Thanks to COVID-19, we’ve all had to figure out a new normal. Working from home, social distancing, and spending so much time indoors has changed day-to-day life in various ways. Those changes include our toilet habits. And that's given rise to a new term, “quarantine constipation."
Even if you didn’t have an issue with constipation before the coronavirus pandemic struck, you might find yourself struggling to go number two now, Robert Lerrigo, MD, gastroenterologist at Santa Clara Valley Medical Center, California, tells Health. “To some, [constipation] means stools are too hard, requiring much straining, or they may be too small in volume," says Dr. Lerrigo. Others have bowel movements less frequently than usual or require excess straining to evacuate stools, even if the stools aren’t hard.
Understanding why some people are becoming constipated during lockdown begins with the circadian rhythm—a natural process in the brain that regulates the sleep-wake cycle and repeats more or less every 24 hours. The colon has its own circadian rhythm that’s easily disrupted by a lack of physical exercise, poor sleep, changes in eating schedules, and stress, says Dr. Lerrigo.
Of course, staying at home because of a global pandemic will likely affect each of those elements. “When we’re at home sitting around and not staying active or engaging in our usual routine, colonic motility (the process by which the colon sequentially contracts to propel feces along) decreases, causing constipation,” says Dr. Lerrigo.
If your gym has shut its doors and you haven't made the transition to an at-home workout, lack of regular exercise might be the problem. Dr. Lerrigo recommends 20 to 60 minutes of aerobic exercise (like a brisk walk or home workout) up to five days a week, adding that even working out two days a week can significantly improve constipation.
If you suspect your new stay-at-home diet is to blame—maybe you're cooking up lots of shelf staples like pasta made from processed flour, for example—try adding more fiber into your meal plan. Fiber-rich foods keep water in your stool, making it softer, larger, and better equipped to pass through the intestines. Fiber also adds bulk to feces to help it move more quickly. Dr. Lerrigo recommends upping your intake of nuts, bran, lentils, fruits, leafy vegetables, legumes, fruits such as prunes, and whole grains like oatmeal. At the same time, cut down on foods with a high fat or starch level.
Don’t forget about hydration. “Dryer-than-normal stool travels through the colon more slowly,” says Dr. Lerrigo. “It’s like going down a slip-and-slide without the water turned on." Water and juice are good options, but don't make booze your hydration source. "Keep in mind that alcohol can also contribute to dehydration, so cut that down as well,” he advises.
Thinking of adding over-the-counter fiber supplements to your next online order? Dr. Lerrigo says that’s absolutely fine—though natural sources of fiber come with many other nutritional benefits. Just make sure you read the labels on OTC fiber supplements. “Even if you’re diligent with taking powdered fiber, it only gives you an extra 9 or 10 grams of fiber daily and some ‘fiber’ bars only give you a gram or two,” he says. (The Institute of Medicine recommends 25 to 30 grams of fiber daily.)
Stress and anxiety may also affect your poop, because the brain directly communicates the emotions they cause to the gastrointestinal system. “In some people, this can cause diarrhea, in others it causes constipation,” says Dr. Lerrigo. It’s not easy to keep stress and anxiety levels down during times of widespread uncertainty, but do what you can to relax—whether that’s yoga, meditation, or simply taking some alone time in a quiet room away from the rest of the household.
If all else fails and your quarantine constipation continues, call your doctor’s office for advice. You may not even need to leave your house and break local social distancing guidelines. “Nationally, clinics are moving towards telemedicine to meet the demands of their patients who should remain at home,” says Dr. Lerrigo.
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