What Are the Causes of Chronic Constipation?
A person is considered to have constipation if they have fewer than three bowel movements per week, experience frequent difficulties while trying to pass stools, or are unable to completely empty the colon. Chronic constipation, on the other hand, refers to the persistence of these symptoms for several weeks or longer, often associated with bowel disorders.
Lifestyle factors, medical conditions, and certain medications are significant contributors to chronic constipation. Below, we will explore these causes in detail:
Lifestyle-Related Causes
The health of the digestive system is greatly influenced by diet and daily activities. Here are some lifestyle practices that may lead to chronic constipation:
- Following an unhealthy diet, such as:
- Consuming foods that can cause constipation, including:
- Meats
- Dairy products
- Foods high in sugars and fats
- Caffeinated products
- Insufficient daily intake of fiber-rich foods.
- Consuming foods that can cause constipation, including:
- Leading a sedentary lifestyle with little to no physical activity.
- Ignoring the urge to use the restroom, resulting in postponed bowel movements.
- Insufficient hydration levels from low water and fluid intake.
Medical Condition-Related Causes
Certain medical conditions may lead to chronic constipation, though having a condition does not necessarily guarantee constipation. Among these conditions are:
Diabetes
For individuals with diabetes, poorly controlled blood sugar levels can result in a complication known as diabetic neuropathy. This condition can impair bowel function and contribute to chronic constipation. Recent studies, including research published in the British Medical Journal (BMJ) in 2018, have found that the likelihood of experiencing constipation can be significantly higher in individuals with type 1 diabetes.
Hypothyroidism
The thyroid gland plays a crucial role in regulating metabolism—specifically the processes of catabolism and anabolism, and the conversion of food into energy. Hypothyroidism, or decreased thyroid function, can disrupt metabolic processes and slow down food digestion, which may ultimately lead to constipation.
Anxiety
Anxiety and stress can stimulate the sympathetic nervous system, impacting blood flow away from the intestines toward important organs such as the lungs, heart, and brain. This results in reduced blood flow to the digestive system, thereby slowing digestion and potentially leading to constipation. Chronic anxiety may lead to generalized anxiety disorder (GAD), which can chronically affect digestive health and may necessitate a visit to a healthcare professional.
Irritable Bowel Syndrome (IBS)
Constipation is a common symptom of IBS, which alters bowel movements. When bowel transit becomes sluggish, waste remains in the intestines longer, making it more difficult to expel, thus resulting in chronic constipation and discomfort. Specifically, there is a subtype of IBS known as IBS with constipation (IBS-C).
Depression
Depression can disrupt the brain’s signaling to the intestines, leading to irregular bowel movements. Various theories explain the link between chronic constipation and depression, including:
- The body’s response to depressive states can cause muscle tension and resulting contractions in the intestines.
- Changes in lifestyle caused by depression might lead to a lack of physical activity.
- Individuals with depression may develop unhealthy eating habits, sometimes opting to skip meals or consume alcohol and sugary or fatty foods, leading to constipation.
Less Common Conditions Associated with Chronic Constipation
Additionally, certain less common diseases may cause chronic constipation, including:
- Parkinson’s disease
- Celiac disease
- Multiple sclerosis
- Diverticular disease or proctitis
- Bowel obstructions, which can occur due to tumors
- Colorectal cancer, or cancers that press against the spinal cord
- Amyloidosis
- Hemorrhoids and anal fissures
- Lupus
Medication-Related Causes
Some medications can lead to chronic constipation as a side effect, commonly observed with the following types:
- Diuretics
- Antihistamines
- Blood pressure medications, such as calcium channel blockers
- Antidepressants
- Antipsychotics
- Anticonvulsants
- Anti-diarrheal medications
- Antacids
- Opioid pain relievers like morphine and codeine
- Calcium or iron supplements
Can Pregnancy Cause Chronic Constipation?
Yes, pregnancy often results in chronic constipation, particularly during the second and third trimesters. This is primarily attributed to elevated levels of the hormone progesterone during this period, which slows down the movement of the stomach and intestines, resulting in slower digestion and increased risk of constipation.
During pregnancy, various factors may contribute to chronic constipation, including anxiety, lifestyle changes, dietary adjustments, and the use of certain medications or dietary supplements previously mentioned.
Risk Factors for Chronic Constipation
In addition to the aforementioned causes, several risk factors may increase the likelihood of developing chronic constipation, including:
- Advanced age
- Gender (women are more susceptible)
- Genetics and family history
- Dehydration
Conclusion
Chronic constipation may arise from various factors, including daily lifestyle habits related to physical activity and diet, medical conditions affecting nerve function or bowel movement, and other factors involving medication use or hormonal changes.