So, what is constipation? Constipation means it is difficult to poo, or you poo less. You may be constipated if:
- You poo less than 3 times each week.
- You poo less than you normally do.
- Your poo looks different – it may be small, dry, hard, and lumpy like type 1 on the Bristol Stool Chart.
- You have to push really hard or strain to poo.
- It is painful to poo.
- It feels like you could poo more after you have had a poo.
Doctors and nurses may use confusing words when they ask about constipation. Poo is also known as “bowel motion” and “stool”. If there are changes to your poo, the doctor or nurse may ask about changes to your “bowel habit”.
Why is constipation more common in autistic women?
Constipation is more common in women than in men, and 2-3 times more common in autistic people than in neurotypical people. So, as an autistic woman, it’s especially important to understand constipation.
Autistic people often have differences in interoception (the feelings and sensations that the body gives). This can make it harder to know if we need to poo. We may not poo when our body wants us to, because we don’t know it wants to, and so we hold onto our poo and get more and more constipated. The differences in interoception can mean it is harder to know if we need to see a doctor or nurse and ask for help.
Studies have shown that autistic adults are 7 times more likely to have gut problems than neurotypicals, and constipation is the most common of these problems. We think this is due to differences in how the brain and the body are linked through the gut-brain axis in autistic people. If we are stressed and anxious, that can affect our poo too, because of this gut-brain link.
It has also been found that autistic people have differences in the gut microbiome, a community of organisms that live in the guts. The gut microbiome likes lots of variety in food intake, so as an autistic person, if you like to have the same food every day, this can impact your gut microbiome.
Constipation and periods
If you have periods, you may notice you get more constipated before your period. This is due to increases in the level of the progesterone hormone, which slows down your guts. When your period starts, your body releases a different chemical, prostaglandin, which speeds up your guts and makes you poo more often, which is known as period poo. Autistic women are more likely to be hypermobile. This can affect the bowel tissues and pelvic floor, and make constipation more likely.
“Studies have shown that autistic adults are 7 times more likely to have gut problems than neurotypicals, and constipation is the most common of these problems.”
Why you need to know about constipation
Constipation is really common, and once it is recognised, it can usually be treated easily. For some people, it has affected them for many years; they have got used to it and it is hard to recognise if there is a problem. Constipation can make us feel unwell. We may get stomach pain, we may just know something is not right, but not know what the problem is. If you’re having trouble with constipation or see blood in your poo, don’t ignore it. You can see a doctor or nurse – they will talk to you, they may ask your permission to feel your belly, and they may want to do some tests, like collecting a sample of your poo.
What can help with constipation?
There are some things you can do yourself at home to help with constipation. Other things that could help, like medication, will need to be prescribed to you by your doctor or nurse.
- Nutrition. Eating enough plants like fruit and vegetables every day, trying new things if you can to have more variety. Having less processed food helps too.
- Hydration. Drinking enough water every day.
- Position. Use a footstool when you sit on the toilet to poo, to raise your knees above your hips.
- Routine. Set up a regular time to poo, for example, sit on the toilet 15 minutes after eating your breakfast.
- Exercise. Moving your body by going for walks every day or taking other exercise helps.
- Medication. Your doctor or nurse can prescribe medication for you to make it easier to poo. Medicines are also available from the pharmacy, but you should not take them all the time.
- Medical reasons. Constipation can happen because of medical reasons like thyroid problems, endometriosis, coeliac disease, or as a side-effect of some medications. So it can be good to talk to your doctor or nurse if it’s a problem for you.
