What causes constipation? 44 possible conditions

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What Is Constipation?

According to the National Institute of Diabetes and Digestive and Kidney Diseases, constipation is one of the most common digestive problems in the U.S. More than four million Americans every year complain of frequent constipation. Frequent constipation is commonly defined as having bowel movements fewer than three times a week and with hard, dry stools.

What Causes Constipation?

Your colon’s job is to absorb water and salt from food as it’s passing through your digestive system. It then creates stool (waste). The colon’s muscles eventually propel the waste out through the rectum to be eliminated. If stools remain in the colon too long, it can become hard and difficult to pass.

Poor diet frequently causes constipation. Dietary fiber and adequate water intake are necessary to help keep stools soft. Fiber-rich foods are generally made from plants, and there are plant components that your body is not able to digest. Fiber comes in soluble and insoluble forms. The soluble fiber can dissolve in water and creates a soft, gel-like material as it passes through the digestive system. Insoluble fiber retains most of its structure as it goes through the digestive system.

Fiber is very helpful in easing constipation. Both forms of the fiber join with the dry, hard stools, increasing their weight and size while also softening the stools. This makes it easier for them to pass through the rectum.  

Changes in routine, stress, and other conditions that slow muscle contractions of the colon or delay your urge to go may also lead to constipation.

Common Constipation Causes

Some common causes of constipation include:

  • low-fiber diet (particularly diets high in meat, milk, or cheese)
  • dehydration
  • lack of exercise
  • delaying the impulse to have a bowel movement
  • travel or other changes in routine
  • certain medications, such as antacids and pain medications
  • pregnancy

Underlying Medical Problems That Can Cause Constipation

The following are some underlying medical problems that can bring about constipation:

  • certain diseases, such as stroke, Parkinson’s disease, diabetes, and lupus
  • problems with the colon or rectum, including intestinal obstruction, irritable bowel syndrome, or diverticulosis
  • overuse or misuse of laxatives (medications to loosen stools)
  • hormonal problems, including an underactive thyroid gland
  • anal fissures (tears) or hemorrhoids

What Are the Symptoms of Constipation?

Every person’s definition of “normal” bowel movements may be different. Some individuals go three times a day, while others go three times a week. However, you may be constipated if you experience the following symptoms:

  • fewer than three bowel movements a week
  • passing hard, dry stools
  • straining or pain during bowel movements
  • a feeling of fullness, even after having a bowel movement
  • experiencing a rectal blockage

Who Is At Risk for Constipation?

Eating a poor diet and not exercising are major risk factors for constipation. However, you may be at greater risk if you are:

  • 65 or older. Older adults tend to be less physically active, may have underlying diseases, and may eat poorer diets that lead to constipation.
  • confined to bed. Those who have certain medical conditions, such as spinal cord injuries, often have difficulty with bowel movements.
  • a woman or a child. Women have more frequent episodes of constipation than men, and children are more often affected than adults.
  • pregnant. Hormonal changes and pressure on your intestines from your growing baby can lead to constipation.

How Is Constipation Diagnosed?

Many people affected by constipation choose to self-treat by changing their diets, increasing their exercise, or using over-the-counter laxatives. However, laxatives should not be used for more than two weeks without consulting a physician because your body can become dependent on them for colon function.

You should talk to your general or family practitioner if:

  • you have had constipation for more than three weeks
  • you have blood in your stool
  • you are experiencing pain during bowel movements
  • you are losing weight
  • you have sudden changes in your bowel movements

Your doctor will ask questions about your symptoms, medical history, and any medications or underlying medical conditions. A physical examination may include a rectal exam and blood tests to check your thyroid function.

In severe cases, additional tests may be required to identify the cause of your symptoms. These may include:

  • an examination of how food is moving through your colon, called a marker study or colorectal transit study. For this test, you will swallow a pill that contains tiny markers that will show up on an X-ray. Numerous abdominal X-rays will be taken over the next few days so the doctor can visualize how the food is moving through your colon and how well the intestinal muscles are working. You may also be asked to eat a diet high in fiber during the test.
  • an examination of the anal sphincter muscle function, called anorectal manometry. For this test, your doctor will insert a thin tube with a balloon-tip into your anus. When the tube is inside, the doctor will then inflate the balloon and slowly pull it out. This test allows him or her to measure your anal sphincter’s muscle strength and see if your muscles are contracting properly.
  • an examination of the colon with a barium enema X-ray. For this test, you will drink a special liquid the night before the test to clean out the bowel. The actual test involves the insertion of a dye called barium into your rectum, using a lubricated tube. The barium highlights the rectum and colon area, allowing the doctor to better view them on an X-ray.
  • an examination of the colon with a colonoscopy. In this test, your doctor will examine your colon using a tube that is outfitted with a camera and light source (colonoscope). A sedative and pain medication is often given, so you will likely not even remember the examination and should feel no pain. To prepare for this test you will be on a liquid-only diet for one to three days, and you will have to take a laxative or enema the night before the test to clean out the bowel.

How to Treat and Prevent Constipation

Changing your diet and increasing your physical activity level are the easiest and fastest ways to treat and prevent constipation. Try the following techniques as well:

  • Every day, drink 1.5 to 2 quarts of fluids, such as water or juice, to hydrate the body.
  • Limit consumption of alcohol and caffeinated drinks, which cause dehydration.
  • Add fiber-rich foods to your diet, such as raw fruits and vegetables, prunes, or bran cereal. Your daily intake of fiber should be between 20 and 35 grams. If you have IBS-related constipation, eat fiber that contains psyllium (a soluble fiber) instead of bran in order to ease constipation.
  • Cut down on low-fiber foods, such as meat, milk, cheese, and processed foods.
  • Aim for about 150 minutes of moderate exercise every week (about 20 minutes a day), such as walking, swimming, or biking.
  • If you feel the urge to have a bowel movement, don’t delay. The longer you wait, the harder your stool will become.
  • Add fiber supplements to your diet if needed. Just remember to drink plenty of fluids because you can aggravate constipation if you add extra fiber without also adding fluids to your diet.
  • Use laxatives sparingly. Your doctor may prescribe laxatives or enemas for a short period of time to help soften your stools. Never use laxatives for more than two weeks without talking to your doctor because you can cause your body to become dependent on them for proper colon function.

If you still have trouble with constipation, your doctor may prescribe medications to help. According to the American College of Gastroenterology, linaclotide (Linzess) and lubiprostone (Amitiza) are two drugs that are strongly recommended for people who suffer from IBS-related constipation. These medications work by increasing the secretions in your intestines, making the stool easier to pass.

Your doctor may also advise that you stop taking certain medications that may cause constipation. More severe colon or rectal problems may require manual procedures to clear the colon of impacted stool, therapy to retrain slow muscles, or surgery to remove the problem part of your colon.

What Is the Outlook for Constipation?

Most cases of constipation are mild and are easily treated with changes in diet and exercise. If you are experiencing chronic constipation, or constipation along with other changes in bowel movements, it’s important that you talk to your doctor.

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See a list of possible causes in order from the most common to the least.

1

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a chronic condition that affects the large intestine and causes many uncomfortable symptoms, such as bloating, gas, cramping, diarrhea, constipation, and pain.

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2

Hypothyroidism

The thyroid gland produces a hormone that controls how your cells use energy (metabolize). Hypothyroidism occurs when the body doesn't produce enough. Untreated, it can cause comlications like obesity and heart disease.

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3

Hemorrhoids

Hemorrhoids, also called piles, are swollen veins located around the anus or in the lower rectum. Internal hemorrhoids develop within the anus; external hemorrhoids develop outside of the anus. Of the two forms...

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4

PMS (Premenstrual Syndrome)

Premenstrual syndrome (PMS) is a condition that affects a woman

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5

Diabetic Neuropathy

Diabetic neuropathy is a common complication of types 1 and 2 diabetes due to uncontrolled high blood sugar levels that result in damage to the nerves. According to the American Diabetes Association (ADA), between 6...

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6

Anal Fissure

An anal fissure is a small cut or tear in the skin lining the anus. Childbirth, straining during bowel movements, or bouts of constipation or diarrhea can all tear the anal lining. Anal fissures are usually not a caus...

Read more »

7

Anal/Rectal Abscess

An anal, or rectal, abscess occurs when a cavity in the anus becomes filled with pus. In addition to extreme pain, the abscess can cause fatigue, rectal discharge, and fever. In some cases, anal abscesses can result i...

Read more »

8

Crohn’s Disease

Crohn's disease is a chronic bowel disease that causes severe inflammation of the digestive tract. It is associated with abdominal pain, diarrhea, and may affect your quality of life. Crohn's disease is characterized b...

Read more »

9

Intestinal Obstruction

If your small or large intestine becomes blocked, fluid and digested food cannot move through. This can cause bloating, stomach cramps, and burping.

Read more »

10

Depression Overview

Depression is a mood disorder that can cause extreme and persistent feelings of sadness, hopelessness, and worthlessness. Depression type largely determines what kind of medical treatment is best.

Read more »

11

Pregnancy

Pregnancy occurs when a sperm fertilizes an egg after it is released from the ovary. An egg enters one of the fallopian tubes where it may be fertilized. The egg then enters the uterus where implantation occurs...

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12

Colorectal (Colon) Cancer

Colorectal cancer is a cancer that originates in the rectum or colon. Both of these organs are located at the lower portion of your digestive system. The colon is at the end of the large intestine and the rectum is a...

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13

Colonic (Colorectal) Polyps

Colonic polyps, also known as colorectal polyps, are growths that appear on the surface of your large intestine, or colon. You can have more than one polyp, and they may be flat or raised, benign or cancerous. Accordin...

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14

Encopresis

Encopresis is also known as fecal soiling. It occurs when a child over the age of 4 years has a bowel movement and soils his or her pants. This behavior is often linked to constipation . Constipation occurs when stoo...

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15

Anorexia Nervosa

Almost everyone worries about gaining too much weight. But in some people the worry becomes obsessive, causing a condition called anorexia nervosa. Anorexia nervosa is an eating disorder that can result in severe weigh...

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16

Proctitis

Proctitis occurs when the rectum becomes inflamed. The rectum is part of your lower digestive system. It is located between your colon and anus. Stool passes through the rectum as it exits the body. Proctitis can b...

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17

Celiac Disease (Gluten Intolerance)

Celiac disease is a digestive disorder. It is caused by an immune reaction to gluten. Celiac disease is also known as: sprue nontropical sprue gluten intolerance gluten-sensitive enteropathy Gluten is a protein found i...

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18

Spinal Cord Injury

This condition is considered a medical emergency. Urgent care may be required.

A spinal cord injury, or damage to the spinal cord, is an extremely serious type of physical trauma. It will likely have a lasting and significant impact on most aspects of daily life. According to the Nationa...

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19

Diverticulitis

Diverticulitis occurs when diverticula (bulging sacs that usually appear in the lining of the large intestine) get infected or inflamed. Although diverticula are most common in the large intestine (colon), they ca...

Read more »

20

Low Blood Potassium

Hypokalemia occurs when the blood's potassium levels are too low. A normal level of potassium is 3.6-5.2 millimoles per liter. Levels below 3.6 are considered low.

Read more »

This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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