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Causes
By Mayo Clinic staff
Normally, the waste products of digestion (stool) are propelled through your intestines by muscle contractions. In the large intestine (colon), most of the water and salt in this waste mixture are reabsorbed because they're essential for many of your body's functions.
However, when the colon absorbs too much water, or if the colon's muscle contractions are slow, the stool becomes hard and dry and passes through your colon too slowly. This is the root cause of constipation.
You may also experience constipation if the muscles you use to move your bowels aren't properly coordinated. This problem is called pelvic floor dysfunction (anismus), and it causes you to strain with most bowel movements — even soft ones.
A number of factors can cause an intestinal slowdown, including:
- Inadequate fluid intake, or dehydration
- Inadequate amounts of fiber in your diet
- Inattention to bowel habits or ignoring the urge to have a bowel movement
- Lack of physical activity (especially in older adults)
- Irritable bowel syndrome
- Changes in lifestyle or routine, including pregnancy, aging and travel
- Illness
- Frequent use or abuse of laxatives
- Specific diseases, such as stroke, diabetes, thyroid disease and Parkinson's disease
- Problems with the colon and rectum, such as intestinal obstruction or diverticulosis
- Certain medications, including pain medications, diuretics and those used to treat Parkinson's disease, high blood pressure and depression
- Hormonal disturbances, such as an underactive thyroid gland
- Anal fissures and hemorrhoids, which can produce a spasm of the anal sphincter muscle
- Loss of body salts through vomiting or diarrhea
- Injuries to the spinal cord, which can affect the nerves that lead to the intestine
In rare cases, constipation may signal more serious medical conditions, such as colorectal cancer, hormonal disturbances or autoimmune diseases. In children, constipation might indicate Hirschsprung disease, a congenital condition that results from missing nerve cells in the colon.
Children may also become constipated if they are afraid of or unwilling to use the toilet. Older children may ignore or forget to attend to bowel movements.
- Constipation. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/. Accessed Nov. 10, 2008.
- Wald A, et al. Treatment of chronic constipation in adults. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
- Wald A, et al. Etiology and evaluation of chronic constipation in adults. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
- Pohl D, et al. Pharmacologic treatment of constipation: What is new? Current Opinion in Pharmacology. 2008;8:724.
- Constipation. American Society of Colon and Rectal Surgeons. http://www.fascrs.org/patients/conditions/constipation. Accessed Nov. 10, 2008.
- Constipation. American Gastroenterological Association. http://www.gastro.org/wmspage.cfm?parm1=687. Accessed Nov. 10, 2008.
- Bharucha A. Constipation. Best Practice and Research Clinical Gastroenterology. 2007;21:709.
- Patel S, et al. Constipation. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://ww.mdconsult.com/das/book/body/113047217-6/780888909/1389/98.html?printing=true. Accessed Nov. 10, 2008.
- Culbert T, et al. Integrative approaches to childhood constipation and encopresis. Pediatric Clinics of North America. 2007;54:927.
