The relationship between intestinal problems, especially constipation and diarrhoea, and the frequency of urinary tract infections in both children and adults has long been known. Classically, it has been estimated that an "overload" of intestinal bacteria in the perineal area could be the cause, leading to neighbouring invasion of the bladder and consequent urinary tract infections. However, this theory does not explain why not all people with bowel transit problems develop urinary tract infections, especially considering how common these pathologies are, especially constipation.
According to the NIH (National Institutes of Health), constipation is a condition that occurs when there is a lack of food:
- A decrease in the frequency of defecation (less than three times per week)
- Difficulty or pain in passing stools
- Hard, dry or earthy faeces
- A feeling of not having passed all the stools
It affects 15% of the population, and especially the population over 60 years of age, where its prevalence is one in three people. Classically, several causes are considered:
- Presence of slow transit, often due to a dietary origin (low fluid and/or dietary fibre intake) or lack of physical exercise, but also naturally due to ageing.
- A functional problem at the pelvic floor level (lack of relaxation of the anal sphincter during defecation which can lead to retrograde dilatation of the bowel).
- Certain diseases such as irritable bowel disease, diabetes or hypothyroidism, food intolerances or allergies such as coeliac disease, neurological diseases such as Parkinson's, Alzheimer's or spinal cord injury, obstructive anatomical or tumour problems, etc.
- Intake of certain drugs: anticholinergics or antispasmodics, such as those used to treat overactive bladder or diarrhoea, antacids containing aluminium and calcium, calcium channel blockers or diuretics, iron supplements, neurological treatments for Parkinson's disease or depression, opioid painkillers or antitussives (morphine, tramadol, codeine, fentanyl, etc.).
Natural situations such as pregnancy, due to an increase in blood levels of the hormone progesterone, which slows intestinal transit by relaxing the smooth muscle of the colon.
The consistency and shape of the stool is measured by a visual scale called the "Bristol Scale", which is very useful to get a concrete idea of a patient's stool and can be found on the internet.
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