If you're struggling to move your bowels, you might first look to the common culprits of constipation — not eating enough fiber or drinking enough water — for answers. But aside from dietary causes, there are many other factors that may prevent you from producing plentiful poops.
From lifestyle habits to underlying medical issues, Nikhil A. Kumta, MD, a gastroenterologist and associate professor at the Icahn School of Medicine at Mount Sinai, breaks down six reasons your bowels might be blocked and offers tips to promote healthy poops.
If you experience symptoms including weight loss, bloody stools, iron deficiency anemia or worsened GI symptoms at night, or you have a family history of colon cancer or inflammatory bowel disease, your constipation might be the sign of a more serious health issue that requires an evaluation by a medical professional, Dr. Kumta says.
1. Not Getting Enough Exercise
Being a couch potato may be to blame for feeling backed up.
"Sedentary lifestyle has been associated with constipation, and management strategies that include increased exercise have demonstrated an improvement in constipation symptoms," Dr. Kumta says.
So, how much should you work out to help stimulate your digestive tract and enjoy regular poops? Dr. Kumta suggests 20 to 30 minutes of moderate physical activity three times a week.
2. Being Stressed
During moments of high stress, your adrenal glands produce more epinephrine, a hormone involved in the fight-or-flight response. This causes your body to redirect blood flow from your GI tract to other vital organs, such as the heart, lungs and brain, resulting in slower intestinal movement and constipation, according to The American Institute of Stress (AIS).
Stress may also alter the healthy bacteria in your gut, which could hypothetically slow digestion, but more research is needed to confirm this theory, per the AIS.
All this is to say, to get your bowels moving, you may first need to focus on stress management.
"Mental health should be prioritized in high-stress individuals, and health care providers can assist with treatment, coping mechanisms and behavioral modifications to assist with relaxation," Dr. Kumta says.
3. Ignoring the Urge to Go
Holding in your poop occasionally isn't a big deal, but routinely delaying your bathroom trips can backfire and back you up.
"Ignoring the urge to defecate can contribute to the development of constipation," Dr. Kumta says. And if you put off pooping frequently, there might be a larger underlying issue at play.
Some people might be avoiding the pain associated with the passage of a large, hard stool, an anal fissure or hemorrhoid while a history of sexual or physical abuse or an eating disorder may cause others to suppress the urge to defecate, Dr. Kumta explains. In these cases, it's best to enlist the help of a medical professional.
"Developing a daily regimen is also helpful," Dr. Kumta says.
For example, each night take a fiber supplement. Then, in the morning, engage in mild physical activity, drink a hot, preferably caffeinated beverage and eat a high-fiber cereal within 45 minutes of waking.
"This routine augments early morning, high-amplitude peristaltic contractions (the wave-like muscle contractions of the digestive tract)" and will get things flowing in the bathroom, Dr. Kumta says.
4. Being Pregnant
When you're expecting, you can also expect your regular poop habits to grind to a halt. That's because "pregnancy leads to hormonal and mechanical changes that can contribute to constipation," Dr. Kumta says.
In fact, "constipation is second only to nausea as the most common digestive complaint in pregnancy, with up to 40 percent of women suffering symptoms of constipation at some stage in their pregnancy," he adds.
5. Having Certain Medical Conditions
It's probably no surprise that underlying gastrointestinal problems, like irritable bowel syndrome, can lead to constipation, but other non-GI health issues can slow down bowel movements too.
"Endocrine, neurologic and multisystem disorders can be associated with constipation, including hypothyroidism, diabetes, scleroderma, Parkinson's disease and connective tissue disorders, among others," Dr. Kumta says.
Pelvic floor dysfunction, which can impair the relaxation and coordination of pelvic floor and abdominal muscles during evacuation, can also result in constipation, Dr. Kumta says, adding that "Biofeedback therapy can be implemented to retrain the pelvic floor muscles and relax the anal sphincter."
And just as emotional stress can strain your bowels, so can psychological disorders like depression. One-third of people struggling with depression also battle chronic constipation, according to Columbia University Irving Medical Center. The reason why may be chemical: A study conducted in mice discovered that low serotonin (which can lead to depression) can cause constipation, per a May 2019 paper in Gastroenterology.
6. Taking Certain Medications
Some medications could cause poop problems too.
"Several medications are associated with constipation, including anticholinergic drugs, opioids, calcium-channel blockers, iron supplements and certain antidepressants," says Dr. Kumta.
Older adults, who often take these medications simultaneously, may have an increased risk of being bound up in the bowels, he adds.
Dr. Kumta recommends reviewing your list of medications with your doctor to uncover any potential constipation-inducing side effects.
How to Combat Constipation
Below, Dr. Kumta shares seven simple strategies to stimulate your bowel movements.
1. Drink more water. Dr. Kumta suggests sipping at least eight 12-ounce glasses a day.
2. Up your fiber intake. Dr. Kumta recommends a diet with 25 to 30 grams of fiber daily. Fruits, veggies, whole grains and legumes supply a font of fiber.
3. Get moving. Do at least 20 to 30 minutes of moderate physical activity three times a week.
4. Don't delay bathroom trips. "People should learn to recognize and respond to the urge to defecate, especially in the morning," Dr. Kumta says.
5. Incorporate breathing techniques. Deep breathing can help relax the pelvic floor muscles, Dr. Kumta says.
6. Try a toilet footstool like the Squatty Potty. These can "straighten the angle between the anus and the rectum, allowing for easier defecation and minimal straining," Dr. Kumta says.
7. Opt for OTC meds. "When lifestyle, dietary and nonmedical interventions are not enough to improve constipation, a variety of over-the-counter and prescription medications are available," including bulk fiber supplements, laxatives and stool softeners, Dr. Kumta says. If these remedies are ineffective, speak to your doctor about possible prescription therapies.
Is This an Emergency?
- The American Institute of Stress: “How is stress linked with constipation?”
- Columbia University Irving Medical Center: “A Moody Gut Often Accompanies Depression—New Study Helps Explain Why.”
- Gastroenterology: “Effects of Serotonin and Slow-Release 5-Hydroxytryptophan on Gastrointestinal Motility in a Mouse Model of Depression.”