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Constipation is no fun. Luckily, it can usually be remedied with a handful of prunes, a few cups of coffee, and some patience. However, if you don't poop for a long, long time, constipation can develop into some serious health problems.

Hosted by: Hank Green

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Sources:
http://ddc.musc.edu/public/diseases/small-intestine/dysmotility.html
https://emedicine.medscape.com/article/179937-overview#a4
https://www.aboutgimotility.org/disorders-of-the-large-intestine.html
https://www.health.harvard.edu/digestive-health/constipation-and-impaction
https://www.huffingtonpost.com/Greatist/how-bad-is-it-to-hold-in_b_9331542.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348734/
https://www.ncbi.nlm.nih.gov/pubmed/7065551
https://www.webmd.com/digestive-disorders/exercise-curing-constipation-via-movement
https://emedicine.medscape.com/article/180955-overview#a7
https://www.healthline.com/health/toxic-megacolon
https://www.realclearscience.com/blog/2014/09/can_you_poop_via_your_mouth.html
This episode's gonna get real, so be prepared for that.  Let's start here: nobody likes to be constipated.  Sometimes because of things like diet or stress, you don't poop for a little while.  It happens to me whenever I go on vacation and I'm like, why?  I'm supposed to be having a good time.  This is not fun.  Thankfully, that's usually fixable with coffee, or like a bunch of fiber, have a couple of bran muffins, but if that little while turns into a long time and you just stop pooping entirely, things can get pretty ugly.

Poop, of course, is your body's way of getting rid of undigested or undigestable food and other wastes that your body produces.  After the stuff travels through your small intestine and large intestine, it ends up at the rectum, which stretches and sends a signal to your brain, 'It's time to go.'  Sometimes, though, things can stop chugging along as nature intended.  That's where constipation comes in, and it can be caused by anything from holding it in too long to a lack of exercise.  Some diseases can also make your intestines struggle to propel the poop along.

Parkinson's or Inflammatory Bowel Diseases, for example, can prevent the muscles and nerves in the colon from working properly so it can't pass along feces or gas.  In severe cases, that can cause a megacolon, and that's the actual name for this thing. It's an abnormally large or swollen colon, which can create a fecal backup.  Regardless of what causes it though, nothing good happens when your poop gets stuck in your body.

When it hangs out in the colon, more and more water is sucked out of it, and that makes it harder, which in turn, makes it more difficult for your body to push out, and when you do try, you have to push harder.  That strain can cause hemorrhoids, which are inflamed veins in your rectum or anal fissures, which are small tears in the lining of the anus.  All this sounds so fun!  And if you don't go for a long, long, long time, your poop gets too hard and dry.  It can also cause something called a fecal impaction, a hardened mass of stool that can't move at all.

Those masses can cause nausea, ulcers, and press on the bladder, causing urinary incontinence.  They can also cause the colon to perforate or rupture, which is life-threateningly dangerous and requires surgery, and in really, really, really rare cases, things can get, oh goodness.  A severe fecal impaction can actually make the intestines contract in reverse.  In an effort to get things moving, they will contract and relax, which unfortunately, can send their contents in the wrong direction.  They're just trying to save your life.  Liquid from the small intestine backs up into the stomach and causes the unfortunately named condition 'fecal vomiting'.  Now, it's not quite as nasty as it sounds, like, it's not fully formed stools or anything, but also definitely not pleasant.  

Thankfully, fecal impactions can be broken up with laxatives or can be broken up manually by a doctor.  If a person is chronically constipated or develops fecal impactions, their intestinal muscles might weaken over time, making it more difficult to regulate the pooping on their own, so make sure to eat plenty of fiber, don't hold it for too long, and if you're not pooping regularly, go talk to a doctor, because the alternatives, no.  

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