Everything You Need to Know About Constipation
As far as our health and fitness is concerned, a great deal of the time, people use what is going on on the outside, as an indication of whether they need to clean up their act. By this, we mean that body fat percentages are typically used as an indication of health and well-being. While obesity is indeed a sign that something has to change, the fact is that there are a number of people of a healthy weight out there that are far from healthy on the inside.The digestive system for example, is an incredibly complex system that plays a vital role in countless physiological processes within our bodies. The digestive system helps us break down and digest food, it enables us to absorb nutrients and energy from what we consume, and it helps us to get rid of what we don’t need. If our digestive health is suffering however, we tend to suffer. Constipation for example, is an all too common digestive health issue that affects hundreds of thousands of people, if not more, every day, all over the globe. Constipation is not only dangerous for our health, it can also make life truly miserable. Thankfully there is a solution. In fact, there are several solutions, so you needn’t suffer in silence. If constipation is making life miserable for you, here’s a look at everything you need to know about this awful condition.
Phase 1 – Before we can start talking about constipation, first we need to understand the digestive system, how it works, and digestive health in general. If you want to put things very simply, basically the digestive system is a collection of organs within your body that work in synergy with one another to take produce we consume, convert it into fuel for the body, extract beneficial nutrients from it, and expel waste that we don’t need. To get more technical however, think of it like this. You’ve had a long day, you’re tired, you’ve not eaten, and you’re feeling very hungry. Suddenly, as you walk past the local pizza place, the scent of freshly baked pizza pie hits your nostrils and sends your mouth in salivation overload. Even though you’ve not even laid eyes upon the delicious dish of cheesy pizza goodness, the fact that your mouth is salivating shows that your digestive system is already doing its job. If you are lucky enough to pick up said pizza and take it home, the second you open the box and take a bite out of it, salivary glands within your mouth produce yet more saliva. Saliva contains enzymes that help to break down the food as you chew it, plus the liquid makes it easier for you to chew or masticate (don’t laugh!) and break down. Each day the average person produces around 1 litre of saliva, although if you hang around too many pizza places that amount is likely to triple. So, the saliva and the action of your teeth, breaks down the pizza and basically turns it into small pieces of mush before you swallow it, but what then?
Phase 2 – Next the masticated food makes its way down your Esophagus, which is a tube connecting the stomach with the throat. Muscles in the throat contract and propel the chewed pizza down the throat, while muscles in the wall of the Esophagus create concentrated waves which force the food downwards towards the stomach. This is a process known technically as Peristalsis. As it reaches the end of the Esophagus, pressure created via the food sends a signal to the Esophageal sphincter telling it to relax to let the food pass through and make its way to the stomach.
Once it enters the stomach, the stomach actually begins churning and mixing up the food further, like a gentle food processor almost. Along with this, special digestive glands located in the stomach secrete digestive acid and enzymes, which, along with the churning action, helps to break the food down into even smaller pieces. The acids and enzymes are mixed together with what is left of the food to form a paste, which is technically known as ‘Chyme’. When the stomach is happy that everything is mixed well and broken down, little by little it passes through a valve known as the Pylorus, and enters the duodenum, which you may know as the small intestine. Here the food, or Chyme, is combined with yet more enzymes and juices, this time from the gall bladder, the pancreas, and the liver. Enzymes from the pancreas are secreted to break down the macronutrients (protein, fats, and carbs) whereas the liver produces bile to help improve lipid (fat) digestion. The gall bladder is used to store bile and squeeze it through bile ducts, into the small intestine.
Phase 3 – In the final stages of digestion, what was left of the delicious pizza you ate not long ago, continues to be broken down by digestive juices and enzymes to break it down into small pieces of nutrients that the body can absorb. Finally, it makes its way to the ileum, which is the longest part of the small intestine. Here through the walls of the ileum, any remaining nutrients that are needed by the body but have not yet been absorbed, are absorbed. After this phase, what may have been left of the food is nothing more than water, electrolytes, and waste products that will do the body no good at all, and which, if left, would actually cause harm. The residue continues to make its way along, until it passes through the colon where pretty-much all the water is absorbed. The end result is typically a formed, brown substance which we’ll call stool. Yeah, it’s poop. In the colon are muscles which contract to break the stool into more manageable pieces that make their way through to the lower colon and rectum. When the walls of the rectum become stretched, this signals that the body is ready for a bowel movement. A healthy bowel movement will involve muscles in the anal sphincter (seriously, stop laughing!) relaxing, while muscles in the rectum contract. This pattern of muscle contraction will result in your body expelling the stool. And that’s how a typical bowel movement occurs. However, if you happen to suffer from constipation, things are sadly a great deal more painful than that. And are far from simple.
So, as we’ve covered why it’s so important to look after our digestive systems, and what is involved in a healthy bowel movement, we need to now look at what happens when things don’t run smoothly (pun, kind of intended). Yes, we’re talking about constipation!
Constipation is a very common problem that pretty-much everybody will suffer from at some point in their lives. Despite it being so common, like all things bathroom-related, it seems to be quite a taboo and embarrassing subject, which means that a lot of people choose to suffer in silence, rather than talking about it and seeking help. Constipation typically involves making a bowel movement less frequently than normal, or it involves having to strain and push incredibly hard to expel the stool from your body. This condition is very common, and what’s more, constipation does not discriminate. It affects men and women of all ages, shapes, and sizes. It doesn’t matter whether you’re a new born baby, or a pensioner in your nineties, you can be affected by constipation if you aren’t careful. As mentioned, constipation typically results in you passing stool less frequently than normal, having to strain and push to make stool, or sometimes both. Although it varies from person to person, you are likely affected by constipation if you haven’t had a bowel movement more than 3 times in a week, your stools are hard, lumpy, and/or dry, and if you have to push, strain, and force yourself to pass the stool in the first place. You may also find that the stool, when/if you eventually expel it, is larger in size than usual. Other people find themselves suffering from a stomach ache or feeling full and bloated because they are literally carrying around this stool, which is growing larger after each meal, and are unable to pass it.
Constipation can be caused by a variety of different things, though ordinarily it occurs if there isn’t enough water in your stool. If too much liquid is absorbed via the intestines, this can result in a hard, dry stool. In some people however, constipation can occur for no obvious reasons. Some of the main causes of constipation include:
A lack of fiber in the diet – Fiber, or roughage, is a part of a plant-based food that is not fully digested. Once your body has digested the food, broken it down, and extracted the nutrients required from it, one of the things left behind is the fiber. Fiber stays in the gut and adds bulk to your stools and ensures that the bowels function correctly. Experts recommend at least 18g of fiber per day, yet the majority of the population get around 12g, which is clearly not enough. Fiber is found in a variety of different foods, though some of the most common forms of fiber include cereals, grains, wholemeal bread, fruits, and vegetables.
Not drinking enough water – The human body is made up of more than 70% water, so we need to ensure we’re drinking plenty. Water not only hydrates us and ensures our organs are functioning correctly, it also helps to soften the stools and make them easier to pass. Those that fail to drink enough water are far more likely to suffer from constipation than those that get enough water each day.
Medication – Ironically, the very medications that are prescribed to help us can actually be causing us some damage. Pain-killing medicines which are opioid-based such as morphine, codeine, and co-codamol can result in constipation. As effective as these drugs are for killing, or rather, masking pain, the downside is that they do cause pretty severe constipation. Though there is a lot more science involved, basically opioids slow down the rate in which food passes through the digestive tract, and sometimes it can prevent it entirely. Not only that, but they also partially paralyze the stomach, which means that food stays in there for longer. As if that wasn’t enough, they also reduce the volume of digestive enzymes and secretions, so basically, they make you far less efficient at digesting your food.
Health issues – Sometimes those afflicted with various medical issues can suffer from constipation. Irritable bowel syndrome, although commonly associated with diarrhoea which is the exact polar-opposite of constipation, can sometimes cause constipation. An underactive thyroid is another condition heavily linked with constipation.
Pregnancy – For any female readers out there, if you do plan on falling pregnant anytime soon, it is worth noting that 1 in 5 pregnant women will suffer from constipation during their pregnancy. Yes, as if pregnancy wasn’t tough enough already, there’s also the risk of constipation to deal with. Hormonal changes within the body can inhibit digestive health and function, though as the baby grows larger, it could simply be the fact that the baby is taking up so much room that it is pushing or squeezing the bowels to one side.
Idiopathic constipation – Sometimes, people that are perfectly healthy, can suffer from constipation for no apparent reasons. They may get regular exercise, drink plenty of water, eat heaps of roughage, rarely consume junk, and still suffer from constipation. This is known as idiopathic constipation and it is believed that the cause is simply the bowels becoming lazy, for want of a better word. Though this condition can affect men and women, it is women that are statistically more likely to suffer with it than men.
Ordinarily, constipation is not considered to be overly serious, though it can be very painful and can make life pretty-miserable for a lot of people. There are of course some exceptions, though to ensure we attempt to cover all bases, here’s a look at some common dangers and side-effects of constipation, some of which may be more serious than others.
Weight gain – Yes, being constipated sucks for a number of reasons. One of which is the fact that being constipated results in you gaining weight. Step on the scales and you’ll be a pound or two heavier than normal because you’re walking around with a hard, dense, stool in your body that you can’t get rid of. However, constipation can also result in you gaining a few additional pounds of body fat as well, and here’s how. You see, being constipated can disrupt your hormones and intestinal flora (bacteria) which can result in the storage of body fat. Not only that, but other hormonal imbalances like excess Estrogen, can also result in your body storing more body fat than it should be doing. Ordinarily, passing stool will help to rid the body of excess Estrogen before it can be reabsorbed by the body. If you are unable to pass stool however, this excess Estrogen has nowhere to go, so the body reabsorbs it, putting you at a greater risk of fat gain.
Faecal impaction – If you thought that regular constipation was bad, just hope and pray that you never have to deal with faecal impaction. This is basically a condition where the bowel becomes fully blocked and obstructed by the incredibly hardened stool in the colon. It becomes so hard and solidified that it causes a full blockage. Those dealing with faecal impaction often suffer with what they think is diarrhoea at the same time, as liquid stool is able to bypass the blockage, but nothing solid. This condition is not only very painful, it can cause nausea, bowel perforations, and ulcers.
Fatigue – One of the most common side-effects associated with constipation is fatigue. In fact, the two go hand-in-hand with one another. You see, constipation disrupts hormonal levels and intestinal flora levels, which can result in the fermentation of carbohydrates in the body, which then causes gasses such as Hydrogen Sulphide. Hydrogen Sulphide has been found to damage our cells, or more specifically – it damages the mitochondria located within the cells. The mitochondria is the part of the cell responsible for producing energy, almost like a battery. So, by attacking the mitochondria, our cells are unable to produce as much energy, which means we have less energy and we feel fatigued and lethargic much quicker than usual. Not only that, but as digestion in general is disrupted, this means that we absorb fewer nutrients, some of which play a key role in the healthy function of the metabolism. Not only that, but if you imagine straining and pushing for a number of minutes, sometimes hours, trying to make a bowel movement, you can imagine how tiring this will be.
Suppressed immunity – As you might have guessed, if your body isn’t able to absorb the vitamins, minerals, antioxidants, and other nutrients it needs from food, in adequate amounts, immunity can suffer. The immune system thrives on these beneficial nutrients, and so the more you can absorb, the stronger and healthier it becomes. Sadly, the fewer you absorb, the weaker it becomes. A weak immune system makes you more susceptible to illness and disease. This means that you will be at a greater risk of everything from the common cold, to more serious conditions such as cancer. Not only that, but the reason we pass stool in the first place is because we are getting rid of everything we don’t need or want in the body. If it is sitting there, unable to go anywhere, toxicity is a risk as toxins from the stool can seep out and be reabsorbed into the blood stream, where they will then be carried around the body, via the red blood cells, and delivered, along with oxygen and beneficial nutrients, to the other cells in your body. Yuck! Not only can this suppress the immune system, it can also result in you suffering from bad skin and acne. Basically, if you’re constipated, you’ll not only feel rough you’ll look it too. Great, huh?
Pain and discomfort – Finally, the last typical side-effect associated with constipation is pain and discomfort. Constipation can make you feel bloated and heavy, which is going to make you uncomfortable. More seriously than that however, is the fact that through straining and pushing when trying to pass the stool, you could end up in a great deal of pain. To begin with, trying to squeeze out a rock hard and oversized stool is not going to be easy, and could result in rectal trauma, bleeding, and haemorrhoids, which are sometimes known as piles. All in all, we can probably agree that constipation can make life pretty-miserable, and that it is something that ideally, we will all want to avoid.
Bad breath – This final side-effect sounds gross, and while it is gross, thankfully it’s not quite as gross as you may have thought. Most people affected by constipation experience a bad taste in their mouth, and reportedly have bad breath. Some people say that this is because the poop is reabsorbed by the body, so the taste and smell is actual human faecal matter. Thankfully that’s not true. The real reason is believed to be due to the fact that constipation results in an increase in toxic bacteria within the gut, which produce noxious-smelling gases which cause the bad taste and smell emanating from the breath.
Before we get to really useful stuff and look at what you can do to cure or prevent constipation, we are first going to take a look at a few common myths and misconceptions associated with constipation, like the poop-breath theory we just cleared up above. Here’s a look at a few common myths associated with constipation, and at why you shouldn’t always believe everything that you read on the internet (as if you needed anybody to tell you that anyways)!
More fiber is all you need – Yes, we’ve already looked at how important fiber is when it comes to creating healthy stools and preventing constipation, but fiber is not the be-all and end-all when it comes to constipation. If you happen to be comfortable enough with somebody to tell them that you’re constipated, you can almost put money on the fact that one of the first things they’ll tell you to do is to ‘drink prune juice’. Prunes are great source of fiber, and there is strong evidence to point to the fact that they are amongst some of the best healthy foods out there when it comes to constipation. However, a lack of fiber isn’t always the culprit, so increasing fiber intake may not always help. In fact, it could make matters worse because it may add bulk to the stuck stool, which would increase its size and cause you even more pain and discomfort.
You should have at least one bowel movement a day – Bowel movements are like people, in that each one is different. Some people are as regular as clockwork and will have several bowel movements per day, at roughly the same time, without fail. Others however, are more erratic. Some go four times per day, whereas others may only go four or five times per week. If you do happen to go longer than a day without having a bowel movement, don’t panic just yet, as it isn’t necessarily because of constipation. As long as you feel fine and as long as when you do make stool, you can do so with no real issues, constipation isn’t to blame. Sometimes it’s just one of those things. Making stool less than 3 times per week however, is more likely to be due to constipation.
If fiber doesn’t cure you, drinking water will – If only curing constipation was as simple as eating more fiber and drinking more water. People tend to work under the assumption that, if drinking prune juice or eating more fiber doesn’t cure you, all you need to do is chug down a few glasses of water and you’ll be sat on the toilet in no time at all. We need water for a variety of reasons, and yes, that includes going to the bathroom. However, some people find themselves constipated, despite the fact that they consume copious amounts of water each day. The fact remains that if dehydration is not the sole cause of your constipation, increasing your fluid intake is going to do absolutely nothing, other than result in you needing to urinate more frequently. Drinking water certainly helps constipation, and is a great way of softening the stool and preventing the condition, but if a lack of water isn’t the cause of the ailment, increasing water intake isn’t a guaranteed way of curing yourself.
All fiber helps – When we talk about dietary fiber, it’s important to note that there are actually two types of fiber commonly found in a variety of different food sources. These are: insoluble fiber and soluble fiber. Soluble fiber dissolves and breaks down in water, so when it makes its way to the stomach, it is dissolved and broken down, meaning that it doesn’t offer many constipation-related benefits. The useful fiber however, is insoluble fiber. Insoluble fiber does NOT break down and dissolve when it comes into contact with water in the stomach, and so it is therefore able to add bulk to the stool and help it to pass along the intestinal tract. If faecal impaction is a concern, insoluble fiber is very beneficial indeed.
Coffee is a great solution – Another common myth associated with constipation is that coffee is a great solution for people struggling to make a healthy bowel movement. Now, there is strong evidence to suggest that coffee can promote a bowel movement in some people, depending on their body chemistry and genetic makeup, due to the fact that it contains compounds that help stimulate lower colon muscle contractions, which in turn can help you to go to the bathroom. However, this does not occur in all people, and it only helps if you are able to pass a healthy, constipation-free stool in the first place. Drinking coffee while constipated is actually one of the worst things you can do. This is because it contains the stimulant caffeine. Caffeine is a diuretic, which basically means that it causes you to excrete more fluids than you are taking in. You don’t need to be a genius to figure out that this is a recipe for dehydration, and dehydration can not only act as a precursor for constipation, it can also exasperate the condition and cause you greater levels of pain and discomfort.
Laxatives help you to lose weight – Okay, technically you could call this true, because laxatives do help you to pass stool, which will mean that you weigh less when it’s out of you. However, when people talk about losing weight, 99% of the time they are referring to body fat. We’ve heard some ridiculous claims over the years, that laxatives help you to burn fat because somehow the body fat is allegedly absorbed by the stool, before being excreted by the body. We’re here to tell you outright that this is simply not true. When it comes to fat loss, there is no quick fix or one true tried and tested solution to help you to lose body fat, and you certainly can’t reduce your bodyfat percentages by simply pooping more often. So, when it comes to constipation, by all means use laxatives as they are proven to work, but don’t try to lose weight by consuming them, as this is very dangerous and it simply does not work.