Constipation

When Things Stop Moving

Constipation is one of the most common complaints we see and one of the most dismissed. It is rarely just about fiber. Slow, infrequent, or difficult bowel movements are the body telling you that something upstream — motility, hydration, the nervous system, the microbiome, the thyroid, or the muscles of the pelvic floor — is not doing its job.

This is the GoodMedizen lens. The body is not malfunctioning. It is responding accurately to the information it is being given. Change the inputs and the response begins to change with them.

What Constipation Actually Is

Clinically it is defined as fewer than three bowel movements a week, or stools that are hard, difficult, or incomplete. The number that matters to us, though, is your number. Daily, complete elimination is the goal, and going every few days is not normal even when it is common. Constipation is a symptom, not a diagnosis, and the work is finding what is slowing the system.

The bowels are the body’s primary exit. When they are not moving, everything the body is trying to clear — hormones, metabolic waste, the products of detoxification — backs up. This is why we open the exits before any deeper detox work; pushing toxins into a body that cannot eliminate them only makes people feel worse.

What Is Actually Driving It

• Low motility from a stressed, “fight or flight” nervous system that shuts digestion down
• Dehydration and inadequate or poorly matched fiber
• An underactive thyroid, a classic and frequently missed cause
• Gut dysbiosis and low microbial diversity, including methane-predominant patterns
• Magnesium and other nutrient insufficiencies
• Medications, including opioids, iron, and some antidepressants
• Pelvic floor dysfunction, where the muscles fail to coordinate the release
• Low stomach acid and sluggish bile flow upstream

Why It Gets Brushed Off

Most people are handed fiber and a laxative and sent on their way. That can manage the symptom while leaving the cause untouched, and long-term laxative use can weaken the very motility it is meant to help.

Signs and Patterns

• Fewer than one comfortable, complete bowel movement a day
• Hard, dry, or pellet-like stools
• Straining, or a sense of incomplete emptying
• Bloating and abdominal discomfort
• Going several days between movements
• Relying on laxatives, magnesium, or coffee to go at all

How We Look at It — The Testing

• Thyroid — a full panel with antibodies, since an underactive thyroid slows the gut, and we often see symptoms at a TSH as low as 1.75
• The gut — GI-MAP through Diagnostic Solutions, to see the microbiome, low-diversity or methane-predominant patterns, and markers of digestion and inflammation
• Foundational — RBC magnesium, a comprehensive metabolic panel with GGT (bile and liver clearance matter for elimination), 25-OH vitamin D around 60 to 70, a complete iron and ferritin profile, and a CBC with differential
• Where relevant — fasting glucose and HbA1c, since blood sugar and nerve function influence motility

Broad baseline labs do not have to be expensive. Services such as Function Health let patients obtain large workups affordably, and we have no financial stake in that — we would rather your budget go toward care than toward lab markups. For targeted functional testing we order through Diagnostic Solutions (GI-MAP) for the microbiome, Quicksilver Scientific for heavy metals, and through Fullscript where it serves you best, with every marker read against optimal ranges rather than the wide line between “normal” and “abnormal.”

The Chinese Medicine Lens

Chinese medicine reads constipation through several distinct patterns, and the treatment changes entirely depending on which is present. There is a heat pattern, with dry, hard stools and a body that runs warm; a qi-stagnation pattern, where stress and tension lock the bowels; a qi-deficiency pattern, where there is simply not enough force to move things along; and a cold or fluid-deficiency pattern, common with age, where the intestines lack the moisture and warmth to function.

Naming the pattern is what makes treatment effective. Moistening a dry bowel, moving a stagnant one, and warming and strengthening a depleted one are very different interventions.

How Acupuncture and Functional Medicine Help

Acupuncture shifts the nervous system out of the stress state that shuts digestion down, stimulates motility, and is used along the abdomen and key points to encourage the bowels to move on their own.

The functional work restores hydration and the right fiber, addresses the thyroid, rebuilds the microbiome, repletes magnesium, and supports stomach acid and bile upstream, retraining motility rather than overriding it. This is foundational groundwork — opening the exits — and it is the first step of the GoodMedizen pathway for nearly everyone.

Care That Works With Your Other Providers

For stubborn or sudden constipation, especially with red-flag signs such as blood, unexplained weight loss, or a sharp change in habits, evaluation by your physician comes first, and we coordinate and support alongside it.

Your Body Isn’t Broken

If you have spent years being told your labs look normal while you clearly do not feel normal, you have not been imagining it. With constipation, the work is to find and fix the signal that stopped the system, not to keep forcing it. Your body is not broken. The support has just been missing.

At GoodMedizen in downtown Seattle, we treat the system driving the condition, not only the symptoms it produces.