We know that diets high in fiber can help patients struggling with constipation. Fiber, defined as a non-digestible substance, enters the GI tract and passes through – the fiber is not absorbed and minimally changed. The nonabsorbed and minimally changed fiber helps bulk your stool and stimulate bowel movements.
Patients have been searching the web and asking me about how they can increase their fiber intake and be less constipated. In addition to eating fruits, vegetables, and legumes, patients are wondering if there are natural herbs, High Fiber Herbs, that will help them have bowel movements, offering Constipation Relief.
Below is a list of herbs that are High in Fiber and Low in Calorie, having greater than 5% fiber in each calorie. Serving size for all is 1 tablespoon of herb.
List: Top herbs that are high in fiber and low in calories
| Herbs | Fiber per Calorie (%) | Calories (kCal) | Fiber (grams) |
| Savory | 17% | 12 | 2.0 |
| Oregano | 16% | 14 | 2.3 |
| Basil | 15% | 11 | 1.7 |
| Marjoram | 14% | 5 | 0.7 |
| Thyme | 13% | 12 | 1.6 |
| Rosemary | 13% | 11 | 1.4 |
| Sage | 13% | 6 | 0.8 |
| Peppermint | 10% | 1 | 0.1 |
| Spearmint | 10% | 5 | 0.5 |
| Parsley | 8% | 5 | 0.4 |
| Bay leaf | 8% | 6 | 0.5 |
*calories are rounded to the nearest whole calorie
*fiber is rounded to the nearest tenths
In addition to the list above, patients have asked to learn about the following herbs in particular:
- Senna
- Cascara Sagrada
- Ashwagandha
- Triphala
- Slippery Elm
Let me break these down for you:
Senna and Cascara Sagrada
These are anthraquinone based herbal stimulant laxatives. These stimulant laxatives cause bowel contractions through acting on nerves in the smooth muscle lining the bowel. The anthraquinone component may soften stool and cause bowel contractions by reducing reabsorption of water from the bowel lumen. Stimulant laxatives are not always well tolerated – common reasons patients stop taking these laxatives include too much stimulation (diarrhea) and or cramping abdominal pain.
Senna is currently recommended as a short term treatment for constipation – take four weeks or less. Limited data suggests that when regularly used, Senna may cause problems, including but not limited to melanosis coli (change in the color of your colon), inflammation of the liver, and possibly bowel tolerance (more senna is needed to produce the same effect).
Cascara sagrada is not recommended at this time because of the increased reports of hepatotoxicity.
Based on the current research findings, I recommend against the use of Cascara Sagrada. I recommend only consuming Senna as needed for constipation for short periods of time – no more than 4 weeks – and try to avoid this medication if you have a history of liver disease!
Ashwagandha (Withania somnifera)
Ashwagandha is a high fiber herb that has been historically consumed to improve many human problems, including constipation. To date, there is not much data on how this herb directly acts on the intestines to improve constipation. However, there is some data, suggesting that Ashwagandha root extract (600 mg daily) can positively affect the thyroid, and patients struggling with thyroid problems can experience constipation. In other words, if you have a thyroid problem causing your constipation, then Ashwagandha may help you improve your thyroid problem, which then helps you improve your constipation. Ultimately, the data on Ashwagandha is limited, but you could try Ashwagandha for a couple weeks and see if your bowel movements improve. If you find yourself feeling worse or experience no improvement while taking Ashwagandha, then I would recommend stopping consumption. Of note, Ashwagandha is contraindicated in patients with hormone-sensitive cancer, patients taking sedating medications such as anxiety or seizure medications, and pregnant women.
Triphala
Triphala contains fiber and consists of dried fruits from three herbal plants. Studies suggest that Triphala can improve bowel movement caliber, size and frequency in patients with constipation. The exact mechanism of action is unclear. In these trials there were no significant adverse reactions noted. Therefore, it seems reasonable to try Triphala for a couple weeks if struggling with constipation. Of note, Triphala may increase the risk of side effects from drugs that are metabolized by certain pathways, so it is important that prior to trying Triphala you to check with us through an online consultation or the provider prescribing your medications if Triphala will affect your prescribed medications. If you find yourself feeling worse or experience no improvement while taking Triphala, then I would recommend stopping consumption rather than just continuing.
Slippery Elm
Patients often are interested in trying Slippery Elm, an herb native to North America. Slippery Elm contains fiber that is thought to improve bowel movements by bulking the stool. Slippery Elm may also improve bowel movements through increased mucin production. The data on Slippery Elm is very limited, and studies to date evaluate Slippery Elm in combination with other products rather than by itself. Overall though, it appears that Slippery Elm in combination with other products can improve constipation and or diarrhea symptoms. Because of such limited data, I would use Slippery Elm cautiously, and if the bowel movements fail to improve or worsen, then I would simply stop consuming Slippery Elm.
At this point, you may be on information overload, or you may be wondering about herbal teas. Well, let’s put the tea on pause and come back to it in another blog.
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– Dr. Nicole
