Bowel habit varies from one person to another. Some people may go one or more times in a day, others may only go after every second or third day. However, it is accepted that your bowel habit is normal if you pass stool at least three times a week but not more than three times a day. It is not just about the frequency of bowel movements. The quantity of stool, consistency of the feces and ease of passing stool are other factors that can determine abnormalities such as diarrhea and constipation from what can be considered a normal bowel habit.
Seasonal Changes In Bowel Habit
Our bowel habit does change slightly during the course of the year. It can even change over days, weeks and months. The problem is not always with the body regulating the bowel habit. More often than not, constipation that arises suddenly in a person who is otherwise not constipated is a dietary and/or lifestyle issue. Inadequate dietary fiber and insufficient fluid intake are the two main factors that contribute to constipation in many people.
Seasonal constipation would mean that the bowel habit has become abnormal during certain periods in the year. It would meet one or more of these criteria:
- Passing stool less than three times in a week.
- Experiencing difficulty (straining) to pass stool.
- Passing stool that is hard in consistency.
Seasonal constipation is not a medical diagnosis as such. It is just constipation linked to the time of the year which is largely a diet and lifestyle issue, but may at times even be associated with environmental factors like cold and sunlight.
Causes of Seasonal Constipation
Some allergic conditions are seasonal, like allergic rhinitis. While this condition does not affect the bowel habit directly, medication used for this condition can cause constipation as a side effect. Older generation antihistamines have been associated with constipation, however, this is less common with newer drugs. Certain inhaled corticosteroids that is used for conditions like allergic asthma may at times cause constipation although it is a relatively uncommon side effect.
Fluid intake is another important factor in normal bowel habit. Adequate fluid intake is important for ensuring that stool stays soft, which allows it to move faster through the bowels and pass out easily during a bowel movement. Inadequate fluid intake, or excess loss of fluid without sufficient replacement like during summer and heat waves can therefore lead to constipation at certain times. Furthermore, replacing water with other beverages like cola, coffee or alcohol can expedite water loss.
Many foods play different roles in ensuring regular bowels. Fiber is one of the main such components, and is primarily sourced from fruits, vegetables, cereals and certain grains. Changes in diet that does not include sufficient fiber will ultimately contribute to constipation. The change in diet may at times be related to seasonal availability of certain foods. Sometimes the festivities associated with certain times of the year leads people to abandon a healthy diet.
Bowel motility is closely linked to the degree of physical activity within a day. People who are sedentary are therefore at a higher risk of becoming constipated. Levels of physical activity also change with seasons. Many people are more active during summer, with the longer daylight hours and warm environment, than they are during winter. Therefore bowel habit may change during certain periods of the year as a result of the altered levels of physical activity.
Diuretics are mainly drugs that cause water loss which is used for conditions such as hypertension (high blood pressure) and heart failure. However, it can also include certain foods and beverages. It is known that caffeine and alcohol are two such substances. Caffeine is widely available in coffee, tea, cola and chocolates. Consuming these substances without adequate rehydration can contribute to constipation. Some of these beverages may be consumed in larger quantities during certain seasons.
Apart from old-generation antihistamines, corticosteroids and diuretics discussed above, a number of other drugs may also contribute constipation. Most notable among these are narcotic painkillers. Seasonal use of these drugs may be linked to seasonal aggravation of the conditions it is being used to treat. For example, using painkillers for arthritis that worsens during winter or additional hypertensive medication for high blood pressure during winter.
Constipation that tends to occur in winter may arise for a number of reasons. Apart from the iatrogenic (medication-induced) causes discussed above, there are also other dietary, lifestyle and environmental factors that also play a role.
- Higher intake of caffeinated beverages like coffee.
- Constipation associated with seasonal affective disorder (SAD)
- Lower levels of physical activity during the winter months.
- Alcohol consumption during the winter holidays (year end festivities in the northern hemisphere).
- Restraining bowel movements in order to avoid toilet visits due to the cold.
- Seasonal availability of high fiber foods like fresh fruit and vegetables may be a factor in certain parts of the world.
Constipation during the summer months is usually a result of specific dietary, lifestyle and environmental factors associated with this time of the year. Apart from iatrogenic causes, these factors may include:
- Higher intake of cola and certain alcoholic beverages in the hot weather.
- Excess fluid loss due to increased perspiration and increased physical activity.
- Being away from a familiar toilet as people travel more during summer.
- Replacing water intake with cola, alcohol and other diuretics.
- Reduced food intake as people try to shape up for summer fashion that may be more revealing.
Treatment and Remedies
Mild to moderate constipation can be fairly easily treated without medication. Simple measures include:
- Increasing water intake – 2 to 2.5 liters per day or drinking at least eight 8oz glasses of water daily.
- Rehydrating with oral rehydrating solutions particularly when perspiring excessively or exercising vigorously.
- Staying active throughout the year with dedicated exercise time irrespective of the weather. Indoor activities may be preferable in winter.
- Reducing the intake of caffeinated beverages and alcohol, especially overindulging in alcohol repeatedly during seasonal festivities.
- Maintaining a constant intake of fiber throughout the year even with seasonal variation of available foods. Use a fiber supplement if necessary.