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Understanding and Tackling Constipation, Especially in Autoimmune Conditions
When the going gets hard, we experience constipation. Although it’s not a fun subject, it’s one of the most common gastrointestinal complaints seen in healthcare practices. We may all experience constipation at some point in time, and certain conditions make it more likely to occur. In fact, after the age of 60, about 33% of people experience constipation. For those managing autoimmune conditions, constipation can be a frequent and frustrating issue that complicates an already challenging health journey.
Struggling with chronic constipation can have far-reaching effects on your health. Beyond discomfort, constipation can lead to issues like bloating, abdominal discomfort, and even impact your energy levels and overall mood. For those managing autoimmune conditions such as Hashimoto’s thyroiditis, lupus, or IBS, maintaining optimal gut health is crucial for keeping symptoms in check and supporting overall well-being.
Managing constipation can be tricky. Conventional treatments, like laxatives, can provide temporary relief but may worsen symptoms over time, especially in those with autoimmune disorders. Relying on these treatments can lead to dependency, where your body no longer functions naturally to regulate bowel movements. As your body starts to rely on those treatments to have a bowel movement, it doesn’t truly treat the root cause of your constipation. A more holistic approach that identifies the cause and introduces easily implemented lifestyle changes will yield better results, particularly for those managing autoimmune conditions.
What Is Constipation?
The definition of constipation varies by person, as we all have different digestive routines. However, for those with autoimmune diseases, constipation can be more than just an occasional issue—it can be a persistent symptom that affects overall health. As a general rule, constipation is characterized by:
Small, hard stools.
Having a bowel movement fewer than three times a week.
Bloating and discomfort.
Straining on the toilet.
Feeling like you still have to “go” after you go.
What Causes Constipation?
Stool travels through your large intestine propelled by rhythmic muscle contractions known as peristalsis and is primarily composed of water, undigested fiber, bacteria, and dietary fat. Without the correct balance of water and fiber, stool can become harder and more difficult to pass. This also happens if it sits too long in the colon. For those with autoimmune conditions, the digestive system may be even more sensitive to these imbalances, leading to frequent bouts of constipation.
Here are some common causes of constipation, and a few you may not have even considered:
Dehydration is a common cause of constipation, with even fairly mild dehydration having an impact. To avoid constipation, keep up with your recommended water intake. One reason some people struggle with constipation when they travel is because they’re more likely to be dehydrated. For individuals with autoimmune diseases like Sjogren's syndrome, staying hydrated is particularly important, as this condition can reduce saliva and tear production, leading to a higher risk of constipation.
Poor diet is also a major factor, particularly when it comes to fiber intake. If you’re not getting enough fiber, you’re more likely to become constipated. However, some people experience constipation with too much fiber if it’s not increased carefully. Many people find that overindulging in low-fiber foods like cheese and chocolate results in constipation. For those with autoimmune conditions, it’s important to find a dietary balance that supports both gut health and overall immune function.
Thyroid disorders are often characterized by an increase in constipation since thyroid hormone influences your metabolism and bowel motility. When thyroid hormone levels are low, as in hypothyroidism, the digestive system slows down, leading to less frequent and more difficult bowel movements. Addressing thyroid health can be a crucial step in managing chronic constipation, particularly for those with autoimmune thyroid conditions like Hashimoto’s.
Hormonal shifts can affect constipation, with menopausal women often experiencing difficulties. Interestingly, one recent study found a link between frequent constipation and more severe menopausal symptoms. This connection can be even more pronounced in women with autoimmune conditions, as hormonal imbalances can exacerbate both constipation and autoimmune symptoms.
Pregnancy frequently triggers constipation, with up to 38% of pregnant women experiencing slower bowel movements. The hormonal changes of pregnancy contribute to this, as well as decreased activity levels and supplements containing iron that are often taken during pregnancy. For women with autoimmune conditions, managing gut health during pregnancy is especially important to avoid further complications.
Other supplements and medications that can contribute to constipation include painkillers, particularly opioids, antidepressants, and antacid treatments. Paradoxically, laxatives can also contribute to constipation since your body can develop a dependency. Autoimmune patients often need to manage multiple medications, making it crucial to monitor how these treatments might affect digestive health.
Inactivity is another culprit. Not only does regular exercise stimulate your digestive system, but good muscle tone in your abdomen helps with bowel movements. If you’re not moving, your digestive system isn’t moving either! Many people experience constipation if they suddenly don’t get as much exercise as they usually do. This is particularly important for those with autoimmune conditions, where regular, moderate exercise can play a significant role in managing symptoms and preventing constipation.
Certain medical conditions can lead to constipation, including Parkinson’s and diabetes. Issues with the digestive system like irritable bowel syndrome and diverticulosis often feature alternating bouts of constipation and diarrhea. Autoimmune conditions, such as multiple sclerosis and scleroderma, can also directly affect the muscles and nerves involved in bowel movements, leading to chronic constipation.
Changes to your routine can also trigger constipation. Your body gets used to certain triggers for a bowel movement, like a cup of coffee. Disrupting that routine, or even pooping in a new setting, can trigger constipation. For those with autoimmune conditions, maintaining a consistent routine is often key to managing both digestive health and overall symptoms.
Stress is another factor in constipation. Your mood and your digestion impact each other in complex ways. For some people, chronic stress slows digestion, ultimately leading to constipation. Autoimmune conditions can often be triggered or exacerbated by stress, making stress management a vital component of both gut health and overall well-being.
Constipation Relief Through Dietary Adjustments
Instead of turning to medication for constipation, start by making adjustments to your diet. Here are some proven solutions to get things moving, especially for those managing autoimmune conditions:
Increase Fiber Intake. You should be getting at least 22 grams of fiber per day, preferably a mix of insoluble and soluble fiber.
Insoluble fiber doesn’t dissolve in water. It moves through your digestive system unchanged, which can help add bulk and increase the frequency of your stools.
Soluble fiber, on the other hand, absorbs water to form a gel-like substance, which can help soften your stool.
Many high-fiber foods contain a mixture of both types of fiber. Good sources of insoluble fiber include fruits, nuts and seeds, vegetables, wheat bran, and whole grains. Soluble fiber is found in fruits, vegetables, oats, and barley. If you’re used to a low-fiber diet, be sure to increase fiber content gradually to make the transition easier on your system.
Some foods that are particularly effective for constipation include:
Apples: This fruit is not only high in fiber, but it also contains pectin, which can act to soften stool and increase frequency.
Prunes: A time-honored cure for constipation because of their high fiber content, prunes also contain the natural sugar sorbitol, which has a laxative effect.
Kiwis: Several studies confirm that the many benefits of eating kiwis include constipation relief.
Sweet potatoes: This versatile veggie is high in both insoluble fiber and pectin.
Leafy greens: Most varieties of leafy greens are high in fiber. Try to choose darker greens, such as spinach or kale, instead of iceberg lettuce, to improve your fiber intake.
Beans and lentils: Replacing meat with legumes in some meals goes a long way to increase your fiber intake!
Flax and chia seeds: Sprinkling flax seeds on meals is an easy way to increase your fiber. Chia seeds are particularly high in soluble fiber, so a chia seed pudding is much better for digestion than many other desserts.
Stay Hydrated. Increasing fiber will also lead to problems if you’re not also increasing your water intake. To increase water consumption, many people find it useful to carry a non-toxic water bottle with them throughout the day. Adding slices of lemon or cucumber can make water more appealing if you’re not a regular water drinker. Remember to increase your water intake when it’s hotter outside or if exercising.
Caffeine and alcohol are both diuretics, which means they can contribute to dehydration. It’s best to limit both, and alternate with water when you do drink them.
Focus on Probiotics. Your gut contains a complex microbiome of bacteria, which plays an important role in digestion and overall well-being. Probiotics are live, beneficial bacteria that support that microbiome. They’re naturally present in fermented foods like kombucha, kefir, sauerkraut, and tempeh.
You can also purchase probiotic supplements. Several studies have found that probiotic supplements are particularly useful for constipation caused by medication or supplements, such as iron supplements. There is a broad range in quality and effectiveness when it comes to probiotic supplements, so it’s good to work with a healthcare practitioner to find the right type and dose for you.
Practical Lifestyle Tips for Better Bowel Movements
Regular Exercise. Regular exercise is a key part of fending off constipation. Even walking each day can stimulate your digestive system and regulate your bowels.
Establish a Routine. The best way to regulate your digestion is to establish a daily routine. For many people, morning is the best time to have a bowel movement, often after a hot drink. For those with autoimmune conditions, consistency is key, so try to have your morning routine at the same time every day. To increase your chances of success, don’t ignore the urge to go!
Take Your Time. Don’t hurry to finish a bowel movement. It’s important to give your body enough time to have a bowel movement.
Relax. The connection between stress and digestion is real, so try not to stress if you’re constipated, or about anything else! Dealing with stress is an important part of health, whether that’s physical stress from overworking your body or emotional stress from your job or relationships. Learn to set healthy boundaries, relax with your favorite music, or spend more time with people you care about.
Why Addressing Constipation Matters
For individuals managing autoimmune diseases, gut health is a critical component of overall health and symptom management. Constipation is more than just a discomfort; it’s a sign that something in your body is out of balance. Left unaddressed, chronic constipation can exacerbate autoimmune symptoms, leading to increased inflammation, fatigue, and discomfort.
Rather than relying on temporary fixes, a functional approach that considers your unique needs can provide lasting relief. By focusing on diet, hydration, probiotics, and lifestyle changes, you can support both gut health and overall well-being, making it easier to manage your autoimmune condition and enjoy a better quality of life.
If you’re struggling with constipation or any digestive issues, especially if you have an autoimmune condition, it may be time to explore how gut health and immune balance are connected, and what can be done to support both. Don’t hesitate to reach out to us! Together, we can develop a plan that works for you, ensuring that you feel your best every day.
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