Is being locked-down getting you blocked up?

Let’s talk about poo! Not my best chat up line, I know, but my husband is used to it. It comes with marrying a dietitian.

But seriously, most of us have recently experienced a very sudden upheaval in our day to day life and that means changes to our activity levels and, maybe, to what we’re eating. That, in turn, can have major repercussions on our body’s ability to process what we put in it and how easily the waste comes out (or not!).

Anyone who’s spent any length of time in hospital will vouch for this. They’re likely to have required the assistance of a laxative at some point. But, whilst there’s a place for medications in treating constipation, there are plenty of other things we can do before we pop a medication down (or, ‘ahem’, up).

But let me be clear. There is no ‘normal’ when it comes to frequency of pooing. Normal for you may be 4 times a week or twice a day. Don’t be intimidated by that flatmate who emerges smugly from the bathroom at 10am every morning! I’m talking about a change in what’s normal for you.

I’m quite prepared to admit that, prior to moving to Mallorca where my days are varied and lots of time is spent outdoors, I was pretty sedentary from Monday to Friday; sitting at my desk, in a clinic room or on a chair next to a patient on a dialysis machine. As a result, I wasn’t the most regular in spite of following my own dietetic advice and exercising at weekends.

So, I can vouch for the fact that constipation is no fun! Neither for the sufferer nor for their flat/house/room mates.

You might feel sluggish and grumpy, you might not know what to eat, so you try a bit of everything only to find the situation worse. Bloating, pain and wind may ensue. Overall it can turn you into someone that isn’t exactly a delight to spend all day and all night and all the next day and all the next night and all the next …….with.

Is this ringing any bells?

If it’s any consolation, it’s not your fault, even if your lockdown companions appear to be functioning totally normally in all departments. The change in lifestyle for you may have been greater, you have different genes, different levels of gut health and, very importantly, different gut microbes from them. You deserve sympathy and, of course, some handy advice.

To help you identify what might be the culprit for you, here are some likely contenders:

Exercising less:

I’m not just referring to stopping a regular 10km run or daily hot yoga session, I mean your normal walk to work and back and trip out to get lunch or doing the daily shop and playing with the grandchildren in the park. Let’s face it, there are only so many laps you can do of a one bedroom flat. Unless you have a large garden, you’ve really got to put your mind to it to keep up your normal activity levels, not to mention the temptation to just relax and make the most of a break from work.

Exercise massages the bowel and stimulates the muscle movement (known as peristalsis) which moves the waste along the gut and expels it.

Any simple gut stretches will do. Here’s a link to a few you could try:

Find stretches that suit you and your abilities. Essentially, any movement that is safe for you and gets your body moving is a good idea right now: gyrate those hips, put on some music and do your thing. Who’s watching?

Are you suddenly eating less or more fibre? Yes, it can work both ways.

Do you find yourself grazing on low fibre sweet or savoury snacks, just out of boredom or for a bit of comfort, rather than eating your normal more balanced meals?

If so, let me explain. Fibre makes the poo more bulky because it reaches the colon intact and that’s where poo is formed. The fibre then irritates the colon which expels it out the other end.

So, trying to keep to regular mealtimes might bring the valuable fibre back into your diet.

If you think your diet needs a fibre boost here are some easy additions:

– Tomatoes on toast for breakfast

– Defrost a handful of frozen fruit at night to add to your cereal or have with yoghurt as a snack

– Snack on fruit and nuts

– Use carrot or pepper sticks for scooping up dips

– Swap crisps (chips) for popcorn

– Replace some meat in your pasta dishes, curries etc with a spoonful or two of lentils, chickpeas or beans,

– Toast some seeds and sprinkle on salads or cereal

– Throw a few frozen peas into your soup.

Here are a few more ideas from the British Heart Foundation

Studies show linseeds (flaxseeds) can be particularly helpful with constipation. Start with ½ tablespoon and work up to 2 tablespoons if tolerated. Always take with a drink or high fluid meal such as cereal, yoghurt or soup.

Conversely, did you find yourself on automatic pilot stockpiling lentils and chickpeas which you’ve never eaten in your life, because it seemed like a good idea and everyone else was doing it?

If so, you might have doubled your usual fibre intake overnight and this can also cause problems. For your gut and its resident microbes it might be a case of too much too soon. It’s a great idea to up the fibre but maybe introduce your gut to the new fibrous foods more gradually.

And, did you know that fibre needs fluid to do its magic? Picture fibre as a hard piece of sponge you might find on the beach. It wouldn’t exactly slip down easily, would it? But add some water and it becomes soft and pliable and definitely more slippery. So, you may just need a few more glasses of fluid if you’ve upped your fibre intake. Ideally this would be alcohol-free fluid, since alcohol tends to dehydrate and have the opposite effect, but these are challenging times and I’m in no position to lecture.

Are you drinking less fluid?

Perhaps you had a water machine at work or always had a bottle of water in your bag before but, now you’re at home, the usual prompts to drink have gone. There isn’t a golden rule as to how much to drink and official advice varies from 1.5 – 2L – it’s very person, climate and exercise-level dependent. However, a small deficit every day compared with your normal intake soon builds up and dehydration can set in. If your urine is getting darker it’s probably a sign that more fluid is needed.

The great thing about fruit is that it comes with its own water supply. I’d recommend eating it as whole fruit since you get the fibre too. Interestingly there is some specific evidence for two kiwis a day but start with one and increase gradually. (Please be aware that some people are allergic to kiwis before you start recommending them to others.)

Are your gut microbes feeling neglected?

I could write a whole blog on our amazing gut microbes but the key point here is that our health is intrinsically linked with theirs. Our gut is more important to our immune system than any other organ in our body and right now a healthy immune system is just what we need. Here’s a link to a piece published on Friday by Tim Spector, Professor of Genetic Epidemiology at King’s College London, about this very topic. Excellent timing!

But remember, gradual changes!

Have mealtimes become a bit haphazard?

In addition to the fact that irregular mealtimes often mean less fibre, your gut simply prefers routine. Our bodies and wonderful gut bacteria work to their own rhythms across the day and night. If we suddenly change our eating patterns, our digestive system might not be geared up to deal with what we’re giving it or when. Again, gradual change or maintenance of previous meal patterns may help keep the bowels emptying regularly.

Has your sleep pattern gone to pieces?

See above. Sticking to a routine helps keep us in sync with our digestive system.

However, what we put in our bodies isn’t the whole story.

What and when we eat are perhaps the obvious culprits but these sudden changes we’ve all experienced take their toll on us in other ways too. We’re spending far more time in close proximity with others which means less privacy and many of us are stuck in limbo, living from day to day and feeling ever so slightly out of control of our futures. What can we do to alleviate these added obstacles to having a comfortable poo?

Are you missing your usual poo venue?

This can be a tricky one to overcome. Again, we like routine. If you’re used to taking advantage of the sound-proofed cubicle at work, it might not be such a relaxing experience in a shared bathroom next to the lounge. Or perhaps you have young children (in my case cats) who like to supervise your every move! This is not conducive to relaxation of muscles. The problem is that, if we hold it in, there’s more time for the fluid to be reabsorbed back into the body and we end up with that hard piece of sponge from the beach I spoke about earlier.

Turn up the music, take a book, be honest and ask everyone to give you space but, most of all, take your time (and it looks like time is something we’re going to have a lot of for the next few weeks so there’s no point rushing to flush!)

Is that niggling anxiety diverting your body’s attention away from waste disposal?

These may be anxious times for many of us and chronic anxiety can play havoc with our digestion. It means that we’re permanently in fright or flight mode. Whilst being keenly alert is essential to protect us from imminent danger by directing blood and nervous supply away from our gut to our brain and limbs, it’s not so helpful when we’re constantly set to ‘On’. It can have one of two effects on our gut: we dump everything to make us lighter for a speedy getaway (a bit like a plane dumps fuel when faced with a tricky landing) or the muscles which propel the poo out just slow down and we end up constipated.

So, any form of relaxation technique can be helpful to reduce the anxiety and let the body focus on digestion when it’s needed. This includes reading, drawing, taking a long bath as well as meditation and breathing techniques – whatever works for you.

Stress also affects our gut in another way. It can alter the gut microbes, allowing less healthy species to take over. So, pamper your own mental health and the good guys are more likely to stick around.

Could your guts do with a helping hand? (Don’t panic, I’m only talking about massage!)

A gentle massage of the gut may help things progress down the tube. Here’s how to do it but please don’t try if you have had recent abdominal surgery or any other gut issues which might be exacerbated by this kind of pressure.

Last resort laxatives

If all else fails, visit your local pharmacist to ask about the various laxatives available and, of course, seek medical help if necessary.

So, if you are suffering from quarantine-induced constipation and its getting you (and your fellow inmates) down, I hope you find this enlightening and ‘relieving’.

A happy gut means a healthy body and a healthy body will be more likely to stand up to nasty viruses we might meet once we’re allowed out again.

(This blog caught the attention of a journalist for the Majorca Daily Bulletin. This is her take on the story. )

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