Constipation has side effects, some of which may surprise you. Here are five consequences of this disorder and how to avoid them.

EVIDENCE

Constipation is defined as having less than three bowel movements per week. Even if you’re more regular, hard stools are problematic. The longer food takes to traverse your large intestine, the firmer waste becomes.

Then, when the nudge to evacuate arises, you may experience straining, rectal fullness, and incomplete emptying. Moreover, constipation has the following repercussions.

1. HEMORRHOIDS

Hemorrhoids are swollen veins that emerge around the rectum and anus. Also called “piles,” they can arise internally and externally. Your intestines are lined with smooth muscles whose job is to contract, propelling food through your digestive tract. Straining to evacuate clenches these muscles, exerting pressure against rectal veins, overstretching, weakening, and enlarging them.

Piles are often accompanied by anal pain, itching, and leaking stool. Repeated pressure against hemorrhoids leads to their rupture and bleeding.

Treatments

Frequently, veins normalize with consistent healthy eating and regular evacuation of soft stools. Meanwhile, apply drugstore gels, creams, and pads containing witch hazel or hydrocortisone. These topical agents lower venous swelling, while soothing itching and pain. Cold compresses work similarly.

For persistent piles, rubber band ligation is an outpatient technique, applying an elastic band to the base of a hemorrhoid, cutting off its blood supply. Subsequently, the vein shrinks and detaches. Infrared coagulation involves burning hemorrhoid tissue, followed by scar formation and detachment. Severe hemorrhoids are removed surgically by a gastroenterologist.

2. ANAL FISSURES

fissure is a small cut in anal skin, producing sharp pain and bleeding during bowel movements. A tear may be accompanied by anal burning, itching, and appearance of a skin tag next to the cut.

Fissures are typically the result of laceration by hard stools. Like hemorrhoids, straining plays a role. The anus is controlled by external and internal muscle rings called “sphincters.” When the internal sphincter is subject to added force, it can spasm and prevent blood flow to the anus, making it prone to tearing.

By keeping stools soft, fissures usually heal within a few days to a month. A cut that persists beyond two months requires medical intervention.

Treatments

Soothe a fissure by using Preparation H wipes or Tucks pads after a bowel movement, rather than toilet tissue. Subsequently, apply a drugstore cream containing zinc oxide, hydrocortisone, or witch hazel.

Sitz baths promote healing by calming tissue inflammation and relaxing the internal sphincter. To prepare a sitz bath, fill your tub with a few inches of warm water. Then soak in the water for 20 minutes, up to three times daily.

For a non-healing fissure, a gastroenterologist can apply nitroglycerin to relax the sphincter, promote blood flow, and expedite closure. If nitroglycerin isn’t effective, blood pressure medications may ease sphincter constriction.

Lidocaine numbs pain. Botox is another alternative to quell spasm. A last resort is “lateral internal sphincterotomy,” surgical incision to relax the sphincter.

3. ACNE

Constipation impacts the bacterial balance in your digestive system, causing harmful flora to predominate, which triggers tissue inflammation. When waste stays in the colon for prolonged periods, toxins accumulate in the blood.

Frequently, acne reflects these blood impurities, released through skin pores. In fact, roughly 30 percent of body toxins are eliminated by your skin. Internal pollutants prompt sebaceous glands to crank out more oil, blocking pores and further aggravating acne.

Beneficial flora prevent acne by helping you digest food, absorb its nutrients, and eliminate toxic substances. Such bacteria, called “probiotics,” naturally exist in your large intestine. In a healthy colon, probiotics thrive in populations of 100 billion to 1,000 billion per milliliter.

Constipation can slash your probiotic count to 4 billion per milliliter. Other causes of probiotic decline are alcohol, smoking, infections, antibiotic overuse, non-steroidal anti-inflammatory drugs, inadequate sleep, stress, and a diet low in whole foods and fiber.

Healing

To reduce breakouts, optimize your probiotic levels. One way is eating fermented foods, such as low-fat kefir and yogurt, with “live active cultures” shown on product labels. Each day, enjoy a 6-ounce serving of low-sugar, cultured dairy. Additionally, feed your good flora the plant fiber they love, present in legumes, onions, oats, asparagus, and leeks.

You can also take a probiotic supplement. Choose a brand with at least seven different strains. Ideally, a product should contain at least these five strains – L. acidophilus, B. longum, B. bifidum, L. rhamnosus, and L. plantarum.

Ensure that each dose delivers 20 to 50 billion live organisms or “colony forming units” (CFUs). The potency should be guaranteed through the time of expiration or shelf life. Organisms guaranteed live at the time of manufacture may no longer be viable when you ingest them. Probiotics also need protection from stomach acid by delayed-rupture technology, such as encapsulation, coating, or a time-release mechanism.

The best time to take a probiotic supplement is 15 minutes before breakfast. An empty stomach expedites arrival in the colon.

4. WEAK IMMUNITY

When food has a layover in your colon, nutrient transport and assimilation are impaired. Over time, malnourished immune cells don’t function well, increasing vulnerability to viral and bacterial infection.

Additionally, as mentioned above, beneficial bacteria wane, crippling your defense against invaders. Amazingly, probiotics initiate 80 percent of your immune response to pathogens! Toxins from poorly digested food inflame tissue, another cause of illness and disease.

Defense

Optimal hydration flushes out pathogens and softens waste, making it easier to expel. Drink a volume of healthy fluids equal to half your body weight, with water as your primary source.

Also, consume foods that boost immunity, such as carrots, chard, kale, beets, Brazil nuts, spinach, mushrooms, and ginger. Additionally, the fiber they supply stimulates the gastrointestinal muscle contraction known as “peristalsis.” Complement the action of these protective foods with a multivitamin containing Vitamin C, B complex, and zinc. Also, take a probiotic supplement, as above.

5. DIVERTICULITIS

By age 50, it’s common to develop weak, bulging areas in the large intestine, called “diverticula.” Having many of these pouches constitutes “diverticulosis.” The disease is prevalent in people who have low-fiber diets. Straining causes such strong peristalsis and pressure that it weakens intestinal walls.

In some cases, diverticulosis produces no discomfort. When diverticula impede digestion, symptoms include constipation, cramping, and bloating. If bacteria or stool get lodged in the pouches, they can become inflamed and infected, a condition called “diverticulitis.” Flares can occur suddenly, characterized by abdominal pain, fever, vomiting, chills, and nausea.

Treatment

For mild pain and infection, a gastroenterologist may prescribe acetaminophen and an antibiotic. You can also ease pain and cramping with a heating pad on the abdomen, set to “low.” While inflammation remains acute, doctors advise a diet of clear liquids, such as low-sodium broth, gelatin, fruit juice, and tea. The next dietary phase is bland foods, followed by slowly increasing easily digested fiber.

Once the intestine has adapted to low-fiber food, usually after two weeks, a person can progress to fiber-rich legumes, grains, vegetables, and fruits. Adequate hydration must also be maintained, to soften waste.

PREVENTION

By now, you’ve grasped two key ways to avoid constipation and its side effects:

  • a fiber-rich diet
  • adequate hydration

Women under age 50 need 25 grams of fiber daily, and men should aim for 38 grams. Women over age 51 need 21 grams of daily fiber, while men require 30 grams. Here’s a chart to facilitate getting your daily quota. Also, keep a water bottle handy during the day, refilling it as needed to stay optimally hydrated.

Minimize the consumption of fatty meats, cheese, fast and fried foods, caffeinated drinks, carbonated beverages, white flour, and sugar.

Also, try to get at least 20 minutes of fun exercise daily. After each meal, give yourself time to have a bowel movement. This habit promotes regularity.

NOTE – If medication is causing constipation, speak with your prescribing doctor regarding a less binding substitute drug. If a neurological disorder, such as multiple sclerosis or Parkinson’s disease, is delaying elimination, consult with a physical therapist for abdominal strengthening exercises.

YOUR PARTNER

When constipation and its offshoots persist, make an appointment with Digestive Care Physicians. For nutritional guidance, our staff includes a registered dietitian.

We have four Georgia locations, in Alpharetta, Cumming, Lawrenceville, and Johns Creek. We also serve residents from neighboring cities, including Canton, Milton, Duluth, Marietta, Roswell, Sandy Springs, and Suwanee.

Call us at (770) 227-2222. For a Lawrenceville appointment, call (470) 210-7766. Don’t delay evaluation of any symptoms! Let us partner with you for optimal digestive health.

Note: The information shared here cannot take the place of professional medical care. For any digestive worries, contact Digestive Care Physicians.

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