Causes and Risk Factors of Constipation

There are several possible causes of constipation. Luckily, the most likely ones—including diet, exercise, and medication use—are usually easily addressed, and doing so typically gets the bowels moving again and eases related symptoms. There are times, however, when a health condition that requires management is what causes constipation, so it should not be ignored if it occurs often.

While it can happen at any age, constipation is more frequent in pregnant and postpartum women, and people who have lower income levels. People who have mental health conditions such as depression or an eating disorder have a higher risk of constipation.

There could be one or more causes of your constipation. Explore some of the possibilities and discuss any concerns with your doctor.

You may not immediately connect your lifestyle with your bathroom troubles, but it is often a contributing factor, if not the cause of constipation itself.

Lifestyle concerns that can affect your bowel habits include:

• What you eat
• Inadequate water intake throughout the day
• Holding back bowel movements; ignoring urges to use the bathroom
• Insufficient exercise; being sedentary most of the day
• Travel
• Changes in your routine
• Inadequate stress management

Eating too much dairy, high-fat meats, eggs, and sugar-containing sweets can lead to constipation, as can a diet low in fiber.

You may not realize how low your diet is this essential nutrient. If you mostly eat processed foods, dairy, and meat, you may be lacking fiber. High-fiber foods are a recommended part of a healthy diet. If you aren't eating a good quantity of vegetables, fruits, beans, and whole-grain products, look for ways to include them.

If you take dietary supplements, realize that some carry the risk of constipation. High doses of iron supplements (45 milligrams or more per day) can cause nausea and constipation as well.

Many medications used to treat other health conditions may cause constipation as a side effect, including:

• Antacids containing calcium or aluminum
• Anticholinergic medications (antispasmodics)
• Antidepressants
• Antihistamines (allergy medications)
• Calcium channel blockers (for high blood pressure)
• Diuretics
• Narcotic pain medications
• Some seizure medications
• Some blood pressure medications
• Iron supplements
• Some herbal supplements

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.

There are many health conditions in which constipation may be a symptom, including:

• Pregnancy
• Diabetes
• Irritable bowel syndrome (IBS)
• Thyroid disease
• Electrolyte deficiencies
• Chronic idiopathic constipation

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

• Anal fissure
• Bowel obstruction
• Bowel stricture
• Rectocele (a bulge from the rectum into the vagina)

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.

The following 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:

• Dysautonomia
• Multiple sclerosis
• Parkinson's disease
• Spinal cord injury
• Stroke

Any cancer that affects the functioning of the colon 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:

• Colon cancer
• Rectal cancer

Because constipation often runs in families, there may be some genetic predisposition to this condition, as well as 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.

If you are experiencing constipation on a regular basis, you need to make an appointment with your physician to accurately pinpoint what is going on, as well as to establish a treatment plan. Your doctor will work with you on developing a management plan that is right for you.