Daliah Wachs, MD, FAAFP
As if being constipated isn’t bad enough, a study out of Memphis VA Medical Center and the University of Tennessee found constipation to substantially increase one’s risk of chronic kidney disease and failure.
Researchers studied the medical records of 3.5 million United States military veterans who had normal kidney function and followed them for 7-9 years. The majority of the participants were male and over 60. They found those with constipation had a 13 percent higher risk of kidney disease and a 9 percent increased risk of kidney failure. Diagnoses of constipation ranged from absent to mild to moderate/severe. Its not clear what level of constipation and for what time duration was necessary to affect kidney function.
So how do we define constipation?
Constipation is a decrease in frequency of bowel movements or difficulty passing stool that persists longer than one’s normal bowel movement cycle. In general, less than three bowel movements a week could be considered constipation.20-30% of the US population suffers from constipation and this percentage increases in those who are elderly or confined to medical facilities. Some people have hard stools that are difficult to pass with normal motility, whereas others have soft stool but poor motility.
What causes constipation?
A variety of factors could be the culprit. These include:
Lack of water
Lack of fiber in one’s diet
Certain foods in one’s diet such as cheese, diary, fat, gluten, those high in meat
Lack of exercise
Irritable Bowel Syndrome
Inflammatory Bowel Disease
Medications such as narcotics, antidepressants, iron supplements
Constipation should never be ignored………
Why would constipation be linked to kidney disease?
In this study the authors theorized that changes in gut bacteria caused slowing of the bowel, leading to constipation, inflammation and factors that could affect the kidney. An additional theory I have is those with a poor balanced diet, such as one high in fats, can cause both constipation and kidney disease.
What should our stool look like?
When someone is constipated, the stool is not moving through the colon as quickly as it should. The more hours and days it sits in the colon, the more water is absorbed. So the stool churns and churns becoming dryer, smaller and harder. So pebbles or rock-like stool is a sign of constipation. Conversely, as in diarrhea, stool has not been processed by the colon properly, water has not been absorbed and thus it appears very soft or liquid-like. This puts one at risk of dehydration. Therefore healthy stool is a happy medium.
Using the Bristol Stool Chart, the ideal stool would be in the shapes of Type 4 and 5.
What should I do if I’m constipated?
First drink more water. Secondly look at your diet and see if you have any offending agents such as dairy or fried foods. Thirdly visit your medical provider for an evaluation. Finally, try and relax. Many of us have difficulty pooping because we are stressed or on a time crunch. Your body doesn’t care if you have a meeting in 5 minutes. The body likes to relax when it relieves itself so grab a magazine, or my bl0g, and take some time out of your day to poop. Sometimes we need to stop and smell the roses……
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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician