Do you struggle having a poo? Do you often feel stomach discomfort, but you can’t go to the toilet? If this is so, you may have chronic constipation. Here we will tell you more about this disorder, its related complications, why can it happen during menopause and how to alleviate it.

What is chronic constipation?

It is a common condition that may happen to people of all ages that consists of difficulty expulsing feces due to a low frequency of evacuation. The term ‘chronic’ refers to the illness’ graduality and persistence through the years.

Risk factors

In rare cases, constipation is caused by a medical condition, associated with colitis or irritable bowel syndrome. But some risk factors make it happen, for example (Gotfried, 2022; NHS, 2020)

• Low water intake.
• Sedentary lifestyle.
• Frequently ignoring the need to go to the toilet.
• Abrupt changes in diet or daily routine.
• Low consumption of fruits, vegetables, and cereals fibre.
• Stress, anxiety, or depression.
• Medicines that slow down bowel movements.
• Pregnancy.
• Menopause.

Chronic constipation: signals and symptoms

Some signals and symptoms that allow you to identify the constipation are (NHS, 2020):

• Less than 3 poos per week during the last 3 weeks.
• Feces are big, dry, hard, and lumpy looking.
• You need to try and push to evacuate.
• You feel pain going to the toilet.
• After going to the toilet, the feeling of not having completely emptied the bowels persists.
• You have a stomachache and abdominal distention that is only alleviated by the bowel evacuation.

Remember that not everyone has a daily poo and that is normal. A healthy range goes from 1 to 3 per day to 3 per week. If there is a change and now you poo less than usual, you may have constipation (Gotfried, 2022)

Menopause and chronic constipation worsening

Menopause is characterised by a reduction of oestrogen levels (a hormone produced by your ovaries). These hormones participate in some important gastrointestinal system functions, including intestinal motility. That’s why during perimenopause, menopause, and post menopause you may notice a slower bowel movement. This contributes to the constipation appearance and/or worsening. In addition, age can enable the emergence of other ailments, requiring the consumption of medicines, and that may worsen the problem. Psychological changes experienced by women during menopause such as anxiety or depression also contribute to constipation (Gotfried, 2022; Jiang et al., 2019).

Complications

This illness may generate some complications, such as (Gotfried, 2022):

• Hemorrhoids.
• Anal fissure.
• Rectal prolapse.
• Diverticular disease.
• Fecal impaction.

Alarm signals

Visit a physician if you have constipation signals and symptoms, as well as these issues:

• Blood in the feces.
• If you have not been able to have a bowel movement for a long time.
• Feeling tired regularly.
• If there is unexplained weight loss.

Chronic constipation: Recommendations to alleviate it

In general, chronic constipation can be treated at home with healthy habits such as (NHS, 2020):

• Drink enough water during the day, around 2 litres per day (MedLine Plus, 2019).
• Avoid alcohol consumption.
• Keep moving! The best way is to exercise 30 minutes 5 days per week.
• Ingest from 25 to 38 grams of fibre daily. You can achieve this by increasing the daily consumption of fruits and vegetables. Also, eat wheat bran, oats, or flaxseed per day (Mayo Clinic, 2021).
• Establish a schedule and try to go to the toilet at the same time every day.
• If you wish to go to the toilet, don’t wait so long to do it.
• You can rest your feet on a low bench to facilitate.
• Consult your physician about the use of a stool softener. Avoid using laxatives indiscriminately.

Chronic constipation is a common affection that can worsen during menopause due to the hormonal changes that happen at that stage of life. But fortunately, it gets better by having a healthy lifestyle. We invite you to follow the recommendations in this article to control constipation and improve your quality of life.

References:

• Chen C, Gong X, Yang X, Shang X, Du Q, Liao Q, Xie R, Chen Y, Xu J. (2019) The roles of estrogen and estrogen receptors in gastrointestinal disease. Oncol Lett.; 18 (6): 5673-5680. Available on: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6865762/#:~:text=In%20recent%20years%2C%20researchers%20have,gastric%20cancer%2C%20inflammatory%20bowel%20disease%2C
• Gotfried J. (2022). Constipation in adults. MSDmanuals. Available on: https://www.msdmanuals.com/es/hogar/trastornos-gastrointestinales/s%C3%ADntomas-de-los-trastornos-digestivos/estre%C3%B1imiento-en-adultos
• Jiang Y., Greenwood B., Johnson A., Travagli A. (2019). Role of estrogen and stress on the brain-gut axis. Gastrointestinal and liver physiology. Vol 317 No 2. Available on: https://journals.physiology.org/doi/full/10.1152/ajpgi.00144.2019
• Mayo Clinic (2021). Nutrition and healthy eating. Available on: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/basics/healthy-diets/hlv-20049477
• Medline Plus. (2019). Water in the diet. Available on: https://medlineplus.gov/spanish/ency/article/002471.htm#:~:text=Recomendaciones&text=La%20ingesta%20diet%C3%A9tica%20de%20referencia,cualquier%20afecci%C3%B3n%20que%20pueda%20tener.
• NHS. (2020). Constipation. https://www.nhs.uk/conditions/constipation/
• Yang P., Heitkemper M., Camp K. (2021). Irritable bowel syndrome in midlife women: a narrative review. Women's midlife health journal 7, 4. Available in: https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-021-00064-5#SeThe roles of estrogen and estrogen receptors in gastrointestinal diseasec3