Quarantine Constipation Is a Very Real Thing—Here's How to Deal with It
Experts explain what's behind your recent tummy troubles.
There's no shortage of things that have changed over the past few months, and your bathroom habits may very well be on this list. If your stomach has been feeling, well, a little bit off, it's likely not just your imagination—quarantine constipation is legit.
"The common diagnostic criteria for constipation is having less than three bowel movements per week," says Michael Rogowski, Ph.D., senior nutrition scientist for Plexus, a supplement company. But that's not necessarily a hard and fast rule, according to Rogowski (and the American College of Gastroenterology). For some people, three BMs might be totally normal. So, a better way to think about constipation is if you suddenly start defecating less than usual for you and/or are experiencing other signs of discomfort when you go number two. Think: Straining, hard stools, feeling like you need to go but nothing happens, and abdominal pain. (FYI: Diarrhea, on the other hand, could be a sign of COVID-19.)
Ahead, experts explain exactly why you might be blocked up or dealing with other tummy troubles amid the coronavirus pandemic—plus the best ways to get your digestion back on track.
What Might Be Causing Your Quarantine Constipation?
At the risk of pulling a Captain Obvious, seemingly everyone is experiencing higher stress levels these days. And that can impact everything from your mood to your skin to your period to your bowel habits. So if you've been wondering: can stress cause constipation? The answer, dear reader, is a resounding "yes" (followed by "ugh").
Good ol' stress causes many different hormones to be thrown out of whack, including epinephrine, better known as adrenaline. When your palms start to sweat and heart starts to race, this fight-or-flight hormone spikes and causes more blood flow to be sent to vital organs (i.e. heart) rather than your intestines. The result? Reduced or slower gastrointestinal motility—aka the movement of food from your mouth through your digestive system—and, in turn, less frequent and more difficult bowel movements, explains Rogowski. (Related: How Your Mental Health Can Affect Your Digestion)
But stress doesn't stop there: It also may negatively impact the barrier of the gut, allowing inflammatory molecules to get into the bloodstream and cause (you guessed it) inflammation that further exacerbates constipation-related symptoms, says Rogowski. What's more, quarantine constipation isn't the only stress-related digestive issue you might experience; stress can also cause nausea and stomach aches, adds Niket Sonpal, M.D., New York-based internist, gastroenterologist, and adjunct professor at Touro College.
Changes In Diet
"A change in diet, in general, is one of the most common reasons why someone would experience constipation," says Dr. Sonpal. And there's no denying that quarantine life has led to some drastic dietary shifts. Working from home (read: easy kitchen access 24/7), boredom, panic-buying shelf-stable groceries—all of these things can (and likely have) altered what you eat and how much you eat, he says.
On top of that, digestion-disrupting stress can also come into play and lead to emotional eating. "People tend to reach for highly-palatable snack foods when they're stressed, often justified as a reward or consolation for whatever stressful event they're enduring," explains Rogoswki. Three more weeks of social distancing and lockdown? Let me eat half this loaf of freshly-baked banana bread. If this sounds familiar, don't sweat it. Emotional eating happens to so many (🙋) and it makes sense—food has been shown to provide comfort and reassurance during particularly trying times.
And need not forget about the fiber, of course. Here's the thing: Most people are only consuming half the amount of recommended daily fiber (25-35 grams) to begin with, says Rogowski. In fact, about 90-95 percent of Americans do not get enough fiber, according to research. So, it's quite possible that you went into quarantine with weaker bowel health and function. "Add to that a proportionally lower intake of dietary fiber and a drastic reduction of activity, and it's like a house of cards that's collapsed, resulting in this phenomenon of quarantine constipation," he says.
Along with what you're eating, there's also been a shift in when you're eating, according to Rogowski. A change in meal times can impact your circadian rhythm (think: eating later, going to bed later), disrupting the sympathetic and parasympathetic nervous systems that regulate gastrointestinal motility, he adds. (See also: How and Why the Coronavirus Pandemic Is Messing with Your Sleep)
TL;DR—many people are eating fewer nutritious, fiber-rich foods, and instead, indulging in more fat, processed snacks, and carbs that lack fiber, says Dr. Sonpal. It's a recipe for all kinds of digestive problems, including bloating, gas, and, yep, constipation, according to the experts.
ICYMI earlier, reduced activity—fewer sweat sessions since the gym is closed, walking less now that you're sans-commute—is also a constipation culprit. "Exercise helps optimize our metabolism and good muscle tone can help improve bowel movements," says Dr. Sonpal. Regular physical activity speeds up how quickly food moves through the intestines, and your body adapts to a baseline amount of movement and regular routine. Abruptly halting your exercise regime—as you likely had to do during quarantine (at least until you figured out your fave at-home workout)—or suddenly walking way less can end up causing constipation, bloating, and gut aches, he explains. (Related: Why Does Running Make You Poop?)
What Should You Do If You Have Quarantine Constipation?
From a big-picture perspective, it's about learning how to adapt to this new normal. "This virus is here to stay for the foreseeable future, so learning to manage our lives around it is essential," says Dr. Sonpal. "This means learning to safely shop for groceries, so you can assess nutritious natural produce, learning to workout outdoors or at home, and practicing mindfulness if you're having trouble with boredom or stress eating." (And, hey, maybe even investing in a Squatty Potty to help you out on the throne.)
How much exercise should you be getting, exactly? The U.S. Department of Health and Human Services (HHS) recommends that adults get at least 150 minutes (less than 3 hours) of moderate-intensity physical exercise each week. But keep in mind that you're likely also walking and moving way less now that you're spending so much time at home, says Rogowski. "Increased amounts of structured exercise activity beyond the 150 minutes weekly recommendation is likely needed to make up for this reduced walking in order to maintain optimal bowel health," he says. That means more cardio-focused exercises, think running, biking, or even HIIT workouts that get your heart rate up. On top of that, Dr. Sonpal advises walking at least 15 minutes per day to keep your digestive system healthy. Strong core muscles can also help ensure you have healthy bowel movements, he adds, so consider adding in some core exercises daily as well.
As far as more tangible, daily practices go, make sure you're staying hydrated. The longer stool sits in your colon without being eliminated, the more water is extracted from it and harder, dryer stools are more difficult to pass, explains Rogowski. (FYI: The colon is the last place where water and electrolytes are extracted from the food you eat and delivered to the rest of your body.) Dehydration only exacerbates this issue, so upping your water intake is essential.
Eat More Fiber
Also essential? Increasing the amount of fiber you're eating on the reg. "Fiber helps attract and retain water in fecal matter, making it easier to pass, and stimulates intestinal motility so that things move things along faster," says Rogowski. "It also increases mucus production in the gastrointestinal tract, which is important for gut barrier integrity and preventing gut irritation," he adds. That irritation is generally more associated with IBS (irritable bowel syndrome) than constipation, but could also exacerbate constipation-like symptoms such as pain and bloating. (See also: These Benefits of Fiber Make It the Most Important Nutrient In Your Diet)
If you can't hit the recommended daily fiber requirement of 25 grams (for women under 50) via diet alone, Rogowski suggests considering a fiber supplement. It may require a bit of trial and error to determine which type is best for your body, but generally speaking, glucomannan and galactomannan tend to be well-tolerated, he says. Wheat or oat bran, which you can easily find at the grocery store, are also good bets and can be mixed in with other foods, like smoothies or oatmeal.
If All Else Fails...
All of the tactics described above can help prevent and treat constipation (though keep in mind that the digestive process is quite lengthy, so it can take up to three days or more to notice the effects of any lifestyle changes, adds Rogowski). That being said, if you need something to help you go, stat, or these techniques simply aren't cutting it, he says you may want to consider trying a laxative. But (!!) not all laxatives are created equal. Rogowski recommends osmotic laxatives (i.e. Miralax), which work by attracting water to your colon (and keeping it there) so that stools are softer and easier to pass. And skip on stimulant laxatives, such as those that are aloe- or senna-based. These work by causing your intestinal muscles to contract, but they're unnecessarily strong and may cause abdominal pain, he says. (Related: This Anti-Stress Drink Has Been a Total Game-Changer for My IBS)
Bottom line (no pun intended): Quarantine constipation is annoying, yes, but largely NBD."Most people will experience occasional constipation at some point, and that doesn't really necessitate a doctor's visit," says Rogowski. When should you call a doc, though? If these issues persist for six months or more or you can't have a bowel movement without using a laxative, as this can be indicative of a more serious underlying digestive condition, he explains. Otherwise, consider making the lifestyle changes the experts suggest and you should be able to get things moving again.