No one likes to think too deeply about their bathroom habits, but the truth is, there’s a lot you can learn from your body when you close that door. If you are feeling backed up, you aren’t alone. In fact, according to the American Gastroenterological Association, about 16% of US residents have constipation, including one-third of the population of over 60 years of age. Constipation means that you have less than three bowel movements every week, your small, hard stools will be difficult to pass (maybe even painful), and you may need to strain to clear everything out.
If you are suffering from constipation, here are the 7 top reasons why you may be experiencing it:
Top 7 Reasons for Constipation
1. Not Drinking Enough Water
If you are dehydrated, there is a good chance that the stool is going to be too hard to pass and therefore you are going to be less likely to have a bowel movement once a day. There’s a chart called the Bristol Stool Chart, which outlines different typical types of stool – if your stool looks like a 1 or 2 (small hard lumps or a sausage that looks like it’s made from small hard lumps), you’re likely not drinking enough water.
If you’re experiencing constipation, increase your water intake. This should help add more moisture to your bowel movements and make them easier and less painful to pass.
2. Low Fiber Diet
Having a low fiber diet can also lead to constipation. It is the fiber within the foods we eat, such as vegetables, beans, and whole grains, that help to bring water from our bodies into the stool. It’s important to remember that fiber passes through the body, so it adds volume and helps ensure you have regular movements.
If you have a low fiber diet, water will not be drawn into the intestines to allow for the proper movement of stool through the gut, and the consequence will be constipation. This is why people who follow a low-carb diet (such as Keto) often suffer from constipation. Consider increasing your fiber intake if you’re not experiencing a daily bowel movement.
3. Sedentary Lifestyle
Another thing that will cause constipation is having a sedentary lifestyle. When you are sedentary and not really moving around, whether that be sitting at a desk all day, sitting on the couch for long periods, or spending a lot of time in bed, then your gut is also going to be moving less than it should.
It is the movement of your body that allows for the colon to move. Even just a gentle walk is necessary to ensure that you are having regular bowel movements without any discomfort.
4. Hormonal Imbalance
Constipation isn’t always the result of a lifestyle choice, but rather a hormone imbalance, such as during menopause. This could include estrogen, progesterone, or thyroid imbalances. While this can seem like something out of your control, improving your diet (increasing fiber, eliminating processed and sugary foods) and increasing your exercise (remember, functional exercise is just as important as a workout, so take the stairs instead of the elevator and park a little further away from the store) will help get your gut moving again.
Stress is another thing that can lead to constipation as it negatively affects the gut microbiome. When you are stressed, your body uses its sympathetic nervous system, also known as “fight or flight,” as opposed to the parasympathetic nervous system which allows your body to rest and digest.
If you are always in fight or flight mode, your body will never get back to the parasympathetic system and therefore your body is not going to take the time or feel relaxed enough to have a normal bowel movement. Your body needs to be calm to “rest and digest,” which simply can’t happen if you are subject to high levels of stress.
One thing that I always ask my patients is, “do you have time in your day where you unwind and relax?” This is when you will feel relaxed enough to have a bowel movement.
If you get up and immediately start your day, rushing around, not taking a moment to relax, then most likely, you are not going to have a bowel movement that day.
Even if you have to wake up that little bit earlier, it is beneficial to you and your digestive system to take the time to get ready for the day with a cup of coffee and some chill-out time before you have to get to work. Or, take some time at the end of your day to get out of the headspace where you feel like you’re “running away from a tiger.” This will help you feel relaxed enough to have a bowel movement and avoid uncomfortable constipation.
6. Imbalance of Your Gut Microbiome
You also have a bigger chance of getting constipated if you have an imbalance in your gut microbiome. Whether it is just an overgrowth of one bad bacteria or overgrowth of multiple bad bacteria, such as in small intestinal bacterial overgrowth (SIBO), that that could contribute to constipation. Eating processed foods, high-sugar foods, and a high density of foods with yeast can all throw your microbiome out of whack.
7. Medication Side Effect
Several medications can lead to a side effect of constipation. Medications that can cause constipation include:
- anti-nausea medications
- blood pressure medications
- iron supplements
- opioid pain relievers
- tricyclic antidepressants
- urinary incontinence medications
If you are taking a medicine with this possible side effect, you want to ensure that you are drinking plenty of water and getting a high fiber diet as I discussed above. If you believe a new medication has caused constipation, make sure you reach out to your primary care physician to discuss the symptoms and decide on the best next step for you – don’t stop taking medication without first discussing the change with a medical professional.
Whatever the reason for your constipation, if your stool looks like either one or two on the Bristol Stool Chart, you have a hard time going to the bathroom and it is causing you to strain, or you simply feel uncomfortable because you aren’t going regularly enough, you must talk to your primary care physician or your gastroenterologist about possible solutions and lifestyle changes you can make to improve your digestive health.
Dr. Nancy Rahnama, MD, ABOM, ABIM, is a medical doctor board certified by both the American Board of Obesity Medicine and the American Board of Internal Medicine. Her specialty is Clinical Nutrition, that is, the use of nutrition by a medical doctor to diagnose and treat disease. Dr. Rahnama has helped thousands of people achieve their goals of weight loss, gut health, improved mood and sleep, and managing chronic disease.