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Constipation
Constipation involves more than fibre. Bowel regularity depends on gut motility, hydration, thyroid function, hormones, the nervous system, and pelvic floor coordination, and when it becomes chronic these are worth assessing together. We work to identify what is slowing things down and restore comfortable, regular bowel function without relying on laxatives long term.
Constipation symptoms: is your body telling you something?
Most people think of constipation as infrequent bowel movements, but it also includes straining, hard stools, a sense of incomplete emptying, or needing increasing amounts of fibre or laxatives to stay regular. Fewer than three bowel movements per week is the clinical definition, though many people with daily movements still struggle with the other symptoms.
Constipation deserves proper assessment when it persists, because the digestive tract rarely slows down without a reason. The cause is sometimes simple. Often it involves several overlapping factors that each need attention.
You may benefit from an assessment if you experience:
- Fewer than three bowel movements per week
- Straining or hard, dry stools
- A feeling of incomplete emptying
- Bloating or abdominal discomfort between movements
- Alternating constipation and loose stools
- Reliance on laxatives, coffee or supplements to stay regular
- Constipation that worsens before your period
- Symptoms persisting despite more fibre and water
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2 to 3x
What causes constipation?
Gut Motility
The muscles of the digestive tract move stool along through coordinated contractions. When this rhythm slows, transit time lengthens, stools become harder and constipation follows.
Thyroid Function
Low thyroid function slows many body processes, including digestion. Constipation is one of the more common and more overlooked symptoms of an underactive thyroid.
Hormonal Fluctuations
Progesterone naturally slows gut transit, which is why many women notice constipation in the second half of their cycle or during pregnancy.
Pelvic Floor Coordination
Emptying the bowel requires pelvic floor muscles to relax at the right moment. When they don't coordinate well, stool can be difficult to pass even when it reaches the rectum normally.
Diet, Hydration and Routine
Fibre intake, fluid, movement, stress and even ignoring the urge to go all influence bowel habits. These fundamentals matter, but when they've been addressed and symptoms persist, something else is usually involved.
How is constipation tested?
Assessment starts with a detailed history: your bowel patterns, stool form, diet, fluid intake, medications, supplements, thyroid symptoms, menstrual cycle and what you've already tried. This often narrows the likely contributors considerably before any testing is discussed.
Where appropriate, we may recommend thyroid testing, iron studies or other bloodwork, and we screen carefully for signs that warrant referral for medical investigation, such as bleeding, unexplained weight loss or a sudden change in bowel habits.
How is constipation treated?
Constipation isn’t always a “just eat more fibre” problem. Effective treatment starts by understanding what’s contributing whether that’s diet, gut function, stress, hormones, thyroid health, medications, or pelvic floor coordination.
Your plan may include practical nutrition changes, targeted supplements when appropriate, strategies to support regular bowel habits, and collaboration with pelvic floor physiotherapy if muscle coordination is part of the picture.
How Somewhere Health helps
Care starts with the bigger picture rather than a single test. If you've already been diagnosed, we build on what you know. If you suspect something deeper but have never had a full workup, we can order the testing that gets you clear answers.
Your first visit is 75 minutes with a licensed naturopathic doctor who has reviewed your full intake. Together you'll create a plan that may include nutrition and lifestyle changes, targeted supplementation, and functional testing where appropriate. Bloodwork happens at any LifeLabs or Dynacare, and specialty panels like the DUTCH test ship to your door.
Appointments are completely virtual, so you can access care from anywhere in Ontario, and visits are covered by most extended health benefits plans.
Our Approach
- Nutrition and dietary guidance
- Lifestyle recommendations
- Stress and sleep support
- Targeted supplementation
- Functional or laboratory testing when appropriate
- Ongoing monitoring and treatment adjustments
- Collaborative care with your broader healthcare team when needed
How it Works
Dr. Courtney Ranieri is a licensed naturopathic doctor with Therapeutic Prescribing authorization, in practice since 2018. She holds a Doctor of Naturopathic Medicine from the Canadian College of Naturopathic Medicine and an Honours BSc from Western University, and her clinical focus is women's health: hormones, fertility, digestion, pelvic floor and metabolic care. She sees patients across Ontario virtually.
