Constipation is a common health complaint. It affects 16 out of 100 adults in the US and 33 out of 100 American adults over the age of 60.
Though relatively normal, constipation can become abnormal when it is severe, prolonged, or recurring. Experts typically recommend seeing a doctor if constipation leads to less than three bowel movements a week.
What causes constipation, and what can people do to treat and prevent it?
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Disclaimer: The health information on this site is provided for general informational and education purposes only and is not a substitute for professional advice. Accordingly, before taking any actions based upon such information, we encourage you to consult with the appropriate professionals. The use or reliance of any information contained on this site is solely at your own discretion. Revolution Gut Health does not claim to heal, treat or cure any of the conditions mentioned.
What Is Constipation?
Constipation is a symptom that features fewer than three bowel movements in one week. Experiencing constipation every once in a while is normal. However, when this symptom persists, it can start interfering with someone’s life.
Someone with fewer than three bowel movements per week for over a few months may have chronic constipation. Chronic constipation may also be to blame for severe difficulty passing stools regularly.
People who experience normal constipation may think it is no big deal. Yet, when this problem is chronic, it can create a great deal of stress and anxiety. Individuals may struggle with work or school performance or in their social life.
There are many reasons why someone might become chronically constipated. For example, some medications cause constipation as a side effect. No matter what the underlying cause is, people with chronic constipation should seek medical attention. Whether episodes occur back to back or intermittently, not getting treatment may lead to other health complications.
Not all forms of constipation are chronic. Some cases may feature intense symptoms, but they only last for a short period of time. Experts may refer to these severe but short-term cases as acute constipation.
The biggest difference between acute and chronic constipation is onset. Acute constipation strikes suddenly and, often, severely. On the other hand, chronic constipation may start as a mild issue before worsening and then persisting.
Acute constipation does not always require medical attention. For instance, drinking water or consuming fiber may help. However, if this symptom persists, individuals should see a doctor as soon as possible to prevent complications.
How to Explain Constipation
For functional constipation, the Rome IV criteria say that at least two of the following symptoms must be present for at least three months:
- At least 25% of bowel movements are hard to pass.
- At least 25% of people have lumpy or hard stools.
- At least 25% of defecations feel like they aren’t finished.
- The feeling of anorectal blockage or obstruction in at least 25% of defecations
- There needs to be hand assistance for at least 25% of bowel movements. Less than three poopy diapers a week.
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What Causes Constipation?
Poor mobility of food through the digestive tract causes constipation. When digested food stays in the large intestine for too long, the small intestine absorbs water from it, resulting in hard, dry stools.
The reason why food gets stuck during digestion, however, is multifaceted. Certain medications, pre-existing health conditions, and even dehydration may slow digestion.
The lifestyle habits and conditions leading to constipation can be divided into primary and secondary causes. Learn more about what these terms mean and how they may cause constipation.
Primary Causes of Constipation
In the medical world, “primary causes” are not due to an underlying health condition. Instead, these symptoms happen due to lifestyle and other factors. Primary constipation may happen for reasons including but not limited to:
- A low-fiber diet
- A sudden shift in lifestyle habits, especially eating
- A lack of exercise
- Low fluid intake
- Being underweight
- Mental health conditions, such as anxiety and depression
- Physical or emotional abuse during childhood
- Other childhood traumas
- Suppressing bowel movements
- Rushing bowel movements
- Excessive dairy consumption
Another primary cause of constipation is bowel evacuation disorder. Evacuation disorder features an ineffective pelvic floor muscle. Problems with this muscle can make it more difficult for people to have a normal bowel movement.
Secondary Causes of Constipation
Contrary to primary causes, secondary causes of constipation are due to pre-existing medical conditions. For example, the following diseases and disorders may feature constipation as a symptom:
- Irritable bowel syndrome (IBS)
- Muscular dystrophy
- Multiple sclerosis (MS)
- Parkinson’s disease
- Inflammatory bowel diseases (IBDs)
- Bowel cancer
In addition to these causes, medication and pregnancy may play a role. Certain antacids, antidepressants, painkillers, and other drugs feature constipation as a side effect. Also, 2 in 5 pregnant people experience early-stage constipation.
A full medical history and physical exam are the first steps in diagnosing constipation. This is done to find any secondary causes, look for signs of a more serious condition (like sudden weight loss or bleeding from the rectal area), and figure out how constipation affects the person’s quality of life.
In some cases, more tests may be needed, especially if the symptoms are severe, if they come on quickly in older people, or if there is a history of colon cancer or inflammatory bowel disease in the family. Some of these tests are a blood test to check for hypothyroidism, a colonoscopy to check for blockages or cancer, and anorectal manometry to check how well the rectum and anus muscles are working.
Risk Factors for Constipation
Risk factors for constipation encompass demographic, lifestyle, and health-related considerations. Age, gender, and socioeconomic status have the most evidence.
A leading myth about constipation is that the number of bowel movements increases as we get older. In fact, age is correlated with fewer bowel movements. Fewer bowel movements may cause a higher risk of constipation.
Not only that, bowel movements themselves slow down with aging. The longer stool sits in the large intestine, the more water the body absorbs. As mentioned, this is the main reason constipation happens.
Studies show that women are twice as likely to experience constipation as males. This is due, in part, to the prevalence of constipation as a pregnancy symptom. However, pregnancy does not fully explain this risk factor.
Other reasons gender may play a role include higher rates of eating disorders and other primary causes of constipation. For example, having an eating disorder increases the risk of constipation, and two-thirds of people with eating disorders are female.
Other primary causes of constipation that may have gender bias include suppressing or rushing bowel movements and mental health conditions like anxiety and depression.
Having a lower income is another common risk factor for constipation. There are a few possible reasons for this. People of lower socioeconomic status may not have access to fiber-rich foods, suffer from more constipation-causing health conditions, and have higher rates of obesity.
Symptoms of Constipation
The leading symptom of constipation is having fewer than three bowel movements a week. People suspecting they may have severe or chronic constipation can also look out for the following signs:
- Lumpy stools
- Hard stools
- Excessive strain during bowel movements
- A feeling of blockage in the rectum, especially during bowel movements
- Not being able to complete a bowel movement
- Having to manually remove stool during a bowel movement
People who experience two or three of these symptoms consistently for three or more months should schedule a doctor’s appointment. These symptoms, especially when prolonged, can indicate chronic constipation.
How to Prevent Constipation
Addressing underlying health conditions and other risk factors for constipation can help prevent it from happening. Here are some of the top preventative measures people can take to reduce their risk:
- Eat fiber-rich foods, including fruits, veggies, whole grains, and beans
- Avoid low-fiber foods, and highly processed snacks and beverages
- Increase fluid intake, especially of water and water-containing drinks like tea and 100% juice
- Exercise and partake in physical activity regularly
- Reduce stress levels when possible and manage stress when not
- Never suppress bowel movements
- Pass bowel movements on a regular schedule each day where possible
These positive lifestyle habits can help reduce the risk of constipation and improve overall health. However, these preventative measures can’t guarantee that someone will be constipation-free for life.
How to Treat Constipation
If left untreated, constipation (especially chronic constipation) may lead to health complications. Hemorrhoids, anal fissures, fecal impaction, and rectal prolapse are all potential consequences of not getting medical attention.
In extreme cases, chronically untreated constipation can be life-threatening. For example, obstructed bowels may lead to a back-up of stool. Eventually, the intestines could rupture, which may be fatal.
Luckily, getting treatment can prevent these risks. People suffering from severe or chronic constipation can see a doctor for diagnosis. There are many ways to diagnose constipation, from blood tests and X-rays to physical exams and evaluations.
After diagnosis, individuals can work with their doctors to develop a treatment plan. The best treatment plan depends on the underlying cause(s), so it should be tailored to the individual.
With that in mind, constipation treatment plans may include one or more modalities.
Diet and Lifestyle Changes
Sometimes, alleviating constipation is as simple as making a few tweaks to someone’s diet. Incorporating weekly exercise and practicing good bathroom hygiene can also help.
The best diet for constipation is one rich in fiber. Research shows that the average person eats around 15 grams of fiber per day. However, the current recommendations for daily fiber intake are:
- 15 grams for children 1 to 3 years
- 16-20 grams for children 4 to 8 years
- 9-13 grams for children 9 to 13 years
- 24-31 grams for teens 14 to 18 years
- 25 grams for women 19 to 50 years
- 38 grams for men 19 to 50 years
- 21 grams for women aged 51 or older
- 30 grams for men aged 51 or older
Additionally, consider getting more exercise. Doing a once-daily physical activity as simple as walking is enough to prevent constipation. Incorporating more physical activity can also improve your overall health and fitness.
Finally, always practice good bathroom hygiene. Good bathroom hygiene means passing bowel movements when the urge arises and allowing enough time and privacy to use the toilet without rushing.
Pelvic Muscle Training
As mentioned, ineffective pelvic floor muscles can be a primary cause of constipation. One way to treat this underlying issue is with pelvic muscle exercises. These exercises can help people learn to relax and flex their pelvis normally.
Natural Remedies for Constipation
Aside from lifestyle changes and supplements, is there another natural remedy for constipation? Yes, people can try multiple at-home treatments before resorting to over-the-counter or more extreme measures.
People can start by increasing their water intake. Recommendations for water intake vary based on gender, weight, and other factors. A good place to start is with 11.5 cups for women and 15.5 cups for men.
Drinking a cup of coffee can also sometimes help with regularity. People with constipation due to IBS should consume coffee cautiously, though, as it may worsen their symptoms.
Prunes are another common go-to for constipation. These fruits contain high fiber content, as well as sorbitol. Sorbitol is a sugar with natural laxative effects, but like coffee, it may exacerbate IBS.
Another herbal laxative is senna. Obtained over the counter, senna’s laxative properties come from glycosides. Glycosides may stimulate nerves of the digestive tract, resulting in more regular bowel movements.
Last but most importantly, consider incorporating a probiotic or prebiotic. Probiotics are supplements containing live bacterial cultures that are excellent for gut health. Prebiotics contain the foods these beneficial gut bacteria eat.
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