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Dr. Shustina is an incredibly knowledgeable doctor who truly takes time to find root cause.
RG
Rochel Gordon
Condition · Gastrointestinal
Chronic Constipation
Infrequent bowel movements, persistent straining, and that uncomfortable feeling of incomplete evacuation aren't just minor inconveniences—they're signs of a complex digestive disorder affecting 10-20% of people worldwide, with significant impact on quality of life and overall health. Research shows that most people struggling with constipation are prescribed laxatives without proper investigation into root causes, leading to ongoing dependence without addressing the underlying dysfunction. Our comprehensive approach identifies and treats the true mechanisms driving your constipation for lasting relief and optimal digestive function. Many digestive disorders are caused by incorrect nutritional choices, suboptimal lifestyle factors, chronic stress, and unresolved childhood experiences.
What Exactly Is Chronic Constipation?
Chronic constipation is a symptom-based disorder characterized by unsatisfactory defecation, including infrequent bowel movements (fewer than three per week), difficulty passing stools, hard or lumpy stools, straining, or feeling of incomplete evacuation. Rather than a single condition, constipation represents dysfunction in the complex process of defecation, which involves coordinated activity of the colon, pelvic floor muscles, and nervous system. Effective treatment requires identifying the specific type and underlying causes—whether related to slow transit, pelvic floor dysfunction, or combined mechanisms—rather than simply masking symptoms with laxatives.
Types of Constipation and Their Characteristics
Constipation can be categorized based on underlying mechanisms, each requiring specific diagnostic approaches and targeted treatment strategies for optimal outcomes.
| Type | Primary Mechanism | Common Symptoms | Considerations |
|---|---|---|---|
| Slow Transit Constipation | Delayed colonic motility (dysmotility) | Infrequent bowel movements, bloating, feeling of fullness | Often requires prokinetic agents and gut motility support |
| Dyssynergic Defecation (Pelvic Floor Dysfunction) | Inability to coordinate pelvic floor muscles during defecation | Excessive straining, incomplete evacuation, need for manual maneuvers | Responds best to biofeedback therapy and pelvic floor rehabilitation |
| Normal Transit Constipation | Functional disorder with normal colonic transit | Hard stools, difficulty evacuating, abdominal discomfort | Often related to dietary factors, dehydration, or lifestyle issues |
| Combination Approaches | Combination of slow transit and outlet dysfunction | Variable symptoms, poor response to single treatments | Requires comprehensive approach addressing multiple mechanisms |
Why Constipation Impacts More Than Digestion
Chronic constipation creates systemic effects throughout the body due to prolonged retention of waste products, bacterial imbalances, and the interconnected nature of gut health. When waste remains in the colon too long, it can lead to increased absorption of toxins, altered gut microbiome composition, and chronic inflammation that affects brain function, immune health, and energy levels. Additionally, the straining and pressure associated with constipation can contribute to pelvic floor dysfunction, hemorrhoids, and urinary issues, while the chronic stress of dealing with unpredictable bowel function impacts sleep, mood, and overall quality of life.
Common Signs of Chronic Constipation Include:
Infrequent bowel movements (fewer than three per week)
Difficulty passing stools or excessive straining
Hard, lumpy, or pellet-like stools
Feeling of incomplete bowel evacuation
Need to use manual maneuvers to facilitate bowel movements
Abdominal pain, cramping, or discomfort
Bloating and distension
Fatigue and brain fog
Nausea or loss of appetite
Hemorrhoids or anal fissures from straining
Food intolerances or sensitivities
Headaches or mood changes
Diagnostic and Screening Options at Whole Gut Health
Comprehensive constipation evaluation goes beyond symptom assessment to identify the specific mechanisms and root causes driving your digestive dysfunction. At Whole Gut Health, we use advanced diagnostics to determine the most effective treatment approach for your individual needs.
Testing options may include:
Comprehensive Stool Analysis to assess gut microbiome balance, digestive enzyme function
Applied Kinesiology or Muscle Testing to help identify root causes, triggers, and help direct optimal treatment.
SIBO Breath Testing to identify bacterial overgrowth that may contribute to constipation and bloating.
Functional Lab Work including thyroid function, nutrient assessments, and metabolic markers that may contribute to constipation.
Pelvic Floor Assessment when dyssynergic defecation is suspected.
We customize testing protocols based on your symptom pattern, medical history, and previous treatment responses to ensure comprehensive evaluation.
Our approach
Why Whole Gut Health is different
At Whole Gut Health, we go beyond conventional symptom management and traditional functional medicine protocols. We trust your body's innate ability to heal itself when given the right support.
In Dr. Shustina's many years of practice, she has seen that many digestive diseases have their root cause in emotional traumas and unhealed wounds. When these underlying causes are healed, the body can heal from the inside out in a lasting way.
We focus on the mind-gut connection, incorporating energy healing techniques, personalized nutrition that evolves as you heal, and integrative approaches addressing mind, body, and spirit. If this resonates with you, contact our office to schedule your consultation and take the first step on your healing journey.
Our Constipation Treatment Approach
Our Three-Phase Constipation Protocol Includes:
Phase 1 — Assessment and Root-Cause Identification
- Comprehensive diagnostic testing to determine constipation type and severity
- Detailed analysis of dietary, lifestyle, and stress factors
- Gut microbiome imbalances (SIBO, dysbiosis)
- Pelvic floor dysfunction and coordination issues
- Medication effects and hormonal influences
- Dietary triggers and nutritional deficiencies
- Addressing stress and emotional root causes with energy medicine
Phase 2 — Targeted Intervention
- Structural abnormalities or anatomical factors
- Underlying medical conditions affecting gut motility
- Treatment of underlying bacterial overgrowth or gut microbiome imbalances
- Optimizing motility with visceral manipulation and cranial osteopathy
- Targeted dietary modifications and elimination of triggers
Phase 3 — Rebuilding and Prevention
- Curated supplement regimen to optimize gut function
- Comprehensive gut microbiome restoration and maintenance
- Long-term dietary strategies supporting regular bowel function
- Pelvic floor health maintenance and coordination training
- Lifestyle optimization including movement, stress management, and sleep hygiene
- Ongoing support to maintain natural bowel function and prevent recurrence
Expert-Led, Personalized Care
Dr. Alexandra Shustina is a board-certified gastroenterologist and internist specializing in complex digestive disorders, gut health, and the gut–brain connection. Drawing from both conventional gastroenterology and integrative medicine, she takes a comprehensive approach to uncovering the underlying factors contributing to illness and guides patients toward lasting wellness.
At Whole Gut Health, every patient receives highly personalized care rooted in a deep understanding of digestive health, nutrition, the gut microbiome, and the interconnected systems that influence overall well-being. By combining evidence-based medicine with a thoughtful, individualized approach, we help patients move beyond symptom management and create a clear path toward long-term healing and vitality.
Frequently Asked Questions
Common questions, answered
What is chronic constipation?
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Chronic constipation is a symptom-based disorder characterized by unsatisfactory defecation, including infrequent bowel movements (fewer than three per week), difficulty passing stools, hard stools, straining, or feeling of incomplete evacuation. It represents dysfunction in the complex process of defecation involving the colon, pelvic floor muscles, and nervous system.
What are the different types of constipation?
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Slow Transit Constipation
- Primary mechanism: Delayed colonic motility (dysmotility)
- Common symptoms: Infrequent bowel movements, bloating, feeling of fullness
- Often requires prokinetic agents and gut motility support
Dyssynergic Defecation (Pelvic Floor Dysfunction)
- Primary mechanism: Inability to coordinate pelvic floor muscles during defecation
- Common symptoms: Excessive straining, incomplete evacuation, need for manual maneuvers
- Responds best to biofeedback therapy and pelvic floor rehabilitation
Normal Transit Constipation
- Primary mechanism: Functional disorder with normal colonic transit
- Common symptoms: Hard stools, difficulty evacuating, abdominal discomfort
- Often related to dietary factors, dehydration, or lifestyle issues
Mixed Pattern Constipation
- Primary mechanism: Combination of slow transit and outlet dysfunction
- Common symptoms: Variable symptoms, poor response to single treatments
- Requires comprehensive approach addressing multiple mechanisms
What are the common signs and symptoms of chronic constipation?
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- Infrequent bowel movements (fewer than three per week)
- Difficulty passing stools or excessive straining
- Hard, lumpy, or pellet-like stools
- Feeling of incomplete bowel evacuation
- Need to use manual maneuvers to facilitate bowel movements
- Abdominal pain, cramping, or discomfort
- Bloating and distension
- Fatigue and brain fog
- Nausea or loss of appetite
- Hemorrhoids or anal fissures from straining
- Food intolerances or sensitivities
- Headaches or mood changes
How is constipation diagnosed?
+
Comprehensive constipation evaluation identifies specific mechanisms and root causes. Testing options include:
- Comprehensive Stool Analysis: Assesses gut microbiome balance and digestive enzyme function
- SIBO Breath Testing: Identifies bacterial overgrowth that may contribute to constipation
- Applied Kinesiology or Muscle Testing : Helps identify root causes, triggers, and helps direct optimal treatment
- Functional Lab Work: Includes thyroid function, nutrient assessments, and metabolic markers
Testing protocols are customized based on symptom pattern and medical history.
What does constipation treatment involve?
+
Our comprehensive three-phase constipation protocol includes:
Phase 1: Assessment and Root-Cause Identification
- Comprehensive diagnostic testing to determine constipation type and severity
- Detailed analysis of dietary, lifestyle, and stress factors
- Identification of contributing factors including gut microbiome imbalances, pelvic floor dysfunction, medication effects, and underlying medical conditions
Phase 2: Targeted Intervention
- Treatment of underlying bacterial overgrowth or gut microbiome imbalances
- Addressing stress and emotional root causes with energy medicine
- Optimizing motility with visceral manipulation and cranial osteopathy
- Targeted dietary modifications and elimination of triggers
- Curated supplement regimen to optimize gut function
Phase 3: Rebuilding and Prevention
- Comprehensive gut microbiome restoration and maintenance
- Long-term dietary strategies supporting regular bowel function
- Pelvic floor health maintenance and coordination training
- Lifestyle optimization and ongoing support to maintain natural bowel function
Why is it important to identify the specific type of constipation?
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Different constipation types require different treatment approaches. For example:
- Slow transit constipation may need prokinetic agents and motility support
- Dyssynergic defecation responds best to biofeedback and pelvic floor therapy
- Normal transit constipation often improves with dietary and lifestyle changes
- Mixed patterns require comprehensive approaches addressing multiple mechanisms
Can I stop using laxatives once treatment begins?
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Yes, our goal is to help you achieve natural bowel function without laxative dependence. We provide gradual weaning protocols while addressing root causes and supporting natural motility. This process requires patience and proper guidance to ensure comfortable transition to medication-free bowel function.
What makes your approach to constipation treatment different?
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At Whole Gut Health, we move beyond laxative management to identify and treat the root causes of constipation. Our approach focuses on:
- Comprehensive testing to determine specific constipation type and mechanisms
- Targeted treatment based on individual underlying causes
- Integration of gut microbiome restoration, pelvic floor therapy, and lifestyle optimization
- Gradual elimination of laxative dependence through natural function restoration
- Long-term maintenance strategies for sustained relief
Who provides colon cancer prevention care at your practice?
+
Dr. Alexandra Shustina is a board-certified gastroenterologist and internist who serves as NYC's and Miami's premier gut health specialist. She has training in both conventional gastroenterology and functional gut health, with expertise in the gut microbiome and its role in health and wellness.
How do I get started with constipation testing and treatment?
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The first step is scheduling a comprehensive consultation where we'll:
- Review your symptoms, medical history, and current treatments in detail
- Determine the most appropriate testing strategy for your specific case
- Develop a personalized treatment plan based on your constipation type and underlying causes
Contact our office to schedule your initial consultation and begin your journey toward natural, comfortable bowel function without laxative dependence.
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Dr. Shustina is a great doctor and healer! She is an expert and has great results. She has helped me and my family and I highly recommend her.
I know doctor Alexandra Shustina very well. She is a great physician. High integrity and good a good diagnostic.
Dr. Shustina is an incredible professional. She goes to the root level of the issue, not only superficial, so in reality there’s healing. And she is holistic meaning that her approach is from a whole, complete point of view and she provides it through her education, knowledge, wisdom and experience. Dr. Shustina was so patient with me, asking me question and guiding me how I could take charge of my health. Thank you Dr. Shustina
Dr. Shustina is truly exceptional! I met her at a health and wellness event and I was so blown away by her perspective on health. Dr. Shustina combines expertise in gastrointestinal health with a holistic approach, considering not just the physical symptoms but the whole person. Since meeting her I have invited her to talk at an event that I put together and I have also had my daughter be seen by her. She is now my go to person for everything Holistic and Gut related. Thank you Dr Shustina for everything!
Dr. Shustina is an incredibly knowledgeable doctor who truly takes the time to find the root cause of every patient’s illness. I am constantly awed by her excellent diagnostic ability and her efforts on behalf of her patients. She really goes above and beyond to treat and cure.
Dr Shustina is an outstanding and brilliant holistic physician with a wonderful understanding of the whole body. I highly recommend her!!
Dr. Shustina has helped me and my family improve our health. She is very knowledgeable in medical and in holistic and natural treatments and was able to find the source of the problem whc=ic created lasting results
Dr shustina is a wise and helpful doctor. She talks to you and consults with you about everything and spends a generous amount time asking questions about your health, grasping a full understanding of how your symptoms are making you feel, and what lifestyle you have. Our first appointment we spoke for a complete hour. I had struggled on and off with sibo for about 3 years before seeing her. I was extremely tired and had lots of symptoms of digestive issues. I saw 2 gastroenterologist before me they didn’t help much and they definitely did not consult with me for as thoroughly as she did. But upon seeing dr Shustina she was able to diagnosis me immediately and start a treatment plan that helped and got to the root cause of the issue. She has given me health and my life back and I can’t be grateful enough. Dr Shustina is the last gastroenterologist I need to see because I’m healthy and if problems happen in the future I trust her.
Dr. Shustina is the best doctor I have ever been to. She really takes the time and makes the effort to assess the root of the problem. She went above and beyond to help me a number of times with a variety of tools. She has the medical training and specialty along with a broad range of tools and experience to help patients in a natural and holistic way.
Dr. Shustina is very kind and very patient and has helped me change my lifestyle in a way that I thought I could not. By changing some things, she was able to help me heal my gut which was an area that I thought could not be healed. I highly recommend her!!
Doctor Shustina is the absolute best! It is hard to put into words how significant of an impact she has had on my well-being. She has helped me resolve numerous issues - from physical to mental- that other doctors dismissed, and she has spent countless hours answering my questions and teaching me lifestyle changes that have enabled me to thrive. She takes a whole person approach, focusing on root causes and not simply symptoms. She is not only a doctor but a friend, and she cares deeply about her patients. It gives me a lot of comfort knowing that whatever the issue is, I can come to Doctor Shustina for guidance and support. I could not recommend her enough! Thank you Dr. Shustina!
I recently had the privilege of consulting with Dr. Shustina. She is an outstanding doctor who truly understands the body's ability to heal itself and focuses on holistic remedies. I highly recommend Dr. Shustina for anyone seeking natural solutions and long-lasting relief. She patiently listened to me and answered all my questions. She provided me with holistic supplements and remedies that not only improved my symptoms but also enhanced my overall well-being. If you're looking for a knowledgeable and caring gastroenterologist who prioritizes natural remedies, Dr. Shustina is undoubtedly the ideal choice.
I have been under Dr. Shustina's care for the past 5 months which have been excellent. In these months, my digestive system has improved considerably. In my experience she is the first doctor which listens to her patients and works in treating the conditions and not only the symptoms. She is willing to explore alternative ways to achieve a better health. I highly enjoy the doctor-patient relation. I do highly recommend her.
Dr. Shustina is a fantastic doctor who truly cares for the patient. Her holistic approach attacks the root cause, leading to healing that lasts. Her expertise in gut health is evident, and the results reflect her vast knowledge and dedication towards each patient.
“I found Dr. Shustina after many months of searching for a board certified doctor who was able to incorporate holistic healing and nutrition into a treatment plan rather than simply diagnosing my symptoms and prescribing medication. Dr. Shustina has a wealth of knowledge and is helping me a heal years of gastrointestinal issues. p.s Her podcast, available on her site, is a GOLD MINE.”
Reviews
The body remembers when it's finally heard
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Dr. Shustina goes to the root level of the issue, not only superficial, so there's healing.
LG
Leah Glickman
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She has significantly improved my health. I was suffering from Ulcerative Colitis and now live normally.
ML
Monica LaBadia
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Dr. Shustina has helped me change my lifestyle and heal my gut in a way I thought impossible.
DL
Dalit Lonstein
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She listens to patients and treats conditions, not symptoms.
GS
Gabriela Salazar
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Dr. Shustina is the best doctor I have ever been to. She assesses the root of the problem.
MS
M. S.
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She is an outstanding doctor who understands the body's ability to heal itself and holistic remedies.
SS
Sibel Sebi Sharabi
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Dr. Shustina has a wealth of knowledge and is helping me heal years of gastrointestinal issues.
DC
Daniela Chaparro
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Dr. Shustina is an amazing doctor. She diagnosed my cancer early and saved my life.
MW
Mordechai Weinstein
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After one session with Dr. Shustina, my digestive pain went away.
TP
Taryn Parascand
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Doctor Shustina is the absolute best. She has helped me resolve numerous issues other doctors dismissed.
RS
Rachel S.
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Dr. Shustina is a fantastic doctor who truly cares. Her holistic approach attacks the root cause.
CS
Clay Simonsen
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