American exceptionalism strikes again, this time in the pharmaceutical aisle. According to a recent article in the Wall Street Journal, the US is having a love affair with laxatives; Americans of all ages are ingesting so much of the stuff that there are now shortages nationwide.
“It’s crazy to think that our collective bowel dysfunction problems have gotten so bad that we’re running out of stool softeners,” Dr George Pavlou, head of the Gastroenterology Associates of New Jersey, told the WSJ.
If you’re feeling embarrassed or slightly icky about the subject, let me reassure you that digestive issues are very on-trend. Gone are the days where you couldn’t mention flatulence or constipation in polite society without someone piping up and saying: “Excuse me, you’re spoiling my dinner.” Now, everyone wants to discuss their guts in gruesome detail.
TikTok is flooded with influencers promising weird and wacky methods to hack your gut health and videos with the hashtag #GutTok have amassed hundreds of millions of views. Then there are BuzzFeed lists such as 10 Signs You’re a Hot Girl With Stomach Issues which, in turn, are inspired by trending hashtags like #HotGirlsHaveStomachProblems and #hotgirlshaveibs (IBS being irritable bowel syndrome). Hot girls, you’ve probably gathered, have a lot of tummy problems.
What about all the hot boys, you may be wondering? How are their tummies? While I don’t have a definitive answer for that, studies suggest that IBS is more common in women than men. Women are certainly more likely to open up about it on TikTok. Women are also more vulnerable to disordered eating than men, which can lead to digestive problems and result in laxative abuse.
Disordered eating isn’t the only factor feeding into a boom in bowel problems. Our guts and brains are connected and anxiety often manifests itself in stomach issues. The pandemic has obviously taken a big toll on our collective mental health and that has filtered down to our gut health.
Of course, there is a more obvious culprit: the food we eat. Many of us eat a lot of crap because that is what tends to be convenient, cheap, and tasty. Ultra-processed food (UPFs) make up 57% of the UK diet; among children and lower-income people that number is as high as 80%. The UK is outdone only by the US: UPFs make up 73% of the US food supply, according to Northeastern University’s Network Science Institute, and provide the average adult with more than 60% of their daily calories.
Our ultra-processed diets are resulting in more than an uptick in laxative use and cutesy colon-focused social media hashtags; the US and UK are also seeing a significant rise in bowel cancer in people under 50. While this disturbing trend may have flown under the radar for a while, it got mainstream attention after the tragic death of 43-year-old Black Panther actor Chadwick Boseman in 2020. To be very clear: nobody is entirely sure what is behind the increase in colon cancer rates among young people and a number of factors are probably at play. Still, it seems likely that a diet high in processed food is a risk factor for the disease.
Don’t worry, this isn’t a lecture on how you ought to be cultivating a healthy gut by subsisting on homegrown kale, foraged berries, and thrice-filtered spring water. (Do you know what I’m having for dinner tonight? Takeaway pizza.) Nope, that sort of advice is Gwyneth Paltrow’s domain.
I’m just here to say, very emphatically, that a nationwide shortage of stool softeners isn’t normal. The fact that #HotGirlsHaveStomachProblems is a trending hashtag isn’t normal. I’m very glad that frank discussions of digestive issues have become normalised, but we should all be concerned about why stomach problems are now so ubiquitous. Don’t let all the hot girl hashtags lull you into a sense of complacency: if you’re worried about your bowel movements go to the doctor. Trust your gut, not TikTok.
• Arwa Mahdawi is a Guardian columnist
