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Constipated - Underlying Factors you Need to Know

Constipation can be so much more than just an inconvenience; It's a common digestive ailment that can significantly impact your daily life.

Defined by infrequent bowel movements or difficulty passing stools, constipation can manifest differently for each person, but its effects are universally discomforting.

What defines constipation?

The hallmark of constipation lies in the irregularity of bowel movements. The general medical guidelines suggest that having fewer than three bowel movements per week, experiencing difficulty passing stool, straining, or incomplete emptying of bowels could all indicate constipation.

You may also feel quite uncomfortable with cramping and bloating in the abdomen, accompanied with a feeling of fullness or discomfort.

What is a healthy bowel movement?

A healthy bowel movement is one that occurs regularly, typically one to three times per day, (first one in the morning, then after meals) and is easy to pass without straining. It is characterized by formed smooth, soft, snake-like stools that are brown in color, with a mild to no odor, has a consistent texture and leaves you feeling completely evacuated.

Achieving daily regularity of bowel movements is integral to overall health and well-being

Constipation on the other hand is often indicated by stools that are hard, lumpy, and difficult to pass, resembling separated nuts or forming into lumps despite being somewhat formed. The Bristol Stool Chart gives a good indication of each type of stools. Types 1,2 being constipated, type 3,4 normal and types 5,6,7 indicating diarrhea.

Bristol Stool Chart

Failure to regularly eliminate stools allows waste material to stagnate in the colon, where it can undergo reabsorption into the bloodstream. This process can introduce toxins and harmful substances back into the body, contributing to a variety of health problems such as bloating, abdominal discomfort, nutrient malabsorption, skin issues and even systemic inflammation. Regular bowel movements are crucial for preventing the accumulation of waste and maintaining optimal digestive and overall health.

How does constipation occur?

Constipation occurs when the muscles in the colon (large intestine) contract slowly or inadequately, resulting in delayed passage of stool. This delay allows excess water to be absorbed from the stool, making it harder and drier, and thus more difficult to pass.

There are many common factors that can contribute to constipation:

  1. Inadequate Fiber Intake: A diet lacking in fiber can lead to sluggish bowel movements and difficulty passing stool. Fiber adds bulk to the stool, making it easier to pass through the intestines.

  2. Dehydration: Insufficient fluid intake can result in hard, dry stool, making it challenging to pass. Adequate hydration is crucial for maintaining the proper consistency of stool and supporting regular bowel movements.

  3. Sedentary Lifestyle: Lack of physical activity can contribute to slowed digestion and reduced bowel motility. Regular exercise helps stimulate intestinal contractions, promoting more frequent bowel movements.

  4. Medications: Certain medications, such as opioids, antacids containing aluminum or calcium, iron supplements, and some antidepressants, can cause constipation as a side effect by slowing down intestinal transit.

  5. Ignoring the Urge to Defecate: Suppressing the urge to have a bowel movement can disrupt the body's natural rhythm and lead to constipation over time. It's important to heed the body's signals and respond promptly to the urge to go.

Even stress, travel, pregnancy, lack of sleep and changes in daily routines can disrupt bowel habits, contributing to temporary bouts of constipation.

Occasional constipation may resolve on its own with dietary changes, like increasing water, fiber, exercise, and reducing stress, but for those that suffer from chronic constipation these simple dietary fixes just don't work and further investigation is needed.

Explore the underlying factors of chronic constipation:

It is crucial to recognize that constipation is actually a symptom. Delving deeper to uncover the underlying factors contributing to chronic constipation is essential for addressing the root cause:

Conditions contributing to chronic constipation include:

  • Irritable bowel syndrome (IBS) - a common gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits such as diarrhea or constipation.

  • Small intestinal bacterial overgrowth (SIBO) - An excessive growth of bacteria in the small intestine, which produces methane gases, is associated with constipation due to its potential to slow down intestinal transit and hinder regular bowel movements.

  • Hypothyroidism - Overall bodily functions are slowed down including intestinal motility

  • Poor digestion -  Insufficient stomach acid, enzymes or bile production hinders the breakdown of food delaying digestion and transit through the intestines.

  • Microbiome imbalances/parasites - Harmful bacteria may produce neurotoxins that slow intestinal muscle movement, hindering waste removal and promoting further pathogen growth.

  • Abdominal injury or scar tissue - These can obstruct the intestines making stool passage difficult.

  • Neurological disorders - Conditions affecting the nervous system disrupt the signals that control bowel movements

  • Overuse of laxatives - Excessive use can lead to constipation rebound, where the bowel becomes reliant on laxatives for regular movements, ultimately worsening constipation.

  • Food intolerances - Intolerances like soy, lactose, and gluten can all inflame the gut

  • Inflammatory bowel disease (IBD) -  Inflammatory bowel diseases like Crohn's or ulcerative colitis can cause constipation during periods of active inflammation or when strictures narrow the intestines, impeding stool passage.

Understanding your unique situation can help chart a path toward relief, and while there are specific tests available to help dig deeper, like SIBO breath tests, GI mapping and blood tests, here are a few other ideas that you can try today:

  1. If you haven't already tried increasing your water or daily movement start there

  2. Eliminate the foods you already know or feel are binding you up this includes fiber

  3. Add prune juice, aloe vera or kiwi fruit to your daily diet

  4. Try a squatty potty, abdominal massage and applying heat with a wheat bag

  5. Definitely don't delay the urge to goes when it arises, just go

  6. De-stress with deep breathing and yoga

Why I don't recommend increasing fiber for chronic constipation straight off!

Increasing fiber intake may not always bring the relief you are after. Factors such as insufficient water intake, varying types of fiber, individual sensitivities, underlying medical conditions, and medication interactions can impact its effectiveness and may even exacerbate symptoms.

That is why it is essential to seek personalized advice before making dietary changes to ensure they align with your specific health needs and circumstances.


Unlock further mysteries behind your symptoms and get clear on the solutions that work for you.

If you have identified with any of the above and need more support, targeted relief strategies and further investigation, let's book a free clarity call and chat about how I can help you further. 

Or contact me at   We can meet online or in clinic 

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