Though constipation is a very common problem yet many of us feel uncomfortable talking about it. In today’s post, we shall find out how chronic Constipation can affect your Mental Health.
Some interesting facts about Constipation and Mental Health
1 . The Ayurvedic Concept
Ayurvedic Medicine is based on Doshas, it believes that one of the main Doshas, “Pitta” is closely related to the digestion of foods, intelligence, thoughts, emotions, and experiences; Pitta Dosha governs nutrition and metabolism, body temperature, and learning. Wow! That means Ayurveda already says that bad gut health or constipation can affect your mental health.
2 . The Chinese View
Thousands of years ago, The Chinese Traditional System of medicine had recognized the strong link between the gut and all of the body’s organs. It says that the state of your gut affects the state of your mind.
3 . The Psychoanalytic View
Sigmund Freud, the father of Psychoanalysis, attributed many psychological problems to the Anal stage of development. The Anal stage of development is the stage when the child learns toilet training. Freud stated that controlling the bowel movement and passing it at the right moment led to a sense of accomplishment and a positive self-image a kind of pleasure. He further postulated that any emotional problem suffered at the Anal stage affects the personality of that person lifelong.
4 . The Literary concept
Literature refers to an Anal retentive person as a person who pays too much attention to detail. This habit then becomes an obsession and maybe an annoyance to others. Anal retentives are often neurotic by nature. They are control freaks quite commonly labeled as a “Pain in the ass”!
Enough of the Gut stories, we now come back to the topic at hand namely which is how can constipation affect your mental health?
But first of us let us know what technically constitutes constipation.
So should you worry if you skip going to the loo for a day or two in a week ?
Let us see …
Constipation in medical terms means any of the following :
- Having less than 3 bowel movements per week
- Passing less than 35 gms of stool per day
- Straining at stool, straining 25 % of the times that stool is passed
- Passing hard dry, sometimes ball-like stool
Constipation can be of two types :
A. Organic Constipation
Organic constipation is generally secondary to some other disease in the body, that’s why it is also called secondary constipation.
Causes of Secondary constipation
Narrowing of the bowel due to Inflammatory Bowel Disease, Cancer of the large intestine, Strictures, Spinal cord injury, motility disorders, Diabetes, Hypothyroid, etc.
B. Functional constipation
When constipation is not because of any underlying disease condition, we call it functional constipation. It is often reversible.
Causes of Functional constipation
Causes of Functional constipation include decreased fluid intake, a less active lifestyle, reduced fiber intake, possible side effects of certain medications like Anti-depressants, pain relievers with Opiates, Calcium channel blockers used to treat Hypertension, etc.
Why doctors think Constipation can affect your Mental Health
The gut is also called the “second brain ” because the gut secretes many hormones that aid digestion and also regulate appetite and satiety. Many Neurotransmitters have a pronounced action on the gut and bowel movement.
Also, did you know 90% of serotonin (our feel-good neurotransmitter) is produced in the gut!
Scientific evidence that shows Constipation can affect Mental Health
1 . A study by Chattat et al, showed that constipated patients had higher psychological distress than healthy subjects ( Source 1)
2 . Another research conducted in Iran found a relatively high prevalence of anxiety and depression (as high as 33 % ) in patients suffering from chronic constipation.
(Hosseinzadeh ST, Poorsaadati S, Radkani B, Forootan M. Psychological disorders in patients with chronic constipation. Gastroenterology and Hepatology From Bed to Bench. 2011;4(3):159-163. PMID: 24834176; PMCID: PMC4017427.)
3 . Many studies on Functional Gastrointestinal Disorders (FGD) have shown that psychosocial factors affect bowel movement. Anxiety, depression, panic, post-traumatic stress, and somatization disorders (previously called hysteria ) are frequently present or precede Functional Bowel disorders like constipation.( Source 2 )
An Unhealthy Obsession with the BM
The world and Indians in particular is obsessed with bowel movement (BM). The inappropriate stress on the timely and proper evacuation of bowels creates a kind of neurosis in children. We teach our children to hold the stool in till the time and place are appropriate. We cajole our children to pass stool first thing on waking up in the morning. If they don’t have a BM it right after waking up , we start giving them a good scolding or good dose of castor oil to get that elusive BM. Both will affect the child’s health badly in the long run.
We treat the stool as something bad, to be ashamed of. Our stool is just a by-product of a healthy digestive system, it is nothing to be ashamed of. The toilet training has to be freed of excessive stress.
Some healthy habits that improve constipation
1 . A High Fiber Diet
A low fiber diet lacking in raw vegetables and fruits. Adults need to take about 5 cups of fruits and vegetables daily. Children may do well with 2-3 cups of the same.
2 . Check for Lactose Intolerance
When a person lacks in the enzymes needed to digest milk then this condition is called Lactose Intolerance. It causes the milk to curdle for long in the gut and cause constipation. This condition stays undetected in many children. Dairy free substitutes or more easily digested milk products like yogurt and curd can help.
3. Access to clean , adequately ventilated and lit Toilets
Many children avoid going to the school toilet because toilets are dirty, smelly, and frightening places to them. Sometimes like in rural India, there are no toilets and one has to keep holding the shit in till one can reach an appropriate place to relieve oneself.
Unfortunately, despite concrete evidence that chronic Constipation has an undeniable relationship with Mental health, we do not know which comes first. The vice versa may likely be true – chronic constipation may affect your mental health in the long run and so it is best to avoid getting constipated or seek help if your problem fits in the medical definition of constipation mentioned above.
( This post is my contribution to Blogchatter’s initiative #CauseAChatter to spread awareness about #MentalHealth )
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