What You Need to Know About Constipation and Hepatitis C
It’s rarely talked about, but constipation is one more issue that those with chronic Hepatitis C may have to contend with. A potential symptom of chronic liver disease, side effect of Hepatitis C treatment or consequence of taking other medications, constipation can be a major nuisance. Luckily, the primary strategies for easing constipation also help to prevent it – and they don’t put the liver of someone with chronic Hepatitis C in jeopardy.
Constipation is a common gastrointestinal problem that encompasses the following three experiences:
- Infrequent bowel movements
- Passing hard stools
- Straining during bowel movements
Believed to affect 25 percent of the population at any given time, constipation is different for each individual. This is mostly because normal bowel patterns have a great range – from several movements a day to several per week.
Normally, stool is propelled through the intestines via peristalsis – wave-like muscle contractions that move material towards its final destination. A certain amount of fluid is also necessary to keep stool moving. Some of that fluid is reabsorbed in the colon, but there should still be a sufficient amount to lubricate the stool’s passage. Besides slow peristaltic activity, issues with re-absorption in the colon can cause a fluid imbalance – the main cause of constipation. The stools will dry and harden if the colon absorbs too much water or if the person is dehydrated.
When it comes to age groups more susceptible to constipation, the elderly are at a disadvantage. This is because the intestine’s peristaltic muscles weaken with age and the elderly are more likely to take medications that include constipation as a side effect.
Constipation with Hepatitis C
Constipation is rarely mentioned in most Hepatitis C symptom lists. Despite this omission, many with this chronic liver disease report troubling bouts with constipation. Besides those who were prone to constipation prior to their Hepatitis C infection, the following are two likely explanations for why infected individuals have difficulties with bowel movements:
- Those with advanced liver disease are more likely to have digestive complications such as insufficient bile secretion, which reduces lubrication in the intestines.
- Hepatitis C causes inflammation of the liver, which can hamper its ability to synthesize proteins and vitamins necessary for healthy intestinal motility.
In addition, many on Hepatitis C antiviral therapy are challenged by constipation. This may be for the following reasons:
- Interferon treatment can reduce appetite, which may lead to poor nutrition – a frequent predecessor to weakness and constipation.
- Ribavirin can initiate anemia, a condition that often leads to dehydration.
- Nausea and vomiting is a common side effect of Hepatitis C antiviral therapy. Vomiting repeatedly can easily lead to dehydration.
- Diarrhea is another common side effect of antiviral therapy. Although seemingly the polar opposite of constipation, diarrhea can lead to dehydration. This is why diarrhea and constipation can become a vicious cycle.
Tips to End Constipation
Constipation is easier to correct in some people more than others. Even so, the following tips to help get things moving smoothly in the colon are generally safe for those with Hepatitis C:
- Increase the Fiber in Your Diet – A high-fiber diet (at least 20 to 35 grams of fiber per day) helps the body form soft, bulky stool. High-fiber foods include beans, whole grains, fresh fruit and vegetables.
- Stay Hydrated – Prevent the drying effects of dehydration on the colon by making sure to drink plenty of liquids and other clear fluids. Limit caffeine intake, which can worsen constipation by causing dehydration.
- Keep Active – Regular physical activity helps stimulate peristalsis in the intestines.
- Massage – Abdominal massage can help release tension in the organs and promote bowel activity.
- Acupuncture – A standard component of post-surgical care in China to move the bowels, acupuncture can stimulate peristalsis in the colon.
Constipation is rarely life-threatening, but it can be a frustrating, painful problem. For individuals battling Hepatitis C, there are plenty of reasons why moving the bowels might be troublesome. Fortunately, there are some safe, non-invasive ways to prevent and help ease the unwelcome and under-addressed symptom of constipation.
Cohen, Misha Ruth, OMD, et al, The Hepatitis C Help Book, St. Martin’s Press, New York, NY, 2007; pp 199, 208.
http://www.hepatitis.va.gov/vahep?page=treat-05-01, Hepatitis C: For Patients and the Public – Side Effects Guide, Retrieved December 5, 2010, United States Department of Veteran Affairs, 2010.
http://www.mayoclinic.com/health/constipation/DS00063, Constipation, Retrieved December 5, 2010, Mayo Foundation for Medical Education and Research, 2010.
http://www.netdoctor.co.uk/diseases/facts/constipation.htm, Constipation, Jeni Worden, GP, Retrieved December 5, 2010, NetDoctor.co.uk, 2010.