05/16/2013 11:00 am ET Updated Jul 16, 2013

Constipation 101, Part II: You, Improved!

Constipation can be due to a wide range of issues: stress (remember the fight, flight, or freeze response? When you are busy being stressed out, your digestive system will shut down), not enough water, not enough fiber, too much of a food you have an allergy to (knowingly or unknowingly), or overgrowth of harmful bacteria or Candida in the gut -- both of which may lead to lowered intestinal motility and slower processing of waste.

I can't tell you how many people ask me how much water they should drink every day. The guideline I use is to take your weight in pounds and divide it in half. This number is the approximate number of ounces you should aim for; however, this number doesn't include exercise, which typically calls for an additional 8-24 ounces, depending on the intensity of your workout.

Identifying a food you react to can be more challenging, since it's possible to have reactions that occur one to two days after eating something. In addition, when we eat a food frequently, we often cannot recognize the symptoms it causes, since we're too used to them to identify them. The most common food groups that constipate individuals are dairy products, products containing gluten, and processed carbohydrates (e.g., cake, candy, cookies, pasta, breads, and cereals). For example, you may note that when you've eaten these foods for days on end, you're more constipated; you're probably right to question whether you are reacting to them.

There are a number of nutritional supplements that can help with constipation through various mechanisms. Some increase the water content of your gut, others increase the bulk of the stool, thereby helping it pass, and still others help increase the motility of the gut, helping move things along. I often get asked why I'm not more specific in these posts. It's because your needs differ from the person next to you. Assuming you both have the same needs is exactly the problem with "modern medicine," which assumes we all process things exactly alike! During a functional medicine evaluation, how you work and your body's specific needs are front and center, and we don't assume you react the same way as your neighbor.

Next, let's talk about veggies. Vegetables contain fiber, water content, antioxidants, and are fantastic for improving constipation. The current guidelines recommend 3-5 servings a day of vegetables. However, let's look at what I mean by vegetables. Vegetables often have color to them: purple or yellow beets, green broccoli, red or green kale, Swiss chard, purple potatoes, sweet orange potatoes, orange carrots. They are pretty and can be eaten raw, sautéed, baked, or ground up. (Deep fried and slivered french fries do NOT count as a vegetable.) Fruits are nice but don't count toward the daily five! Lettuce isn't bad, but also doesn't count for our purposes, since, while its water content is great, its fiber content is terrible. One cup of iceberg lettuce contains 0.8 grams of fiber. The recommended daily intake of fiber for women (this is age-dependent) is approximately 25 grams. So, you'd have to eat over 30 cups of lettuce to get close to what you need. In contrast, 3/4 cup of broccoli has 7 grams. And, 1/2 cup of black beans has 9.5 grams.

Lastly, we come back to the thing I discuss the most: stress reduction. It's important to tell your body every day that it's safe to get back to its digestive, restorative and restful work. Make sure you take time every day to relax, restore and rejuvenate. Because your digestion hinges on quieting the fight or flight response, if you do this, your gut will thank you! Next week, we'll talk about breast cancer, hormones and prevention.

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