The causes and cures of chronic constipation

2.5 million people in the U.S. see their doctor for constipation each year, making it one of the most common gastrointestinal complaints. Despite these numbers, constipation isn’t something often discussed. So when it does happen to us, we’re left with a lot of questions. What causes constipation? What helps with constipation? Most importantly, we want to know how to get rid of constipation. This guide will walk you through all of those questions so you can get back to feeling like yourself.

What causes constipation?

Before we can move on to what causes constipation, we must understand what it is. Although constipation is technically defined as having three or fewer bowel movements per week, the normal amount can vary widely depending on your lifestyle. Some people go to the bathroom several times per day, while others go a few times a week. Constipation is when you deviate from your normal schedule and have much fewer bowel movements than normal. They will also be dry, hard, and painful to pass.

Risk factors of constipation

There are several reasons you might be more inclined to experience constipation, including:

  • Gender: Women are more likely to have constipation, especially while pregnant or after childbirth due to hormonal changes. Pregnant women also have the added pressure of a baby squishing the intestines and slowing down the digestive system as it works to remove stool.
  • Age: Older people tend to have a slower metabolism, less strength for muscle contraction, and are less active, all of which make it harder for their digestive system to do its job.
  • Diet: People who don’t eat enough high-fiber foods or drink enough water experience issues with moving food through the digestive system, which can lead to constipation.

Causes of constipation

Apart from risk factors, causes of constipation include:

  • Medications, especially opioids, antacids, antidepressants, antispasmodics, bismuth salts, tranquilizers, sedatives, iron supplements, anticonvulsants, diuretics, and anticholinergics
  • Changes in life, activity, or routine, such as travel
  • Changes to what you eat
  • Stress
  • Resisting the urge or holding a bowel movement in
  • Living a sedentary lifestyle
  • Consuming large amounts of dairy products
  • Overusing laxatives
  • Eating disorders
  • Irritable bowel syndrome (IBS)
  • Neurological conditions, like Parkinson’s disease and multiple sclerosis
  • Colon cancer
  • Underactive thyroid (hypothyroidism)
  • Nerve and muscle problems in the digestive system
  • Overactive parathyroid glands, cancer, or medications that cause excess calcium in the blood

What causes constipation internally?

Regardless of what causes constipation, what’s happening internally typically looks the same. When you eat, the body moves the food along the digestive tract and absorbs nutrients, leaving any remaining partially digested food to be removed from the body as waste. Then, your colon absorbs water from the stool to turn it into a solid.

When you experience constipation from any of the above causes, the food moves slower than normal through the tract, giving you lots of time between bowel movements. This also means that the colon has much more time to remove water and actually absorbs too much. As a result, the stool becomes very dry and hard, making it difficult to push out.

How to get rid of constipation

Understanding what causes constipation should give you some clues as to how to get rid of constipation. Depending on the cause and severity, you may be able to treat it at home or with an over-the-counter remedy. More severe cases may require a visit with your doctor.

What helps with constipation at home

Mild or moderate cases of constipation can often be treated at home. The following are preventative measures that can both treat constipation and prevent it from happening in the future:

  • Add high-fiber foods to your diet, like vegetables, fruits, whole grains, and beans.
  • Meet the recommended daily water intake – 11.5 cups (2.7 liters) for women or 15.5 cups (3.7 liters) for men.
  • If you’re struggling to drink enough water, try to drink two to four additional glasses of water each day.
  • Get at least 30 minutes of activity each day, whether you do a full workout or simply go for a walk. This gets the muscles in your intestines to be more active.
  • Don’t delay or ignore the urge to have a bowel movement.
  • Adjust your posture on the toilet by raising your feet, leaning back, or squatting.
  • Try to avoid stress and give yourself plenty of time in the bathroom.

What helps with constipation beyond lifestyle changes? You can also try a more active treatment, like massages and enemas. Massaging your abdomen can help encourage movement in the digestive system. An enema, done with tap water or over-the-counter medication, can help soften and flush out stools.

Over-the-counter medications

Over-the-counter medications that help with constipation come in many forms. These include:

  • Fiber supplements, like Metamucil or Benefiber
  • Laxatives or stool softeners, like Milk of Magnesia or Colace
  • Stimulant laxatives, like Dulcolax
  • Mineral oil enemas, like Fleet
  • Suppositories, which are inserted directly into the rectum and can work faster than a laxative

It’s important to note that there are two types of laxatives – those that stimulate the bowel and those that increase water content in the stool. While both can help get rid of constipation, they also come with some downsides. Bowel stimulants may cause cramps. Laxatives that increase water content may cause the stool to swell or bulk up. In either case, be sure to follow package instructions and tell your doctor if you’re using them for more than two weeks.

Prescription medications

If the above remedies aren’t effective, it’s best to call your doctor. You should also call your doctor if you’re experiencing severe pain, have blood in the stool, experience constipation for over two weeks, or are losing weight without meaning to.

Your doctor may prescribe a medication, such as:

  • Prucalopride, which aids the colon in moving the stool
  • Lubiprostone, which improves intestinal fluid levels
  • Plecanatide or linaclotide, can help make bowel movements regular
  • Vibrant®’s unique drug-free treatment uses gentle vibrations to stimulate the colon mechanically.
    The pre-programmed timing of the mechanical stimulation is thought to improve the natural colonic motility by leveraging the colon’s biological clock.
    Phase 3 clinical trial demonstrates an increased number and frequency of complete bowel movements and improvement in the quality of life, with 1.2% diarrhea occurrence.

Your doctor may also recommend some testing, such as a blood test to review hormone levels or a colonoscopy to look for blockages. As a final option, surgery may be needed to remove a blockage, stricture, or rectocele for those with chronic constipation.

Ultimately, everyone’s body is different, so there’s no one size fits all answer. The good news is that once you find out what causes constipation, you can begin figuring out with helps with constipation for you. If you’ve tried the home remedies and are still struggling, see your doctor. They are trained on how to get rid of constipation and can help you regardless of the cause or severity. Remember, constipation is incredibly common – there is a solution for you out there and you will return to feeling normal.

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