Chronic constipation is one of the most common digestive complaints reported, however many people are not familiar with the primary reason for their suffering. By understanding the root cause of any condition, one may create a better roadmap to improved health!
Let’s dive right in and find out more about the root causes of chronic constipation.
What is chronic constipation?
It is a very common gastrointestinal disorder related to slowed movement through the digestive tract that results in unsatisfactory defecation (bowel movements). Some report infrequent bowel movements, difficulty passing stool (straining), lumpy or hard stools, incomplete evacuation, or the feeling of obstruction (blockage). Use of laxatives are usually required for more comfortable and frequent bowel movements.
While the exact amount of weekly bowel movements for ideal health is still under debate, most digestive health specialists classify constipation with less than 3 spontaneous bowel movements per week. Constipation is considered a chronic condition if symptoms occur for at least 3 months.
What are the main reasons for having chronic constipation?
There are a wide variety of reasons one may suffer from chronic constipation.
Physical or Functional Causes:
Physical or functional issues may cause constipation. This includes slow-transit time constipation related to issues with the nervous system of the gastrointestinal system (enteric nervous system). Another example is ano-rectal dysfunction which is when the muscles of the pelvic floor are not functioning optimally, impairing complete evacuation. Adhesions (scar tissue), strictures (narrowing of tissues), and fissures (cracks/tears) are other examples of physical disrupters of healthy bowel movements.
Lifestyle and Dietary Causes:
Lifestyle and dietary factors also contribute to chronic constipation. First, review your fiber and fluid intake. Inadequate fiber (undigested plant material) and fluid intake contribute to lack of stool bulk, which prevents easy passage of stool. Additionally, lack of physical activity throughout the day may contribute to constipation as gut movement (motility) is closely related to body movement!
Disease State Causes:
Various disease states provoke constipation including:
- Multiple sclerosis
- Parkinson’s disease
- Irritable bowel syndrome
- Eating disorders
- Anxiety and depression
It is important to talk with your doctor about all medical conditions to assess if chronic constipation may be a potential side effect.
Side Effects of Medication/Supplement Use:
Side effects of certain medications and supplements often cause constipation. Examples include iron and calcium containing products, NSAIDs, opioids, antidepressants, antihistamines, etc. Talk to your doctors or pharmacist to find out if constipation may be a side effect of any drugs you use.
What are the top 3 things to do to help manage chronic constipation?
Slowly increase fiber intake from plant material, including prunes and psyllium fiber:
- Women should aim to include about 25 grams of total fiber per day whereas men should aim to include 38 grams of total fiber per day.
- Increase fiber grams SLOWLY by adding in about 5 extra grams each week until you reach your goal. Fiber intake should only be added as tolerated.
- Include a mix of soluble and insoluble fiber sources. Some of the best foods to include to relieve constipation are psyllium fiber, whole grains, fruit and vegetable skins, and prunes.
- Prunes, also known as dried plums, contain about 0.7g of fiber per prune. The primary way they work to relieve constipation is through their sorbitol content, a sugar alcohol that has a laxative effect.
- Psyllium fiber, aka Metamucil, not only bulks the stool but also forms into a “gel” that helps move stool through.
- Download my Fiber Handout to find out the fiber content in various foods. Download Fiber Handout
Slowly increase fluid intake from unsweetened beverages:
- Aim for at least 8 cups of fluid each day. For a more specific fluid need calculation, take your body weight in pounds and divide it by 2 to get the number of ounces to consume each day. This calculation may overestimate your needs if you are overweight/obese, so try using your ideal body weight.
- All fluid counts towards your needs, but ideally drink purified water! If you do not like water, then include the type of fluid you do enjoy. Tea, coffee, 100% juice, kombucha, smoothies, milk, broth, and flavored or infused water all count towards your total fluid intake.
- Keep a water bottle with you at all times to encourage drinking throughout the day. This strategy will also help you keep track the amount of water consumed.
Move your body:
- Aim for at least 30-minutes of moderate-intensity aerobic exercise 5 days per week
- The best type of exercise is the type that you enjoy the most! Try out dancing, Zumba, aerobics, swimming, jogging, or whatever else allows you to move your body.
- If you dislike exercise, then just start with walking. Try increasing your steps by monitoring them with a pedometer or other tracking device. Aim for 10,000 steps per day.
To conclude, chronic constipation impacts many people for many different reasons. While many turn to medication management, it does not always address the root cause of the problem. Try these lifestyle tips for at least a few weeks to see desired results. If there is still no relief in your symptoms, do not fret, there are plenty of other interventions to explore!
Do you need more personalized care or would you like to learn more about this topic? Reach out to me today. I help people across the nation improve their digestive health through diet and lifestyle modifications.