It’s time to talk about constipation. It’s uncomfortable. It’s embarrassing. It’s frustrating. But it’s a common symptom. In fact, about 16% of adults have symptoms of constipation. And that number jumps to 33% if you’re over 60.
Constipation is more nuanced than you probably think. It isn’t just when you can’t go at all. There’s a little more to it than that. Any of these conditions count as symptoms of constipation:
? Fewer than three bowel movements a week
? Hard, dry, or lumpy stools
? Stools that are painful or difficult to pass
? Feeling like your bowel movement is incomplete
It’s even possible to have a bowel movement every day and still be constipated. You know your body. And if you feel like you’re struggling with constipation, whether you meet these criteria or not, you probably are.
Nearly everyone gets constipated now and then. Dietary changes, stress, and travel can all stop up the works. But some people struggle with constipation on a regular basis.
So let’s dive into the world of chronic constipation, a pesky problem that can really put a damper on your day. You know the drill — feeling like your bathroom trips are never quite complete, struggling with infrequent visits to the porcelain throne, and dealing with that uncomfortable belly bloating. But don’t worry! I’m here to shed some light on the causes behind this frustrating condition.
Before we dive into the causes though, I want to take a minute and talk about the risks and complications of untreated chronic constipation.
Risks of Chronic Constipation
Constipation is uncomfortable to be sure — belly pain, bloating, discomfort when you move around, and more. But chronic constipation also carries some health risks. I don’t tell you these to scare you. But if you’re dealing with chronic constipation, it’s important to know that the downsides are more than just inconvenience and discomfort. But don’t worry. Over the next few weeks, we’ll be talking about proactive steps you can take to get your constipation under control.
Complications associated with chronic constipation include:
? Hemorrhoids
? Rectal bleeding
? Anal fissures (tears in skin around the anus)
If you aren’t able to pass a stool, you can develop these complications as well:
? Rectal prolapse. This is when the large intestine detaches and pushes out of the rectum.
? Fecal impaction. This occurs when a hard, dry stool gets stuck in the body and cannot be expelled naturally.
Causes of Chronic Constipation
Of course I can’t diagnose you with anything in an article. This information is for educational purposes only. My goal is to give you some idea of what could potentially be the core issue that’s causing your constipation. Then, armed with this information, you can work with your practitioner to find solutions that work for you.
Methane SIBO, aka Intestinal Methanogen Overgrowth (IMO)
Small intestinal bacterial overgrowth — SIBO for short — is a common condition where the small intestine becomes home to unwelcome bacteria that feed on the nutrients you eat and cause unpleasant symptoms like bloating, gas, and more.
Never heard of SIBO? I’ve got you covered. You can read about what SIBO is, who might have SIBO, and what to eat if you have SIBO. Last month I did a whole series on SIBO FAQs. If you think (or know) you have SIBO, I have a resource guide you might find helpful. My free IBS Resource Guide lists my favorite resources for both IBS and SIBO and tells you how to use them to address your symptoms.
Methane SIBO is a little different though. It’s kind of like SIBO+. When you have SIBO, the bacteria in your small intestine produce gassy byproducts including hydrogen. In fact, when I test my clients for SIBO, I use a breath test that looks specifically for excess hydrogen.
With methane SIBO, there’s an additional player involved — a single-celled organism called archaea. Archaea love to hang out in the small intestines of people who have SIBO. Why? They consume hydrogen. And people with SIBO have lots of excess hydrogen in their small intestine.
Archaea eat hydrogen and produce methane. And here’s the kicker — methane can slow transit time in your intestines, which leads to CONSTIPATION.
Not all SIBO leads to constipation. Many people with SIBO end up with diarrhea. But when these archaea are present, that’s when you get the methane that causes the constipation.
But it doesn’t stop there. This interaction creates a cycle that’s hard to break:
Excess bacteria in the small intestine produce hydrogen
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Archaea consume the hydrogen and produce methane
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Methane causes painful bloating and constipation
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Constipation leads to more bacterial overgrowth in the small intestine, which produces more hydrogen to feed the archaea, which then produces more methane to further slow transit time and cause more constipation…
You see the problem? You can break this cycle. But you need the right intervention from a practitioner who knows what she’s doing — like me ?.
Low Bile Production and Constipation
Bile is a yellowish-green fluid produced by your liver and stored in your gallbladder. It might not sound glamorous, but it’s a true digestive powerhouse. Bile’s main job is to break down fats and help your body absorb essential nutrients like vitamins A, D, E, and K. Think of it as your personal emulsifier, turning those fat molecules into tiny pieces your body can easily absorb and put to good use.
Without enough bile, your body may not be able to digest fats properly, leading to undigested fat particles in your stool. These greasy, bulky stools can be difficult to pass, causing constipation and discomfort.
Bile also acts as a natural lubricant for your intestines, helping to soften the stool and promote its smooth passage through the digestive tract. When bile levels are low, the stool can become dry and hard. This can contribute to constipation and make it more challenging to maintain regular bowel movements. So, if you’re experiencing constipation, it’s worth considering the role of bile.
Chronic Stress and Constipation
Your brain and your bowels are closely connected. Seems strange, I know. But cliches like “trusting your gut” and “butterflies” in your stomach when you’re nervous are no accident. The gut-brain connection is powerful. What happens in your brain affects your gut.
When you’re under stress, your body goes into fight-or-flight mode and the sympathetic nervous system is activated. This causes a cascade of physiological responses that prepare your body to protect itself from danger. And this includes slowing down digestion and gut motility. And when this happens, your stool spends too much time in your intestine, dries out, and becomes harder to pass.
Stress can also lead to inflammation in your gastrointestinal tract, which may increase constipation.
Dehydration and Constipation
It’s been reported that as much as 75% of the adult population in America is chronically dehydrated. Our bodies need water. Our bodies are made of water. In fact, about 60% of your body is water. You have water in every cell. And you also need it for elimination, and I don’t just mean when you pee.
There is water in your stool also. And if you’re dehydrated, your body is going to get water wherever it can. It’s that important. So while your stool travels through your colon, your body will literally remove the water so it can use it elsewhere. This dries out your stool and makes it harder to pass. And yes, this means constipation.
How do I figure out what’s causing my chronic constipation?
I’d start with water. You’re probably not drinking enough of it. If you increase your intake, you might just find that it does the trick for your constipation. I recommend drinking half your body weight in ounces each day. So if you weigh 150 pounds, drink 75 ounces of water. No matter what you weigh though, I don’t recommend you exceed a gallon of water per day.
If that doesn’t work, your best bet is to work with a practitioner who has expertise in digestive issues like constipation. Chronic constipation isn’t something you want to mess around with. It can lead to more serious problems like the ones I listed at the top of this article.
If you haven’t found the right practitioner, I’m here for you. I specialize in digestive issues and have helped literally hundreds of people feel better. You can schedule a consultation below.
