Our gastrointestinal health can often tell us a lot about our general well-being. Usually, when we are struggling with some condition – or even an increase in stress levels – we can see changes in our gut health. Our stomachs are very sensitive organs; they can be easily thrown off balance due to ill health, disease, anxiety or overindulgence. For this reason, constipation can even be seen as one of the more obscure addiction symptoms. But why are our digestive systems impacted by substance use? How can you identify constipation as an addiction symptom, and what are the best ways to manage the associated discomfort?
Understanding constipation
Research suggests that between 25 and 30% of the population experience chronic constipation. Constipation can occur across all different groups; however, clinical data suggests it is more prominent among specific demographics. These are:
- women
- elderly individuals
- residents of chronic care facilities
- individuals with a mental health condition
- normal transit
- slow transit
- dyssynergic defecation (DD)
- slow-transit dyssynergic combination
- straining
- hard or lumpy stools
- sense of ‘incomplete evacuation’
- fewer than three bowel movements a week
- Alcohol
- Opioids
- Tricyclic antidepressants
- Antipsychotics
- Anticonvulsants
- Various painkillers
- Medications for high blood pressure
- Calcium and iron supplements
- Abdominal bloating
- Nausea
- Sickness
- Straining
- Changes in appetite
- Blood in your stool
- Seeking medical intervention (such as medications, enemas or manual disimpaction) in severe cases
- Drinking enough water
- Eating foods naturally rich in fibre
- Moving regularly
- Eating at regular intervals throughout the day
- Use the bathroom as regularly as you need
- Practising mindfulness to reduce stress
Whilst all of these categories are associated with various sets of symptoms, as a whole, constipation can be diagnosed when any two of the following signs are present:
Why is constipation linked to addiction?
In recent years, researchers and medical clinicians have suggested that ‘constipation secondary to drugs’ is quite a common cause of the condition. Clinical data on the side effects of substances have identified a range of drugs (both prescription medications and recreation or otherwise illicit drugs) that are more likely to cause constipation. These include:
Alcohol consumption can lead to dehydration, which can slow down our digestive systems and lead to constipation. Opioids (such as heroin, morphine and codeine) are medications with a high addiction potential. Opioids are known for their ability to ‘inhibit gastric emptying,’ so much so that a specific type of constipation secondary to drugs, known as Opioid-induced constipation (OIC), has been identified as a unique condition in and of itself.
Specific types of antidepressants block the neurotransmitter acetylcholine. This leads to a slowing of muscular contractions in the dietary tract, leading to constipation. Antipsychotics can also cause constipation – up to 60% of individuals using clozapine deal with constipation.
As many individuals dealing with an addiction also have a diagnosis of a mental health condition (an estimated 7.7 million adults), it is likely that both the addictive substance and the psychiatric medications being used can both contribute to constipation symptoms.
Constipation and addiction symptoms
If you are dealing with constipation during your addiction recovery, it is likely that you will experience the following symptoms:
Constipation and detoxification
As we have seen, constipation can be identified as a specific addiction symptom. It can also, however, be experienced during rehab treatment, particularly in the context of detoxification. When constipation occurs in detox, it can be considered as a type of withdrawal symptom. This means that, unfortunately, constipation may be experienced during the early stages of addiction treatment.
Constipation can occur as a result of psychiatric distress, reduced eating and drinking, modified general activity and sitting or lying down for longer periods of time. All of these experiences can happen during the detoxification phase as you adjust to the absence of substances in your system. This means that your experience of constipation may worsen at the beginning of your recovery journey. Once your physical activity returns to normal levels and you are able to eat, drink and exercise in the same manner as before, constipation symptoms should begin to alleviate. You may also find that as you become more settled in addiction rehab and begin to feel more relaxed, your bowel movements also become more regular.
Identifying constipation as an addiction symptom
It can be very difficult for health professionals to identify when constipation is a clear marker of substance use or addiction. This is because constipation can be a symptom of a range of different conditions. This highlights the need for thorough patient assessment in both general and specialist healthcare settings in order for sufficient screenings for substance abuse to be carried out appropriately. Taking a patient’s history and asking about health and lifestyle-related concerns can be a positive way to ‘catch’ addiction in individuals presenting with other symptoms in order to provide access to addiction intervention as early as possible.
Managing constipation
Constipation can affect our lives drastically. Alongside limiting our appetite and reducing our ability to feed ourselves healthily, it can also lead to severe discomfort. This discomfort can dramatically impact quality of life, leading to stress, anxiety, irritability and restlessness. For that reason, it is important to manage the symptoms of constipation during your time in addiction rehab.
You can do this by:
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