Causes and Risk Factors of Constipation

Most people experience constipation from time to time. It is often temporary due to lifestyle factors or side effects of medication. Constipation that persists (chronic) can also be caused by a health condition, structural problems, or functional problems. It is also very common during pregnancy.

Constipation is defined as:

  • Having fewer than three bowel movements a week
  • Stools that are hard, dry, or lumpy
  • Stools that are difficult or painful to pass
  • A feeling that not all stool has passed

This article discusses the lifestyle, medical, and genetic causes of constipation. It also provides a detailed list of medications that can cause constipation.

woman with abdominal pain
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Common Causes

The underlying mechanism behind constipation is the slow movement of stool through your large intestine (colon).

As food travels through the digestive system, it is broken down into fluid, nutrients, and waste. By the time it reaches the colon, most of the nutrients have been absorbed, leaving fluid and waste. The fluid is absorbed in the large intestine, turning the waste into stool.

However, if digestion stalls, the colon continues to absorb fluid. This, in turn, causes hard stools that are difficult to pass. What you eat, how much you move, and other lifestyle factors can impact how quickly or slowly food transitions through the digestive tract.

Diet

A top cause of constipation is diet. Eating too much dairy, high-fat meats, eggs, and sugar-containing sweets can lead to constipation. Dairy products, in particular, have a reputation for binding up stool. This includes cow's milk, cheese, and ice cream.

If you mostly eat processed foods, dairy, and meat, you are probably not getting enough fiber. Fiber—found in vegetables, fruits, beans, and whole grains—promotes the movement of food through your colon.

How Much Fiber Do You Need?
 Gender by Age  Recommended Daily Fiber Intake
 Women (19–30 years)  28 grams (g)
 Women (31–50 years)  25 g
 Women (51+ years)  22 g
 Men (19–30 years)  34 g
 Men (31–50 years)  31 g
 Men (51+ years)  28 g

Not Enough Fluids

Constipation can also be caused by not consuming enough fluid. This is especially true in people who are getting enough fiber—water helps fiber work to prevent constipation.

How much water and other fluids you need a day varies by age and sex. The U.S. National Academies of Sciences, Engineering, and Medicine recommends a total daily intake that combines fluid in water, other beverages, and food. About 20% of our daily fluid intake comes from foods. The daily fluid recommendations for adults are:

  • Women: 11.5 cups (2.7 liters) of a day
  • Men: 15.5 cups (3.7 liters) a day

Lifestyle Factors

Other lifestyle factors that can affect your bowel movements and lead to constipation include:

  • Being sedentary most of the day
  • Changes in your routine
  • Ignoring urges to pass your bowels
  • Stress
  • Travel

Get Moving

If you have a sedentary job or lifestyle, make it a point to get up and move around each hour. Exercise as simple as a brisk 15-minute walk can help your digestive tract do its job better.

Medical Causes of Constipation

Different medical conditions, illnesses, functional problems, and medications cause constipation.

Health Conditions

Health conditions that can contribute to constipation include:

Medications

Medication is a common cause of constipation. Certain medications cause changes to the gastrointestinal tract that slow motility causing constipation. Medications that have a side effect of constipation include:

You may also develop constipation by taking too many laxatives or enemas in an attempt to treat constipation. Using these remedies repeatedly can result in dependence on them to the point that you no longer have normal bowel movements.

Structural Conditions

The following conditions involve a structural problem within the digestive system that can contribute to the symptom of constipation.

Pelvic Floor Dysfunction

Dyssynergic defecation is a form of pelvic floor dysfunction in which the muscles of the pelvic floor do not work as they should. A primary symptom of dyssynergic defecation is constipation.

Neurological Causes

Several neurological conditions can contribute to constipation. Some conditions affect the functioning of the muscles in the colon and rectum, which must contract to move stool. If the nerves that trigger these muscles are affected, it can result in constipation.

Neurological causes of constipation include:

Cancer

Any cancer affecting the colon's functioning can cause constipation as well. It is important to note that colon cancer also typically presents itself with symptoms of weight loss, fatigue, and signs of blood in the stool:

Genetics

Because constipation often runs in families, there may be some genetic predisposition to this condition and environmental factors such as shared habits and similar diets. Children with chronic constipation often have family members who are constipated.

There is a rare genetic condition, Hirschsprung disease, in which the nerves required to move stool through the intestinal tract are absent. This can occur due to a chromosomal disorder or due to specific genetic combinations. In this disease, the symptoms are seen in the first 2 months of life.

Lifestyle Risk Factors

Several lifestyle factors increase your risk of constipation. These include:

  • Being age 60 and older
  • Being female
  • Having an eating disorder
  • Having a lower income level

Summary

Constipation can be caused by diet, not drinking enough fluids, not getting enough exercise, a change in your routine, medication, or a medical condition.

A Word From Verywell

If you are experiencing constipation on a regular basis, talk to your healthcare provider. It is important to accurately pinpoint what is going on and to establish a treatment plan. Your healthcare provider will work with you on developing the right management plan for you.

Frequently Asked Questions

  • When should you see a healthcare provider about constipation?

    If constipation lasts longer than three weeks, you should see a healthcare provider to ensure there isn't an underlying condition.

  • What is the fastest way to treat constipation?

    Over-the-counter laxatives will provide reasonably quick relief, but you should avoid overusing them or relying on them in the long term. Prevention is the best way to manage constipation: Make sure to get enough fiber in your diet, exercise regularly, and drink plenty of fluids.

  • Why is constipation more common in pregnant women?

    Pregnant women frequently experience constipation because of hormonal changes, a growing uterus pressing on the digestive tract, and less physical activity.

  • How long can you safely go without a bowel movement?

    There is no set time that a person can go without pooping. However, in general, if you go longer than three days without a bowel movement, you should start at-home treatments, such as increasing fiber and water and taking laxatives.

    If you go a full week or more without pooping, talk to your healthcare provider.

    You should also seek medical treatment if constipation is accompanied by severe abdominal pain, difficulty passing gas, or vomiting.

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14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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