Constipation in women linked to anxiety, depression, and feeling 'unfeminine'

July 11, 2001

[Relationship between psychological state and level of activity of extrinsic gut innervation in patients with a functional gut disorder 2001; 49; 209-13]

Chronic constipation in some women is linked to anxiety, depression, and feeling "unfeminine," suggests a study in Gut.

Researchers from St Mark's Hospital, Middlesex, studied 34 women between the ages of 19 and 45 who had suffered from constipation for five years or more. The study group was then compared with women who had no history of constipation. Each of the women completed a widely used general health questionnaire which, among other things, tests for levels of anxiety, depression, somatic symptoms, and impaired social skills. The women also completed psychological assessments to gauge how they felt about their femininity and their ability to form and maintain intimate relationships.

Rectal blood flow, which reflects the function of nerve pathways from the brain to the gut, was measured using a laser ultrasound technique.

Women with constipation had a worse score than the healthy women for the general health questionnaire. They also felt less feminine and found it harder to form close relationships than the healthy women. Reduced rectal blood flow was strongly associated with anxiety, depression, bodily symptoms, and impaired social skill scores, as well as feeling "unfeminine." The higher the psychologically abnormal score, the lower was the rectal blood flow.

The authors conclude that a patient's individual psychological make-up alters the function of the involuntary nerves that link the brain to the gut. Reduced activity of these nerves affects gut function, resulting in constipation in some people.

Dr Anton Emmanuel, St Mark's Hospital, Northwick Park, Middlesex.
Tel: +44 (0)20 8235 4089

BMJ Specialty Journals

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