Module 5 GIT Revision PDF

1. Hypochlorhydria (Low Stomach Acid) Definition: Low production of stomach acid, with a gastric pH above 3.0. Symptoms: Gas, bloating, heartburn, sensation of fullness after meals, nutrient deficiencies (iron, B12, zinc), and foul-smelling stools. Complications: Poor pr...

1. Hypochlorhydria (Low Stomach Acid) Definition: Low production of stomach acid, with a gastric pH above 3.0. Symptoms: Gas, bloating, heartburn, sensation of fullness after meals, nutrient deficiencies (iron, B12, zinc), and foul-smelling stools. Complications: Poor protein digestion, reduced mineral absorption, and increased risk of infections like H. pylori and SIBO. Management: Digestive bitters, apple cider vinegar, zinc, betaine HCl supplementation. 2. Exocrine Pancreatic Insufficiency (EPI) Definition: Insufficient production of pancreatic enzymes needed for digestion, leading to malabsorption of fats. Symptoms: Steatorrhea (greasy stools), bloating, flatulence, food intolerances, low zinc/B12, and IBS-like symptoms. Complications: Poor digestion and absorption of fats, leading to nutrient deficiencies. Management: Pancreatic enzyme replacement therapy (PERT), dietary adjustments, and vagus nerve stimulation. 3. Bile Insufficiency Definition: Inadequate bile synthesis or flow, which affects fat digestion and absorption. Symptoms: Fatty stools, bloating, cramping, intolerance to fatty foods, nausea, and diarrhea or constipation. Complications: Deficiencies in fat-soluble vitamins (A, D, E, K) and essential fatty acids, hormone imbalances, and gallstones. Management: Hydration, taurine and choline-rich foods, bitter foods, choleretic and cholagogue herbs. 4. Small Intestinal Bacterial Overgrowth (SIBO) Definition: Overgrowth of bacteria in the small intestine, leading to fermentation of undigested food. Symptoms: Bloating, abdominal discomfort, diarrhea or constipation, malabsorption (especially of iron), and fatigue. Aetiology: Caused by conditions like hypochlorhydria, poor bile flow, low SIgA, stress, and chronic use of antibiotics. Management: Low FODMAP diet, specific carbohydrate diet, antimicrobials (e.g., oregano oil, berberine), and digestive support (e.g., bitters). 5. Dysbiosis Definition: Imbalance in the gut microbiota, where harmful bacteria outnumber beneficial bacteria. Causes: Poor diet (low fiber, high refined carbs), chronic stress, antibiotics, low stomach acid, and chronic infections. Symptoms: Bloating, diarrhea, fatigue, brain fog, food intolerances. Management: Probiotics, prebiotics, antimicrobial herbs (garlic, oregano), and dietary changes to support healthy microbiota. 6. Metabolic Endotoxemia Definition: Presence of bacterial toxins (LPS) in the bloodstream, leading to chronic low-grade inflammation. Causes: Dysbiosis, leaky gut, and high-fat or ketogenic diets that increase LPS transport across the intestinal membrane. Symptoms: Chronic inflammation, linked to cardiovascular disease, diabetes, and autoimmune conditions. Management: Increase dietary fiber, polyphenol-rich foods (berries, green tea), avoid alcohol and Western diets, and support gut health with probiotics. 7. Gastro-Oesophageal Reflux Disease (GORD) Definition: Reflux of stomach acid and bile into the esophagus due to a weakened lower esophageal sphincter. Symptoms: Heartburn, regurgitation, chest pain, bloating, and sore throat. Risk Factors: Obesity, pregnancy, large meals, smoking, and certain foods (caffeine, spicy foods, alcohol). Management: Avoid trigger foods, small frequent meals, support digestion (digestive bitters, ACV, digestive enzymes), and elevate the head during sleep. 8. Candidiasis Definition: Overgrowth of Candida yeast, typically affecting mucosal surfaces like the mouth, gut, and genitals. Symptoms: Digestive issues (bloating, gas), fatigue, sugar cravings, frequent UTIs, skin issues, and brain fog. Risk Factors: Antibiotic use, high sugar intake, low immunity, dysbiosis, chronic stress. Management: Anti-candida diet (low sugar, low carbohydrate), natural antifungals (e.g., caprylic acid, berberine), probiotics, and addressing predisposing factors. 9. Peptic Ulcer Definition: Ulceration in the stomach or duodenum due to breakdown of the mucosal barrier and erosion by stomach acid. Symptoms: Epigastric pain, nausea, vomiting, decreased appetite, and dyspepsia. Complications: GI bleeding, perforation, and peritonitis. Management: Avoid irritants (alcohol, caffeine, NSAIDs), increase fiber, use demulcent herbs (slippery elm, marshmallow), and address H. pylori infection. 10. Gallstones Definition: Crystalline calculi formed in the gallbladder, often composed of cholesterol. Symptoms: Pain in the upper abdomen, nausea, vomiting, bloating, and jaundice (if a stone obstructs the bile duct). Risk Factors: Obesity, high-fat diets, Type 2 diabetes, and hormonal factors (OCP, HRT). Management: Increase fiber, avoid processed foods, weight management, choleretic and cholagogue herbs, and possible supplementation with ox bile or lecithin. 11. Coeliac Disease Definition: Autoimmune condition where ingestion of gluten leads to damage of the small intestine’s villi, causing malabsorption. Symptoms: Abdominal pain, diarrhea, weight loss, fatigue, anemia, and skin rashes. Complications: Malabsorption, osteoporosis, anemia, neurological issues, and dermatitis herpetiformis. Management: Strict lifelong gluten-free diet, addressing nutritional deficiencies, and gut healing with a specific carbohydrate diet (SCD). 12. Irritable Bowel Syndrome (IBS) Definition: Functional GI disorder characterized by chronic abdominal symptoms without structural damage. Symptoms: Abdominal pain, bloating, diarrhea, constipation, or alternating symptoms. Subtypes: IBS-C (constipation), IBS-D (diarrhea), IBS-M (mixed), and IBS-U (unclassified). Management: Dietary changes (low FODMAP, probiotics, soluble fiber for constipation), stress management, and addressing underlying causes (e.g., SIBO, food intolerances). 13. Inflammatory Bowel Disease (IBD) Types: o Crohn’s Disease: Inflammation can affect any part of the GI tract, but mainly the ileum and colon. o Ulcerative Colitis: Inflammation is confined to the colon and rectum. Symptoms: Abdominal pain, diarrhea, rectal bleeding, weight loss, fatigue. Complications: Colorectal cancer, osteoporosis, malabsorption, anemia. Management: Anti-inflammatory diet (e.g., low FODMAP, specific carbohydrate diet), omega-3 supplementation, vitamin D, mucosal repair with glutamine, and avoiding food triggers. Elimination Diet Purpose: Identify and remove food intolerances or allergies that may contribute to GI symptoms, skin issues, or chronic conditions. Stages: 1. Detox (Days 1-2): o Action: Increase intake of whole foods like fruits, vegetables, gluten-free grains, and water. Remove processed foods, alcohol, caffeine, and additives. o Goal: Cleanse the body and prepare for elimination. 2. Elimination (Days 3-14): o Action: Remove common allergens (e.g., gluten, dairy, soy, eggs) or other suspected foods one at a time. o Goal: Observe changes in symptoms. If symptoms don't improve after two weeks, consider other triggers. 3. Reintroduction (Days 15+): o Action: Reintroduce each eliminated food one at a time over 1-3 days while monitoring for symptoms. o Goal: Identify specific food sensitivities by noticing reactions to the reintroduced food (e.g., digestive issues, skin problems, headaches). Common Triggers: Gluten, dairy, corn, soy, eggs, nuts, beef, nightshades, chocolate, and coffee. 5R Protocol The 5R protocol is a structured approach to treating gastrointestinal (GI) dysfunctions: 1. Remove:  o Action: Remove harmful substances like pathogens (bacteria, fungi, parasites), toxins, and food irritants (e.g., processed food, food additives, caffeine, gluten). o Support: Use antimicrobial herbs (e.g., garlic, berberine, oregano oil) for infections, and eliminate food allergens through an elimination diet. 2. Replace: o Action: Replenish digestive factors that may be missing. o Support: Stomach acid (e.g., betaine HCl), digestive enzymes (e.g., plant- based or pancreatic enzymes), and bile support (e.g., ox bile, cholagogues). 3. Reinoculate: o Action: Restore healthy gut flora with probiotics and prebiotics. o Support: Probiotic-rich foods (e.g., kefir, sauerkraut), supplements with Lactobacillus and Bifidobacterium strains, and prebiotics like inulin (e.g., from chicory, leeks). 4. Repair: o Action: Heal the intestinal lining and support the mucosal barrier. o Support: L-glutamine, zinc, collagen, bone broth, and demulcent herbs (e.g., slippery elm, marshmallow) help repair the gut lining. Polyphenols (e.g., from green tea) reduce inflammation. 5. Rebalance: o Action: Address lifestyle factors that contribute to gut dysfunction. o Support: Stress management (e.g., mindfulness, breathing exercises), improving sleep, and regular exercise. Metabolic Endotoxemia Definition: Metabolic endotoxemia is the presence of bacterial toxins, especially lipopolysaccharides (LPS), in the bloodstream, causing chronic low-grade inflammation. Mechanism: LPS, which comes from the outer membrane of gram-negative bacteria, crosses the intestinal barrier (due to increased gut permeability or dysbiosis) and triggers the immune system, causing inflammation. Conditions Linked: Cardiovascular disease (CVD), diabetes, autoimmunity, neurodegenerative diseases. Natural Support: Diet: Increase dietary fiber (to bind and clear LPS), avoid Western or ketogenic diets (which can increase LPS transport), focus on polyphenol-rich foods (e.g., berries, green tea). Lifestyle: Cold exposure (e.g., cold showers), stress management, and supporting the gut barrier with probiotics and anti-inflammatory herbs (e.g., curcumin, green tea). Dysbiosis Definition: Dysbiosis refers to an imbalance in the gut microbiota, where harmful bacteria outweigh beneficial species. Aetiology: Poor diet (e.g., low fiber, high refined carbs), chronic stress, antibiotic use, and low digestive secretions (e.g., hypochlorhydria) contribute to dysbiosis. Common Symptoms: Bloating, diarrhea/constipation, brain fog, fatigue, food intolerances. Natural Support: Diet: Increase fiber and prebiotic foods (e.g., chicory, leeks), and probiotics (Lactobacillus, Bifidobacterium) to restore balance. Anti-Microbials: Herbal antimicrobials (e.g., garlic, oregano oil) may be used to reduce pathogenic overgrowth. Difference Between Dysbiosis and Metabolic Endotoxemia Dysbiosis: Refers to an imbalance in gut bacteria, where the ratio of harmful bacteria to beneficial bacteria is skewed. This imbalance can lead to both local gut issues and systemic problems. o Focus: It's mainly about the gut environment and microbiota. Metabolic Endotoxemia: Refers to the presence of bacterial toxins (LPS) in the blood, usually stemming from a damaged gut barrier. This condition leads to chronic systemic inflammation. o Focus: It’s about the toxins produced by bacteria crossing the gut barrier and entering the bloodstream, triggering an immune response. In short, dysbiosis is an imbalance of gut bacteria, while endotoxemia is the toxic effect when bacterial byproducts, like LPS, escape the gut into the bloodstream, causing inflammation. Difference Between Crohn’s Disease and Ulcerative Colitis Both Crohn’s Disease and Ulcerative Colitis are types of Inflammatory Bowel Disease (IBD), but they differ in terms of location, pattern of inflammation, and symptoms:  Feature Crohn’s Disease Ulcerative Colitis Can affect any part of the GI tract Location (mouth to anus), most commonly Limited to the colon and rectum. the ileum and colon. Confined to the mucosal and Pattern of Transmural (affects all layers of submucosal layers (innermost layers) Inflammation the intestinal wall). of the colon. Continuous inflammation without Skip lesions: inflamed areas are Appearance healthy sections, starting from the scattered between healthy tissues. rectum and extending upwards. Abdominal pain, diarrhea, weight Bloody diarrhea, urgency to defecate, Symptoms loss, fatigue, malnutrition. rectal bleeding, abdominal pain. Fistulas, strictures, abscesses, Toxic megacolon, increased risk of Complications malnutrition. colorectal cancer. Surgery does not cure Crohn’s, Surgical Colectomy (removal of the colon) can but may remove damaged Treatment be curative for Ulcerative Colitis. sections. Key Differences: Crohn’s Disease can affect any part of the GI tract, with patchy inflammation and deeper tissue involvement. Ulcerative Colitis affects only the colon and rectum, with continuous inflammation confined to the innermost layers of the colon. Mucosal Barrier and How to Support It Definition: The mucosal barrier refers to the protective layer lining the gastrointestinal (GI) tract, consisting of mucus, epithelial cells, and immune components like secretory IgA (SIgA). This barrier plays a crucial role in protecting the gut from harmful substances, pathogens, and toxins while allowing nutrient absorption. Components of the Mucosal Barrier: 1. Mucus Layer: A thick, viscous layer that physically separates the gut epithelium from the contents of the gut, preventing direct contact with harmful bacteria and other irritants. 2. Epithelial Cells: These cells form a tight barrier that controls the selective absorption of nutrients and blocks harmful substances from entering the bloodstream. 3. SIgA (Secretory Immunoglobulin A): An antibody that neutralizes pathogens and toxins by trapping them in the mucus, preventing them from adhering to or crossing the intestinal lining. Damage to the Mucosal Barrier: When the mucosal barrier is compromised (a condition known as leaky gut or intestinal permeability), it can lead to: Increased gut permeability, allowing toxins, bacteria, and undigested food particles to enter the bloodstream. Chronic inflammation and immune system activation, which may contribute to conditions like IBD, SIBO, autoimmune diseases, and metabolic endotoxemia. How to Support the Mucosal Barrier From the document, several strategies and supplements can help support and repair the mucosal barrier: 1. Glutamine: o Mechanism: Glutamine is the primary fuel source for the cells lining the gut, promoting repair and regeneration of the intestinal lining. o Dosage: 5-10 g daily. 2. Zinc: o Mechanism: Zinc is essential for maintaining tight junction integrity in the gut epithelium, helping to reduce permeability. o Dosage: 15-30 mg daily. 3. Polyphenols: o Mechanism: Polyphenols, found in foods like green tea, berries, and dark chocolate, reduce inflammation and promote the growth of beneficial gut bacteria that support barrier function. o Sources: Green tea extract, berries, grapes. 4. Mucilage Herbs (e.g., Slippery Elm, Marshmallow): o Mechanism: These herbs provide a protective, soothing coating for the gut lining, reducing inflammation and irritation. o Usage: Take as a tea or powder (1-2 tsp) 2-3 times daily. 5. Probiotics: o Mechanism: Probiotics like Lactobacillus and Bifidobacterium help maintain a healthy balance of gut bacteria, reducing inflammation and preventing harmful pathogens from damaging the mucosa. o Dosage: 10-20 billion CFU daily. 6. Saccharomyces boulardii: o Mechanism: A probiotic yeast that enhances gut immunity and increases the production of SIgA to neutralize pathogens. o Dosage: 250-500 mg daily. 7. Omega-3 Fatty Acids: o Mechanism: Omega-3s, particularly EPA and DHA, reduce gut inflammation by modulating immune responses and supporting mucosal repair. o Dosage: 2-4 g daily from fish oil. 8. Vitamin D: o Mechanism: Vitamin D plays a key role in modulating immune function and supporting the integrity of the mucosal barrier. o Dosage: 1000-4000 IU daily. Summary of Key Points Crohn’s Disease and Ulcerative Colitis are both forms of IBD but differ in location, inflammation pattern, and complications. The mucosal barrier protects the gut from harmful pathogens and toxins, with components like mucus, epithelial cells, and SIgA. Supporting the mucosal barrier involves using nutrients like glutamine, zinc, omega-3s, and probiotics, along with soothing herbs like slippery elm and marshmallow to reduce inflammation and promote repair. These measures help maintain gut health, reduce inflammation, and protect against further damage. Flashcard 1: What is hypochlorhydria? Answer: Hypochlorhydria is low stomach acid production, characterized by a fasting gastric pH above 3.0. Normal gastric pH is 1.5–3.0. Flashcard 2: What are the key symptoms of hypochlorhydria? Answer: Key symptoms include gas, bloating (especially within 30 minutes of eating), heartburn, sensation of fullness after meals, foul-smelling stools, diarrhea, nausea after supplements, food allergies, brittle nails, and nutrient deficiencies (e.g., iron, zinc, folate, B12). Flashcard 3: What are the natural approaches to treating hypochlorhydria? Answer: Natural approaches include chewing thoroughly, avoiding overeating, drinking apple cider vinegar diluted in water before meals, increasing intake of zinc and B6-rich foods, and eating bitter foods and herbs like rocket, chicory, and dandelion. Flashcard 4: What is exocrine pancreatic insufficiency (EPI) and its symptoms? Answer: EPI is a deficiency of pancreatic enzymes leading to nutrient malabsorption, particularly fats. Symptoms include bloating, belching, steatorrhea (greasy stools), food intolerances, low zinc, B12, and folate absorption, and IBS-like symptoms. Flashcard 5: How is pancreatic insufficiency diagnosed and managed? Answer: It can be diagnosed using low pancreatic elastase-1 in stool tests. Management includes correcting stomach acid levels, stimulating the Vagus nerve (deep breathing, laughter), and using pancreatic enzyme replacement therapy (PERT). Flashcard 6: What is bile insufficiency and its symptoms? Answer: Bile insufficiency refers to inadequate bile synthesis or flow, affecting fat digestion. Symptoms include greasy stools, constipation or diarrhea, intolerance to fatty foods, bloating, and cramping. Flashcard 7: What natural approaches support bile insufficiency? Answer: Approaches include adequate hydration, avoiding processed foods, consuming taurine and choline-rich foods (e.g., seaweed, eggs), and using herbs like dandelion and ginger to stimulate bile flow. Flashcard 8: What are the three stages of the elimination diet? Answer: 1. Detox (Days 1-2): Remove processed foods, increase fruits and vegetables. 2. Elimination (Days 3-14): Remove suspected allergens (e.g., gluten, dairy, soy) for 2 weeks. 3. Reintroduction (Days 15+): Reintroduce foods one at a time while monitoring symptoms. Flashcard 9: What is the 5R protocol for gastrointestinal health? Answer: The 5R protocol involves: 1. Remove harmful foods and pathogens. 2. Replace digestive enzymes, bile salts, and stomach acid. 3. Reinoculate the gut with prebiotics and probiotics. 4. Repair the gut lining with nutrients like glutamine and zinc. 5. Rebalance lifestyle factors such as stress management. Flashcard 10: What is dysbiosis, and what are its causes? Answer: Dysbiosis is an imbalance of gut bacteria, often caused by poor diet (low fiber, high processed foods), chronic stress, antibiotic use, and low digestive secretions (e.g., hypochlorhydria). Flashcard 11: What are the symptoms and treatment for dysbiosis? Answer: Symptoms include bloating, diarrhea, fatigue, and brain fog. Treatment involves probiotics, prebiotic-rich foods, and antimicrobial herbs like garlic and oregano oil. Flashcard 12: What is metabolic endotoxemia? Answer: Metabolic endotoxemia is the presence of bacterial toxins (LPS) in the bloodstream, leading to chronic low-grade inflammation. It is linked to diseases like cardiovascular disease and diabetes. Flashcard 13: What are natural ways to reduce metabolic endotoxemia? Answer: Natural approaches include increasing fiber, avoiding alcohol and a Western diet, consuming polyphenol-rich foods (e.g., berries, green tea), and using probiotics to support gut health. Flashcard 14: How do digestive insufficiencies like hypochlorhydria and EPI affect overall digestion? Answer: Hypochlorhydria impairs protein digestion and nutrient absorption, while EPI leads to fat malabsorption due to a lack of pancreatic enzymes, affecting energy and nutrient intake. Flashcard 15: What is SIBO and its hallmark symptoms? Answer: SIBO (Small Intestinal Bacterial Overgrowth) is an overgrowth of bacteria in the small intestine. Symptoms include bloating, diarrhea or constipation, and malabsorption of nutrients. Flashcard 16: What dietary interventions are commonly used to manage SIBO? Answer: Common interventions include a low-FODMAP diet, the specific carbohydrate diet (SCD), or a combination of both to reduce fermentable sugars and fibers that feed bacteria. Flashcard 17: What is a common protocol for supplementing with Betaine HCl for hypochlorhydria? Answer: Start with 1 capsule containing 350-750 mg of Betaine HCl with a protein-containing meal. If no discomfort occurs, increase by 1 capsule every 2 days, with a maximum of 3 g, until a tingling or warm sensation is felt. Then reduce the dose by 1 capsule and use this amount with subsequent meals. Flashcard 18: What is the role of pancreatic enzyme replacement therapy (PERT), and how is it dosed? Answer: PERT supplements pancreatic enzymes (amylase, lipase, and protease) for those with pancreatic insufficiency. The dosage depends on meal size: Take enzymes at the start of the meal. For meals lasting 30 minutes, take enzymes in thirds (start, middle, and end). Flashcard 3: What dosage of zinc is recommended for hypochlorhydria and digestive support? Answer: Zinc is important for digestive health, and a typical dosage for zinc supplementation is 15-30 mg daily. Zinc-rich foods like meat, nuts, and seeds can also support zinc levels. Flashcard 4: How should digestive bitters be used to improve stomach acid and bile production? Answer: Digestive bitters, such as gentian, dandelion, and artichoke, should be taken 10-15 minutes before meals to stimulate digestive secretions. Typically, 1-2 tsp of bitters or a few drops of a tincture in water is sufficient. Flashcard 5: What is the recommended dosage for Saccharomyces boulardii to support the gut and increase SIgA levels? Answer: The typical dosage of Saccharomyces boulardii is 250-500 mg, taken 1-2 times daily. It helps improve gut immunity and balance the microbiota. Flashcard 6: How should probiotics be supplemented for dysbiosis and SIBO? Answer: For general gut health, take Lactobacillus and Bifidobacterium species at a dosage of 10-20 billion CFU (colony-forming units) daily. For SIBO, low-dose probiotics or spore-based probiotics are often better tolerated. Flashcard 7: What is the dosage of digestive enzymes for pancreatic insufficiency? Answer: Supplement with 1-2 capsules of digestive enzymes containing amylase, protease, and lipase with meals. Adjust the dosage based on the size of the meal—larger meals may require additional enzymes during the meal. Flashcard 8: What are the recommended dosages of herbal antimicrobials for SIBO, such as oregano oil and berberine? Answer:  Oregano oil: 200 mg, taken 2-3 times daily for 4-8 weeks. Berberine: 500 mg, taken 2-3 times daily for 4-8 weeks. Antimicrobials should be rotated to avoid bacterial resistance. Flashcard 9: How should curcumin be dosed for inflammation and gut health? Answer: A typical dosage of curcumin for reducing inflammation is 500-1000 mg, taken 2-3 times per day. It supports gut health by inhibiting inflammatory cytokines. Flashcard 10: What is the recommended dosage of L-glutamine for gut repair? Answer: For gut healing, the recommended dosage of L-glutamine is 5-10 grams daily. It can be taken in divided doses with or between meals to support intestinal repair. Flashcard 11: What is the recommended dosage of aloe vera for gastrointestinal health? Answer: Aloe vera juice can be taken at a dosage of 20-30 ml, 2-3 times daily, to soothe the digestive tract, support wound healing, and reduce inflammation. Flashcard 12: How much omega-3 (EPA/DHA) is recommended for inflammatory bowel disease (IBD)? Answer: For IBD, a dosage of 2-4 grams of EPA/DHA from fish oil is recommended daily. It reduces inflammation by inhibiting pro-inflammatory cytokines. Flashcard 13: What dosage of vitamin D is recommended to support immune function and gut health? Answer: The recommended dosage for vitamin D3 is 1000-4000 IU daily, depending on blood levels and individual needs. It supports immune modulation and helps maintain gut barrier integrity. Flashcard 14: What is the appropriate dose of NAC (N-Acetyl Cysteine) for liver detoxification and supporting the gut? Answer: NAC is typically taken at a dosage of 600-1200 mg per day. It supports liver detoxification, boosts glutathione production, and helps reduce gut inflammation. Flashcard 15: How should caprylic acid be dosed for candida overgrowth? Answer: For candida, caprylic acid is typically dosed at 500-1000 mg, 2-3 times daily. It disrupts candida cell membranes and helps control overgrowth. Flashcard 16: What is the dosage of mastic gum for H. pylori infection? Answer: For H. pylori, mastic gum is usually dosed at 500 mg twice daily, taken on an empty stomach. It has antibacterial properties and supports ulcer healing. Flashcard 17: How should vitamin C be dosed for gallstones? Answer: To support gallstone management, vitamin C is typically dosed at 500-2000 mg per day. It helps improve bile composition and supports cholesterol solubility in bile. Flashcard 18: What is the recommended dosage for magnesium to relieve constipation? Answer: Magnesium citrate is recommended at 250-500 mg daily to help relieve constipation by relaxing the intestines and drawing water into the bowel.