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Constipation: Causes, Consequences, + Treatment

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If you’re one of the 4 million folks in the United States who struggle with constipation, it’s more important than ever to find the get-up-and-go you need to become regular.

Causes of Constipation

We’ve known for a while that lack of exercise, not consuming enough liquids or fiber, postponing going to the bathroom, and irritable bowel syndrome can back you up. So can medications such as NSAIDs (non-steroidal anti-inflammatory drugs), iron supplements, and some blood pressure and depression meds. Overuse of laxatives can also perpetuate constipation.

But recent research reveals a whole new cause of constipation: disruption of your gut biome. 

One study examined data on more than 110,000 people over six years and found that constipation was associated with fewer gut bacteria that produce butyrate, a fatty acid that provides energy to colon cells, may support the immune system, and reduces inflammation. Constipated-prone people also had fewer bacteria responsible for digesting dietary fibers.

The Consequences of Constipation

The most eye-opening headline from that study of gut bacteria is that constipated people had 73% higher odds of reporting cognitive decline compared to folks who had daily bowel movements. On the other side, the study also found that going to the bathroom more than twice a day was associated with a slightly increased risk of cognitive decline—possibly because that also reveals an imbalance in the gut microbiome. Having the right amount of poop seems to clear our minds as well as our colons.

There’s more: A second study out of UT Health San Antonio examined fecal samples and cognitive measures from 140 cognitively healthy middle-aged people and found elevated levels of Alzheimer' s-associated amyloid and tau were associated with lower levels of neuro-protective gut bacteria. 

Now we know that constipation affects cognition, we can add that to the list of other profound health consequences that come from being backed up, which include elevated blood pressure, heart disease, and depression.

4 Ways to Relieve Constipation

To restore balance to your gut biome, protect your brain, and help your body move waste through your digestive system smoothly, adopt these four habits.

Eat More Fiber

Eat high-fiber, unprocessed, 100% whole grains, fruits, and vegetables. Aim for 25g of fiber a day. Eliminate over-processed foods and added sugars.

To get the amount of fiber you need daily, enjoy these foods:

  • Lentils and quinoa (1 cup = 15-19g fiber)
  • Veggies like collards, broccoli, Brussels sprouts, and sweet potatoes (2g fiber per cup)
  • Raspberries and blackberries (8g fiber per cup)

Hydrate

Drink water, coffee, or tea as needed. Eight or more glasses may be appropriate, but you should never get thirsty. Ditch sugar-added and artificially sweetened beverages

Talk to Your Doc

Ask your doctor if any of your medications may cause constipation, and if so, look for alternatives.

Helpful Supplements

Try natural laxatives like psyllium fiber and probiotics to restore gut health. Aloe vera juice or supplement may ease constipation, as may senna (tea or supplement) and rhubarb (as food or supplement).

For a full list of foods that may help, check out this article: “Best Constipation Natural Remedies from a Dietitian: Foods, Tips, Supplements.”

References:

  1. Keiichi Sumida, Miklos Z. Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Kunihiro Yamagata, Kamyar Kalantar-Zadeh, and Csaba P Kovesdy. Constipation and risk of death and cardiovascular events. Atherosclerosis. 2019 Feb; 281: 114–120. doi: 10.1016/j.atherosclerosis.2018.12.021
  2. Qingping Yun, Shiyu Wang, Shanquan Chen, Hao Luo, Bingyu Li, Paul Yip, et al. Constipation preceding depression: a population-based cohort study. eClinical Medicine. Published: January 16, 2024. DOI: https://doi.org/10.1016/j.eclinm.2023.102371
  3. Johns Hopkins Medicine. Constipation. www.hopkinsmedicine.org. Published 2024. https://www.hopkinsmedicine.org/health/conditions-and-diseases/constipation
  4. Clinical study presented at AAIC finds a link between chronic constipation and cognitive decline in older adults. wwwalzheimer-europeorg. Published online June 17, 2024. Accessed June 24, 2024. 
  5. Constipation Associated with Cognitive Aging & Decline | alz.org. AAIC. Published 2024. Accessed June 24, 2024. 
  6. What is Butyrate and What Can It Do? Cleveland Clinic. https://health.clevelandclinic.org/butyrate-benefits
  7. Constipation and risk of death and cardiovascular events. Atherosclerosis. 2019;281:114-120. doi:https://doi.org/10.1016/j.atherosclerosis.2018.12.021
  8. ‌https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00548-5/fulltext

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