Diet, underlying health conditions, and medication side effects are some of the things that may be making it difficult for you to go.
Many of us get constipated from time to time. We may get backed up as a result of changing our diet or not drinking enough water.
The occasional bout of constipation can be annoying, but it usually isn’t anything to be too concerned about. If you’re chronically constipated, however, it may be a sign that something’s not quite right with your digestive system.
According to the American College of Gastroenterology Chronic Constipation Task Force, chronic constipation means you’ve been experiencing infrequent bowel movements, difficulty pooping, or both for at least 3 months.
If you’re dealing with chronic constipation, you’re probably wondering why. While there isn’t always a clear answer for what triggers this uncomfortable condition, there are several known causes.
Here are eight common causes of chronic constipation and some advice on how to get things moving again.
If you’re like most people, your fiber intake is way lower than it should be, which could be the reason you’re experiencing chronic constipation
The average American consumes just 15 grams of fiber per day, which is well below the current daily fiber recommendations of 25 and 38 grams for women and men ages 19 to 50, respectively.
Fiber helps keep your bowel movements regular and your poop soft, so slacking in the fiber department could cause you to have consistent issues with constipation. Adding more of the right kinds of fiber to your diet — think fruits, oats, veggies, chia seeds, and beans — can help get things moving.
Increasing your fiber intake all at once can cause uncomfortable bloating and gas, though, so it’s best to gradually add more fiber to your diet.
Just as eating too little fiber can stop you up, so can not drinking enough water. Your digestive system depends on proper hydration for healthy bowel movements. If you’re not meeting your daily hydration needs, you may experience chronic constipation.
Many people — especially older adults — don’t drink enough fluids. In fact, it’s estimated that up to 28% of older adults are chronically dehydrated.
If dehydration is the cause of your chronic constipation, it’s usually an easy fix. Although water needs vary depending on factors such as your body weight, activity level, and environment, general guidelines range from 67 to 91 ounces (2 to 2.7 liters) per day for women and 84 to 125 ounces (2.5 to 3.7 liters) per day for men.
Motility disorders are conditions caused by nerve or muscle issues in your digestive tract, including your large intestine and rectum. A motility disorder can cause constipation by affecting your body’s ability to properly push out stool.
If your doctor thinks a gut motility disorder may be causing your chronic constipation, they can order tests and recommend treatments to help you feel better.
In order for you to have a comfortable bowel movement, your pelvic floor muscles and the muscles that help open your anus must relax in a coordinated way. Dyssynergic defecation (DD), or anismus, is when the muscles in your pelvic floor don’t function properly or there’s an issue with your ability to effectively push out poop.
Symptoms of DD include:
- excessive straining when going to the bathroom
- feeling like your bowel isn’t completely emptied after pooping (incomplete evacuation)
- having fewer than three bowel movements per week
It’s estimated that DD is the cause of 25% of all cases of chronic constipation. To diagnose DD, your doctor will ask you about your symptoms and may test your pelvic floor function. If you have DD, treatments such as pelvic floor physical therapy and Botox can help.
Some medical conditions can cause constipation, including:
- irritable bowel syndrome with constipation (IBS-C)
- inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis
- neurological conditions such as multiple sclerosis and Parkinson’s disease
Also, constipation is more common in people who have depression.
Often, symptoms of these conditions, including constipation, get better or go away with proper treatment. If you have a medical condition that’s making it hard to go to the bathroom, ask your doctor for advice.
Medications often come with side effects, including gastrointestinal issues such as constipation. Medications linked to constipation include:
- antidepressants such as imipramine and fluoxetine
- antipsychotic medications such as haloperidol
- antiepileptic medications
Certain supplements, including calcium and iron supplements, can also lead to constipation.
If you think medications or supplements may be the reason you can’t go, talk with a doctor about what you can do to manage this side effect.
If constipation runs in your family, you’re more likely to have it too. Thanks, Mom and Dad!
Researchers have discovered that people with chronic constipation often have family members with the same condition. But they have not identified specific genes associated with constipation, so the relationship isn’t yet fully understood.
You know that one food that messes with your stomach, but you just can’t stop eating? It could be the reason you have trouble pooping.
Lactose intolerance — the inability to properly absorb the milk sugar lactose — can lead to gastrointestinal symptoms such as constipation. So can gluten-related disorders such as celiac disease and non-celiac gluten sensitivity.
If you think a food allergy or intolerance may be causing your digestive issues, try removing the problem food or ingredient from your diet for a few weeks to see whether it helps your symptoms.
If you’re interested in trying a more complicated elimination diet that cuts out several foods, it’s best to work with a doctor or a registered dietitian to make sure the diet is safe and appropriate for you.
How you manage constipation depends on what’s causing it. For example, if your chronic constipation is caused by a low fiber diet or dehydration, you can help improve the condition by including more fiber-rich foods in your diet and drinking more water every day.
In general, you can help improve your digestive health and reduce or relieve constipation by:
- eating a diet high in fiber and low in ultra-processed foods
- drinking enough water
- getting plenty of physical activity
- doing your best to manage stress
But not all cases of chronic constipation are caused by factors that are easy to change.
Underlying health conditions, such as hypothyroidism and IBD, require proper diagnosis and medical treatment to manage associated symptoms, including constipation.
If you have a motility disorder or dyssynergic defecation, you may need a specific therapy or medication to improve your quality of life and help you have more comfortable bowel movements.
The first step in managing chronic constipation is figuring out the cause. If you’ve made dietary changes and your constipation isn’t getting better, it’s important to make an appointment with a doctor or a specialist such as a gastroenterologist to get checked out. They can perform tests to diagnose common conditions associated with chronic constipation.
Depending on your diagnosis, a doctor may recommend medication, diet changes, or other treatments that can help you feel better.
Chronic constipation is an uncomfortable condition that has a number of potential causes.
Low fiber consumption, dehydration, medical conditions, medication side effects, and food intolerances are just some of the reasons people experience chronic constipation.
While some causes of constipation, like not drinking enough water or not eating enough fiber, can be easy to fix on your own, other causes need medical treatment.
If you’ve been experiencing frequent constipation and aren’t sure why, consider making an appointment with a doctor so they can help you get to the bottom of your bowel issues.