6 causes of constipation that have nothing to do with diet

Like a lot of things in life, constipation becomes more common as you age. About 16 percent of American adults have problems with constipation. And that number rises to 33 percent after age 60.¹

Sometimes, the obvious is to blame, such as a poor diet. And with a few changes, such as eating more fiber and drinking more water, you can get things moving again. But sometimes, no matter how many veggies or how much water you take in, you stay backed up. What then?

The first thing to do is see your doctor. They can rule out any underlying and potentially serious medical conditions. “Constipation in a young and healthy person can lead to a very different set of differential diagnoses than in an older person,” says Jill Deutsch, M.D. She’s the director of the Yale Functional Gastrointestinal Disorders Program at Yale Medicine in New Haven, Connecticut. “We want to make sure constipation is not caused by something like a bowel obstruction, motility disorder or even colon cancer.” Other medical problems, such as a stroke or diabetes, can also cause constipation. These conditions can affect the muscles or nerves you use when you have a bowel movement.

But once you’ve been checked out to make sure nothing is physically wrong, there are a few common culprits that can trigger constipation. Here’s a look at what they are — and ways to fix them.

Being inactive

Your colon responds to activity. In general, the more active you are, the speedier things will move through your digestive tract, says William D. Chey, M.D. He’s a professor of gastroenterology and nutrition sciences at Michigan Medicine, University of Michigan, in Ann Arbor. Exercise also helps keep your abdominal and pelvic muscles strong. Both are important to help you poop. One review of recent studies suggests that regular exercise — especially aerobic exercise, such as walking — significantly improved symptoms in people with constipation.²

Your medications

As you get older, you’re more likely to be taking a number of different medications. As the side effects add up, there’s more and more risk in terms of how those medicines can affect you in the bathroom, says Dr. Deutsch. Some of the most common offenders include:

• Narcotic pain medicines, such as codeine, oxycodone (Oxycontin) and hydromorphone (Dilaudid)
• Over the counter (OTC) painkillers, such as ibuprofen (Advil, Motrin) and naproxen (Aleve)
• Antidepressants that are selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac)
• OTC antacids with calcium, such as Tums, or ones with aluminum
• OTC allergy or sleep medications that contain diphenhydramine (Benadryl)
• Certain blood pressure medicines, including calcium-channel blockers, such as nifedipine (Procardia), and beta blockers, such as atenolol (Tenormin)
• Seizure medications, such as phenytoin (Dilantin) and gabapentin (Neurontin)
• Anti-nausea medications, such as ondansetron (Zofran)
  

If you’re on any of these medications and have constipation, talk to your doctor, says Dr. Deutsch. You may be able to switch to a different drug, or even go off it entirely. It’s also a good idea to do a medication review once a year. That’s when a pharmacist reviews all of your medications for side effects such as constipation.

Your supplements

“I see many patients who walk into my office with a big bag of supplements, not understanding that some can cause constipation,” says Dr. Chey. The two biggest offenders are calcium and iron, he says. Vitamin D in high doses may also cause you to get plugged up.³ Other constipating supplements include:

• Chlorella
• NAC (N-acetylcysteine)
• Nattokinase
• Beta-sitosterol
• Some protein powders and drinks

Laxative overuse

If you use laxatives for weeks or months, they can decrease your colon’s ability to contract. That can make constipation worse. “We often see it among folks who have been hospitalized. They get put on laxatives when they’re in the hospital and just stay on them,” says Dr. Deutsch. If you find that you’ve become dependent on laxatives, talk to your doctor about how to slowly stop taking them.

Travel

It’s easy to become backed up when you’re traveling, even if you’re usually as regular as clockwork. You can become dehydrated while flying, which can trigger constipation, says Dr. Chey. If you’re traveling across time zones, it can mess with your body’s internal clock, or circadian rhythm. This throws off everything, including your bathroom schedule. You can help avoid travel-related constipation with a few tips:

• Drink plenty of fluids. Focus on water and clear liquids. Avoid alcohol and caffeine, which can be dehydrating.
• Don’t overdo it on fiber. If you’re dehydrated, it can actually make constipation worse in the short term.
• Avoid high-fat foods, such as meat and dairy. They can back you up more.
• Stay active. It can be hard to exercise when traveling. But even getting up to stretch when you’re on a plane or during breaks on a road trip can help.
• Listen to your body. When you gotta go, you gotta go, even if it means putting sightseeing on hold. If you ignore your urges, it can make constipation worse.

Stress

While some people run to the bathroom when they’re on edge, the opposite can also happen. Why? When you’re stressed, your body releases stress hormones. This increases blood flow to your heart, lungs and brain — but it sends it away from your digestive tract. As a result, movement in the bowels slows down.

Don’t feel guilty about taking some time for self-care. Soak in a warm bath or read a good book. Your bowels will thank you for it.

¹National Institute of Diabetes and Digestive and Kidney Diseases. Definition and facts for constipation. May 2018. Accessed June 13, 2022.

²Gao R, Tao Y, Zhou C, et al. Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials. Scandinavian Journal of Gastroenterology. February 2019; 54(2): 169-177.

³Panarese A, Pesce F, Porcelli P et al. Chronic functional constipation is strongly linked to vitamin D deficiency. World Journal of Gastroenterology. April 14, 2019; 25(14): 1729-1740.