Herpes may be a common cause of chronic constipation and urinary tract symptoms, according to a study showing that infection with herpes viruses causes constipation in mice (Cell Host & Microbe, June 8, 2016). The researchers showed that the herpes virus spread from nerves in the genitals to nerves in the spinal cord, and then traveled from the spinal cord to nerves in the colon and killed them.

Normally peristalsis, the rhythmic contraction of muscles around the intestines, squeezes food residue forward until stool passes from your body. However herpes viruses can damage the nerves that cause peristalsis, and your colon then lacks the muscle power to push the food out. The colon then fills with stool to make you feel miserable.

Other members of the herpes virus group, such as Epstein–Barr virus, chicken pox virus, and cytomegalovirus, have also been found in colon nerves of people with chronic constipation. Herpes can also damage nerves in the bladder to cause urinary burning and other discomfort, frequency, urgency, night-time urination, and inability to empty the bladder.

Herpes Stays in Nerves
More than 85 percent of North American adults have been infected with herpes, primarily in the mouth, genitals and rectum. Herpes viruses are the most common causes of cold sores and genital blisters in humans. After you are infected with the herpes virus, you may keep that virus in your nerves forever, even if it does not cause any other symptoms whatever. We do have drugs to make a current attack of blisters caused by herpes go away faster, but we have no drugs to keep the blisters from coming back or to rid your body of the virus permanently.

Herpes can be acquired through any type of skin-to-skin contact with a person infected with herpes, even if that person has no symptoms at all. Barriers such as condoms and dental dams reduce risk, but the virus travels in fluids and therefore can easily get around them. Once you are infected, you keep the virus forever in your nerves. Many people do not know that they have been infected as they may have no symptoms at all. The most common symptom is blisters that go away after a few days without treatment, but they may recur days, months or even years later.

The Physiology of Constipation
When you eat, the pyloric sphincter at the end of your stomach closes and food is not allowed to pass into your small intestine until is converted to a soupy liquid. In your intestines some of the food is broken down and absorbed, but most of it passes to your colon, where most of the fluid is absorbed. The longer stool remains in your colon, the more water is absorbed, the harder the stool becomes and the more difficult it is to pass.

Constipation has many causes. You increase risk for being constipated by:
• not eating enough plants that contain fiber (fruits, vegetables, whole grains, beans, nuts and other seeds),
• eating a lot of refined carbohydrates that are low in fiber, such as bakery products and pasta,
• not replacing lost fluids,
• not exercising,
• being pregnant,
• taking certain medications such as sedatives, narcotics, antidepressants and some blood pressure drugs, and
• according to this new research, being infected with a herpes virus.

Less common causes include:
• rectal cracks and infections
• intestinal blockage
• cancers
• strictures (narrowing of colon)
• rectocele (protrusion of the rectum)
• various causes of nerve damage such as diabetes, multiple sclerosis, Parkinson’s disease, spinal cord injury or stroke
• weak muscles in the pelvis
• overactive parathyroid gland
• hypothyroidism

To Prevent or Treat Constipation
We have no treatment for damage to the colon nerves by herpes viruses, but this new research does help to explain why some people suffer from constipation even when they follow all of the rules to prevent it.

• Exercise every day. Exercise causes giant contractions of the colon which push food out. The longer and harder you exercise, the greater the movement of food toward the outside.

• Drink plenty of fluid because dehydration increases the rate that fluid is absorbed from your colon.

• Eat lots of high-fiber foods that hold extra water in your colon: vegetables, whole grains, beans, nuts and other seeds. Dried fruits such as prunes or dried apricots are particularly effective for pushing food onward.

• Try to empty your colon less than a half hour after eating to take advantage of the gastro-colic reflex. When food reaches your stomach, the stomach is stretched, sending a message along nerves from the stomach to cause the colon to contract and push foods forward. The longer stool remains in your colon, the drier and harder it becomes, so you want to empty your colon as soon as it fills.

• Get in the habit of trying to empty your colon at the same time of day every day.

Over-the-counter remedies may help with occasional constipation, but if you have chronic constipation that does not respond even with strict adherence to the diet and lifestyle changes listed above, check with your doctor to rule out the more serious causes.
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Checked 4/6/23