Constipation

Key Influences

Most commonly, constipation is symptomatic of poor diet and lifestyle behaviors. Medications, lack of exercise, a diet low in fiber and fluids, travel, a change in routine and illness can all be factors. Constipation can also result from several medications and the hormonal changes you experience during pregnancy or in the week before your period.

To understand constipation, it helps to know how the colon, or large intestine, works. As food moves through the colon, the colon absorbs water from the food while it forms waste products, or stool. Muscle contractions in the colon then push the stool toward the rectum. By the time stool reaches the rectum it is solid, because most of the water has been absorbed.

Constipation occurs when the colon absorbs too much water or if the colon’s muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly. As a result, stools can become hard and dry. Common causes of constipation are:

  • not enough fiber in the diet
  • lack of physical activity (especially in the elderly)
  • medications
  • milk
  • irritable bowel syndrome
  • changes in life or routine such as pregnancy, aging, and travel
  • abuse of laxatives
  • ignoring the urge to have a bowel movement
  • dehydration
  • specific diseases or conditions, such as stroke (most common)
  • problems with the colon and rectum
  • problems with intestinal function (chronic idiopathic constipation)

Not Enough Fiber in the Diet

People who eat a high-fiber diet are less likely to become constipated. The most common causes of constipation are a diet low in fiber or a diet high in fats, such as cheese, eggs, and meats.

Fiber—both soluble and insoluble—is the part of fruits, vegetables, and grains that the body cannot digest. Soluble fiber dissolves easily in water and takes on a soft, gel-like texture in the intestines. Insoluble fiber passes through the intestines almost unchanged. The bulk and soft texture of fiber help prevent hard, dry stools that are difficult to pass.

Not Enough Liquids

Research shows that although increased fluid intake does not necessarily help relieve constipation, many people report some relief from their constipation if they drink fluids such as water and juice and avoid dehydration. Liquids add fluid to the colon and bulk to stools, making bowel movements softer and easier to pass. People who have problems with constipation should try to drink liquids every day. However, liquids that contain caffeine, such as coffee and cola drinks will worsen one’s symptoms by causing dehydration. Alcohol is another beverage that causes dehydration. It is important to drink fluids that hydrate the body, especially when consuming caffeine containing drinks or alcoholic beverages.

Lack of Physical Activity

A lack of physical activity can lead to constipation, although doctors do not know precisely why. For example, constipation often occurs after an accident or during an illness when one must stay in bed and cannot exercise. Lack of physical activity is thought to be one of the reasons constipation is common in older people.

Medications

Some medications can cause constipation, including:

  • pain medications (especially narcotics)
  • antacids that contain aluminum and calcium
  • blood pressure medications (calcium channel blockers)
  • antiparkinson drugs
  • antispasmodics
  • antidepressants
  • iron supplements
  • diuretics
  • anticonvulsants

Changes in Life or Routine

During pregnancy, women may be constipated because of hormonal changes or because the uterus compresses the intestine. Aging may also affect bowel regularity, because a slower metabolism results in less intestinal activity and muscle tone. In addition, people often become constipated when traveling, because their normal diet and daily routine are disrupted.

Abuse of Laxatives

The common belief that people must have a daily bowel movement has led to self-medicating with OTC laxative products. Although people may feel relief when they use laxatives, typically they must increase the dose over time because the body grows reliant on laxatives in order to have a bowel movement. As a result, laxatives may become habit-forming

Ignoring the Urge to Have a Bowel Movement

People who ignore the urge to have a bowel movement may eventually stop feeling the need to have one, which can lead to constipation. Some people delay having a bowel movement because they do not want to use toilets outside the home. Others ignore the urge because of emotional stress or because they are too busy. Children may postpone having a bowel movement because of stressful toilet training or because they do not want to interrupt their play.

Specific Diseases

Diseases that cause constipation include neurological disorders, metabolic and endocrine disorders, and systemic conditions that affect organ systems. These disorders can slow the movement of stool through the colon, rectum, or anus.

Conditions that can cause constipation are found below:

  • Neurological disorders
    • multiple sclerosis
    • Parkinson's disease
    • chronic idiopathic intestinal pseudo-obstruction
    • stroke
    • spinal cord injuries
  • Metabolic and endocrine conditions
    • diabetes
    • uremia
    • hypercalcemia
    • poor glycemic control
    • hypothyroidism
  • Systemic disorders
    • amyloidosis
    • lupus
    • scleroderma

Click here to learn more about how you can get regular and stay regular!

*Special thanks to The National Digestive Diseases Information Clearinghouse for helpful content

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This information is not intended to substitute the recommendations of your healthcare providers. Women’s Health Foundation disclaims any liability for the decisions you make based on this information.