Constipation, "Autointoxication" & Brain Health
History & "Civilization's Curse," Causes of Constipation, Cognitive & Cardiovascular Health, Addressing the Symptom & the Cause
Is constipation simply a nuisance on the spectrum of normal gastrointestinal functioning? Is it a risk factor for other health conditions, including those involving the brain? Is it the cause of such conditions or a symptom of something else? In this post, I’ll explore these questions and weigh in based on my clinical experience.
Constipation Defined
Constipation is defined as a condition that occurs when someone has infrequent or uncomfortable bowel movements. The strictest definition is having fewer than three bowel movements per week. Other symptoms of constipation can include difficulty passing stool, having hard, dry, or lumpy stool, straining to have bowel movements, or feeling you haven’t fully emptied your bowels. Despite this definition, I and most other functional medicine practitioners would say constipation is having a bowel movement less than once a day. Even more ideal than daily is having bowel movements twice a day.
How Common is It?
Constipation is a common problem affecting 16% of the world’s population. In developing countries, the rate is 14-27%. This is difficult to pin down because many people don’t seek medical attention for constipation. After the age of 40, the incidence increases each decade. Women tend to have a higher incidence, presumably because of higher progesterone and estrogen.
“Civilizations Curse”
Likely, constipation wasn’t always a common problem. From the late 1700s onward, European and American physicians felt that it was becoming more common because of lifestyle changes that came with urbanization, including dietary changes, decreased exercise, and a faster pace of life.
Causes
When it comes to causes, there are lifestyle factors that you’re likely familiar with, as well as less common organic factors. I will also include factors that I see in my practice that appear to contribute to brain symptoms and constipation.
As you look at some of the causes below, remember that the movement of the bowels or peristalsis is a coordinated process that involves the muscles of the GI tract and the nerves that supply them. Several of the below causes impact the functioning of those nerves.
Lifestyle
Not getting enough fiber in your diet - the less “whole” and more processed/refined our diet is, the less fiber there will be.
Not drinking enough water.
Not exercising and moving enough.
Consuming large amounts of milk or cheese.
Medication - pain medications, SSRI’s, antihistamines, blood pressure medication, antacids
Stress. This puts our autonomic nervous system into a physiologic fight or flight (and out of rest and digestion) and increases catecholamines (dopamine and adrenaline), further slowing our GI tract's motility.
Resisting the urge to have a bowel movement can occur in some children.
Less Common Organic Factors
Obstruction - by stool or twisted bowel
Neurological - Parkinson’s, stroke, spinal cord injury
Hypothyroidism
Diabetes and high blood sugar can impact the nerves
Hirschsprung’s Disease (local nerves are affected)
Methanogen Overgrowth - a bacterial overgrowth that makes methane, which can slow the movement of the bowels