Side Effects of Constipation: Top 10 You Need to Know
Constipation isn’t something we often talk about, unless you hang around with me… But given it affects up to 25% of the population (and mostly women) it means a lot of us are suffering in silence (1). And while most people think of constipation as just an annoying symptom, it can also be the root cause of other symptoms and conditions, including fatigue, weight gain, low mood, and many more. Here are the top 10 side effects of constipation that I see almost everyday.
But before we get in too deep, let me just say that this blog post isn’t for you if you ate a crappy diet for three days and got bunged up. It happens, and can be easily fixed by cleaning up the diet and a little exercise to help move things along. This blog post is for that special someone with a chronic case of constipation, the kind that has been following you around (like a bad smell) for months or even years. I know this special someone because she was me, chronically constipated and constantly feeling bloated, toxic and really tired because of it. If that sounds familiar, then I’m here to tell you that constipation is a HUGE health risk, and to hammer home exactly why you need to clear it out ASAP.
Here is a summary of what we are going to cover:
> What exactly is constipation?
> How chronic constipation can wreak havoc with your health
> 10 side effects of constipation
> How to find strategies to clear constipation that will work for you
WHAT DO I MEAN BY CONSTIPATION, EXACTLY?
Constipation can mean different things to different people. Here, we are talking about chronic constipation; the serious, long-term type. There’s two different ways to tell if you have constipation. The first is the Rome III diagnostic criteria. It identifies people as having functional constipation when 25% of bowel movements are associated with at least two of the following symptoms: straining; hard or lumpy stools; a sense of incomplete evacuation; a sense of anorectal obstruction; the need for manual manoeuvres; or fewer than three bowel movements per week in the previous three months, with an onset of symptoms longer than six months (2).
Another way to look at constipation is with the help of the Bristol Stool Form Scale – a visual aid designed to classify poop into one of seven categories (3). Frequently passing poop that matches Type 1 or 2 in the table below generally indicates a problem with constipation that should not be ignored. Here is a post on DIY gut health tests you can do yourself if you’re not sure.
HOW CONSTIPATION WRECKS YOUR HEALTH
Most people think of constipation as a symptom rather than the cause of their health problems. And for many functional gastrointestinal conditions like gut pathogens, leaky gut and food sensitivities, this is definitely the case – which is why you might want to get tested and uncover the root cause of your constipation.
But, constipation itself can also be the root cause of other symptoms and conditions. Constipation can wreak havoc with your insides, stemming from one of three main issues;
1. Toxin reabsorption in the colon, including excess hormones, that would normally be excreted in the stool (4).
2. Imbalance of intestinal flora, including a reduction in healthy species and overgrowths of unwanted bacteria or pathogens (5).
3. Structural and physical effects of large hard stools and the straining that commonly accompanies them (6).
It is these mechanisms that can cause a whole range of unwanted symptoms and are the side effects of constipation that you may be struggling with right now…
TEN SIDE EFFECTS OF CONSTIPATION
Constipation and fatigue go hand-in-hand, with strong evidence for a connection between the two (7). A dysbiosis caused by constipation can increase the fermentation of carbohydrates and the production of various gases, including super smelly hydrogen sulphide thought to cause dysfunction of the mitochondria – the energy producers within our cells (8, 9). A lack of healthy flora in the gut can also decrease the absorption of nutrients required for energy and normal physiological function (10, 11). Impaired detoxification of toxic substances that can enter the bloodstream may also impact energy levels and cause fatigue.
2. WEIGHT GAIN
Yes, a buildup of poop can add a few extra kilos – anyone who has done colonic irrigation or an enema can attest to that… But what about ‘real’ weight, the fat storage kind? Yes, that too. Science is just starting to understand how a dysbiosis of intestinal flora can cause weight gain and obesity – but the link is definitely there (12). Hormone imbalances, particularly those relating to oestrogen have also been linked with obesity (13). So, not clearing those excess oestrogens and having them reabsorbed back into your system might not be so good for your waistline.
3. BAD SKIN
Another side-effect of toxicity associated with constipation is acne and skin breakouts. This happens when toxins and waste are re-absorbed back into the bloodstream via the colon, rather than being eliminated. From the bloodstream, these toxins can exit the body by its largest detoxification organ – the skin. The other mechanism by which constipation can impact skin is through the alteration of gut bacteria. This study showed that 54% of acne patients have significantly altered gut flora while probiotics (beneficial bacteria) have also been shown to reduce symptoms (14). One thing is for sure, beauty begins in the bowel.
Constipation is one of the highest risk-factors and most common causes of small intestinal bacterial overgrowth (SIBO) (15). This recently discovered condition, where bacteria from the large intestine end up in the small intestine where they don’t belong, is thought to be responsible for up to 80% of IBS cases (16). While the most common symptoms associated with SIBO are constipation, diarrhoea and extreme bloating, it has also been connected with fatigue, weight gain and many of the other issues discussed here (17).
5. BRITTLE NAILS AND THINNING HAIR
Nutritional deficiencies can affect the growth of both hair and nails (18, 19). And as we know, a lack of healthy flora in the gut can also decrease the absorption of many nutrients essential for energy and growth (11). Excess toxins being reabsorbed into the bloodstream doesn’t help your beauty regime, leaving you at risk of brittle nails and thinning hair. This might not seem as bad as some of the other side effects of constipation but it can and does have an impact on our overall health and wellbeing.
6. POOR IMMUNITY
Our intestinal flora is responsible for much of the body’s immune response, including the removal of cell debris, viruses, bacteria, and cancerous cells (20). As constipation is often associated with missing or damaged bacteria (intestinal flora), the impact on your immune system can be significant. The toxic buildup and inflammation associated with constipation can also impair the immune system and leave you vulnerable to infections like urinary tract infections (UTIs) – here’s a post about how to heal a UTI naturally.
7. OESTROGEN DOMINANCE
Constipation can inhibit the excretion of unwanted oestrogen from the body and promote its reabsorption (4). We are exposed to a lot of environmental sources of oestrogens through toxins such as plastics, medications and hormones in the animal proteins we consume. This means that most people have excess oestrogen coming into the body that needs to be excreted each day. If we are constipated, these excess oestrogens can be re-absorbed in the colon and cause elevated oestrogen levels, a condition also associated with allergies (21), weight gain (22) and fatigue (23).
8. STRUCTURAL CONDITIONS
Beyond functional and chronic disease, constipation can also cause structural problems that may require surgical intervention. Straining during bowel movements and sitting on the toilet for extended periods can result in haemorrhoids, rectal prolapse, and anal fissures. Gone are the days of visiting the loo with a magazine for entertainment.
Hard stools and increased intra-abdominal pressure are thought to add extra pressure to the veins around the anus and increase the risk of haemorrhoids (24, 25). The connective tissue around the anus can also weaken, leading to rectal prolapse, a condition in which the rectum protrudes through the anus (26) – not a nice thing to happen to anyone. And, passing hard or large stools can cause anal fissures, which are small tears in the skin of the anus (6).
9. FAECAL IMPACTION
Faecal impaction is the result of chronic or severe constipation and is basically a bowel obstruction caused by poop that has hardened in the colon to the point that it is causing a solid blockage (27). Liquid stool can bypass the impacted poop, causing overflow incontinence, often mistaken for diarrhoea (28). In severe cases, faecal impaction can cause ulcers or bowel perforation. This is definitely one of the more severe side effects of constipation.
10. ANXIETY AND DEPRESSION
Mood and anxiety disorders have long been scientific bedfellows with constipation and other gastrointestinal disorders (29). And while constipation is often thought to be the symptom, recent neuroscientific research has begun to show the importance of intestinal flora in the development of brain symptoms (30, 31). So, there’s even more reason you might be feeling low if you can’t go to the loo. And it’s these kinds of side effects of constipation that people aren’t often aware of that make a huge difference to our everyday lives.
WHAT STRATEGIES CAN I USE TO GET THINGS MOVING?
So, there you go – chronic constipation is B.A.D. news! And it has to go (PERMANENTLY) for you to enjoy good health and perfect poops in the future. As always, it is really important that you seek the root cause of your constipation, but in the meantime, if you want sure-fire strategies to help you clear out chronic constipation and get on top of some of these nasty side-effects, check out my free eGuide: CHRONIC CONSTIPATION CLEAR-OUT eGUIDE (below).
Discover four strategies guaranteed to get things moving when everything else fails, including:
> My number 1 go-to breakfast smoothie for keeping bowel habits regular
> The quick-fix protocol to achieve a needed bowel movement within 24 hours
> 4 must-try supplements, and my favourite brands, that won’t waste your money
> Everything you need to know about a detoxing “C” Flush to have you feeling less bloated and toxic
These strategies are more than the usual, basic recommendations of “clean up the diet”, “drink more water” or “do more exercise”. These are clinical techniques that I use with my clients who have been struggling for years and they work!!
References for Side Effects of Constipation:
- Liu, L. W. C. (2011). Chronic constipation: Current treatment options. Canadian Journal of Gastroenterology, 25(Suppl B), 22B–28B
- Longstreth, G., et al. (2006). Functional bowel disorders. Gastroenterology, 130(5), 1480-91
- Lewis, S., Heaton, K. (1997). Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol, 32(9), 920-4
- Lewis, S., Heaton, K., Oakey, R., & McGarrigle, H. (1997). Lower serum oestrogen concentrations associated with faster intestinal transit. British Journal of Cancer, 76(3), 395–400
- Zhu, L., et al. (2014). Structural changes in the gut microbiome of constipated patients. Physiol Genomics. 46(18), 679-86
- Zaghiyan, K. N., & Fleshner, P. (2011). Anal Fissure. Clinics in Colon and Rectal Surgery, 24(1), 22–30
- Burnet, R. B., & Chatterton, B. E. (2004). Gastric emptying is slow in chronic fatigue syndrome. BMC Gastroenterology, 4, 32
- Lemle, M. (2009). Hypothesis: chronic fatigue syndrome is caused by dysregulation of hydrogen sulfide metabolism.Med Hypotheses, 72(1), 108-9
- Guo, W., et al. (2012). Hydrogen Sulfide as an Endogenous Modulator in Mitochondria and Mitochondria Dysfunction. Oxidative Medicine and Cellular Longevity, 2012, 878052.
- Giloteaux, L., et al. (2016). Reduced diversity and altered composition of the gut microbiome in individuals with myalgic encephalomyelitis/chronic fatigue syndrome. Microbiome, 4, 30
- Krajmalnik-Brown, R., Ilhan, Z.-E., Kang, D.-W., & DiBaise, J. K. (2012). Effects of Gut Microbes on Nutrient Absorption and Energy Regulation. Nutr Clin Pract, 27(2), 201–214
- Clarke, S., et al. (2012). The gut microbiota and its relationship to diet and obesity: New insights. Gut Microbes, 3(3), 186–202
- Cleary, M. P., & Grossmann, M. E. (2009). Obesity and Breast Cancer: The Estrogen Connection. Endocrinology, 150(6), 2537–2542
- Gueniche, A., et al. (2010). Lactobacillus paracasei CNCM I-2116 (ST11) inhibits substance P-induced skin inflammation and accelerates skin barrier function recovery in vitro. Eur J Dermatol, 20(6), 731-7
- Quigley, E. M. M. (2011). Microflora Modulation of Motility. Journal of Neurogastroenterology and Motility, 17(2), 140–147
- Rana, S. V., & Malik, A. (2014). Breath tests and irritable bowel syndrome. World Journal of Gastroenterology : WJG, 20(24), 7587–7601
- Dukowicz, A. C., Lacy, B. E., & Levine, G. M. (2007). Small Intestinal Bacterial Overgrowth: A Comprehensive Review. Gastroenterology & Hepatology, 3(2), 112–122
- Goluch-Koniuszy, Z. S. (2016). Nutrition of women with hair loss problem during the period of menopause. Przegla̜d Menopauzalny = Menopause Review, 15(1), 56–61
- Cashman, M., Sloan, S. (2010). Nutrition and nail disease. Clin Dermatol, 28(4):420-5
- Wu, H.-J., & Wu, E. (2012). The role of gut microbiota in immune homeostasis and autoimmunity. Gut Microbes, 3(1), 4–14
- Bonds, R. S., & Midoro-Horiuti, T. (2013). Estrogen effects in allergy and asthma. Current Opinion in Allergy and Clinical Immunology, 13(1), 92–99
- Cleary, M. P., & Grossmann, M. E. (2009). Obesity and Breast Cancer: The Estrogen Connection. Endocrinology, 150(6), 2537–2542. http://doi.org/10.1210/en.2009-0070
- Möller, M., et al. (2012). Effect of estrogen and testosterone replacement therapy on cognitive fatigue. Gynecol Endocrinol, 29(2), 173-6
- Lohsiriwat, V. (2012). Hemorrhoids: From basic pathophysiology to clinical management. World Journal of Gastroenterology : WJG, 18(17), 2009–2017
- Riss, S. (2011). Haemorrhoids, constipation and faecal incontinence: is there any relationship? Colorectal Dis, 13(8):e227-33
- O’Brien, D. P. (2007). Rectal Prolapse. Clinics in Colon and Rectal Surgery, 20(2), 125–132
- Obokhare, I. (2012). Fecal Impaction: A Cause for Concern? Clinics in Colon and Rectal Surgery, 25(1), 53–58
- Rao, S. S., & Go, J. T. (2010). Update on the management of constipation in the elderly: new treatment options. Clinical Interventions in Aging, 5, 163–171
- Hosseinzadeh, S. T., Poorsaadati, S., Radkani, B., & Forootan, M. (2011). Psychological disorders in patients with chronic constipation. Gastroenterology and Hepatology From Bed to Bench, 4(3), 159–163
- Evrensel, A., & Ceylan, M. E. (2015). The Gut-Brain Axis: The Missing Link in Depression. Clinical Psychopharmacology and Neuroscience, 13(3), 239–244
- Galland, L. (2014). The Gut Microbiome and the Brain. Journal of Medicinal Food, 17(12), 1261–1272