Being constipated is one of the most common afflictions of the human existence because of a wide variety of triggers. This article will enumerate the most common causes that affect bowel movement in adults and children.
One of the most commonly cited reason for constipation is a lack of fiber in the diet. However, constipation is not always a by-product of what we don’t eat, it is often caused by foods that we do eat. Some of the common foods that may trigger constipation are:
Chocolate: Yes, besides adding a couple of inches to your waistline, your sinful indulgence may get you clogged up as well! Scientists are not exactly sure what component in chocolate causes constipation, but there is enough empirical data available to suggest a statistically significant correlation between the amount of chocolate consumed and the chances of suffering from constipation, especially among people with Irritable Bowel Syndrome (IBS). One of the current working theories is that the large amount of fat in chocolate may slow down the digestive process.
Dairy Products: Milk or dairy products such as cheese may cause adults as well as kids to be constipated because:
- Milk and cheese has high amounts of fat, which does not get absorbed by your intestinal tract as quickly, thus slowing down the digestive system in general.
- The sugar in milk (lactose) is quite complex and takes a while to be broken down into simpler sugars for your body to absorb. Some people lack the ability to digest lactose altogether, making them lactose intolerant.
Recently a study was conducted in Iran among children who were suspected to be constipated due to over-consumption of dairy. Researchers saw a drastic improvement in their condition after milk products were eliminated from their diet.
Fiber: One of the most common causes of constipation is a lack of fiber in the diet. So how can fiber actually cause you to be constipated? This is because, fiber is not a nutrient, which means that it does not get absorbed by your digestive system. Its sole purpose is to draw water into the large intestine from the surrounding area, softening the stool and making it easier to pass fecal matter in the process. However, if you are not drinking enough water, then the fiber cannot draw enough water from the surroundings, causing your intestines to be clogged up even further. Hence if you increase your consumption of fiber-rich foods such as oatmeal, peanut butter or popcorn, make sure that you do so gradually and complement the same by increasing your water intake.
Coffee: Another ironic cause for constipation would be coffee. Coffee contains generous amounts of caffeine, which is proven to induce natural peristalsis. However, caffeine is also a diuretic, which means that it can cause you to urinate more than you would do otherwise. Having too much coffee would make your body excrete more water in the form of urine, which could otherwise be used to soften the fecal matter in your colon.
Green tea: This is another drink that is extremely rich in caffeine, overindulging in which will lead to constipation, for reasons we have covered already.
Fruits: Fruits tend to contain fiber and sorbitol, both of which can help relieve symptoms of constipation. However, certain fruits and fruit products like raw bananas and apple juice can actually make your constipation worse because:
- Apple juice: Certain brands of apple juice contain pectin (a complex sugar) or artificial sugar, which can make your constipation worse. It is recommended that you take a close look at the label before making a purchase.
- Raw bananas: Bananas are rich in fibers, but unripe banana contains a lot of starch as well, which slows down the digestive process, especially if your digestive system is not used to it.
Red meat: Red meat such as beef, pork and lamb not only increases your cholesterol, but can also cause you to be constipated because:
- It contains a lot of fat, which takes a lot of time to digest.
- It contains a lot of iron, which is a trigger for constipation as well. The reasons behind this will be discussed later in this article.
Alcohol: Besides making you take some bad decisions that you are bound to regret once you are sober, alcohol can contribute to be constipated because:
- Alcohol slows down the digestive process in general and adversely affects glucose metabolism in particular.
- Beer in particular is a diuretic, causing you to lose too much water as it is excreted in the form of urine. This reduces the amount of water available to soften your stool.
Cause#2: Self-medication/Dietary supplements
Everyone tries to avoid visiting the doctor’s office as much as possible and tend to medicate themselves to cure minor afflictions. However, since most of us do not have medical degrees, we are not always in a position to fully understand the long-term impact that continued un-monitored use of over the counter (OTC) medication may have on our general well-being. Following are some examples of OTC medications that may cause you to be constipated:
- Painkillers (Aspirin/Ibuprofen/Tylenol): We are used to instant gratification, hence many of us do not think twice before popping an Aspirin, Tylenol or an Ibuprofen tablet at the first sign of a headache. However, constipation is a documented side-effect of all of these pills. Tylenol tends to have some mild narcotic agents as well, which numbs the digestive tract, causing you to be constipated.
- Antacids: Taking an antacid during rare or infrequent cases of heartburn or acidity is perfectly fine. However, according to Dr. Benjamin Krevsky, (Associate Chief of Gastroenterology at Temple University in Philadelphia, PA) the aluminum in antacids may cause you to be constipated, if used frequently. Frequent attacks of heartburn are not normal and may signify a far more serious underlying condition such as gastroesophageal reflux disease (GERD). Consult a specialist, if you need to take antacids every day!
- Nutritional supplements: There seems to be an undeclared war in the food supplement industry, where every company is trying to one-up each other by packing as many nutrients as they can in their pills. Just because a particular vitamin or mineral exists in a pill does not mean that your body will be able to process it in that form. However, the damage is not just limited to creating some expensive excreta. Some of these supposed nutrients can make you constipated as well! A couple of examples are:
- Iron: Iron is an essential mineral, as it forms hemoglobin in our red blood cells (RBCs). Hemoglobin allows our red blood cells to carry oxygen and nutrients to all parts of our body. Iron supplements are recommended for people who are anemic (have a low RBC count). However, if your supplements are providing you with more iron than what is necessary, it will remain in your digestive tract in an undigested form, causing you to be constipated. Please refrain from taking supplements that contain iron, unless prescribed by a doctor.
- Calcium: The United States Department of Health and Human Services recommend that people over 50 years of age should daily consume anywhere between 1200 to 1500 mg of calcium. Once people cross that age, both men and women start suffering from osteoporosis, which means that the bones become more brittle and calcium is supposed to compensate for that. However, too much of anything can be a bad thing, hence over-indulging on calcium creates a condition called hypercalcemia, which causes nausea, vomiting, neurological disorders and, you guessed it, constipation. If you are facing any of these symptoms, immediately reduce the dosage and the frequency of your calcium intake.
- Laxatives: To put it simply, laxatives stimulate your digestive system to induce bowel movements. However, over-usage may cause your body to develop a dependency on these laxatives, meaning that peristalsis may not be induced without this stimulant. The mechanism is pretty similar to how your body may become dependent on narcotic painkillers, if used and abused over extended periods of time.
Cause#3: Prescription Medication
Several prescription medications have constipation as one of their side-effects. Licensed medical professionals are aware of the same, hence they always prescribe a mild laxative in conjunction with these drugs. If you are prone to being constipated and you are visiting a doctor who is not familiar with your medical history, do not forget to mention your digestive ailments during the initial consultation!
The following drugs may cause you to be constipated:
- Painkillers: Narcotic painkillers (such as Oxycodone or Vicodin) not only numb your pain, but they tend to numb your digestive tract as well, slowing down your digestive system in the process. A build-up of undigested nutrients in your intestines will cause you to be constipated.
- Blood pressure medications: Blood pressure medication is usually of two types, diuretics and calcium channel blockers. We have already established earlier how diuretics or an over-abundance of calcium may cause you to be constipated.
- Antihistamines: Antihistamines are prescribed to treat any allergies you may have. Constipation is one of its main side-effects, besides dizziness, lack of co-ordination, fatigue, blurred or double-vision, urine retention and dry mouth.
- Antidepressants: There is empirical evidence that the antidepressants that are prescribed to help you combat depression may cause you to be constipated. According to Dr. Thomas Park, MD who is a practicing gastroenterologist at Rochester Medical Center in Central Park, NY tricyclic antidepressants such as amitriptyline (Brand Name: Elavil) will probably disrupt your bowel movement. However, the newer selective serotonin reuptake inhibitor (SSRI) group of antidepressants such as fluoxetine (Brand Name: Prozac) are not free from this side-effect either. The exact reasons behind this is still a mystery.
- Steroids: Steroids aren’t just used and abused by gym rats and athletes with questionable moral ethics. Corticosteroids such as Prednisone are prescribed to cure a wide range of afflictions, such as asthma, Addison’s disease, auto-immune disorders and lupus. There is anecdotal evidence that it may cause you to be constipated as well!
- Antibiotics: Antibiotics are prescribed to treat a bacterial infection anywhere in the body. Unfortunately, antibiotics cannot differentiate between the good and the bad bacteria, hence they also end up killing the helpful bacteria (Lactobacillus, Sacchromyces boulardi, Bifidobacterium etc.) that reside in our intestines and help in the digestive process. You will possibly be constipated until the intestinal fauna is re-populated.
- Anticonvulsants: Anticonvulsants such as phenytoin (Brand Name: Dilantin) or carbamazepine (Brand Name: Tegretol) are prescribed to treat conditions such as epilepsy, which may cause seizures in the afflicted person. Constipation and associated bloating and stomach cramps are common side effects, which occur while the patient’s body tries to adjust to the new medication. A temporary dose of a mild laxative is usually prescribed along with this medication.
- Diuretics: Diuretics such as chlorothiazide (Brand Name: Diuril) are prescribed to increase the urine output among people suffering from kidney stones or other diseases. However, as mentioned earlier, producing a prodigious amount of urine will cause you to be constipated, if you are not consuming enough water to account for that.
Cause#4: Underlying medical conditions
Sometimes, being constipated is not the major affliction, but rather a symptom of a more severe condition. Following are some diseases where constipation is one of the major symptoms:
- Hypothyroidism: When your thyroid gland is not secreting enough of the thyroid enzyme, it will significantly slow down all of your metabolic processes, including peristalsis.
- Diabetes: Advanced cases of diabetes may damage your nerve endings, including those that are present in your gut, slowing down the ability to digest food and induce natural bowel movements.
- Neurological disorders: Several neurological disorders such as Parkinson’s disease, multiple sclerosis, a stroke or even a spinal cord injury may cause nerve damage throughout the body, including those that are present in your intestines, thus hampering your natural ability to digest food and pass stool.
- Inflammatory Bowel diseases: The two most common diseases that fall under this category are ulcerative colitis and Crohn’s disease. Crohn’s disease may cause an obstruction in the small intestine, whereas ulcerative colitis may cause rectal inflammation, both of which would result in you being constipated! However, besides constipation, there will be other symptoms as well, such as bloody stools, stomach cramps and rapid weight loss.
- Anal fissures: Anal fissures are ruptures that occur on the anoderm, the hairless and glandless specialized skin tissue that lines the anal cavity. These are usually caused when a person undergoes a bowel movement with hard stool. These ruptures may cause future bowel movements to be especially painful, causing people to delay their bowel movements as much as they possibly can. This will cause people to be constipated in the long term.
- Colorectal cancer: As the name suggests, colorectal cancer may occur in the colon (large intestine) or the rectum. This happens when the cell lining in your colon or rectum reproduces too quickly and starts protruding into the intestinal or rectal cavity. This constricts the flow of fecal matter, causing you to be constipated.
- Rectocele: This is a condition that only women are vulnerable to. Sometimes due to a myriad of factors, such as a painful childbirth (especially if one gives birth to a ‘large’ baby) or through pelvic surgery, the fascia (a group of connective fibrous tissues) that separates the vaginal and the rectal cavity may become distended, causing a bulge that ends up containing fecal matter that never gets evacuated. This build-up of stool puts a lot of additional pressure when the afflicted woman tries to have a bowel movement, causing her to be constipated. Women suffering from rectocele will also feel a bulge in their vagina and sexual intercourse will be extremely painful.
Cause#5: Psychological factors
Sometimes the causes for constipation lie in our head! The main psychological factors behind constipation are:
- Depression: As already established that antidepressants may cause you to be constipated. However, clinical depression, the condition that antidepressants are prescribed to treat may cause people to be constipated as well! This is because depression slows down all bodily processes, including the digestive system.
- Stress/anxiety: Stress or anxiety triggers the flight or fight mechanism in our body. Hence, when your body is ready to get in a physical altercation or ‘make a run for it’, the last thing that it would want to do is schedule a bowel movement. Hence a heightened state of stress or anxiety may lead to chronic constipation. This can result in a vicious cycle, as being constipated may cause you to feel stress as well!
- Deliberately suppressing bowel movement: Sometimes we deliberately control the urge to pass stool. This can be due to a wide variety of reasons, such as traveling, being in an important meeting, not having access to a proper toilet etc. However, if we get in the habit of controlling our bowel movements, we end up compressing and hardening our stools, causing us to be constipated!
Unfortunately, the little bundle of joy that is growing inside you may cause you to be constipated as well. There are three main reasons for this:
- Pregnancy increases the production of progesterone in the female body. Progesterone relaxes all the smooth muscles inside the body (including those that are in the digestive tract) that slows down the digestive process.
- As the size of your uterus increases to make space for the growing fetus, it will put pressure on your rectum, constricting the rectal cavity in the process. This will decrease the available space for the fecal matter to pass through, causing you to be constipated.
- Iron supplements are usually prescribed during pregnancy and over-abundance of iron in the digestive tract will cause you to be constipated.
Cause#7: Advanced age
Even though we are supposed to be only as old as we feel, unfortunately, the organs in our body are yet to receive the memo. Advanced age slows down all physical processes in the human body, including the digestive system, causing us to be constipated.