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CAUSES OF CONSTIPATION - 13 MOST COMMON CAUSES
- Medically reviewed by: Horia Marculescu, MD
- Photo credits: Licenses / Author
- Last updated: 27 April, 2024
The majority of causes of constipation can result from a multitude of factors.
Psychological triggers like stress, anxiety, and depression, along with medication usage and ignoring the urge to defecate, play a significant role.
Lifestyle choices such as prolonged driving, frequent traveling, excessive video gaming, a sedentary lifestyle, and a slow metabolism can exacerbate the issue.
Poor nutritional habits, including excessive sugar intake, snacking, reliance on fast food, consumption of white flour, improper eating times, dehydration, fermenting fruits, and a diet rich in meat and cheese, contribute to digestive woes.
Additionally, various medical conditions like obesity, diabetes, pregnancy, recent colonoscopy, food poisoning, intestinal polyps, neuromuscular diseases, and laxative dependency can lead to constipation.
Understanding these causes is vital for effective management and prevention of constipation. Follow the guide and discover how to acknowledge them, how to deal with them, and how to prevent them.
I. PSYCHOLOGICAL CAUSES OF CONSTIPATION
1. STRESS
Stress is one of the most known causes of constipation.
Continuous stress, whether due to academic demands, career pressures, social interactions, or health issues, can put pressure on your body.
Stress triggers physiological responses in the body, including alterations in digestion. During periods of stress, the body's sympathetic nervous system becomes activated, diverting resources away from non-essential functions like digestion.
This process can lead to:
- Slower movement of food through the digestive tract.
- Increased water absorption in the intestines.
- Ultimately, difficulty passing stool.
There is an emerging body of research suggesting that stress-induced release of corticotrophin-releasing factor (CRF) can contribute to bowel dysfunction, including constipation, through various pathways.
These pathways may involve the activation of the hypothalamic-pituitary-adrenal (HPA) axis, modulation of the autonomic nervous system, or direct effects on the bowel.
Relaxation techniques, mindfulness practices, and lifestyle adjustments can help mitigate its impact on digestive health and reduce the likelihood of constipation.
2. ANXIETY
Extended periods of anxiety, whether related to familial dynamics, academic pressures, job stressors, or medical concerns, can be a significant factor in the development of constipation.
Anxiety triggers a cascade of physiological responses in the body, including heightened muscle tension and alterations in digestion. The body's fight-or-flight response, activated during moments of anxiety, can slow digestion, leading to decreased bowel movements and increased water absorption in the intestines.
Persistent anxiety can disrupt the natural rhythm of bowel movements, contributing to constipation. Managing anxiety through therapy, relaxation techniques, and lifestyle modifications can help alleviate this symptom and promote digestive health.
Recent medical research suggests that the prevalence of mood and anxiety disorders among individuals with constipation is significantly higher than in the general population.
It is essential to implement an intervention program targeting the comorbid psychological dysfunctions that influence the progression of gastrointestinal disorders.
3. DEPRESSION
Extended bouts of depression, whether stemming from career dissatisfaction, emotional distress, familial discord, or lack of fulfillment in hobbies or relationships, can cause constipation.
Depression can disrupt the intricate balance of neurotransmitters in the brain, impacting various bodily functions, including digestion.
The altered levels of serotonin and dopamine (common in depression) can affect the contractions of the intestines, leading to:
- Slower movement of food.
- Decreased bowel motility.
Lifestyle factors associated with depression, such as poor dietary choices and decreased physical activity, can worsen constipation. Addressing underlying depressive symptoms through therapy, medication, and self-care strategies can help alleviate constipation and promote overall well-being.
4. MEDICATIONS
Medications alter bowel function and affect intestinal motility.
The pathophysiology of constipation is intricate and remains incompletely elucidated. It encompasses a multifaceted interaction among elements affecting the gastrointestinal tract, nervous system, and pelvic muscles.
Common factors include:
- Diminished colonic motility.
- Slowed transit of stool.
- Compromised rectal sensation.
- Inadequate coordination of pelvic floor muscles during defecation.
These challenges can stem from medication use.
Narcotics, such as oxycodone and codeine, can slow down bowel movements and lead to constipation.
Antidepressants like amitriptyline and fluoxetine can also have constipation as a side effect by affecting serotonin levels in the gut.
Antacids containing aluminum or calcium, such as Maalox or Tums, may cause constipation due to their binding effects in the digestive tract.
Similarly, allergy medications like diphenhydramine and loratadine can have constipation as a side effect.
Lastly, antiseizure medications like gabapentin and carbamazepine can disrupt bowel function and contribute to constipation.
5. IGNORING THE URGE TO DEFECATE
Ignoring the urge to defecate can be a significant cause of constipation, often stemming from various reasons such as:
- Imprudence;
- Inconvenience;
When the body signals the need to evacuate waste, delaying or ignoring this urge allows stool to remain in the colon for extended periods, leading to increased water absorption and harder, drier stools.
Over time, habitual suppression of the urge to defecate can disrupt the natural rhythm of bowel movements and contribute to chronic constipation.
Recognizing and responding promptly to the body's signals for bowel movements is essential for maintaining regularity and preventing constipation.
II. LIFESTYLE CAUSES OF CONSTIPATION
1. DRIVING
Driving may seem unlikely to be one of the most common causes of constipation.
Driving during the summer months and in hot weather can dehydrate the body.
Prolonged periods of sitting in a car seat can lead to dehydration as individuals may not consume enough fluids while on the road. Dehydration can result in dry stools, making them harder to pass.
Extended sitting can cause muscle numbness.
This thing also includes the abdominal area, which may affect bowel function. Taking breaks to stretch, staying hydrated, and incorporating fiber-rich snacks can help alleviate constipation risk while driving in hot weather.
Frequent exposure to hot environments puts drivers at risk of dehydration and fluid loss, potentially impacting their ability to perform well while driving. Dehydration could affect muscle strength and increase fatigue. Also, dehydration can influence risk-taking behavior.
2. TRAVELING
Traveling can significantly contribute to constipation by impacting hydration levels and dietary habits.
Dehydration often occurs while traveling, either because of restricted access to water or disruptions in daily routines.
This lack of hydration can lead to dry and hardened stools, making them difficult to pass.
Traveling for long intervals of time leads to eating bad food combinations and drinking sugary drinks.
It's crucial to prioritize hydration by drinking plenty of water and making conscious efforts to include fiber-rich foods in meals, even while on the go.
Medical research indicates that the circadian clock may contribute to "traveler's constipation."
A study involving 70 individuals traveling from Europe to the United States explores this idea.
The severity of constipation seems to correlate with the severity of jet lag.
It's necessary to note that factors besides travel might have influenced the results. These factors can be changes in diet and physical activity.
3. VIDEO GAMING
Extended gaming sessions can cause constipation due to several factors. Sitting in a chair for hours can:
- Slow down bowel movements.
- Inhibit digestion.
The stress and excitement of gaming can also affect gastrointestinal function, leading to irregularity in bowel habits.
Inadequate hydration during gaming sessions, combined with the consumption of fast food and sugary snacks, can worsen dehydration and lack of fiber intake, both of which are common triggers for constipation.
Incorporating regular breaks for movement, staying hydrated, and opting for healthier snack options can help mitigate the risk of constipation associated with prolonged gaming sessions.
A study called “Physical Activity and Constipation in Hong Kong Adolescents” confirms that sedentary behaviors are more common in constipated adolescents.
“In addition to well-known hazards of TV/video viewing and Internet use/computer games on health, such as higher risk of obesity and cardiovascular diseases, our study adds to the current evidence regarding the effects of excessive screening time on bowel movement.”
4. SLOW METABOLISM
A slow metabolism slows the transit time of stool through the intestines.
This action allows excessive water absorption and results in dry, hard stools.
To counteract this, incorporating more liquid foods into the diet can help prevent the formation of dry stools.
Foods with high water content, such as fruits, vegetables, soups, and smoothies, can add hydration to the stool, making it softer and easier to pass.
Increasing fiber intake from these liquid foods can promote regular bowel movements. Maintaining a diet rich in liquid foods can effectively prevent constipation associated with a slow metabolism.
Slow metabolism results in the burning of fewer calories. This action leads to more accumulation of fat in the body.
Conversely, a rapid metabolism burns calories more efficiently, allowing some people to consume larger quantities of food without experiencing significant weight gain.
5. SEDENTARY LIFESTYLE
A sedentary lifestyle without exercises that target abdominal muscles, such as squats and yoga postures, can cause constipation.
Physical activity promotes the contraction of abdominal muscles, which helps facilitate bowel movements by stimulating peristalsis, the rhythmic movement of the intestines. Squatting posture, in particular, aligns the colon for more effective waste elimination.
Some yoga postures, like twists and forward bends, can massage the digestive organs and improve intestinal motility.
Regular exercise, focusing on the abdomen, posture, and movement, prevents constipation by aiding digestion and bowel regularity.
III. NUTRITIONAL CAUSES OF CONSTIPATION
1. SUGAR
An often overlooked contributor to causes of constipation is the excessive consumption of sugar, sugary drinks, and sweets.
Sugar, notorious for its adverse health effects, poses a significant challenge to digestion.
Its high osmotic properties cause it to absorb large quantities of water in the digestive tract.This thing leads to dehydration of stool and difficulty in passing it.
Moreover, prolonged exposure to high sugar intake can damage the intestinal lining, impairing its function in absorbing nutrients and promoting regular bowel movements.
To mitigate the risk of constipation, it's crucial to moderate sugar intake and prioritize a balanced diet rich in fiber, hydration, and whole foods to support healthy digestion and overall gastrointestinal function.
Health experts from MDPI (Basel, Switzerland) state that:
“Studies have previously reported that the amount of sugar in a meal can directly influence gastrointestinal passage. This thing may, therefore, be associated with constipation.”
2. SNACKING
Eating snacks between the 4-5 hour intervals after a meal disrupts the ongoing digestion process, potentially leading to constipation.
Eating additional food before the body has finished processing the previous meal will interrupt the natural digestive rhythm, causing the partially digested food to either move prematurely toward elimination or remain stagnant in the digestive tract.
This disruption can impede the efficient absorption of nutrients and hinder the smooth passage of waste through the intestines, contributing to constipation.
Maintaining consistent meal intervals without interceding snacks allows the digestive system to function optimally, promoting regular bowel movements and reducing the risk of constipation.
3. FAST FOOD
Fast food is probably on top of the causes of constipation list.
Consuming high amounts of fast food, junk food, or processed food has been linked to functional gastrointestinal disorders.
Consuming fast food devoid of vegetables, comprising mainly meat, bread, potatoes, and soda, can worsen constipation. This diet lacks essential fiber crucial for maintaining healthy bowel movements.
The combination of processed meats, refined carbohydrates, and carbonated beverages forms a dense mass in the intestines, akin to a sponge, which absorbs surrounding water. As a result, stools become hardened and difficult to pass, leading to constipation.
Incorporating vegetables into fast-food meals can introduce vital fiber and water content. Fiber from vegetables will help digestion and promote regularity, thus mitigating the risk of constipation associated with such dietary choices.
4. WHITE FLOUR
Excessive consumption of flour and oil-based sweets like cookies, biscuits, bread, and baked treats can lead to constipation.
These products, rich in refined carbohydrates and fats, often lack the fiber necessary for healthy digestion. The body struggles to process them efficiently, leading to slowed bowel movements and difficulty passing stool.
Over time, this pattern can disrupt regularity and contribute to constipation. Incorporating fiber-rich foods like fruits, vegetables, and whole grains into the diet can help alleviate constipation by promoting smoother digestion and regular bowel movements while reducing reliance on sugary, processed confections.
5. EATING TIME
Failing to space meals at intervals of 4-5 hours can contribute to constipation, particularly concerning foods like meat that require prolonged digestion periods.
This interval allows the digestive system ample time to process and absorb nutrients efficiently. When meals are consumed too closely together, especially without considering the complexity of digestion, the body may struggle to adequately break down food, leading to slowed bowel movements and constipation.
By adhering to the optimal 4-5 hour interval between meals, the digestive system can function more effectively, reducing the likelihood of constipation by allowing sufficient time for each meal to digest.
6. DEHYDRATION
Dehydration, often caused by inadequate fluid intake, particularly beverages lacking electrolytes, poses a significant risk factor for constipation.
When the body lacks sufficient hydration, it compensates by drawing water from the colon, resulting in dry and hardened stool, making it difficult to pass.
Factors such as heat and humidity exacerbate fluid loss, further increasing the likelihood of dehydration-induced constipation.
Ensuring adequate water intake, especially in hot and humid conditions, helps maintain proper hydration levels, facilitating smoother digestion and regular bowel movements. Incorporating electrolyte-rich beverages or foods can also replenish lost minerals and support optimal hydration, reducing the risk of constipation.
Health experts from the Canadian Digestive Health Foundation note that:
“Common signs of dehydration may include thirst, dry mouth/, headaches, dizziness, fatigue, muscle cramps, confusion, lethargy, constipation, infrequent trips to urinate, flushed skin, low blood pressure, and increases in body temperature ”
7. FERMENTING FRUITS
Eating fruit alongside other foods is one of the lesser-known causes of constipation.
While fruits are typically considered a healthy dietary choice, their combination with other foods can disrupt digestion.
The sugars and acids present in fruits may interfere with the digestion of proteins and starches, leading to:
- Slowed intestinal transit through the digestive tract.
- Potentially contributing to constipation.
Fruits have a shorter digestion time compared to other food groups. And when eaten together, they can create fermentation and digestive issues.
To promote better digestion and prevent constipation, eat fruits separately from other food groups, allowing for optimal digestion and nutrient absorption.
8. MEAT AND CHEESE
Consuming hard-to-digest foods such as cheese, meat, and oil without balancing them with vegetables, rich in insoluble fiber, can contribute to constipation.
These foods lack the bulk and roughage necessary to stimulate bowel movements, leading to sluggish digestion and stool retention. The absence of insoluble fiber found in vegetables will slow digestion and bowel movement.
Insoluble fiber can act as a natural laxative, adding bulk to stool and facilitating its movement through the intestines. Incorporating vegetables into meals alongside these dense foods will help digestion, promoting regular bowel movements and mitigating the risk of constipation.
9. BAD FOOD COMBINATIONS
One of the most common causes of constipation is the consumption of incompatible food combinations, such as those containing simultaneously:
- Meat;
- Flour;
- Bread;
- Sugar;
- Milk products;
- Cooked sunflower oil.
These combinations disrupt the digestive process, leading to difficulty in bowel movements.
Here are a few examples: pizza, burgers, burgers and fries, pasta with meat, donuts, noodles, rice, and cheesesteaks.
The mix of sugars, fats, and proteins in these foods slows intestinal transit, resulting in waste accumulation in the colon.
Additionally, some individuals may have sensitivities to specific components, worsening digestive issues.
Maintain a balanced diet, focusing on wholesome food choices and mindful pairing to support optimal digestion and regular bowel function.
Incorporating fiber-rich foods, hydration, and physical activity can further prevent constipation.
IV. MEDICAL CAUSES OF CONSTIPATION
12. OBESITY
Obesity is one of the most common causes of constipation and affects a large proportion of people worldwide.
Obesity can be a significant contributor to constipation due to the excess layers of fat that can compress the intestines in various areas.
This compression can impede the movement of stool through the intestines, leading to difficulty in passing bowel movements. Obesity can hinder proper hydration as the excess fat tissue may affect water absorption and distribution in the body.
Reduced muscle movements in obese individuals can intensify constipation by slowing down peristalsis, the rhythmic contractions of the intestines that facilitate the movement of stool. Managing obesity through lifestyle modifications can help alleviate constipation and improve overall digestive health.
“Functional constipation and fecal incontinence were associated with overweight or obesity in children and adolescents who attended specialized pediatric gastroenterology and endocrinology clinics.”
2. DIABETES
Diabetes can contribute to constipation through various mechanisms. Severe dehydration, often associated with uncontrolled diabetes, can lead to dry and hardened stool, making it difficult to pass.
Additionally, the accumulation of glucose within tissues and on the liver, characteristic of diabetes, can disrupt normal digestive function.
Elevated levels of glucose can affect nerve signals in the gastrointestinal tract, impairing muscle contractions necessary for bowel movements. Furthermore, fluctuations in blood sugar levels can impact energy utilization and metabolism, potentially disrupting the timing and efficiency of digestive processes.
Treating diabetes through proper hydration, blood sugar control, and lifestyle modifications can help mitigate constipation risk.
“Patients with diabetes have a significant risk of developing severe constipation, often due to dysfunction of the autonomic nervous system.”
Many individuals comonly manage constipation through self-treatment using over-the-counter laxatives, home remedies, and dietary adjustments. Patients should seek guidance from healthcare professionals regarding constipation management.
3. PREGNANCY
Constipation is a common issue during pregnancy, primarily due to hormonal changes and physical factors.
Hormonal fluctuations, particularly increased levels of progesterone, can relax the muscles of the digestive tract, slowing down bowel movements and leading to constipation.
As the uterus expands during pregnancy, it may exert pressure on the intestines, further impeding the normal movement of stool. Combining these factors contributes to constipation in pregnant women.
Consulting healthcare professionals for safe and effective treatment options is essential.
4. ANTIBIOTICS
Excessive use of antibiotics can disrupt the balance of beneficial bacteria in the gut, leading to constipation.
Antibiotics eliminate harmful bacteria. But they can also remove beneficial bacteria responsible for maintaining healthy digestion.
This imbalance, known as dysbiosis, can result in decreased production of short-chain fatty acids and alterations in gut motility.
Antibiotics may cause changes in the consistency and composition of stool, making it harder and less frequent to pass. Managing antibiotic use and supporting gut health with probiotics and fiber-rich foods can help prevent antibiotic-induced constipation.
5. COLONOSCOPY
Intestinal issues post-colonoscopy or enema can lead to constipation due to various factors.
The procedures can cause irritation and scratching of the intestinal tissues, disrupting their normal function.
Enemas or colonoscopies may strip away the protective layer of the intestinal mucosa, which is essential for lubrication and smooth passage of stool. Without this protective barrier, the intestines may become dry and irritated, making it difficult to pass stool effectively.
Proper hydration, gentle dietary adjustments, and allowing time for the intestinal tissues to heal are essential in the long term.
6. FOOD POISONING
Consuming contaminated or spoiled food can lead to food poisoning.
In cases where the ingested food becomes rotten within the gastrointestinal tract, it can transform into a viscous, adhesive substance that adheres to the intestinal walls.
This 'rotten stool' acts like glue, impeding the normal movement of waste through the intestines and causing constipation. Furthermore, the toxins produced by harmful bacteria during food poisoning can disrupt the natural balance of gut flora, further developing digestive issues.
Prompt treatment of food poisoning and consumption of probiotics to restore healthy gut bacteria can help alleviate constipation associated with this condition.
7. BODY EXHAUSTION
Body exhaustion, following strenuous activities such as sports, work, or extensive traveling, can contribute to constipation. During intervals of exhaustion, the body consumes the energy reserves.
This process affects various bodily functions, including digestion.
Reduced physical activity and increased stress levels associated with exhaustion can slow down the movement of food through the digestive tract, leading to delayed bowel movements and constipation.
Dehydration often accompanies exhaustion, further worsening constipation by reducing the water content in the stool.
Rest, hydration, and incorporating fiber-rich foods into the diet can help alleviate constipation and promote overall digestive health during intervals of body exhaustion.
8. INTESTINALY POPLYPS
Intestinal polyps or tumors, primarily located within the large intestine, can serve as underlying causes of constipation.
These growths can obstruct or narrow the passageway through the intestines, impeding the smooth movement of stool. As a result, individuals may experience difficulty passing bowel movements, leading to constipation.
Polyps and tumors may alter the normal functioning of the intestines, affecting their ability to contract and propel waste effectively.
Detecting and addressing these abnormalities through medical evaluation and appropriate interventions, such as surgical removal or other treatments, is crucial for managing constipation and preventing potential complications.
Intestinal polyps infrequently cause changes in bowel habits. However, if the polyp or cancer grows to a significant size, it can result in constipation or, less commonly, diarrhea.
9. COLONIC AFFECTIONS
Various colonic affections can disrupt normal bowel function.
Conditions like irritable bowel syndrome (IBS), diverticulosis, tumors, strictures, Crohn's disease, ulcerative colitis, colonic ischemia, tuberculosis, hernias, volvulus, and endometriosis can all affect the structure or function of the colon, leading to constipation.
These conditions can lead to colon narrowing, inflammation, blockages, or changes in bowel movements, resulting in difficulty passing stool.
Management of constipation associated with colonic affections often involves addressing the underlying condition through medical treatment, dietary adjustments, and lifestyle modifications to alleviate symptoms and promote regular bowel movements.
10. LAXATIVES DEPENDENCY
Excessive use of laxatives can paradoxically lead to constipation and dependency if not used properly. While laxatives can provide temporary relief by stimulating bowel movements, overreliance on them can disrupt the natural functioning of the digestive system.
Prolonged use of laxatives can lead to a condition known as laxative dependency, where the body becomes reliant on laxatives to produce bowel movements.
This dependency can weaken the natural muscle contractions of the intestines, making it harder to pass stool without the aid of laxatives.
It's crucial to use laxatives as directed and only when necessary to prevent the development of dependency and maintain healthy bowel function.
11. NEUROMUSCULAR DISEASES
Neuromuscular diseases such as Hirschsprung's disease, autonomic neuropathy, Chagas disease, pseudo-intestinal obstruction, cerebral tumors, cerebrovascular accidents, tabes dorsalis, multiple sclerosis, Parkinson's disease, and dermatomyositis are all causes of constipation.
These conditions affect the nerves and muscles involved in bowel movement regulation, leading to impaired peristalsis or decreased sensitivity to stool in the intestines. As a result, individuals may experience infrequent bowel movements, difficulty passing stool, or incomplete evacuation.
Health experts from the World Journal of Gastroenterology state that:
“Parkinson's Disease with constipation (PDC) is considered a unique type of constipation, but its mechanism of formation and factors affecting its severity have been less reported. ”
Management of constipation in neuromuscular diseases often requires a multifaceted approach, addressing underlying neurological issues and promoting bowel function through dietary modifications, medications, and other interventions tailored to individual needs.
12. INTESTINAL OBSTRUCTION
Intestinal obstruction, a mechanical blockage within the gastrointestinal tract, is a severe and direct cause of constipation. This obstruction can occur due to multiple factors:
- Hernia;
- Tumors;
- Strictures
- Impacted feces.
When the intestine is blocked, stool cannot pass through naturally, leading to a buildup of waste material in the colon. As a result, individuals may experience severe Symptoms of Constipation, including infrequent bowel movements, abdominal discomfort, bloating, and potentially vomiting.
Prompt medical intervention is crucial to diagnose and treat intestinal obstruction effectively, as it can lead to complications if left untreated, including bowel perforation or ischemia.
13. OBSTRUCTED DEFECATION SYNDROM
Obstructed defecation syndrome is one of the rarest causes of constipation.
Obstructed defecation syndrome (ODS) is a condition where individuals experience difficulty with bowel movements due to mechanical or functional issues in the rectum or pelvic floor muscles.
Causes may include rectal prolapse, rectocele, pelvic floor dysfunction, or neurological conditions affecting bowel control. ODS can lead to incomplete evacuation, straining during bowel movements, and a sensation of blockage. Lifestyle factors like inadequate fiber intake and dehydration can worsen symptoms.
Treatment often involves dietary changes, pelvic floor exercises, and biofeedback therapy. And in severe cases, surgery. Managing ODS requires a comprehensive approach tailored to address underlying causes and improve bowel function.
Last medically reviewed on 27.04.2024
TRUSTED MEDICAL SOURCES
1. Intestinal mucosal barrier function in health and disease. Jerrold R Turner.
2. Intestinal obstruction from adhesions--how big is the problem? D. Menzies and H. Ellis.