, peanuts, egg, and artificial additives (like coloring and preservatives).

You can confirm a suspected food allergy by getting a standard skin prick test from your allergist. But, again, these tests aren’t infallible. If you suspect a food allergy, I suggest starting an elimination diet. Pick one type of food you think may be causing your problems and eliminate it for at least seven days (up to 21 days for dairy allergies). If you feel worse over the first few days, you know you’re on the right track.

And remember, it’s possible that you can be allergic to milk, but not to cream cheese and yogurt. Just be patient and analyze your symptoms carefully. Also, it’s possible that after quitting a problem food group, you can add it back in, just in smaller doses, such as once a week versus every day.

STEP 7: Skip the laxatives

For those of you who need quick relief, don’t resort to laxatives. These products, when used repeatedly, can actually damage the nerve cells in your colon. Before you know it you can’t have a bowel movement without taking a laxative!

On the upside, there are lots of foods that naturally promote healthy bowel movements. First off, I’d try adding these foods to your diet: bran, bananas, prunes (or prune juice), pears, grapes, kale, licorice, almonds, and olive oil. Also, try sprinkling Salba seeds on your morning oatmeal. These tasteless, odorless seeds have more fiber than flax seeds. Plus, they’re also rich omega-3s fatty acids and antioxidants. You can learn more about Salba here.

Magnesium is another natural laxative. Start with 500 milligrams (mg) at bedtime. If that doesn’t do the trick, take two 500 mg capsules the next night.

Aloe vera is another natural product that I’d recommend. It will help loosen your bowels and keep things moving. Drink ½ a cup of aloe vera juice in the morning and night. You can mix it with a nice cup of herbal tea if you wish.

STEP 8: Take a look at calcium

As far fetched as it sounds, it could be that you’re getting too much calcium. Especially if you’re taking a calcium supplement as well as several antacids a day that contain calcium. I’d suggest getting rid of the antacid. I’m against them anyway, as they reduce the beneficial acidity in your stomach.

STEP 9: Gently cleanse your colon

If you’ve tried steps 1-8 and still haven’t gotten results, I’d recommend you try a 24-hour fast. Here’s a technique that I’ve found is the easiest to stick with: Have a light dinner at 5 p.m. then begin your fast. Drink all the clear liquids you wish. Continue fasting until 5 p.m. the next day. This way, you’re skipping fewer meals and falling asleep with a full stomach at the end of the 24 hours.

If a 24-hour fast is too difficult, try restricting meat and dairy for several days. Both these techniques will give your colon the opportunity to “rest” and gently clear itself.

A more serious approach is a bona fide colon cleanse program with vitamin C. It’s the healthiest and gentlest way I’ve found to cleanse your colon. Take four to eight grams orally of vitamin C per hour. Continue this until reaching bowel tolerance (painless diarrhea). This clears out the bowel and ends constipation simultaneously.

Once you’ve completed the colon cleanse or fast, reintroduce foods high in fiber. And continue with a diet high in fiber with adequate water intake. Also, make sure you keep moving! Take a 20 minute stroll after dinner.

Also, replenish your gut with a healthy dose of prebiotics (like FOS). Prebiotics are carbohydrates that promote the growth and activity of healthy bacteria in your gut. Also, keep up with your regimen of probiotics (such as acidophilus) before meals.

Do all this and you’ll conquer even the toughest long-term or chronic constipation!

STEP 10: Medical testing

Fortunately, most cases I come across resolve by consistently following steps 1 through 9.

However, if you’ve done that and haven’t gotten lasting results, I’d recommend seeking professional help. You may need to get some testing to see if there is a medical explanation for what’s been going on with your bowel.

In closing, remember that moving your bowels every day is a sign of good health. Anything less than that’s a red flag signaling something’s wrong with your diet. Re-read last week’s post for 5 steps you can take to curb constipation and prevent more serious bowel problems before they arise.

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