What is Constipation?

Medically reviewed by John A. Flores M.D., M.S. April 01, 2024| Written by Shahid Bashir

What is Constipation?

If you have less than three bowel movements a week, the condition is called constipation in medical terminology. However, having fewer than three bowel movements a week is not the only symptom indicating constipation. There can be other indications, including hard stools, straining during bowel movements, and the feeling of incomplete bowel emptying.

Though constipation affects people of all ages, it’s more prevalent among older adults. According to stats by theAmerican Gastroenterological Association, about 16 adults out of 100 experience the symptoms of constipation. But this rate is almost double for people aged 60 or more, where at least 33 adults out of 100 suffer from constipation. 

You can manage your constipation at home by making specific lifestyle changes. For instance, increasing fiber and liquid intake. The complications of constipation include hemorrhoids, anal fissures, rectal prolapse, and abdominal discomfort.

Signs & Symptoms

Some common symptoms of constipation include:

  • Fewer than three bowel movements a week
  • Pebble-like hard stool formation
  • Difficulty or pain while relieving oneself.
  • Increase in time it takes for a regular bowel movement
  • A feeling of incomplete emptying of the bowel
  • Abdominal discomfort

While these symptoms usually result from constipation, it’s not always the case. 

For instance, the frequency of bowel movements varies among individuals. Some may poop several times a day, while others may do it three to four times a week. 

So, fewer than three bowel movements can’t always be linked to constipation. 

Similarly, abdominal discomfort or pain while passing feces is common in digestive illnesses. So, diagnosing the root cause of symptoms is crucial before heading towards the treatment. 

Causes

We can divide the causes of constipation into two broad categories for convenience: 

1. Lifestyle Factors

Just as a better lifestyle contributes to improved body health and well-being, asedentary lifestyle does the opposite. An unhealthy diet consisting of junk food with little to no fiber contributes to constipation. It’s because the fiber plays a significant role in making the bowel movement easier and strain-free bybulking the stool

Another important factor related to lifestyle habits that may lead to constipation isinadequate liquid consumption. It’s because the body needs liquid for proper functioning. But in case of dehydration, it tends to absorb more than normal liquid during stool formation. 

This hardens the stool which contributes to constipation.

Ignoring the urge to defecate, or frequently delaying bowel movement can also cause constipation. It’s because as long as the stool stays in the body, the body continues to extract water from it. And so, this hardens the stool and makes it difficult to pass.

Other lifestyle-related factors like lack of exercise can also contribute to constipation. 

2. Medical Factors

The medical factors responsible for causing constipation include certain medical conditions and medicines. 

a. Medical Conditions 

As expected, the digestive tract problems are closely related to the symptoms of constipation.Irritable Bowel Syndrome, pelvic floor muscle coordination defects, intestinal obstructions, and inflammation can also cause constipation.

Neurological conditions, including spinal cord injury,Parkinson's disease, andstroke, have also been reported to cause symptoms of constipation. 

Other healthcare conditions that contribute to constipation include diabetes and hypothyroidism. A study by theAmerican Journal of Gastroenterology shows that chronic constipation is prevalent among diabetic patients. 

b. Medicines and Supplements

Certain medications and dietary supplements can either cause constipation or worsen it. These includenarcotic painkillers, calcium or aluminum-containingantacids,antidepressants,iron supplements, and calcium channel blockers. 

The medicines for managing seizures and Parkinson’s disease can also contribute to constipation.

Diagnosis

A healthcare professional usually diagnoses your symptoms as constipation by asking a few questions about your diet and bowel movement history. But if needed, they may proceed to specific tests to conclude constipation. 

a. Patient History

The physician begins by asking you questions about your previous medical conditions, medications, and dietary supplements. The doctor also questions how frequently you defecate and the nature of your experience. 

The next set of questions is usually related to your diet and lifestyle, as both are major factors in causing constipation. 

b. Medical Tests

For the majority of patients with symptoms of constipation, the doctor usually doesn’t proceed to medical tests. It’s because the questions about diet, lifestyle, and bowel movement are sufficient in most cases to form a diagnosis. 

However, depending on the severity of symptoms and past medical history, your doctor may order a few tests to confirm the root cause of your condition. 

These tests can include blood and urine tests, CT scans, and MRIs. But sometimes, these can include more specific tests i.e.colonoscopy andsigmoidoscopy.

Treatment

Several treatment options are available depending on the severity of the symptoms and cause of constipation. Here is a list of common and effective treatment options:

  • Increase fiber content in your diet if you aren’t eating the recommended levels already. The dieticians recommend about20-35 grams daily for adults, depending on their age and sex. 

Since fiber adds to the bulk of stool; increased fiber intake eases bowel movements and prevents constipation.

  • Drink plenty of water and non-alcoholic low-sugar juices. These prevent constipation as the availability of sufficient liquids in the body results in the formation ofsoft stool. In contrast, alcoholic drinks can cause dehydration which may lead to constipation.
  • Include exercise in your daily schedule, as ithelps with bowel motility. It helps in relieving symptoms of constipation and facilitates normal bowel movements. 
  • Take over-the-counterlaxatives (stool softeners), commonly Docusate or Colace, to relieve your symptoms.

If constipation symptoms worsen despite these measures, seek professional advice. In such cases, doctors usually prescribe drugs like Lubiprostone, Prucalopride, Linaclotide, and Lactulose. 

Plant-Based Diet & Constipation

A plant-based diet has a significant role in improving digestive health and managing conditions like constipation. But you can’t claim that shifting to food from plant sources eliminates the risk of constipation. 

A plant-based diet, if not appropriately managed, can lead to vegan constipation. 

Plant-Based Diet in Causing Constipation

Well, you may have just heard about it, which is understandable as plant-based foods are synonyms for a healthy diet for many of us. The explanation of how a plant-based diet can cause constipation is below 

  • High fiber consumption requires more fluid intake as soluble fiber dissolves in water to create its impact. If water is insufficient, the fiber won’t dissolve and the digestive system may have a hard time moving the fiber through the intestines. 
  • A sudden increase in fiber intake may cause constipation. Ourgut microbiota ferment the fiber to make valuable products likeshort-chain fatty acids. However, an abrupt increase in fiber intake will not suddenly increase such microbes, and it may even harm certain gut microbiota, leading to digestive problems and vegan constipation. 

So, it’s best that you increase your fiber intake gradually. 

  • A plant-based diet is usually low in fats. Though a low-fat diet has its benefits; our body does require a certain amount ofgood fat to function smoothly. One such example is the role of fat in lubricating our digestive system. 

And so, an absence of this required fat can cause constipation. 

Plant-Based Diet in Treating Constipation

If you make your diet plan as per your body's nutritional requirements, it can do miracles. Here is how a plant-based diet improves digestive health and effectively treats constipation:

  • Food from plant origin, such as vegetables, fruits, and seeds, is high in dietary fiber.  Dietary fiber absorbs water and results inincreasing the volume of the stool. It also softens stool which makes bowel movements easy, preventing constipation.
  • Some vegetables and fruits have laxative properties. For example, prune fruit has the chemical substancesorbitol which is a natural laxative as it prevents stool hardening and helps relieve constipation.
  • Dehydration is an important factor among the causes of constipation. Certain vegetables and fruits contain high liquid content and serve as an additional water source for the body. 
  • Plant-based foods are generally rich in antioxidant properties, minerals, and vitamins. Such properties of plant-based food facilitate the optimal functioning of the digestive system and prevent constipation.
  • Our gut contains microbiota that are beneficial for our digestive health. A high-fiber diet from plant sources has prebiotic properties,facilitating the growth of beneficial gut microbes which contributes to efficient digestion and prevention of constipation.

Lifestyle Changes in Preventing Constipation

There is no denying that your lifestyle contributes significantly to shaping your health. Poor diet and lack of exercise are two major lifestyle factors that can cause constipation. A poor diet means consuming processed food with a high trans-fat content but little to no dietary fiber. 

To minimize the risk of constipation, you must change how you eat and what you eat. 

Gradually increase a fiber-rich diet in your meals until you reach your daily fiber requirement levels.Adding fiber to the diet is an easy way of improving digestive functioning and managing constipation. 

One important thing to consider is the amount of liquid intake when consuming fiber-rich meals. Dietary fiber requires fluid availability to perform its role in the digestive tract. 

You must increase your daily water consumption as it not only facilitates the dietary fiber in its role but also directly involves forming a soft stool. 

Stress is a less-known cause of constipation.Studies show that exercise has a significant impact on improving mental health and relieving stress. Exercise promotes regular bowel functioning by influencing bowel motility. You must consider exercise as a part of your daily routine, which will help prevent constipation. 

Some other lifestyle changes to ease constipation include taking laxatives occasionally. But you must refrain from taking them regularly as they can result in adverse effects. 

How to Improve Digestive Health?

A healthy digestive system is less likely to experience symptoms of constipation. In this section, you will find some tips on how to improve digestive health.

1. Refrain From Processed Food

Processed foods contain added fat, sugar, artificial flavors, preservatives, and many other synthetic ingredients that reduce their nutritional value. These synthetic ingredientsharm beneficial gut microbes

Interestingly,research shows that synthetic ingredients can facilitate the growth of harmful gut bacteria. The lack of necessary nutrients in processed food is another factor that can lead todigestive illness

2. Increase Fiber Uptake

Fiber is one key ingredient that emphasizes the importance of a plant-based diet. It is responsible for forming bulky stool that promotes regular bowel movements and protects against constipation. 

Theprebiotic properties of fiber make it a healthy choice for good microbiota in our gut. You can get sufficient fiber from consuming whole foods such as vegetables, fruits, and seeds.

3. Stay Hydrated

Inadequate fluid intake results in hard stool formation, making bowel movements uncomfortable. It can lead to health problems such as constipation and the formation of hemorrhoids. 

Direct water intake is the easiest way to fulfill the fluid demands of the body. 

That said, you can also increase fluid intake by increasing the consumption of vegetables and fruits with high water content.

4. Balance Good & Bad Fat

Fat is not always bad for your health as good fat has several vital functions in your body. For instance, it helps in the absorption of certain essential vitamins in the body. It also has antioxidant and anti-inflammatory properties thatpromote digestive health

Good fat sources include olive oil, avocados, seeds, and nuts. In contrast, meat and fried food often have saturated and trans fats that are generally harmful to the body's overall health.

5. Regular Exercise

Studies show that a healthy amount of moderate exercise positively impacts digestion. Exercise and regular physical movements facilitate the flow of food particles in the digestive system. It promotes regular bowel movements and relieves the symptoms of constipation. 

Studies about theanti-inflammatory effects of exercise and its role in preventing inflammatory diseases of the digestive system are also available. 

6. Habitual Changes

Eating meals at the same time every day and avoiding late-night snacking seem like minor habitual changes but have significant effects on digestive health. 

Smoking can lead toexcess acid production and acid reflux symptoms in the stomach, causing discomfort. Similarly, alcohol consumption is a risk factor forgastrointestinal bleeding. So it’s best that you avoid these habits to safeguard your digestive health and prevent conditions like constipation. 

Conclusion

Constipation is not a disease by itself, but it's a symptom of digestive activity not being optimal. Key symptoms that may appear in constipation include fewer than three bowel movements a week, straining during bowel movements, and hard stool formation. There can be several causes of constipation, including diseases, medications, and a poor diet. 

Fortunately, managing constipation is easy, and you can do so by changing your lifestyle and diet i.e.increasing fiber and water intake. This usually means choosing plant-based diet sources.  

But if diet and lifestyle changes result in no relief in symptoms, you must proceed towards prescribed medicines from your doctor.