By Ben Spierenburg

Constipation - a condition in which a person has infrequent or painful bowel movements. Symptoms include feeling uncomfortable, bloated or sluggish. Untreated, it can cause complications such as hemorrhoids, anal fissures, and rectal bleeding. -Webster's Dictionary

We probably don't have to tell you this, because recent research shows that if you're from Iowa, chances are good you're already all too familiar with this unpleasant dilemma. According to a study released by the government Task Force for Regular Bowel Movements (TFRBM) last month, of the roughly 3 million people in the United States who suffer from chronic constipation, more than 650,000 hail from the Hawkeye State.

With Iowa's current population at approximately 3 million people, this means a staggering 22 percent of Iowans consistently struggle with irregularity. These startling statistics easily make Iowa the most constipated state in the union. Dr. Tim Olsen, a Washington D.C. proctologist, who headed up the TFRBM study, says his team was surprised with their findings, but emphasized that there can be no doubt as to the hard reality of Iowa's stool situation, calling our state "the constipation capitol of the United States - and probably the world."

The reasons for this burgeoning constipation crisis are not as simple as one might expect. For example, some might think that Iowans are constipated due to abysmal eating habits. But we're no worse than the rest of the nation when it comes to eating unhealthy. Others might place the blame directly on the worn-out intestines of Iowa's substantial senior population. However, while 79 percent of elderly Iowans do indeed fritter away their twilight years grunting on the toilet, this wouldn't be entirely accurate either, because 13 percent of teenage Iowans squander the bloom of their youth in the bathroom, as well. In fact, Iowa's constipation rate hovers between 10 to 20 percent in nearly every age range and demographic.

So what's going on in our guts? Why is Iowa so hopelessly constipated? In an effort to find out, the TFRBM tracked 10,000 constipated Iowans for 18 months, and kept track of the frequency and firmness of their bowel movements. When the study was complete, the group found three consistent and compelling reasons for why Iowa leads the nation in constipation. The study found that Iowans are more likely to be constipated because: A) They don't know anything about it and, thus, ignore it B) They don't like being told when to defecate, and 3) They don't trust the water supply.

Ignorance

The TFRBM study found that more than three-fourths of constipated Iowans were extremely uninformed regarding their ailment. For example, only 24.7 percent of Iowans who suffered from irregular bowel movements were able to correctly label their condition as constipation, explains Olsen. "They just thought they had been eating too much cheese," he says. "As mind-boggling as it sounds, most constipated Iowans don't understand what constipation is, or that it's even a problem. This means they usually don't seek medical help until they're already in excruciating pain.

"People in other states identify their problem quickly and get medicine for it. But Iowans just seem to instinctively accept being constipated as their new life-situation and make do with that, hoping things will just 'sort themselves out' on their own."

Olsen notes that 58 percent of those surveyed reported being unaware that straining to defecate was even a problem. How is this possible? Well apparently, while everyone poops, not everyone knows that it's meant to be a somewhat pleasant experience.

"I always thought going number two was just supposed to be this unbearable thing you had to go through once a week, kind of like your period, except more often," says a 22-year-old Iowa City woman, who took part in the study, but asked not to be identified. "And then the TFRBM people tell me last month I'm supposed to go once a day. So I find out I've suffered my whole life for no reason. But on the plus side, I feel much better prepared for the pain of childbirth."

Stubbornness

As Mark Henson, ISU gastronomic scientist, explains, an oft-overlooked reason for this mass ignorance is that Iowans are generally unable to discuss constipation without immediately giving in to making childish poop-jokes.

"It's so easy to make light of this problem," Henson says. "But constipation is no laughing matter. It's a serious medical condition which permanently damages hundreds of thousands of Iowa anuses every year."

Certainly a lack of decorum can be expected when discussing pressing issues of the intestinal variety. The danger begins when this refusal to take constipation seriously stiffens into a stubborn resolve to disregard it entirely. Clive resident Brandon Fullerton, a 27-year-old test subject, is one of those who take a cavalier attitude.

"I love being backed up, I only crap maybe once or twice a week, but it's a monster," Fullerton says. "I drop eight pounds a sitting, and it always feels like I really accomplished something. It's a great feeling. I don't understand what all the fuss is about. I really don't think what I choose to do with my ass is anyone's business but my own."

Proctologists term what Fullerton does "voluntary constipation," while political activists might dub it 'pro-choice pooping,' but whatever you decide to call it, Fullerton's attitude emphasizes another major source of the problem: obstinacy. Iowans have always held a great reputation for being stubborn. This predilection for pigheadedness was reflected in the results of the TFRBM study where a whopping 64 percent of participants indicated that they would take no steps whatsoever to cure their constipation ills. Their bodies, their choice.

"I don't appreciate being asked a bunch of questions about my not shitting, and then lectured on how I have to go out and buy laxatives," Fullerton says. "Who owns Senikot anyway, Halliburton? Those feds need to mind their own business and stop sticking their noses where they don't belong - namely up my ass."

Shitty water supply

But while ignorance and stubbornness undoubtedly play a role, the TFRBM study found the most significant cause for Iowa's constipation crisis is a widespread distrust in the quality of the state's drinking water. Ninety-five percent of respondents said that they don't trust Iowa's tap water enough to drink it. Making matters worse, 83 percent said they don't trust or drink bottled water either because, according to many state residents, "it's just tap water from somewhere in a bottle." All of this lack of trust inevitably leaves Iowans and their stools awfully dried out. Numerous citizens, such as feisty 73-year-old Grinnell resident Donald Binder, who took part in the study, as well, seem to have completely given up on drinking water altogether.

"I don't drink Iowa water. It's too dangerous," he says. "The last time I did, must've been two years ago, I could've shit through a screen door. Never again, I'd rather be constipated. I mean, I'd rather not have any pooping problems at all, but I guess that's just the price you pay to live in Iowa."

Binder might be on to something. As well as being ranked first in overall constipation, Iowa was also recently ranked third in overall diarrhea, just behind Mississippi and Missouri. So maybe it's understandable if Iowans prefer being constipated over drinking diarrhea-inducing toxic water. Either way, experts point out, the state government's complete unwillingness to pass legislation improving the quality of the water is positively incomprehensible. As shocking as it is, Iowa remains the only state in the union still not in compliance with the U.S. Clean Water Act of 1977.

So how could things get this bad? Well, bacteria runs rampant in Iowa's drinking water because there has never been enough government money to adequately upgrade our water-treatment facilities or oversight to keep factory farmers from abusing our natural sources.

Public record shows that time and again state leaders have rejected proposals to adopt high-quality water standards in favor of doing nothing at all. Binder, who believes the people in the statehouse must be as constipated as he is, explains this sad state of affairs in layman's terms.

"See, what you have to understand is, Iowa's politicians are completely full of shit," Binder says. "They could have made our water safe a long time ago, but because, like the rest of us, they're so damn constipated all the time, they're left too bloated and sluggish to get anything done. Sure, they manage to pass one or two pieces of legislation a year, but that's about it."

How do we go from here?

When the TFRBM study was released, reaction from state officials was mixed. Some embraced the report for shining light on a tough problem chafing Iowa's collective behind. Others pooh-poohed the study's findings, claiming there to be no way any study could ever learn so much about constipation. Nevertheless, a handful of legislators have proposed initiatives to help alleviate our collective incontinence.

Both sides of the aisle are solidly in agreement that there isn't enough money in the budget to upgrade our dilapidated water-treatment facilities. But that hasn't stopped Republican and Democrat leaders alike from agreeing to seek out unconventional solutions. An innovative new proposal gained momentum in the house last week, which, if passed, promises to provide free one-time corn-oil enemas for all of Iowa's constipated citizens. Rep. Jeffery Harvell, a Republican from Waterloo, and Rep. Fred Conley, a Democrat from Marshalltown, have been working together to spearhead this enema relief effort.

"Fred and I realized after that report came out that we can't be consumed by our petty differences any longer," Harvell says. "Iowa is severely constipated and it needs our help. I believe it's our civic duty to work together to help aid Iowa's collective ass."

Conley, who has openly admitted to suffering from constipation in the past, has been a staunch supporter of enemas since he first used one in the spring of 1994.

"I believe enemas available for all will help clear this up quickly," Conley says. "We need to do what we can to ensure this not be blocked."

Harvell and Conley's bipartisan enthusiasm for the enema relief effort seems to be paying off. The bill looks likely to pass in the House, and Gov. Tom Vilsack has said if it reaches his desk he will sign it.

Still, while the government's relief effort may momentarily ease Iowa's mass constipation, state bureaucrats know full well that it's not a permanent solution. At pennies a pop, the initial enema relief effort won't cost much, but Iowans will need to get wise to ensure further problems don't remain bottled up. Because when it's done, experts insist, none of the real causes of the constipation problem will have been dealt with, and we'll end up right back at square one, as bloated as ever.

"There is such thing as a quick-fix when it comes to constipation," Olsen says. "But that shouldn't keep Iowans from seeking permanent relief." CV

APRIL FOOLS!

Comment on this story | Return to top