Causes Of Constipation

What Is Constipation?

Constipation is generally defined by the following symptoms:

• Fewer than three bowel movements per week
• Stools that are hard, dry, or lumpy
• Difficulty or pain when passing stools
• A sensation that not all stool has been passed

This article explores the various lifestyle, medical, and genetic causes of constipation and provides a comprehensive list of medications that can lead to this condition.

Common Causes of Constipation

The primary cause of constipation is slow movement of stool through the large intestine (colon).

As food moves through the digestive system, most nutrients are absorbed by the time it reaches the colon, leaving waste and fluid.

The colon absorbs more fluid, which solidifies the waste into stool. However, when digestion slows down, the colon absorbs too much fluid, leading to hard, dry stools that are difficult to pass.

Factors that influence how quickly food moves through the digestive tract include diet, physical activity, and other lifestyle choices.

Dietary Factors

One of the most common causes of constipation is diet. Eating too much dairy, high-fat meats, eggs, and sugary foods can all contribute to constipation. Dairy products, in particular, are known to slow down digestion and harden stool, especially cow’s milk, cheese, and ice cream.

If your diet is low in fiber, especially insoluble fiber found in vegetables, fruits, beans, and whole grains, this can also hinder the movement of food through your colon and lead to constipation.

Inadequate Fluid Intake

Not drinking enough fluids is another key factor that can contribute to constipation.

This is particularly true for individuals who consume a lot of fiber but don’t drink enough water. Adequate hydration helps fiber work efficiently to keep stool soft and promote regular bowel movements.

The U.S. National Academies of Sciences, Engineering, and Medicine recommends the following daily fluid intake:

• Women: 11.5 cups (2.7 liters) per day
• Men: 15.5 cups (3.7 liters) per day

This total includes fluids from beverages and food. About 20% of our daily fluid intake comes from food sources.

Lifestyle Factors

Other lifestyle factors that can affect bowel health include:

• Being sedentary or inactive for long periods
• Sudden changes in routine
• Ignoring the urge to have a bowel movement
• High levels of stress
• Traveling, especially across time zones

Medical Conditions That Can Cause Constipation

Several medical conditions, diseases, and disorders can contribute to chronic constipation:

• Celiac disease
• Chronic idiopathic constipation
• Depression and anxiety
• Diabetes
• Diverticulitis
• Electrolyte imbalances
• Fibromyalgia
• Irritable bowel syndrome (IBS)
• Pregnancy
• Thyroid disease

Medications That Cause Constipation

Certain medications can slow down the digestive system, resulting in constipation. Some common medications that may contribute to constipation include:

• Antacids containing calcium or aluminum
• Anticholinergic drugs (e.g., antispasmodics)
• Antidepressants
• Antihistamines (allergy medications)
• Calcium channel blockers (for high blood pressure)
• Diuretics
• Opioid painkillers
• Some seizure medications
• Iron supplements
• Some blood pressure medications
• Some herbal supplements

It’s also important to note that excessive use of laxatives or enemas in an attempt to treat constipation can lead to dependence, making it difficult for the body to have normal bowel movements without assistance.

Structural Problems

Certain structural issues within the digestive system can contribute to constipation:

• Anal fissures (painful tears in the skin around the anus)
• Bowel obstructions or strictures (narrowing of the intestines)
• Rectocele (a bulge from the rectum into the vagina)

Pelvic Floor Dysfunction

Dyssynergic defecation is a type of pelvic floor dysfunction where the muscles of the pelvic floor don’t function properly, making it difficult to pass stool. This condition is a common cause of constipation, especially in individuals with pelvic floor issues.

Neurological Causes

Certain neurological conditions can interfere with the muscles and nerves that control bowel movements, leading to constipation. These conditions include:

• Autism
• Dysautonomia
• Multiple sclerosis
• Parkinson’s disease
• Spinal cord injuries
• Stroke

Cancer

Cancer affecting the colon or rectum can also lead to constipation. Colon cancer typically presents with additional symptoms, such as unexplained weight loss, fatigue, and blood in the stool. It’s important to be aware of these signs and consult a healthcare provider if you suspect cancer.

• Colon cancer
• Rectal cancer

Genetic Factors

Constipation often runs in families, suggesting that genetic factors may contribute to its development. Children with chronic constipation are more likely to have relatives with the same condition. There is also a rare genetic disorder called Hirschsprung disease, which causes a lack of nerve cells in the intestines, leading to severe constipation early in life.

Risk Factors for Constipation

Several factors increase the likelihood of developing constipation:

• Age: People aged 60 and older are more prone to constipation.
• Gender: Women are more likely to experience constipation than men.
• Eating disorders: Conditions like anorexia and bulimia can affect digestion and lead to constipation.
• Socioeconomic factors: Those with lower income levels may have limited access to healthy foods or medical care, increasing the risk of constipation.

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