This article is for educational and general wellness purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease. If you are experiencing symptoms, please consult a knowledgeable healthcare provider.

Understanding Constipation

Digestive discomfort is something many people experience, especially during times of hormonal change. Constipation — when stool becomes dry, hard, and difficult to pass — can be triggered by a wide range of everyday factors, including:

1. Low Fiber Intake: Insufficient dietary fiber can slow transit of stool through the colon.
2. Dehydration: Inadequate water intake can result in hard, dry stool.
3. Lack of Physical Activity: Sedentary lifestyles can slow down the digestive process and reduce the effectiveness of intestinal muscles.
4. Medications: Some medications, such as certain pain relievers, antacids with aluminum or calcium, and certain antipsychotic drugs, can contribute to constipation.
5. Various health factors: Hormonal shifts and certain underlying health conditions may be associated with changes in digestive regularity.
6. Stress: High stress levels can affect bowel habits and contribute to constipation.
7. Ignoring the Urge: Ignoring the urge to have a bowel movement can lead to stool drying out and becoming more difficult to pass.

Potential Health Problems Associated with Constipation

Prolonged or chronic constipation can be associated with several health concerns:

1. Hemorrhoids: Straining during bowel movements can cause hemorrhoids, which are swollen blood vessels around the rectum.
2. Anal Fissures: The passage of hard stool can lead to small tears in the anal lining, causing pain and bleeding.
3. Fecal Impaction: Severe constipation can result in a blockage in the colon, requiring medical intervention.
4. Diverticulosis: Chronic constipation may be associated with the formation of diverticula (small pouches in the colon) and an increased likelihood of diverticulitis.
5. Bowel Obstruction: In rare cases, untreated constipation can lead to a complete blockage of the intestines, requiring immediate medical attention.

If constipation is chronic, severe, or accompanied by other concerning symptoms, it is worth speaking with a healthcare provider.

Why is it Happening Now?

Constipation tends to become more common as we age and during menopause — and there are real physiological reasons for that. Aging often brings changes in the digestive system, including a reduction in muscle tone and peristalsis (the rhythmic contractions that move stool through the intestines). This slowing of the digestive process can result in stool spending more time in the colon, leading to increased water absorption and the formation of harder, drier stool. Additionally, medications that are more commonly prescribed to older individuals can have constipation as a side effect.

During menopause, hormonal changes — particularly the decline in estrogen — may be associated with changes in bowel function. Estrogen is involved in maintaining the elasticity and tone of the colon and rectum muscles. Its decline may be associated with decreased efficiency of these muscles in moving stool through the intestines. Meanwhile, menopausal symptoms like hot flashes and night sweats can disrupt sleep, leading to changes in daily routines, including eating habits — which can add to the picture.

What About OTC Constipation Relief?

This is where the science comes into play. The research goes back and forth on this issue, largely because these drugs are FDA approved and study funding is often controlled by the same pharmaceutical companies who manufacture and sell them. However, class action lawsuits give some insight into the fact that there are concerns with these medications.

Many of these medications are intended to be used short-term, but since they are OTC and many medications or lifestyle factors can cause constipation, people end up taking them for far longer than intended. Concerns raised over pediatric neuropsychiatry issues first drew attention to the potential toxicity of the ingredients, with many doctors noting that there may be adverse effects in children and that use should be tapered.

But What About Adults?

The key ingredient, Polyethylene Glycol (PEG), is a petroleum derivative. Whilst PEG was long thought to be safe, a growing body of research suggests many people may have adverse reactions to it. Since adult usage is not controlled the same way as pediatric use, the likelihood of prolonged or excess exposure is significantly higher. Choosing natural options when possible is a sensible way to support everyday digestive comfort and reduce exposure to synthetic chemicals like PEG.

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4505343/