Constipation is a common problem that many people experience.
Often, it’s a short-term issue related to lifestyle choices or medication side effects.
However, if it continues, constipation might signal an underlying health condition, structural problems, or functional issues.
It’s also frequently experienced during pregnancy.
What Is Constipation?
Constipation is typically identified by these symptoms:
- Fewer than three bowel movements per week
- Hard, dry, or lumpy stools
- Difficulty or pain when passing stools
- The feeling that not all stool has been passed
This article explores the various lifestyle, medical, and genetic factors contributing to constipation, along with a list of medications that can cause it.
Common Causes of Constipation
The primary cause of constipation is the slow movement of stool through the large intestine (colon). As food moves through your digestive system, nutrients are absorbed, leaving waste and fluid in the colon. The colon absorbs more fluid, which solidifies the waste into stool. But when digestion slows, the colon absorbs too much fluid, leading to hard, dry stools that are difficult to pass. Factors affecting digestion speed include diet, physical activity, and lifestyle choices.
Dietary Factors
Diet is a very common contributor to constipation. Eating too much dairy, high-fat meats, eggs, and sugary foods can all slow digestion. Dairy products, especially cow’s milk, cheese, and ice cream, are known to harden stools. A diet low in fiber—particularly insoluble fiber found in vegetables, fruits, beans, and whole grains—can also hinder food movement through the colon, leading to constipation.
Inadequate Fluid Intake
Not drinking enough fluids is another significant factor, especially for those who consume a lot of fiber but not enough water. Proper hydration helps fiber work effectively, keeping stool soft and promoting regular bowel movements. The U.S. National Academies of Sciences, Engineering, and Medicine recommend the following daily fluid intake:
- Women: 11.5 cups (2.7 liters)
- Men: 15.5 cups (3.7 liters)
This includes fluids from both beverages and food, with about 20% of daily fluid intake coming from food.
Lifestyle Factors
Other lifestyle factors impacting bowel health include:
- Being 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 and disorders can lead to chronic constipation, including:
- 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 digestion and cause constipation. Common drugs linked 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 overusing laxatives or enemas to treat constipation can lead to dependence, making it difficult for the body to have normal bowel movements without help.
Structural Problems
Certain structural issues within the digestive system can cause constipation:
- Anal fissures (painful tears around the anus)
- Bowel obstructions or strictures (narrowing of the intestines)
- Rectocele (a bulge of the rectum into the vagina)
- Pelvic Floor Dysfunction, such as dyssynergic defecation, where pelvic floor muscles don’t work properly, making stool passage difficult.
Neurological Causes
Some neurological conditions can interfere with the muscles and nerves responsible for bowel movements, leading to constipation. These include:
- Autism
- Dysautonomia
- Multiple sclerosis
- Parkinson’s disease
- Spinal cord injuries
- Stroke
Cancer
Cancer affecting the colon or rectum can also contribute to constipation, often with other symptoms like unexplained weight loss, fatigue, and blood in the stool. If these signs appear, it’s crucial to consult a healthcare provider.
Genetic Factors
Constipation often runs in families, suggesting genetics may play a role. Children with chronic constipation are more likely to have relatives with the condition. Additionally, Hirschsprung disease, a rare genetic disorder, causes a lack of nerve cells in the intestines, leading to severe constipation early in life.
Risk Factors for Constipation
Several factors increase your likelihood of developing constipation:
- Age: People aged 60 and older are more prone.
- Gender: Women are more likely to experience constipation than men.
- Eating disorders: Conditions like anorexia and bulimia can disrupt digestion.
- Socioeconomic factors: Individuals with lower income may have limited access to healthy food or healthcare, increasing risk.
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