Can Constipation Cause Depression? (What the research says)

This blog post will answer the question ‘’Can constipation cause depression?’’ and cover the areas like what the research says about the link between constipation and depression, why constipation matters? Symptoms of constipation, factors responsible for constipation, and possible ways to manage and relieve constipation.

Can constipation cause depression?

Yes, constipation can cause depression. The prevalence of mood and anxiety disorders in patients with gastrointestinal disorders has been reported to be greater than in the general population. Similarities between the gut and the brain indicate a common cause might be shared by the two conditions.

“The gut is often referred to as the ‘second brain’ of the body,” Margolis says. Gut: 

  • Has more neurons than the spinal cord
  • Uses lot of the same brain neurotransmitters

So it shouldn’t be shocking that the same process could trigger the two conditions.

What research says? 

A recent research from Columbia indicates that the same neurological glitch – low serotonin – triggers the two conditions.

Anxiety and IBS: Which Came First, the Chicken or the Egg? - GoodRx

Link between constipation and depression

 

There is a strong correlation between depression and gastrointestinal discomfort, but scientists have not really understood why. It is normal for people suffering from depression to also face issues with gut health, such as constipation, at the same time. 

The experiment included a study performed on mice that revealed a deficiency of serotonin that can induce constipation, also known as the happiness chemical. Also, low concentrations of serotonin in the brain can cause depression. Increased serotonin levels were found in both the brain and the gut.

  • Low serotonin contributes to constipation

In the study, the mice have a gene mutation that is related to extreme human depression that slows the capacity of neurons to develop serotonin in both the brain and the gut. The researchers reported that the gut lining of the mice started to decline by hindering the development of serotonin in the gut of the mice, slowing the flow of contents via the digestive tract of the animal that causes constipation.

The mice were essentially constipated,” Margolis says, “and they displayed the same kind of GI improvements that we see in people with constipation.” Marc Caron, Ph.D., and Jacob Jacobsen, Ph.D., of Duke University, co-authors of the study, also created an experimental drug treatment’’.

  • Slow release of drug can be the reason

 

The drug is a gradual release of 5-HTP, a serotonin precursor, which works by increasing the number of adult mice possessing GI neurons. The scientists are satisfied that they can demonstrate that neurogenesis in the gut is possible and that defects in the gut can be corrected.

“As it has been known for years that neurogenesis occurs in some parts of the brain, it is relatively new to the concept that it occurs in the gut nervous system,” Margolis says.

Analysis into the use of 5-HTP slow release as both a constipation relief medication and for use in individuals with treatment-resistant depression.

Why constipation matters?

Up to a third of people suffering from depression have chronic constipation, and a few studies have reported that people with depression rank their associated bowel problems as one of the main factors affecting their quality of life.

Serious constipation can block the GI tract and cause severe pain and contributes to 2.5 million physician visits and 100,000 hospitalizations per year. 

That Gut Feeling: How Depression and Constipation Are Linked

Symptoms of constipation 

Following factors indicate that you might have constipation: 

  • stress and anxiety
  • sleeplessness
  • tiredness and fatigue
  • Affect your sex life
  • Lead you to skip social activities

Alarming symptoms among children and adults 

Among children:

  • Blood in the stools
  • Fever
  • Vomiting
  • Severe abdominal pain
  • Abnormal back passage
  • Abnormal position of rectum
  • Extreme fear of back passage exam
  • Scars on rectum
  • back passage fissures 
  • Hair tuft on spine
  • Abnormal thyroid gland
  • Eczema


Among adults:

  • Change in bowel habits
  • Anemia
  • Recent sudden onset of symptoms
  • Blood in the stools
  • sudden weight loss
  • Abdominal or rectal mass
  • Jaundice
  • Lymphadenopathy
  • Abnormal thyroid gland

Factors responsible for constipation


Pathophysiology of both children and adults

It is considered that functional constipation is multifactorial. Popular factors that are pathophysiological include:

  • Genetic factors
  • lifestyle factors 
  • psychological factors
  • behavioral factors 
  • parental factors 

Genetic factors

Sometimes kids and adults with functional constipation have a positive history of constipation in the family, so it seems to be possible that genetic predisposition may play a role in the onset the disorder. Nonetheless, no functional constipation has been correlated with particular genes, and the precise role of genetic factors in its aetiology remains to be further explained. 

Lifestyle factors

It includes:

  • Diet 
  • Obesity and physical activity 
  • Microbiome 
  • Colonic motility and Anorectal factors

Diet

Dietary variables play an important role in the causing constipation in both children and grown-ups. Feeding changes during infancy, such as the change from breastfeeding to feeding with formula or the introduction of solid foods, is also a cause of onset of constipation. Whether the allergy to cow’s milk protein is correlated with functional constipation is a matter for discussion. 

Obesity and physical activity

There are controversial findings on the link between obesity and constipation. Obesity creates pressure on the pelvic floor and reduced physical activity like exercise, have also been suggested as a major risk of Constipation for children and adults. 

Micro-biome.

The role of the microbiome of the intestine in pathophysiology is well explained and studied. However, intestinal microbiota differ amongst healthy people and people with constipation thus indicating their potential role for development of constipation.


Colonic motility and Anorectal factors

Colonic instability in motility is thought to be present a group of children and adults with functional constipation alongwith delayed transit time. A significant subset of adult functional constipation patients show signs of impaired anorectal function and structure, leading to trouble in expelling stools from the rectum.


Psychological factors

  • Anxiety
  • depression 
  • social isolation 
  • decreased daily activity
  • stressful life events such as physical or psychological trauma

Behavioral factors

The action of withholding is considered the most common cause of constipation in adolescents. In 25–35% of patients, it is the source of constipation. At school and work or unknown locations, teenagers and adults often avoid toilets, thus ignoring the urge to defaecate.

Parental factors

Certain parental characteristics, play an important role in the pathophysiology and prognosis of childhood constipation. For example:

  • neuroticism and depression
  • parental rearing attitudes, such as overprotection and  strict attitudes 

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

Treatment of constipation 

Talk Therapy

One type of talk therapy, called cognitive behavioral therapy, helps to figure out conflicts and understand feelings. It teaches you how to recognize negative and distorted thoughts, and replace them with positive and more realistic ones. It is also helpful with IBS symptoms and the mood disorder. 

Exercise helps constipation

By that the time it takes for food to pass across the large intestine, exercise aids constipation. The amount of water your body absorbs from the stool is limited by this. Hard, dry stools are tougher to get through. Plus, the breathing and heart rate are accelerated by aerobic exercise. This helps to stimulate the muscles in your intestines’ natural squeezing.

Intestinal muscles that squeeze better will help rapidly move stools out. Before doing some difficult physical exercise, wait an hour after a big meal. After feeding, blood flow increases to your stomach and intestines to help your body absorb the food. Constipation can help by simply getting up and moving. 

Education 

Counselling of children by parents on toileting posture and behavior by instructing the child to attempt to defecate at least two or three
times daily helps constipation. Parents should avoid being overprotective and strict with their children.

Behavioral therapy

Regular physical activity plays a role in changing of behaviors. Moreover in adults in order to prevent impairment of rectal sensation and function, behavior modifications are needed. Such as taking time to defecate and promptly responding to the urge to defecate are needed. Biofeedback training and physiotherapy are interventions aimed at gaining better control over the pelvic floor muscles.

Pharmacological treatment 


It involves two steps:

  • faecal disimpaction
  • maintenance therapy

Faecal disimpaction 

It can be achieved with high-dose oral polyethylene
glycol (PEG) or enemas containing active ingredients
such as sodium phosphate, sodium lauryl sulfoacetate or sodium ducosate.

Maintenance therapy 

It is advised to prevent repeat accumulation of stools in maintenance therapy.

Future therapies

  • acupuncture 
  • faecal microbiota transplantation 


Acupuncture

Several Chinese studies have suggested that people with functional constipation showed major improvements in spontaneous bowel movement frequency on the use of acupuncture. 


Faecal microbiota transplantation

Facecal microbiota transplantation is the administration of faecal bacteria from a healthy person into the intestinal tract of a patient with constipation has been suggested as a possible therapy.

Frequently Asked Questions (FAQs): Can constipation cause depression?

Can stress and anxiety cause constipation?

In many ways, stress can contribute to constipation. By influencing bodily functions, stress hormones directly influence bowel movements. Moreover, when depressed, individuals are more likely to have a bad diet, drink too little water, and get less exercise, which may cause constipation.

How to stimulate a bowel movement quickly?

The following quick treatments can help:

  • Take a fiber supplement
  • Use high-fiber food
  • Drink plenty of water
  • laxative stimulant
  • lubricant laxative
  • stool softener
  • enema

How long does constipation last?

When bowel movements become less regular and stools become hard to pass, constipation occurs. It occurs more frequently because of diet or routine changes, or because of insufficient fibre intake. If you have extreme discomfort, blood in your stools, or constipation that lasts for more than three weeks, you can contact your doctor.

Is constipation a sign of stress?

Gastrointestinal symptoms, such as nausea, stomach pain, and changes in bowel movements that may include constipation, may be caused or exacerbated by high levels of stress. Researchers have established numerous brain-stomach associations that may contribute to symptoms of constipation.

Can constipation cause behavior issues?

Yes it cause behavior issues. One can get irritated by not passing out the stools. Reduced social activity can be a result of constipation.

How do you relieve constipation from stress?

This works by the the amount of fluid in the intestines, promoting the flow of faeces. In order to relieve tension, yoga, exercise, and meditation may all help. To help you control feelings of anxiety and depression, try talking therapy or cognitive behavioural therapy.

What we recommend for depression

Professional counselling

If you are suffering from depression then ongoing professional counselling may be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you live a more fulfilling life.

References

Vriesman, M.H., Koppen, I.J.N., Camilleri, M. et al. Management of functional constipation in children and adults. Nat Rev Gastroenterol Hepatol 17, 21–39 (2020). https://doi.org/10.1038/s41575-019-0222-y

Khatri, M. (2020, March 08). The Connection Between IBS & Depression. Retrieved January 06, 2021, from https://www.webmd.com/ibs/guide/irritable-bowel-syndrome-ibs-depression

Miley, J. (2019, May 09). That Gut Feeling: How Depression and Constipation Are Linked. Retrieved January 06, 2021, from https://interestingengineering.com/that-gut-feeling-how-depression-and-constipation-are-linked

Hosseinzadeh, S. T., Poorsaadati, S., Radkani, B., & Forootan, M. (2011). Psychological disorders in patients with chronic constipation. Gastroenterology and hepatology from bed to bench4(3), 159–163.

A Moody Gut Often Accompanies Depression-New Study Helps Explain Why. (2019, May 07). Retrieved January 06, 2021, from https://www.cuimc.columbia.edu/news/moody-gut-often-accompanies-depression-new-study-helps-explain-why

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