There could be many different causes of constipation that induce discomfort and pain, disrupting your daily activities. People’s bowel habits differ and a bowel motion every day is not as common as many believe.

While certain individuals have up to three bowel movements a day, some experience it once in three days. Irregular bowel habits are not the same as constipation, which is the difficulty associated with passing hard, dry stools.

A change in your bowel functions compared to what you perceive to be normal is the most important factor when distinguishing between constipation and irregular bowel habits. Constipation can affect up to one in five people and around 2% of the population suffers from recurrent and constant constipation.

Symptoms

If you are constipated, your stools will be hard, dry, small in size, and difficult to eliminate. You may also find it painful to pass stool and may experience straining, bloating, and the sensation of a full bowel. 

You may also experience gastrointestinal symptoms like abdominal pain and suffer from other symptoms like nausea, headaches, and malaise, which is a general feeling of discomfort. 

Occasionally, your causes of constipation may be symptomatic of an underlying medical issue that may be more damaging to your health. Therefore, it is important to take note of any other symptoms you are experiencing.

Causes

When you eat food, nutrients are absorbed in the small intestine, after which the waste is pushed down to the large intestine with the use of muscular contractions called peristalsis. This waste is then temporarily stored in the rectum until the anus opens at will to allow the removal of your stool.

Constipation occurs when your large intestine absorbs too much water from your stools, making them dry and hard or when the muscular contractions of your large intestine do not take place as they usually do. 

The most common causes of constipation include a change in daily routines, insufficient intake of fibre, poor daily fluid intake, and a lack of exercise. 

• A change in daily routine: Observe how your normal bowel movements have become part of your daily routine and have become part of your body’s internal clock. When your daily routine is disrupted, your bowel movement may be disrupted as well, resulting in constipation. This is often seen in shift workers or travellers.

• Insufficient fibre intake: As fibre is indigestible, it adds weight to your stools helping it pass through your large intestine easily. Specifically, sufficient amounts of insoluble fibre, which are found in bran, wheat, whole-grain bread, and cereals, add weight to your stools.

• Insufficient fluid intake: Without an adequate amount of water in your digestive system, your stools may become too dry and hard making it difficult to pass through the intestine. Water helps to plump up the fibre in your stools.

• Lack of regular exercise: A sedentary lifestyle or disability that restricts movement can be one of the most common causes of constipation.

• The tendency to hold off passing stools: Ignoring the urge to pass stools may result in the increased absorption of water from your stools, making it painful to pass them later on. Continuing to ignore this urge may make your body less sensitive to these signs.

• Medication: Certain medicines like narcotics, antidepressants, iron supplements, calcium channel blockers, and non-magnesium antacids could slow down bowel movements.

• Pregnancy: Constipation is common during pregnancy due to hormonal changes, lack of exercise, and the pressure of the uterus against the intestines.

• Old age: Due to factors such as reduced intestinal muscle contractions and intake of constipation-inducing medication, constipation may be more common among the elderly.

• Illness: Hospitalisation for any kind of treatment, which results in being sedentary, change of daily routine, reduced food intake, pain due to surgery (especially abdominal surgery), and pain-relief medication could cause constipation. Additionally, metabolic disorders such as hypothyroidism, diabetes mellitus, hypercalcaemia, porphyrias, and other gastrointestinal disorders could disrupt bowel functions.

• Mental health issues: Mental health challenges such as stress and anxiety could cause occasional constipation.

Request more information about the causes of constipation

If you constantly need to strain to pass stool and are experiencing significant pain and discomfort during bowel movements, it is highly likely that you are constipated.

Consult Dr Suhirdan Vivekanandarajah, an interventional gastroenterologist and hepatologist in Sydney, to find out more about the underlying constipation causes.