Chronic Constipation

March 25, 2021
Gut Health

Constipation or rather chronic constipation is prevalent in a large part of the population and varies between 16-80% based on age, gender, race, socio-economic status and geographic location of the person. It is known to be more prevalent in population aged 65+ and a higher percentage of females than males (3:1 ratio)report being constipated in the United States. Those are the stats, but if you suffer from constipation, stats don’t help! Therefore, 2 important questions answered here:

1) What defines chronic constipation - so you know if you need to bring this up with your doctor?

2) What are the common causes and treatments? (it’s more than water and fiber!)

Review the following checklist of symptoms that defines if a person has chronic constipation.

o Lacks the urge to have a bowel movement and/or inability to have a bowel movement daily

o Stools are hard to pass and pellet-like

o Excessive straining is required to pass stool – whether soft or hard

o Sense of incomplete evacuation lingers even after one or several bowel movements

o Abdominal pain with bloating and stool retention

o Dependency on coffee/ oral laxatives to initiate bowel movement

If you have determined, you have one or more of these symptoms on a daily or weekly basis, you should speak with your doctor. The intensity and severity may differ for each person, but if it is present, it should be addressed. If your constipation is temporary due to a medication (opioid pain medications are notorious for this!) or post-surgical, it may not need an intervention.However, if it is something that is of sudden onset or slow onset but without obvious reason, read on to see what maybe causing it.

Here are possible causes of constipation starting from most commonly known to lesser-known causes:

· Inadequate hydration i.e., water intake

· Inadequate intake of soluble fiber: Includes most fruits, vegetables,legumes – pulls water into the colon to soften stools.

· Inadequate intake of insoluble fiber: Includes fruit peels, fibrous vegetables like celery, some legumes, seeds and nuts – bulk up the stool so that it is well formed (not loose)

· Lack of physical activity

· Gastroparesis: Intestinal muscle paralysis

· Hypertonic pelvic floor muscles

· Hypochlorhydria- low stomach acid levels (ex: from chronic use of antacids and acid suppressants)

· Low bile/ production

· Low enzymatic activity

· Small intestinal bacterial overgrowth or any form of dysbiosis

· Chronic malnutrition ex: magnesium inadequacy


Needless to say the cause or causes will determine the treatment plan.Psychogenic causes can also co-exist with one or more of the above. Therefore,the treatment may be simple for some patients but complex for others. In ourpractice, we ensure that we create a treatment plan that will address the underlying cause(s). A thorough intake allows us to determine if diet and lifestyle changes are needed and if comprehensive stool testing is required.With the exception of a few cases that may require invasive procedures or referrals to gastroenterologists, most constipation cases can be resolved within weeks to months.

If you feel you suffer from constipation, and common interventions like hydration, increased fiber intake and sustained exercise aren’t helping, callus today to see if we can help.

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