According to a study presented at the Alzheimerโs Association International Conference in July, chronic constipation (i.e., not having a bowel movement for three-plus days) was associated with a 73 percent higher chance of subjective cognitive declineโor the equivalent of three years of advanced cognitive agingโcompared to participants who had a single BM daily.
To unpack this info, we reached out to Kenneth Brown, MD, a board-certified gastroenterologist based in Plano, Texas. Ahead, see if constipation actually worsens cognitive function and how to achieve real relief from brain-bowel blues in no time.
The link between long-term constipation, cognition, and mood
According to Dr. Brown, constipation doesnโt directly cause cognitive impairment. Instead, itโs symptomatic of underlying causes, such as:
- Side effects of medication
- Dehydration
- Underlying health conditions, such as hypothyroidism
Moreover, he says recent research illustrates that gut imbalances (aka dysbiosis) are often at play when constipation and issues with cognition intersect. โWith a healthy microbiome, anti-inflammatory bioactive metabolites keep inflammation down and can cross the blood-brain barrier,โ Dr. Brown explains. โThe exact opposite happens where an inflamed gut can produce inflammatory cytokines. These can have a direct effect by crossing the blood-brain barrier, leading to localized inflammation in the brain, resulting in decreased production of neurologic transmitters and increased oxidative stress.โ
When GABA, serotonin, and dopamine levels nosedive as a result of chronic inflammation, cognitive function may be impacted if this continues long-term. โOver time, this can result in deposits of amyloid proteins and neurofibrillary tangles, causing increased risk of dementia,โ Dr. Brown says.
Itโs not just your ability to process and memorize information thatโs at stake, however. โWhen an individual experiences constipation, it can trigger a series of effects on overall well-being and indirectly affect the brain,โ Dr. Brown shares. โThe discomfort and bloating associated with constipation can lead to mood disturbances, which can amplify stress and anxiety levels.โ Simply put, long-term constipation can create a domino effect that has the potential to adversely impact your mental health, mood, and energy, as well.
4 game-changing tips to overcome long-term constipation
Above all, if you want to keep your gut and brain in fighting shape for years to come, donโt snooze on addressing signs and symptoms: Preventative care is key. โPeople with Alzheimer’s often start having gastrointestinal problemsโspecifically bloating and constipationโmany years before developing dementia,โ he says. On the flip side, just because youโre constantly constipated doesnโt mean youโre guaranteed to struggle with cognitive impairments in the short or long term. The point is that it always pays to be proactive.
Naturally, making constipation a long-lost memory is easier said than done. But youโre in luck: Dr. Brown has some surprising insights and actionable tips to make significant strides that will benefit your bowel movements and brain health alike.
1. Find the underlying cause
โThis may be the canary in the coal mine,โ says Dr. Brown. However, with the help of your healthcare team, you may be able to ascertain or rule out specific causes of constipation, like side effects of meds or thyroid imbalances. If you get the all-clear on these, you may discover that youโre actually dealing with dysbiosis or intestinal inflammation, and can make the appropriate dietary and lifestyle adjustments from there.
2. Be strategic with your fiber intake
Though fiber is a friend for manyโand something that the majority of Americans donโt get enough of dailyโit can actually be a foe for those struggling with constipation. โIf you do not have a healthy gut microbiome, then fiber may cause bloating and discomfort,โ Dr. Brown cautions. Specifically, he calls out insoluble fiber (top sources of which include whole grains and cruciferous veggies like Brussels sprouts, broccoli, and cauliflower), as a potential trigger, especially for those with small intestinal bacterial overgrowth, aka SIBO.
โIf you do not have a healthy gut microbiome, then fiber may cause bloating and discomfort.โ
โKenneth Brown, MD, board-certified gastroenterologist
To work around this, he suggests opting for psyllium husk, a type of soluble fiber that dissolves in water. Integrate it into your diet in small doses, increase intake gradually, and drink plenty of H2O to avoid further digestive discomfort.
3. Nourish your microbiome (and mind) with polyphenols
More mindful fiber intake aside, Dr. Brown highlights how important it is to get large complex polyphenols in your diet. โOur microbiome metabolizes these large polyphenols into many bioactive metabolites, including anti-inflammatory, anti-aging, and promotility molecules,โ he shares. โA clinical study examined how one of the largest and most complex polyphenols, quebracho colorado, and chestnut produced more beneficial metabolites than inulin, the gold standard [of soluble] fiber.โ
Fruit and vegetables, spices, tea, and coffee (!) are also abundant sources of polyphenols; whole grains and legumes make the cut, too. In addition, polyphenol consumption is associated with cognitive benefits (though further research is needed to establish conclusive links).
4. Prime yourself for โthe goโ
To help kick constipation to the curb, Dr. Brown says youโll want to take advantage of the gastrocolic reflexโฆ which is what, exactly? โWhen fluid or solid hits your stomach, it sends a signal to your colon that you need to make room for the day’s food,โ he explains. โThe key here is not to ignore that urge to go [and to] plan around this physiological process.โ Basically, when your body is telling you itโs time to poop, you should have the agency to do so.
Dr. Brown provides the example of drinking coffeeโwhich can stimulate BMsโduring your commute. If you sip on the subway or in your car and routinely resist the urge to poop, โit can train your colon not to go, leading to chronic constipation,โ the gastro warns. To avoid this issue, aim to drink your coffee at home or once you arrive at your workplace where you can access a bathroom.
Parting tip: Dr. Brown suggests investing in a footstool for your home bathroom to facilitate more successful bowel movements. (Another sign of constipation is that you feel like you havenโt entirelyโfor lack of a better termโunloaded.) With your feet elevated, knees above your hips, and by leaning slightly forward, โThis position helps the rectum to straighten out and helps to have larger, more effective bowel movements so you can fully evacuate.โ
Well+Good articles reference scientific, reliable, recent, robust studies to back up the information we share. You can trust us along your wellness journey.
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Claudine Manach, Augustin Scalbert, Christine Morand, Christian Rรฉmรฉsy, Liliana Jimรฉnez,
Polyphenols: food sources and bioavailability,
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Volume 79, Issue 5, 2004, Pages 727-747, ISSN 0002-9165 - Lamport, Daniel Joseph, and Claire Michelle Williams. โPolyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses.โย Brain plasticity (Amsterdam, Netherlands)ย vol. 6,2 139-153. 9 Feb. 2021, doi:10.3233/BPL-200111
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