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Constipation

Updated 29 June 2018

7 surprising causes of constipation

Most people agree that a low fibre diet is a main cause of constipation. However, here are seven causes of constipation you might not be aware of.

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How often you poop per day varies from person to person. Some people might go up to three times a day, while others only have a bowel movement a few times a week.

Dr Danie Pauw previously told Health24, “It should not be less than three times per week.”

Constipation happens when your colon absorbs too much water or the muscles contract too slowly or poorly, which means stool moves through your digestive system too slowly. When the stool loses too much water, it hardens. If the faeces sit in your colon for three days or longer, the mass becomes even harder and more difficult to pass. 

Now you know what constipation is, it’s important to understand that there are a number of different causes besides lack of fibre.

1. Hypothyroidism

An underactive thyroid, or hypothyroidism, can cause your metabolic processes to slow down. According to Dr Catherine Ngo, a board-certified gastroenterologist at Saddleback Memorial Medical Center in California, “The slower the system, the longer the digestive contents have to be reabsorbed by the colon, resulting not only in decreased frequency of stools, but harder stools.”

Although constipation is not always related to thyroid problems, Dr Carla H Ginsburg, assistant professor of medicine at Harvard Medical School in Boston, says, “When I see a young person who’s constipated more than normal and really complaining, I do tend to get a thyroid level.” 

Woman with painful neck

2. Medications

Medications come with side effects and many list constipation. Common offenders include antidepressants (especially SSRIs like Prozac), anti-anxiety drugs, heartburn drugs and blood pressure medication.

“There is always an alternative medication you can try,” Dr Atif Iqbal, a gastroenterologist and medical director of the Digestive Care Center at Orange Coast Memorial Medical Center, told Reader's Digest. “You just need to be clear with your doctor about what problems you’re experiencing.” If your heartburn medication contains calcium, for example, you can try one that contains magnesium.

Painkillers – prescription or over the counter – can also cause constipation. “These medications bind to the same receptors in the stomach, blunting the whole digestive system as well as your pain,” explains Dr Iqbal. Don't use painkillers continuously for longer than 30 days. Dr Iqbal says you should address the underlying injury or find alternative ways to treat your pain. 

Man taking medication

3. Bad bathroom habits

If the need to go strikes while you’re at the office or mall, do you hold it in? Experts say you shouldn’t, and doing it too often can lead to constipation. “You eventually confuse the muscles in the rectum and anal sphincter and develop constipation,” said Dr Gina Sam, assistant professor of gastroenterology at Mount Sinai Hospital in New York City.

In addition, the longer stool remains in your colon, the more water it absorbs which will make it even more difficult to pass when you eventually get home to your toilet. 

"Some research suggests that people who use the bathroom at timed intervals and don’t fight the urge to have a bowel movement tend to have more regular bowel movements," Dr David Poppers, a clinical associate professor of medicine in the Division of Gastroenterology at NYU School of Medicine and NYU Langone Health, told Women’s Health

Public bathroom

4. Diabetes

According to a 2014 study, about one in three diabetics suffer from constipation. When you have diabetes, nerve damage  affects your entire your entire body over time.

When this damage affects your gut, you may experience “slow transit time in your intestines, as well as problems with rectal sensation”, Dr Ron Schey, an associate professor of medicine in the gastroenterology department at Temple School of Medicine, told Men’s Health. And that results in constipation.

Man testing glucose levels

5. Overusing laxatives

When you are constipated, it’s natural to reach for laxatives. But don’t rely on them for long-term use – over long periods of time nerve cells that release chemicals that tell your colon it’s time to move a stool become depleted. Eventually you’ll need to use more laxatives for them to work, until they no longer work.

“More of a problem is that when they stop working, the other simple measures that we might try have less chance of working as well because those stimulatory neurons are now dead,” Dr Pradeep Kumar, a gastroenterologist, told Fox News

Man using toilet

6. Vitamins

Generally, vitamins shouldn’t cause constipation but sometimes calcium or iron can cause your system to become backed up.

"I would tell a patient to stop taking the iron [or calcium] unless they really need it and, if they do need it, I would put them on a stool softener to counteract that," said Dr Ginsburg, who is a spokesperson for the American Gastroenterological Association.

Woman taking vitamins

7. A lack of exercise (or too much)

Not exercising often enough can cause digestive problems that may lead to constipation. Exercise helps stimulate intestinal activity, which keeps food waste moving through your digestive system. In fact, exercises that focus on toning your abdominal muscles can even help with bowel movements. 

On the other hand, however, too much exercise can also cause constipation. Exercising causes your body to sweat, which helps regulate body temperature. As a result, your body may need more water, which your intestines may try to recover from stool moving through your digestive system. Constipation can occur when the poop becomes hard and compact, and unable to pass easily through your rectum.

Make sure you are properly hydrated before, during and after exercise.

Woman doing yoga

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