Understanding Constipation

Constipation occurs when stool becomes dry, hard, and difficult to pass. It can be caused by various factors, including:

1. Low Fiber Intake: Insufficient dietary fiber can lead to slower 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. Medical Conditions: Conditions like irritable bowel syndrome (IBS), hypothyroidism, and diabetes can be associated with chronic constipation.
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 lead to several health issues:

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 contribute to the formation of diverticula (small pouches in the colon) and increase the risk of diverticulitis.
5. Bowel Obstruction: In rare cases, untreated constipation can lead to a complete blockage of the intestines, requiring immediate medical attention.

It's important to consult a healthcare provider if constipation is chronic, severe, or accompanied by other concerning symptoms, as it can be a sign of an underlying medical condition.

Why is it Happening Now?

Constipation tends to become more common as we age and during menopause due to several factors. 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 for various health conditions can have constipation as a side effect.

In the case of menopause, hormonal changes, particularly a decrease in estrogen levels, can affect bowel function. Estrogen plays a role in maintaining the elasticity and tone of the colon and rectum muscles. Its decline can result in a decreased ability of these muscles to efficiently move stool through the intestines, making constipation more prevalent during this life stage. Moreover, menopausal symptoms like hot flashes and night sweats may disrupt sleep, leading to changes in daily routines, including eating habits, which can further contribute to constipation.

What About OTC Constipation Relief?

This is where the science comes into play. The science 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 are manufacturing and selling the drugs. However, class action lawsuits give some insight into the fact that there are issues with these medications.

Many of these medications are intended to be used in the 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 raised concern about the toxicity of the ingredients, with many doctors noting that there are adverse affects in children and use should be tapered.

But What About Adults?

The key ingredient, Polyethylene Glycol, is a petroleum derivative. Whilst PEG (as it is known) was thought to be safe, a growing body of research suggests many people may in fact have adverse reactions to it. Since adult usage of the drug is not controlled the same as pediatric use, the likelihood of prolonged or over exposure is significantly increased. Limiting use, and opting for natural constipation remedies, should always be the first line of defense in mitigating side effects and exposure to chemicals like PEG!


Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC45053...