Here’s why, despite your best efforts, your bowels are still blocked up.
It’s normal to get a little backed up once in a while. Occasional constipation is actually one of the most common gastrointestinal (GI) problems, affecting about 42 million people in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
When faced with a blockage, most people jump to the tried-and-true poop loosening remedies, like doubling down on prune juice, taking an over-the-counter laxative, or adopting constipation-helping lifestyle habits, such as drinking extra water or upping their fiber intake.
But what do you do when you feel like you’ve tried everything under the sun to relieve your constipation, and you still feel backed up and bloated? “We have [a] condition called idiopathic constipation, where people have constipation despite doing the right things from a dietary point of view and a lifestyle point of view,” says Anthony Starpoli, MD, a gastroenterologist in New York City. “They have done all the fiber, they use over-the-counter aids, and they still don’t go very well.”
What Can Cause Chronic Constipation?
Constipation can happen for many reasons, and may even have more than one cause. The most common causes of constipation are:
- Slow movement of stool through the colon
- Delayed emptying of the colon from pelvic disorders, especially in women
- A form of irritable bowel syndrome (IBS) that has symptoms of both IBS and constipation, also called IBS with constipation, or IBS-C.
Aside from these causes, there are also many factors that can make constipation worse, such as:
Laxative abuse: “Often we’ll see laxative abuse, people who have years and years of laxative abuse will essentially have a burned out colon, where it doesn’t respond to the normal stimuli,” says Dr. Starpoli.
Medications: Certain medicines that doctors prescribe to treat other health conditions may cause constipation, such as:
Antacids—used to neutralize stomach acid
Anticholinergics—used to treat muscle spasms in the intestines
Anticonvulsants—used to decrease abnormal electrical activity in the brain to prevent seizures
Antispasmodics—used to reduce muscle spasms in the intestines
Calcium channel blockers—used to treat high blood pressure and heart disease
Diuretics—used to help the kidneys remove fluid from the blood
Iron supplements—used to build up higher iron levels in the blood
Parkinson’s disease medications
Narcotics—used to treat severe pain
Antidepressants—used to treat depression and other disorders
Other health conditions: The most common constipation-causing medical condition is hyperthyroidism, says Dr. Starpoli. Other conditions that may affect bowel movements include disorders or injuries that affect the spinal cord or brain (like Parkinson’s disease) or diabetes.
It’s also possible to have a loss of nerve impulse function in your colon. “Some people can be born with [colon denervation] and in some cases it can be acquired,” says Dr. Starpoli.
Pregnancy: The hormonal changes that happen during pregnancy can cause a woman to feel backed up.
Treating Chronic Constipation
Most of the time, your daily habits are the reason you’re constipated, says Dr. Starpoli. “I think the the most important thing is to do a self-examination of your habits, and you will find, easily 80 percent of the time, people are just not doing things correctly,” he says.
Even if you think you’re eating a high-fiber diet, it may be worth keeping a food diary to see just how much fiber you’re getting. As well, it’s key to avoid certain foods—like these constipation-causing foods—that can cause, well, a bowel traffic jam.
It’s also important to get regular physical activity, which helps keep you regular.
If you’re still blocked up after examining your lifestyle and your constipation is significantly affecting your day-to-day life, it’s wise to see a doc. They can prescribe medications that will help loosen you up, and rule out medical conditions or medications that can contribute to constipation.
“There are medical treatments for chronic idiopathic constipation and some newer drugs that actively cause a flux of fluid into the bowel,” says Dr. Starpoli. “They don’t stimulate the bowel like other laxatives do; they increase the fluid content of the colon and that helps lubricate the colon internally.”
Dr. Starpoli is a board-certified gastroenterologist who is affiliated with Lenox Hill Hospital-Northwell Health, Mt. Sinai-Beth Israel Medical Center, and NYU Langone Medical Center.
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We have conditions called idiopathic
constipation where people have
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constipation despite doing all the right
things from a dietary point of view,
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and a lifestyle point of view.
00:00:19,373 --> 00:00:23,074
They have done all the fiber,
they use over the counter aids, and
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they still don't go very well.
00:00:24,904 --> 00:00:29,926
And some people can have
a colon which has some relative
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degree of denervation,
loss of the nerve impulses.
00:00:34,851 --> 00:00:38,588
Some people can be born with that,
and in some cases it can be acquired.
00:00:38,588 --> 00:00:42,299
Often we'll see with laxative abuse,
people who have years and
00:00:42,299 --> 00:00:46,354
years of laxative abuse will have
essentially like a burnt out colon,
00:00:46,354 --> 00:00:49,254
where it doesn't respond
to the normal stimuli.
00:00:49,254 --> 00:00:52,715
There are medical conditions
that can cause constipation.
00:00:52,715 --> 00:00:56,253
You could have a low thyroid condition,
00:00:56,253 --> 00:00:58,668
that would probably be the most common.
00:00:58,668 --> 00:01:01,748
Pregnancy actually it is not a disease but
00:01:01,748 --> 00:01:07,292
it certainly because of the hormonal
changes can cause constipation, and
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then medications people are on a whole
host of medications these days.
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Whether it be certain blood pressure
medications that can cause constipation,
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antidepressant drugs, other sort of new
disturbance type drugs that are used.
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These can contribute to
constipation as well.
00:01:26,592 --> 00:01:28,454
So you have to really take
a thorough of history.
00:01:28,454 --> 00:01:33,512
Well there are medical treatments for
Chronic Idiopathic Constipation,
00:01:33,512 --> 00:01:38,260
some new drugs that actually causing
any flux of fluid into the bowel.
00:01:38,260 --> 00:01:42,373
So they don't stimulate the bowel
like other laxatives do,
00:01:42,373 --> 00:01:46,499
what they do is they increase
the fluid content of the colon.
00:01:46,499 --> 00:01:50,256
And that helps lubricate
the colon internally if you will.
00:01:50,256 --> 00:01:55,875
Well, I think the most important is to
do a self-examination of your habits.
00:01:55,875 --> 00:02:01,044
And you will find easily 80% of the time
people aren't just not doing things
00:02:01,044 --> 00:02:06,543
correctly, even after the visit they're
not convinced until they start to do it.
00:02:06,543 --> 00:02:11,888
And then they see that by been
conscientious about water intake,
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excluding all their caffeine or
alcoholic beverages and
00:02:16,553 --> 00:02:21,429
then adding some fiber,
it'll often but just get better.
00:02:21,429 --> 00:02:24,340
Constipation. National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on January 8, 2021 at https://www.niddk.nih.gov/health-information/digestive-diseases/constipation)Management of Chronic Constipation in Adults. UpToDate. Accessed on January 8, 2021 at https://www.uptodate.com/contents/management-of-chronic-constipation-in-adults)