The gut microbiome is a dynamic community of trillions of microorganisms residing in our digestive system, playing a crucial role in overall health [1]. This ecosystem not only aids digestion but also influences immunity, mood, and skin health through its intricate connections with other organs via endocrine, humoral, neural, immunological, and metabolic pathways [1]. A balanced gut microbiome ensures smooth digestion; however, when dysbiosis—disruption of this balance—occurs, digestive issues such as constipation may arise, often accompanied by bloating. This article explores the relationship between these two conditions, offering a comprehensive guide to understanding their connection and how to address them effectively.
What is Constipation?
Constipation is a digestive disorder characterized by symptoms such as difficult, infrequent, or incomplete defecation, often accompanied by abdominal pain and bloating [2]. According to the Rome IV criteria, constipation is diagnosed when individuals experience more than 25% of bowel movements with specific conditions for over six months and meet at least two of the following criteria within the last three months [2]:
1. Sensation of straining
2. Hard or lumpy stools (Bristol Stool Type 1 and 2)
3. Sensation of incomplete evacuation
4. Sensation of anorectal obstruction or blockage
5. Manual maneuvers to facilitate defecation (e.g., digital evacuation)
6. Fewer than three spontaneous bowel movements per week
Constipation can stem from a variety of factors, including genetic predisposition, lifestyle habits such as unhealthy diet, insufficient fluid intake, and lack of physical activity, or underlying conditions like colonic dysmotility [2]. Psychological factors such as anxiety and depression also contribute to constipation, as does the gut microbiota—an area that this article focuses on in depth [2].
What is Bloating and Its Connection to Constipation?
Bloating refers to a subjective sensation of increased abdominal pressure, characterized by feelings of fullness, tightness, or distension in the abdomen [3]. While bloating can occur independently, it most often accompanies other gastrointestinal disorders such as constipation, irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), or even gynecological conditions [3].
Constipation and bloating are closely linked, often occurring together due to shared underlying mechanisms. A significant factor is the increased luminal contents in the gastrointestinal tract, particularly retained stools, which delay intestinal transit, and exacerbate bloating symptoms [5].
When stool moves too slowly through the intestines, the body absorbs more water from it [5]. This excessive absorption hardens the stool, making it compact and difficult to pass [5]. The retained faeces not only disrupt the natural flow of the digestive system but also leads to a build-up of gas and pressure [5]. As the stool accumulates in the colon and rectum, bacteria ferments, releasing more gas [5]. This accumulation further slows small intestinal and colonic transit, intensifying the sensation of bloating [5].
How to Prevent and Relieve Constipation-Related Bloating
Constipation-related bloating can be managed through lifestyle changes to address the root causes. These changes include [6]:
1. Increase Prebiotic Fiber Intake
Incorporate prebiotic fibers into your diet, which can help regulate bowel movements by drawing water into your stool content and encouraging growth of innate good gut bacteria.
2. Stay Hydrated
Drink enough water to soften the stools, making it easier to pass. Aim for at least 8 glasses of water daily.
3. Engage in Regular Physical Activity
Exercise stimulates intestinal muscles, promoting healthy digestion and preventing constipation.
4. Practice Stress Management
High stress levels can disrupt gut function. Techniques like yoga, meditation, and deep breathing exercises
The Bottom Line
Constipation-related bloating are common issues that stem from poor lifestyle habits and gut microbiome imbalances. By addressing these root causes, through a prebiotic fiber-rich diet, proper hydration, and regular exercise—you can alleviate and prevent these discomforts. A healthy and balanced gut microbiome is key to digestive wellness and overall health.
References
1. Afzaal, Muhammad et al. “Human gut microbiota in health and disease: Unveiling the relationship.” Frontiers in microbiology vol. 13 99900 https://pubmed.ncbi.nlm.nih.gov/36225386/
2. Zhang, Shengsheng et al. “Role of gut microbiota in functional constipation.” Gastroenterology report vol. 9,5 392-401. https://pubmed.ncbi.nlm.nih.gov/34733524/
3. Foley, Anna et al. “Management Strategies for Abdominal Bloating and Distension.” Gastroenterology & hepatology vol. 10,9 (2014): 561-71. https://pubmed.ncbi.nlm.nih.gov/27551250/
4. Palsson, Olafur S et al. “Prevalence of Rome IV Functional Bowel Disorders Among Adults in the United States, Canada, and the United Kingdom.” Gastroenterology vol. 158,5 (2020): 1262-1273.e3. https://pubmed.ncbi.nlm.nih.gov/31917991/
5. Iovino, Paola et al. “Bloating and functional gastro-intestinal disorders: where are we and where are we going?.” World journal of gastroenterology vol. 20,39 (2014): 14407-19. https://pmc.ncbi.nlm.nih.gov/articles/PMC4202369/
6. Włodarczyk, Jakub et al. “Current Overview on Clinical Management of Chronic Constipation.” Journal of clinical medicine vol. 10,8 1738. https://pubmed.ncbi.nlm.nih.gov/33923772/
