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Let’s break the poo taboo and talk about how our stools are affected in season changes and some solves to this.

Olwethu: Good Afternoon Lara & Welcome to The Sit Down where we will be having a conversation around something that typically impacts some of us during winter – that being constipation (I know, it’s not a topic we usually like to talk about.). This is a conversation that is often neglected because it’s emotionally charged and can be embarrassing. We can get embarrassed when natures call and we just can’t go, which is a normal human process. However, the constipation episode impacts our lives, where we cannot get on with our daily routine. Feeling of being bloated and full can really impact our daily functioning and overall quality of life. So, Lara, let’s talk constipation today which for some might be an embarrassing topic?

Lara: Hi Olwethu and thank for having me on the show again, to share some insights on another gut health related topic. Constipation is a topic people have some difficulty discussing. Somehow there is an element of guilt and embarrassment about not being able to pass a stool.1 We recently conducted some research to understand what the consumer experiences when suffering with this condition and like you pointed out, quality of life is impacted.1

Many people can take up to 3 days to seek help at which point, they feel uncomfortable, sluggish, sore, and bloated.1 This really disrupts their lives.

Let, me first explain what is constipation? So, constipation occurs when bowel movements become less frequent, and stools become difficult to pass. Having fewer than three bowel movements a week is, technically, the definition of constipation.2 However, how often you “go” varies widely from person to person. Some people have bowel movements several times a day while others have them only one to two times a week. Whatever your bowel movement pattern is, it’s unique and normal for you – if you don’t stray too far from your pattern. Regardless of your bowel pattern, one fact is certain: the longer you go before you “go,” the more difficult it becomes for stool/poop to pass.

Other key features that usually define constipation include:

• Your stools are dry and hard.

• Your bowel movement is painful, and stools are difficult to pass.

• You have a feeling that you have not fully emptied your bowels.

It happens most often due to changes in diet or routine, inadequate intake of fibre and fluids and a lack of exercise.2

Olwethu: This is covered above …Ok, I get that but what causes constipation?

Lara: Your colon’s main job is to absorb water from residual food as it’s passing through your digestive system, it then creates stool (waste).3 The colon’s muscles eventually propel the waste out through the rectum to be eliminated.3 If stool remains in the colon too long, it can become hard and difficult to pass. Poor diet frequently causes constipation.2 Dietary fiber and adequate water intake are necessary to help keep stools soft. Fiber-rich foods are generally made from plants. Fiber comes in soluble and insoluble forms. The soluble fiber can dissolve in water and creates a soft, gel-like material as it passes through the digestive system. Insoluble fiber retains most of its structure as it goes through the digestive system. Both forms of fiber join with stool, increasing its weight and size while also softening it. This makes it easier to pass through the rectum. Other causes like stress, changes in routine, lack of exercise, delaying the urge to go, travel, certain medicines, and underlying medical conditions also slow down muscle contractions of the colon.

Olwethu: Some of us, see a change in our bowel habits during Winter? Lara, tell us why?

Lara: Various studies claim that constipation can affect people irrespective of the weather conditions and seasons. For instance, it hits some of us in the winter primarily due to dehydration and bad eating habits. We feel less thirsty during winter and tend to drink lesser amount of water.2 This can lead to dehydration and eventually result in irregular bowel movements. Moreover, people can also face constipation related problems due to the increased consumption of more comfort foods. Winter also tends to increase our appetites that can trigger overeating and contribute to various constipation causes and symptoms.

The cold weather limits exercise or running or any type of exercise programmes which also contributes to slowing down our system.2 Any impact or change to lifestyle could affect our gut health leading to constipation, like holidays with change to eating times and routine, lockdown/quarantine also created a phenomenon with fewer stools being passed during the pandemic, weird as the sale of toilet paper surged at one point. Stress, changes in routine, and conditions that slow muscle contractions of the colon or delay your urge to go may also lead to constipation.

Olwethu: We have covered what constipation is and how & why it can affect some of us during the winter months and routine changes, but I would like us to move on to remedies or treatments etc.?

Lara: Changing your diet and increasing your physical activity level are the easiest and fastest ways to treat and prevent constipation.2 One can increase the fluid and fiber intake, or you could add a fiber bulking agent. You or your HCP may consider a laxative or stool softener if improvements in your diet, lifestyle and toilet habits don’t ease the constipation. There are different laxatives which can be bought from your pharmacy or store. These include bulking/fiber agents which work by increasing the fiber content of the stool, osmotic laxatives help to increase the fluid content being drawn into the colon.4 This softens the stool, making it easier to pass them. Stimulant laxatives work by irritating the lining of the bowel, causing the intestines to contract, and thereby speeding up the passage of faeces. Lubricants such as mineral oils coat the stool, thereby preventing the removal of water from it. This results in a softer stool.

Olwethu: You have touched on over- the -counter laxatives, however laxatives are synonymous with being harsh and unpredictable, is there any truth to this myth?

Lara: Olwethu, you are quite right, it is difficult to know or anticipate how your system and the agents will react. Speaking specifically about the Dulco range, we are all about predictable relief, so when you use Dulcolax tablets at night, you should get a bowel movement the next morning (so 6-12 hrs. after dosing) for more immediate relief within 15mins- 1hr, we have Dulcolax suppositories. Then there is our latest edition which is DulcoSoft which results in a bowel movement 24-72hrs after dosing.

Olwethu: We all know how common constipation is during pregnancy. On my Story Q&A I received a lot of enquiries on whether OTC laxatives/medication can be used during pregnancy or breastfeeding?

Lara: Its always recommended to discuss treatment with HCP, especially when pregnant or breastfeeding, a product like Dulcosoft contains macrogol, which is not absorbed into the bloodstream in significant amounts, so can be used in our special populations.

Olwethu: Talking about this new addition to the Dulco family, Dulcosoft, is there any other features we need to be aware of?

Lara: Like I mentioned, Dulcosoft contains macrogol, which is not absorbed into the bloodstream in significant amounts, so our labelling includes use in pregnancy and breastfeeding, Dulcosoft does not contain sugar, so it may be used by diabetics, it’s also gluten free for those on special eating plans, and it does not have any included electrolytes which is especially important for your hypertensive or patients on a restricted salt/electrolyte diet. As I explained, Dulcosoft passes through the gut without being absorbed in any significant amount into the body. It relieves constipation by causing water to be retained in the bowel instead of being absorbed into the body. This increases the water content and volume of the stools in the bowel, which makes the stools softer and easier to pass, and helping the muscle in the bowel walls to push the stools along, for a gentler motion, which means you do not have to suffer or wait to treat.

Olwethu: That is was quite insightful, thank for taking the time to help us break the poo taboo, around constipation. Even if you go onto the Dulcolax website or social media pages, you can see which product will suit your needs. The Dulco family really aims to start the conversation around constipation in a fun, easy to understand way. So that you don’t need to suffer alone and that there are products that will meet your relief needs. It’s much easier now to have the Consties conversation than ever before.

ABOUT LARA JAGWANTH:

Lara Jagwanth, Africa Head of Medical at Sanofi Consumer Healthcare (let’s include CHC content).