We’ve all been there: the urge to defecate is strong, but the ability to do so isn’t. Despite much huffing and puffing, nothing is forthcoming. You rise defeated, if not deflated.
Constipation is one of the occupational hazards of being human. Perhaps because of how common it is, it has long been regarded as a minor inconvenience, curable by diet and exercise and, if those don’t loosen things up, laxatives.
Much of the time, those remedies help and constipation passes quickly. But for a good many people, being unable to regularly defecate persists for months or even years. And for them, the consequences can be more serious.
That’s why researchers and doctors are starting to pay more attention to constipation. It can have a terrible impact on quality of life, leading to haemorrhoids, anal fissures or, in particularly serious cases, impacted bowels caused by the build-up of faeces in the lower intestine, all of which can be debilitating. In severe – but thankfully rare – cases, constipation can damage internal organs and even be deadly.
And there’s more. Emerging evidence supports the idea that chronic constipation is a causal factor in some more pernicious health problems, including cardiovascular disease, kidney disease and cognitive impairment. Exactly why constipation might play a role in these conditions isn’t entirely clear, which has got researchers on the hunt for potential mechanisms.
What is clear is that being bunged up for a long time can take a real toll on your health and should be avoided. But that is sometimes easier said than done.
Chronic condition
There is a natural variation in people’s bowel habits, but those who are constipated have unusually infrequent movements – just two or fewer a week. If that persists for 12 weeks, along with at least one more symptom, such as frequent straining, hard or lumpy stools, a sense of unfinished business or the need for “manual assistance”, the diagnosis is chronic constipation.
Around 16 per cent of people are chronically constipated at any given time. “That means that one in seven patients globally struggle with symptoms of chronic constipation,” says Brian Lacy, a gastroenterologist at the Mayo Clinic in Jacksonville, Florida.
A diet high in red meat and processed food has long been thought to lead to constipation.
Jonathan Knowles/Getty Images
People become constipated for many reasons. In children, the main cause is withholding faeces during and after toilet training, with a peak incidence rate of about 12 per cent between the ages of 2 and 4. Women account for around two-thirds of adult cases of constipation: reproductive hormones suppress bowel motility and childbirth can damage the muscles of the pelvic floor, including those that control the contraction of the rectum.
In fact, dysfunctional pelvic floor muscles in men and women are to blame for about 30 per cent of chronic constipation cases, according to Lacy. The condition becomes more common with age, with the difference between the sexes evening out in the over 70s. The age-related decline of sensory nerves in the rectum means that older people are sometimes less aware of the need to defecate, which can lead to a build-up of…
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