Anorexia and constipation

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Most people experience constipation at some point. This can happen for many reasons, such as not getting enough fiber in your diet, dehydration, lack of physical activity, or not eating enough food. But those who have anorexia nervosa (AN) often get constipated on a regular basis, as anorexia and constipation are interrelated. 

Not consuming enough food to pass through the digestive tract results in its contents getting stuck. While this can be easily remedied, it can also be deadly if toxins aren’t expelled from the body. And having chronic constipation as a result of anorexia can be more complicated to relieve.

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What causes constipation?

Food normally moves through the gastrointestinal (GI) tract at a steady pace. When you eat a meal, it passes through the stomach, where digestion begins. More digestion occurs in the small intestine next, and the food is passed along further to the large intestine. Nutrients are extracted and transported into the bloodstream, and what remains moves to the rectum. Food eaten after that will push food eaten earlier through the digestive tract until it is discharged as waste. If this does not happen, waste builds up and constipation results.

Constipation is having fewer than three bowel movements per week. It can vary in severity and frequency. The longer waste stays in the body, the more toxic it can become. When toxins build up, they can act as a poison and do serious harm to the body. This is called autointoxication and can even result in death.

How does anorexia cause constipation? 

Constipation can occur in people who have anorexia nervosa because they don’t eat enough food to keep the GI tract moving and push digested food through the intestines to the rectum to be released as waste. 

The GI tract also needs water in order to function properly. Water dissolves nutrients and toxins in food and helps transport them where they need to go in the body. Nutrients get absorbed into the bloodstream where they can nourish organs. Toxins are transported to the kidneys and liver to be filtered or to the rectum as waste. 

The recommended amount of water a person should drink daily is one ounce for every two pounds of body weight. This includes other beverages and the water contained in food. But an individual with anorexia generally isn’t consuming enough water on a daily basis. This causes dehydration and slows down the movement of food through the digestive tract and results in constipation. 

Constipation leaves a person feeling uncomfortable, agitated, and tired, and can be deadly if too much waste builds up and toxins accumulate in the body.

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How to treat constipation with anorexia

The simple solution to constipation is to increase food, fiber, and water consumption to push waste through the GI tract gently.

Some foods that will help get a sluggish GI tract moving include:

  • Apples (3.4 grams fiber/medium sized apple)
  • Pears (3.1 grams fiber/pear) 
  • Beans (6-7 grams fiber/1/2 cup serving)
  • Green beans (4 grams/cup)
  • Broccoli (5 grams/cup)
  • Asparagus (3.6 grams/cup)
  • Garbanzo beans (3 grams/1/4 cup)
  • Strawberries (3 grams/cup)
  • Cherries (2.5 grams/cup)
  • Blackberries (6 grams/cup)

But the solution is not simple when someone has anorexia, because they refuse to eat. Laxatives may be needed. If laxatives don’t work, enemas, or professional colonics are the next step. Natural healing practitioners use herbs, such as cascara sagrada and peppermint, in colon cleanses to retrain a sluggish bowel to get working again as it should. In cases of severe constipation, waste can become impacted and must be removed surgically. (1,2) If left untreated for too long, toxins can build up to dangerous levels in the body and be deadly. This is just one of many complications that can occur in people who suffer from anorexia. Though very serious, anorexia, chronic constipation, and other associated conditions are often treatable with early intervention. 

Acknowledging that you or someone you love may have an eating disorder is never easy. Within Health is here to help with highly specialized care from a multidisciplinary team of experts. If you suspect you or someone you know may have anorexia, please reach out to us today.

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Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Eating disorders common in patients with chronic constipation. Massachusetts General Hospital website. Published on June 10, 2020. Originally published in Clinical Gastroenterology and Hepatology. Accessed online January 31, 2022. https://advances.massgeneral.org/digestive-health/journal.aspx?id=1572
  2. Malczyk, A., Oswiecimska, J.M. Gastrointestinal complications and refeeding guidelines in patients with anorexia nervosa. Psychiatr Pol. 2017 Apr 30;51(2):219-229. Accessed online January 31, 2022.https://pubmed.ncbi.nlm.nih.gov/28581533/

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