family at a festive dinner table taking a selfie

What Causes Constipation and How to Get Relief During the Holidays

Written by: Simon Spichak, M.Sc

Updated: March 9th, 2023

During the holidays, many of us travel to visit friends and relatives, and eat lots of comfort foods. There’s the stress and anxiety of bringing a new loved one to dinner, or the rush to make the perfect dish.

But with the changes in routine, the travel, and the jetlag, you might find yourself with abdominal pain or straining more than usual in the bathroom. According to a recent study published in Gastroenterology, one in four Canadians experience occasional constipation^[1].During the holidays, the changes in your usual routine as well as the portion sizes and foods can have a negative impact on your gastrointestinal health.

This common predicament is nothing to be embarrassed about. There are plenty of proven tips and over-the-counter treatments that can prevent constipation and make it easier to pass your stools.

What is constipation?

Constipation is the most frequent gastrointestinal complaint that patients bring up to their physician^[2]. Imagine the gastrointestinal tract is a water slide and your stools are hitching a ride. If there isn’t enough water lubricating the slide, it’ll be tough to move through it.

In addition, think of how a soft and buoyant inflatable tube has an easier time travelling through a slide than well, a rock or a couch. Similarly, when your stool becomes too dry or hard, it becomes more difficult for it to move through the gut. This leads to a lot more straining, and time spent on the toilet. Once you finally pass the stools, you might still feel like the rectum hasn’t completely been emptied.

Other signs and symptoms of constipation include:

Abdominal pain
Difficult and painful bowel movements
Lower frequency of bowel movements (compared to your normal)
Bloating
Feeling tired or sluggish

Diagnosing constipation

According to ROME IV criteria^[³^], functional constipation can be diagnosed if two or more of the following symptoms occur over the course of the last three months with symptoms starting at least 6 months prior:

Straining during more than ¼ (25%) of defecations

Lumpy or hard stools more than ¼ (25%) of defecations

Sensation of incomplete evacuation more than ¼ (25%) of defecations

Sensation of obstruction/blockage more than ¼ (25%) of defecations

Manual maneuvers to facilitate more than ¼ (25%) of defecations (e.g., digital evacuation, support of the pelvic floor)

Fewer than three bowel movements per week

Loose stools are rarely present without the use of laxatives

Insufficient criteria for irritable bowel syndrome

What causes constipation

A lot of the factors that contribute to constipation are front and center during the holidays. For most healthy individuals, regular bowel movements occur up to three movements a day or as few as three movements a week^[⁴^]. During the holidays, this delicate balance is disrupted by changes in diet, sleep, and travel.

If you’re visiting family, you can guarantee a grandparent will offer you food every ten minutes. If you celebrate any holidays, you’ll be eating delicious courses of holiday-centric foods. And of course, you’re probably going to be drinking more alcohol than usual, after all you don’t need to wake up and work the next day.

Let’s break down the factors that can lead to gastrointestinal disruptions and long trips to the bathroom.

Holiday foods: These foods are a perfect recipe of factors that leads to pain, straining and constipation. There are lots of large portions of foods high in sugar, salt, and fat, as well as low levels of fiber. Large portions can disrupt the digestive process while sweet and salty foods are positively associated with symptoms of constipation ^[⁵^]^,^[⁶^].
Sleepless nights: Many of us travel during the holidays and stay up late catching up with friends and family. These disruptions in your everyday schedule can lead to insomnia, which bears a strong link to constipation^[⁷^].
Not enough water: If you aren’t drinking any water, it becomes easier for waste to get stuck in the colon and become drier and harder. Especially if you’re travelling or busy getting everything ready for a family meal, it is easy to neglect hydration.
Stress: Family get-togethers, preparing for large meals, and last-minute gift shopping are stressful. This can slow gut transit, leading to constipation^[5].

If you want to lower your risk of constipation during the holidays, you’ll need to make sure to get enough sleep and exercise. You might also need to consider compensating for heavy dinners with healthy lunch or breakfast rich in fruits, vegetables, and fibers.

Treating constipation with laxatives

There are many over-the-counter laxative pills and powders that you can take until the constipation is resolved. While laxatives are safe for treating constipation, some will have side effects depending on their mechanism of action^[9].

Stimulant laxatives (ex. Lax-A Senna^®*): Much like caffeine gives the brain a much needed boost, these laxatives help stimulate the gut muscles to move waste through the gut. For painful bouts of constipation, these pills work in as little as six hours. The key ingredients in these products are sennosides and bisacodyl.
Osmotics (ex. Lax-A Day^®*): These laxatives work by moistening the colon, so when your gut muscles push the stool, it is easier to slide on through. The medicinal ingredient, polyethylene glycol, lubricates your gut but may take 2 to 4 days to produce a bowel movement.
Bulk-forming laxatives (ex. Lax-A Fibre^®*): Often sold as powders that are stirred into a glass of water, these products add more mass to the stool, making it softer and easier to pass. These can take up to three days to work and key ingredients include psyllium and inulin.
Stool softeners: These laxatives soften the stool by making it absorb more moisture. Rather than being hard and pellet-like, the stool becomes softer and squishier making it easier to expel. These may take one to two days to begin working. Check the label for docusate sodium and docusate calcium.

Make sure to follow all the instructions on the labels, especially for powder-form laxatives that may need to be mixed with a glass of water or juice.

Conclusion

While holidays bring families and friends together, they may frequently lead to constipation. The travel, stress and dietary changes are a perfect storm leaving you with abdominal pain and straining in the bathroom. By being aware of these risk factors and having a variety of over-the-counter treatments at the ready, you’re prepared all set to deal with the holiday poos.

These products may not be right for you. Always read and follow the label.

Lax-A Day®, Lax-A Fibre® and Lax-A Senna® are registered trademarks owned by Norwell Consumer Healthcare Inc.

Download the ‘Constipation 101’ Infographic

References

Werth, Barry L. “Epidemiology of constipation in adults: Why estimates of prevalence differ.” J. Epidemiol. Res 5 (2019): 37.

Wald, Arnold. “Constipation and Defecation Problems.” American College of Gastroenterology, 13 Oct. 2016, https://gi.org/topics/constipation-and-defection-problems/.

“Rome IV Criteria.” Rome Foundation, 19 Oct. 2020, https://theromefoundation.org/rome-iv/rome-iv-criteria/.

Mitsuhashi, Shuji, et al. “Characterizing normal bowel frequency and consistency in a representative sample of adults in the United States (NHANES).” Official journal of the American College of Gastroenterology| ACG 113.1 (2018): 115-123.

Griffin, R. Morgan. “Holiday Foods, Upset Stomachs, Heartburn, and Digestive Problems.” WebMD, WebMD, https://www.webmd.com/digestive-disorders/features/winter-holidays.

Rollet, M.; Bohn, T.; Vahid, F.; on behalf of the ORISCAV Working Group. “Association between Dietary Factors and Constipation in Adults Living in Luxembourg and Taking Part in the ORISCAV-LUX 2 Survey.” Nutrients (2022): 14, 122. https://doi.org/10.3390/nu1401012

Yun, Byung-Yoon, et al. “Association Between Insomnia and Constipation: A Multicenter Three-year Cross-sectional Study Using Shift Workers’ Health Check-up Data.” Safety and Health at Work 13.2 (2022): 240-247.

Chang, Yu-Ming, Mohamad El-Zaatari, and John Y. Kao. “Does stress induce bowel dysfunction?.” Expert review of gastroenterology & hepatology 8.6 (2014): 583-585.

Mayo Foundation for Medical Education and Research. (2022, March 3). Over-the-counter laxatives for constipation: Use with caution. Mayo Clinic. Retrieved June 2, 2022, from https://www.mayoclinic.org/diseases-conditions/constipation/in-depth/laxatives/art-20045906