From the Guidelines
Alcohol consumption should be limited to moderate levels, defined as no more than 2 drinks per day for men and 1 drink per day for women, to minimize the risk of constipation and other adverse health effects. Alcohol can contribute to constipation through several mechanisms, including dehydration, as it is a diuretic that increases urination and reduces overall body fluid 1. To manage alcohol-related constipation, it is essential to reduce alcohol intake and increase water consumption to at least 8-10 glasses daily. Including more fiber in the diet (25-30 grams daily) from fruits, vegetables, and whole grains can also help alleviate constipation. Regular physical activity is another crucial factor in stimulating bowel movements.
If constipation persists, over-the-counter remedies like docusate sodium (100-300 mg daily), polyethylene glycol (17 grams in water daily), or psyllium fiber supplements (1 tablespoon in water 1-3 times daily) can provide relief by either softening stool or adding bulk. However, it is crucial to note that excessive alcohol consumption can lead to more severe digestive issues, and thus, moderation is key. A study published in Advances in Nutrition in 2018 suggests that avoiding excess alcohol consumption is vital, with recommendations to limit intake to ≤20 g/d in both genders 1.
Key considerations for managing alcohol-related constipation include:
- Reducing alcohol intake to moderate levels
- Increasing water consumption to at least 8-10 glasses daily
- Incorporating more fiber into the diet
- Engaging in regular physical activity
- Considering over-the-counter remedies for persistent constipation
- Being aware of the potential for more severe digestive issues with excessive alcohol consumption, as highlighted by studies such as those cited in 1 and 1.
From the Research
Alcohol and Constipation
There is no direct evidence in the provided studies that discusses the relationship between alcohol and constipation.
Constipation Treatment
- The use of osmotic laxatives such as polyethylene glycol (PEG) and stimulant laxatives like senna are recommended as first-line treatments for constipation, with good evidence to support their use 2.
- Fiber supplements, fruits, and magnesium-based products also have moderate evidence to support their use in treating constipation 2.
- Psyllium with or without senna has been shown to increase defecation frequency and stool weight, with the added effect of senna being clearly evident 3.
Constipation Mechanisms and Management
- Chronic constipation can be either a primary disorder or a secondary one, with colonic sensorimotor disturbances and pelvic floor dysfunction being the most widely recognized pathogenic mechanisms 4.
- Management of constipation should begin with dietary fiber supplementation and stimulant and/or osmotic laxatives, as appropriate, followed by intestinal secretagogues and/or prokinetic agents if necessary 4.
- Defecatory disorders often respond to biofeedback therapy, and slow-transit constipation may necessitate a colectomy in specific patients 4.
Occasional Constipation
- Occasional constipation (OC) is a subtype of constipation that falls outside current classifications, and a new definition has been proposed based on expert consensus: "OC can be defined as intermittent or occasional symptomatic alteration(s) in bowel habit" 5.
- Prospective studies are required to validate this definition and determine OC prevalence in the community 5.
Primary Care Approach to Chronic Constipation
- Primary care is normally the initial point of presentation and management of patients with chronic constipation, and effective management can be a challenge without a structured approach 6.
- Treatment can be stepwise or involve combinations of therapies, with stimulant laxatives being effective, but there is a poor evidence base for most common managements, including lifestyle measures 6.