The swift urbanization of society, characterized by fast-paced living, diets dominated by highly processed foods, and a stress-inducing hustle culture, has made constipation a prevalent yet frequently neglected health concern. Worldwide, constipation affects an estimated 11% to 20% of adults.
In an interview, Dr Harshavardhan Rao B, Professor and Consultant, Gastroenterology at MS Ramaiah Medical College in Bangalore, shared, “Although generally thought of as rare in the Indian community owing to vegetarianism and increased fibre intake, most recent estimates have shown similar rates of constipation, especially in urban areas of the country where the prevalence was as high as 24%. This condition, marked by infrequent bowel movements and/or difficulty in stool passage, affects a significant portion of the population, and several factors coalesce in urban settings to contribute to its increasing prevalence.”
He revealed, “Dietary habits have been drastically altered with urbanisation. The increased consumption of low-fibre ultra-processed foods, which are convenient and widely available in urban areas, is the primary culprit. Fibre plays a crucial role in adding bulk to stool and facilitating bowel movements; thus, diets lacking in fruits, vegetables, and whole grains contribute significantly to constipation. It also results in poor nutrition leading to lifestyle associated disorders like diabetes, hypertension and metabolic syndrome, which in turn add to the burden of constipation in cities. Unfortunately, nutrition is expensive and difficult, but calories are cheap and easily accessible in cities.”
Inactivity and sedentary lifestyles, common in urban areas owing to a large proportion of the population in desk-jobs, play an equally pivotal role in the rising prevalence of constipation. Dr Harshavardhan Rao B said, “Regular physical activity stimulates intestinal contractions, helping move stool through the colon. Furthermore, regular physical activity also prevents obesity, metabolic syndrome, diabetes and a host of other lifestyle-associated disorders that are linked to chronic constipation. Moreover, high stress levels, synonymous with urban living, have been linked to gastrointestinal disturbances, including constipation. Stress increases cortisol production, which can alter gut motility and fluid balance, leading to hardened stools and reduced bowel movements.”
He concluded, “Lastly, the urban lifestyle is often associated with sleep disorders. The tendency of urban dwellers to prioritise extended working hours in front of a computer, often at the expense of a sufficient, restorative night of sleep is a major contributor to lifestyle associated disorders including constipation. In tackling this issue, raising awareness of these contributing factors is essential. Encouraging a balanced diet rich in fibre, ensuring adequate hydration, fostering active lifestyle habits, managing stress effectively, and prioritizing adequate sleep can collectively counteract the rising prevalence of constipation in the urban setting.”
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