Constipation refers to a change in bowel habits resulting in stools that are often hard, difficult to pass or less frequent and is often accompanied by bloating. Constipation is a common problem affecting all populations from infants to the elderly and affects older adults and women more often (women have a longer, more convoluted colon to allow for increased absorption during pregnancy, which increases risk for constipation). Common causes of constipation include diet, medications, hormonal changes, or systemic problems like diabetes and hypothyroidism.
Symptoms of constipation include:
- Feeling toxic and sluggish
- Increased gas production
- Vasovagal reaction (in severely constipated individuals)
If you’re constipated and are also having diarrhea, your diarrhea may be caused by stool overflow. Fermented by bacteria, stagnant stool may become loose and leak out around hard, dry stool sitting in the rectum, or in more severely constipated individuals, a buildup of stool overwhelms the sphincter mechanism causing stool to leak out.
Stagnating stool in the colon may result in toxins being absorbed through the intestinal lining into the bloodstream. Hardened feces that accumulate along the lining of the colon can also lead to overgrowth of harmful bacteria and interfere with absorption of water and nutrients.
Since constipation is a symptom, not a disease, it’s important to uncover the root cause of your constipation, as proper functioning bowels is a determining factor in good health. Some of the most common causes of constipation include:
- Anatomical considerations
- Bacterial Imbalance: Dysbiosis, SIBO, Yeast overgrowth
- Diet: Low fiber or one high in processed foods and animal products
- Gluten intolerance, Celiac Disease
- Hormonal changes
- Irritable bowel syndrome
- Neurological conditions
- Pelvic floor disorder
- Rectal prolapse, Intussusception, and Rectocele
- Sedentary lifestyle
- Shy bowel
- Slow transit, Colonic inertia, Dysmotility
Be Your Inner Doctor: Observe Your Stool
Your stool can be a useful predictor in unveiling the cause(s) of your constipation. Size, shape, consistency, ease of passage, and odor of your bowel movements are all important clues. Here are some helpful signs to look for:
- Small pebbly stool might mean diverticulosis
- Toothpaste-thin stool could be a sign of colon cancer but also occurs commonly with diverticulosis
- Layered concretions that look like they’ve been deposited at different times could suggest motility problems
- Painful passage with bleeding could be a fissure
- A foul smell could mean a parasite or bacterial overgrowth, both conditions that typically cause loose stools but that can also have the opposite effect
There are many different criteria for diagnosing constipation. Most are based on stool consistency, whether evacuation is complete, and the number of stools—less than 3 per week being the standard textbook definition. In general, constipated individuals experience hard, difficult to pass, and less frequent bowel movements.
But you can have a bowel movement every day and still be constipated. Some people move their bowels regularly but always feel full and uncomfortable. While there’s an official guideline for diagnosis, how the individual feels is often the most important factor.
Here are the most effective lifestyle solutions for constipation:
- Eat a fiber-rich diet, including many vegetables, and take a fiber supplement such as psyllium husk (purchase the Gutbliss preferred psyllium powder and capsules)
- Drink more water and avoid caffeine-containing liquids, which can be dehydrating (shoot for 2 liters of water daily)
- Decrease or stop the use of constipating/bloating medications, such as anti-depressants, painkillers, blood pressure medications, vitamins with iron, and antacids
- Practice good bathroom habits: Go when you have the urge to go; sit on the toilet at approximately the same time every morning to encourage a Pavlovian-type response if you have erratic bowels; get in and out quickly to avoid sluggish bowel emptying
- Create the right environment in your bathroom: Creating the right ambience is essential for having good bowel movements. Temperature, lighting, accessibility, and privacy —all are important
- Change your position: Squatting is the most natural stance for having a bowel movement. A squatting position helps to straighten the anorectal angle and keeps the knees pressed up against the abdomen, increasing intra-abdominal pressure, which helps to push the stool out. Use The Squatty Potty to help obtain this position (purchase the Squatty Potty)
- Work with a Biofeedback practitioner
- Be Your Inner Doctor: Observe your stool. Learn to make connections between your lifestyle choices and your bowel movements. It is a crucial part of your ability to care for yourself
Laxatives are often used to treat constipation. Although laxatives (not including bulk forming laxatives like psyllium husk) may resolve your constipation symptoms, they do not treat the root cause of your constipation and can cause a dependency if used long-term.