Struggling to defecate may lead to health issues ranging from hemorrhoids to heart problems
In a world where millions of Americans grapple with constipation, characterised by fewer than three bowel movements per week, dry, hard stools, painful bowel movements, and a feeling of incomplete evacuation, a growing body of research is shedding light on the potential connection between this common digestive issue and heart disease.
Regular exercise, a diet rich in fiber from fruits, vegetables, legumes, whole-grain bread, and cereals, and adequate water intake are all known to help alleviate constipation. However, recent findings suggest that the relationship between constipation and heart disease may run deeper than initially thought.
A positive association has been identified between chronic constipation and markers of systemic inflammation, such as the neutrophil percentage-to-albumin ratio (NPAR), which is also used to predict outcomes in cardiovascular disease patients. This implies that inflammation common in constipation may contribute to or reflect cardiovascular risk.
The "gut-heart axis" offers an explanation for part of this connection. Dietary patterns affecting gut microbiota influence inflammation, metabolism, and cardiovascular risk factors like blood pressure and lipid profiles. Diet-induced changes in gut bacteria and their metabolites (e.g., short-chain fatty acids and TMAO) influence atherosclerosis and heart disease development.
Constipation is also mentioned among symptoms complicating chronic heart failure, which often arises from underlying conditions like coronary artery disease and hypertension that strain the heart.
Straining during bowel movements, a common consequence of constipation, can acutely stress the cardiovascular system. This maneuver raises intrathoracic pressure, which transiently reduces venous return to the heart, lowers cardiac output, and can cause abrupt changes in blood pressure and heart rate. These changes can trigger arrhythmias or ischemic events in vulnerable cardiovascular patients.
While the search results do not directly address straining’s cardiovascular impact, this mechanism is well-established clinically, especially concerning patients with known heart disease or limited cardiac reserve.
In summary, constipation is connected to cardiovascular disease by shared inflammatory pathways and gut microbiota interactions that influence systemic inflammation and vascular health. Chronic constipation is more prevalent in individuals with heart disease, possibly due to overlapping pathophysiology that includes systemic inflammation.
For patients with heart disease, effective management of constipation to minimise straining is advisable to reduce cardiovascular risk. Further research is needed to clarify long-term implications of inflammation markers like NPAR in this context.
In the meantime, maintaining a high-fiber diet, staying hydrated, and avoiding caffeinated beverages while constipated are all sensible measures to promote regular bowel movements and potentially mitigate the risk of heart disease. If constipation lasts more than three weeks, it is crucial to seek medical advice as it may indicate a more serious health issue.
- The relationship between constipation and heart disease appears to extend beyond just shared inflammatory pathways, as research has also indicated a positive association between constipation and markers of systemic inflammation, like the neutrophil percentage-to-albumin ratio (NPAR), often used in cardiovascular disease patients to predict outcomes.
- The gut-heart axis, which involves dietary patterns affecting gut microbiota and their influence on inflammation, metabolism, and cardiovascular risk factors such as blood pressure and lipid profiles, offers an explanation for part of the connection between constipation and heart disease.
- For individuals with heart disease, effectively managing constipation to minimize straining is advisable, as reducing straining can potentially mitigate the risk of heart disease, especially since straining during bowel movements can acutely stress the cardiovascular system and may trigger arrhythmias or ischemic events in vulnerable patients.
