So, how often do you think about your bowel movements? Probably as little as necessary, I'm guessing. Turns out, though, that we've got a few myths floating around about stool, constipation, and what a "healthy" bowel movement needs to be like, and they're causing difficulties. Guess what? You don't have to have one bowel movement a day to be healthy, too little fiber isn't always the cause of constipation (or even the most common one), and constipation isn't going to prompt a build-up of "toxins" that make you sick. What happens in the body during constipation may not be particularly charming to think about, but knowing the process will likely clear up a lot of misinformation about your bowel health and its possible malfunctions.
Constipation is not exactly a rare problem. Up to 42 million people suffer from constipation across the U.S. alone, though we may not be familiar with its technical definition, which is actually very broad: finding it very difficult to pass dry, impacted stool. There's disagreement about how infrequently you have to pass stool to "qualify" as constipated, but three or fewer bowel movements a week is one measure, while the Mayo Clinic describes chronic constipation as a state of constipation that lasts several weeks, or longer. So is it going to kill you? Are you causing yourself irreparable internal damage with your inability to go to the bathroom, and will your poop eventually build up until it presses against your lungs? (This is something that seriously concerned me as a small child, OK?)
Answer to all three: probably not. (OK, definitely not to the last one.) Here's what happens in your body when you get a case of constipation, in hopefully reasonably-palatable detail.
1. Your Colon Absorbes Too Much Water From Your Waste
The basic cause of constipation is dryness. In a normal digestive system, as food moves at a normal rate through your body and is converted into waste, the intestine absorbs water from it and impacts it into stool. In cases of constipation, it seems that food moves too sluggishly through its normal channels, meaning it lingers too long in the colon and has too much water absorbed. The result? Dry stool, which is much harder to push out and gets, well, stuck. (If there's too much stool left, the colon can even stretch to accommodate it, which won't help.)
2. Your Bowel Flora May Have Been Disrupted By An Infection
This is an interesting one: the Center for Digestive Diseases in Australia has a theory about the causes of constipation. (No, it isn't always caused by a lack of fiber or not drinking enough water; the causes are far-ranging, from various types of medication to infections to pregnancy.) The CDD thinks that one overlooked cause of common constipation may be caused when a particular bacteria, clostridia, gets into your system via the mouth, and disrupts its internal bacterial balance. Clostridia increases water retention in the colon, drying out waste, according to a 2001 study; but it's not clear whether it's really responsible for most common-or-garden cases of constipation. At least not yet.
3. You Run The Risk Of Anal Fissues (Yay)
The hazard of not having enough lubrication in a stool as you attempt to pass it can be that it gets stuck and tears the skin. This is called an anal fissure, and it's just as glam as it sounds. It'll likely put blood on the feces and in the toilet bowl, but it can be treated with help from laxatives and special treatment from your GP. If you do see blood or feel pain while passing stool, don't wait: go see a doctor and be upfront about your bum.
4. You May Experience Impaction
If you really can't get rid of your constipation problem, get prepared for a pile-up. The technical term for the accumulation of stool in your rectum and anus is fecal impaction, which sounds better than "poo traffic jam" but amounts to much the same thing. This is a serious medical condition and you'll need to get help to solve it, which will likely involve heavy-duty laxatives, a lot of water, and possibly a suppository or enema.
5. You Have An Increased Risk Of Diverticulitis
Long-term constipation has its own special brand of side effects. They aren't particularly nice, either. One is an increased risk of a phenomenon called diverticulitis, where diverticula (bulges or "pouches" that tend to form naturally on the lining of the colon as you get older) are formed by the pressure of straining to pass your stool, and may eventually become infected if any nasties from the trapped stool get caught in them.
6. No, "Toxins" Don't Build Up In Your Bowel
This is a common misconception, but it's an incorrect one. Yes, stool is made up of waste, and is meant to be exiting the body; but the colon is pretty good at containing it, even in cases of constipation, and its presence will cause you discomfort but not sicken you through the extended presence of "toxins". The only real risk of bacterial infection is if waste products manage to get into any wounds in the colon or rectum, and that's by no means a guaranteed side effect; more like very bad luck.
7. It May Affect Your Bladder Control
There's a closer relationship between your colon and your bladder than you might imagine. And having a very full colon as you strain to get rid of your excess stool has knock-on effects for what's around it. The Department of Urology at the University of California highlights that physical position is an issue: if there's too much pressure on the bladder from a full colon, it won't fill all the way, empty badly, or cause it to leak unexpectedly.
If you strain a lot for bowel movements, you may also damage your pelvic floor muscles, which are necessary for good bladder control. So perpetual constipation problems may cause apparent leakage problems, too. Hurrah.
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