If you're prone to constipation, you're not alone. About 63 million people in the United States experience the condition, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which defines it as having less than three bowel movements a week. And it can be downright uncomfortable, to say the very least. But why are you so constipated? There are myriad common causes of constipation, which range in type and severity. To help pinpoint what's potentially going on, we tapped experts to learn about the most common causes, plus what to do to help constipation.
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Your constipation may be due to a low intake of fiber. According to Marissa Meshulam, MS, RD, CDN, registered dietitian and founder of MPM Nutrition, dietary fiber adds bulk to the stool, making it easier to pass. “Additionally, [insoluble] fiber can work to speed up digestion, which helps move things along,” she adds. However, a diet without adequate fiber will have the opposite effect, making movements irregular and hard-to-pass.
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Hydration, like fiber, is key for healthy digestion. “Our stool is formed in the large intestine, [where] water is reabsorbed,” Meshulam explains. But if you’re not drinking enough liquids throughout the day, there won’t be enough water in your large intestine to make going to the bathroom natural and easy.
When your daily schedule is thrown for a loop, you may experience constipation. “Your gut gets into a routine based on the food you eat [and] schedule you keep,” says Bryan Curtin, MD, MHSc, gastroenterologist at the Institute for Digestive Health and Liver Disease at Mercy Medical Center. “[But] when you travel, these things dramatically change, which has a profound effect on how your gut works.” This can lead to constipation and/or diarrhea, he says, which should resolve once you’re back to your usual routine.
“Good muscle tone, particularly in the abdominal wall and diaphragm, is necessary for regular bowel movements,” says Casey Kelley, MD, ABoIM, founder and medical director of Case Integrative Health. This can be achieved via regular exercise and staying active throughout the day. On the other hand, a sedentary lifestyle can weaken the abdominal wall and diaphragm, making it difficult for the large intestine to properly regulate bowel movements.
According to Dr. Kelley, stress can contribute to constipation by causing the body to release a hormone called epinephrine. This hormone, responsible for the “fight or flight” response, redirects blood flow from the intestine to more vital organs, like the heart, lungs, and brain. “The lack of blood flow [in the intestine] thus slows down the [digestive] process,” she says.
Emotional and mental stress can also make the body release more corticotrophin-releasing factor (CRF), another hormone. “This hormone can slow down intestinal movements,” ultimately causing constipation, notes Dr. Kelley.
Just about every bodily function is controlled by hormones, and bowel movements are no exception. That said, it’s common for hormonal fluctuations to cause bouts of constipation. A common example is the spike in estrogen—the female reproductive hormone—that happens before menstruation. “High levels of estrogen can delay gastric emptying, leading to constipation,” explains Dr. Kelley. Low estrogen levels, which happens during menopause, can have a similar effect. “As estrogen levels decline in menopause, cortisol levels rise, which slow down the digestive process,” she says. Constipation may also be linked to hormonal changes related to pregnancy or hypothyroidism (an underactive thyroid).
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Certain medications might explain why you’re so constipated. “Some, like opioids, slow the motility of the gastrointestinal system, which leads to constipation,” says Dr. Curtin. Taking nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, is another common cause, as these drugs can damage the protective barrier of the gut. Iron supplements—which are taken for anemia—and psychiatric medications can also slow down the gut, resulting in constipation, adds Dr. Curtin.
Whether you’re away from home or busy with work, it can be tempting to ignore nature’s calls. However, doing so can lead to constipation or worsen existing symptoms. “When you don’t go to the bathroom, it sits in the large intestine,” explains Meshulam. “Water continues to be absorbed from it, making it harder to pass.”
Constipation may be uncomfortable, but it's possible to reduce the strain by adopting certain healthy habits. Try these helpful home remedies to get things moving again.
As mentioned, dehydration can seriously contribute to constipation. But drinking plenty of fluids throughout the day can help prevent this, says Meshulam. The Academy of Nutrition and Dietetics recommends a daily fluid intake of 12.5 cups for men and 9 cups women.
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If you often sit for hours on end, try incorporating movement into your schedule. This could be as simple as regular stretching or short walks around the block. Daily movement will keep your abdominal muscles strong, thus improving your bowel movements. As Dr. Curtin notes, “the more you move, the more your gut will move!”
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There’s a good chance fiber is the answer to your digestive woes. After all, according to the American Journal of Lifestyle Medicine, only 5 percent of the population eats enough fiber. (The daily recommended intake is 38 grams for men and 25 grams for women, according to the Academy of Nutrition and Dietetics.) To help you meet the mark, Meshulam recommends reaching for high-fiber foods like:
Fruits with sorbitol, a natural laxative, can also get things moving. According to Meshulam, this includes fruits like:
Meshulam notes that processed and fried foods (think: microwave meals and deli meats) are lacking in fiber. So consuming a lot of these foods can reduce your fiber intake, further contributing to constipation. This doesn’t mean you need to totally ditch these foods. Simply reaching for whole, non-processed foods more often than not can ensure you get more fiber.
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It's important to note the constipation may indicate a more serious gastrointestinal disorder—a condition that affects the function of your intestines.
One of the most common causes is irritable bowel syndrome (IBS), says Meshulam. According to the NIDDK, IBS doesn't cause damage to your GI tract, but it can cause unpleasant symptoms like constipation and stomach pain. And while the exact cause of IBS is unknown, stress may be a factor, according to Dr. Curtin. Another possible constipation cause is diverticulitis, says Dr. Kelley, which involves inflammation of diverticula, or small bulges that develop in the wall of the large intestine. "Over time, this inflammation can lead to a bowel obstruction, which may cause constipation," she explains.
If your constipation lasts for several days to a week, or if it doesn't respond to home remedies, it might be time to call your doctor, Dr. Kelley suggests. Do keep in mind that frequency and need to go are different for everyone; what's normal for one person might not be normal for you, she adds. Your best bet is to recognize what's "normal" for you and chat with your doctor if anything changes.
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