Cause of constipation

We'll start by explaining how the colon (large intestine) works. As food finds it way through the colon, it absorbs water while forming stool (waste products). The stool is being pushed towards the rectum by uscle contractions in the colon. By absorbing the water the stool becomes solid.

The dry and hard stools of constipation occur when the colon absorbs too much water or if the colon's muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly.

Causes of constipation are:

  • lack of fiber in the diet

  • lack of liquids in the diet

  • not enough exercise

  • medications

  • irritable bowel syndrome (IBS)

  • changes in life ( pregnancy, age, travel )

  • abuse of laxatives

  • ignoring bowel movement urges

  • diseases such as strokes

  • colon and rectum related problems

  • intestinal function related problems (chronic idiopathic constipation)

Lack of fiber in the diet
The most frequent cause of constipation is a diet containing too little amounts of fiber, often in combination with too many high fat foods.
Fiber is found in fruits, vegetables, and whole grains. Products high in fat are for example: cheese, eggs, and meats.

People who make sure they eat lots of high-fiber foods are less likely to suffer from constipation.

Fiber (both soluble and insoluble) is the part of vegetables, fruits, and grains which is indigestable by the body.

Soluble fiber dissolves can easily be dissolved in water and takes on a soft, gel-like texture in the intestines. Insoluble fiber basically comes out the way it entered the body, it can not be dissolved in water. The bulkiness and soft texture of fiber helps preventing hard/dry stools. The harder the stool the more difficult it is to pass.

A low-fiber diet is also an important factor in constipation among older adults, who may lose appetite and choose convenience foods like snacks or fast food, which are usually low in fiber. Also, chewing or swallowing problems may force older people to eat softer (processed) foods which are low fiber.

Not drinking sufficient liquids
Bowel movements become softer and easier to pass when one drinks liquids like water and juice. The liquids add fluid to the colon and bulk to stools. People who suffer from constipation should make sure they drink enough liquids daily, about 2 litres or eight 8-ounce glasses. Liquids containing caffeine, like coffee and coke have a dehydrating effect. The same goes for alcohol.

Lack of Exercise
Being physically inactive (couch potato) is also sometimes a cause of constipation, although doctors have not yet figured out why exactly. People who were in an accident or ill (bedridden) often have have problems with constipation. This is attributed to the fact that since they are confined to the bed they can't exercize.

Certain types of medications can cause constipation. Examples are:

antacids that contain aluminum and calcium
antiparkinson drugs
blood pressure medications (calcium channel blockers)
iron supplements
pain medications (mostly narcotics)

Irritable Bowel Syndrome (IBS)
People with Irritable Bowel Syndrome, also known as spastic colon, sometimes have spasms in the colon that can affect bowel movements.
This doesn't only lead to constipation, but often also diarrhea, and often goes along with gas problems, abdominal cramps, and feeling bloated. Although this condiion can produce lifelong symptoms, it is not a condition which is life-threatening. Stress often worsens the symptoms, but in general there is no specific cause or anything unusual that can be seen in the colon.

Changes in Life
Pregnant women may become constipated as a result of hormonal changes or because of the compression of the intestines by the.

Aging can also increase the chances of suffering from constipation. A slower metabolism results in a slowdown of intestinal activity and can have a negative affect on muscle toning.

Changes in routine
People also often suffer from constipation when traveling. This is because their regular diet and routines are disrupted.

Abuse of Laxatives
There are many people who think they need a daily bowel movement and are taking laxatives to accomplish this.

Laxatives are usually not necessary and they can actually slow down bowel movements over time. This is because the colon begins to depend on laxatives to bring on bowel movements. In the long run, laxatives can lead to damage of the nerve cells in the colon and also interfere with the natural ability of the colon to contract. Regular use of enemas is not recommended for the same reason.

Ignoring bowel movement urges
People who ignore bowel movement urges may end up with constipation more often. There are various reasons why people decide to delay having a bowel movement. For example because they prefer not to use bathrooms outside their house. Emotional stress and being too busy are also common factors. Children somtimes postpone bowel movements because of stressful toilet training or simply because they prefer not interrupting their playtime.

Specific Diseases
There are several kinds of disorders that can cause constipation:

  • neurological disorders

  • metabolic disorders

  • endocrine disorders

  • systemic conditions that affect organ systems

The above mentioned disorders can cause a slowdown of the movement of stool through the colon, rectum, and anus.

Neurological disorders

-Chronic idiopathic intestinal pseudo-obstruction
-Metabolic and endocrine conditions
-Multiple sclerosis
-Parkinson's disease
-Spinal cord injuries
-Systemic disorders
-Underactive or overactive thyroid gland

Problems with the Colon and Rectum

-Colorectal stricture
-Intestinal obstruction
-Scar tissue

Hirschsprung's disease, or cancer can narrow or squeeze the intestine and rectum and can thus lead to constipation.

Problems with Intestinal Function (Chronic Idiopathic Constipation)

Somtimes standard treatment doesn't respond to chronic constipation. This uncommoncondition is known as idiopathic (which means: of unknown origin) chronic constipation. The problems the intestinal function which can have have problems with hormonal control or with nerves and muscles in the colon, rectum, or anus. This condition is also called " Functional constipation " and can occur in children and adults. Among adults it is more common in women.

Functional constipation types caused by decreased muscle activity in the colon:

-Colonic inertia
-Delayed transit

These conditions may have an affect on the entire colon or may be restricted to the lower or sigmoid colon.

Anorectal dysfunction or anismus
People who have abnormalities in the structure of the anus can suffer from functional constipation as well. This is called anorectal dysfunction or anismus. As a result of these abnormalities people are unable to relax the rectal and anal muscles, which makes it difficult to exit stool.