"I see this daily in my gastroenterology practice; patients who poop at least once a day can’t possibly imagine that they’re constipated, but the reason that they’re suffering with abdominal discomfort, gas and bloating, a distended stomach, nausea, loss of appetite, or even acid reflux is actually constipation," Fiber Fueled author and gastroenterologist Will Bulsiewicz, MD previously told Well+Good.
In either case, if constipation is something you're dealing with on the reg, you can rely on your G.I. doc asking about your fiber intake. Fiber—found in fruits, vegetables, pulses, whole grains, and the like—is crucial for good digestion and supporting a healthy gut. But if you know you're getting enough soluble and insoluble fiber, Dr. Bulsiewicz says there are some other constipation causes that could be the culprit. Here, he highlights the top five he sees.
What causes constipation? Here are 5 sneaky triggers, according to a G.I. doc:
1. It could be a medication or supplement you're taking.
If you can't figure out why you're constipated, Dr. Bulsiewicz says to check your medicine cabinet. "The classic medications for causing constipation are prescription pain pills," he says. (Over-the-counters, like Advil and Tylenol, don't have the same constipating effect, he adds.) Dr. Bulsiewicz says blood pressure medication is also a common culprit. Ditto some anti-depressants and anti-anxiety medications. "Anti-histamines are another common medication people take that can be constipating," he says. It's not just medications—supplements could cause constipation, too. The biggie here, according to Dr. Bulsiewicz, is calcium.
The reasons why all these medications could cause constipation vary. Dr. Bulsiewicz says blood pressure medication, for example, relaxes blood vessel muscles, also relaxing the muscles in the gut—which can cause constipation. Anti-depressants and anti-anxiety medications also affect nerve endings in the gut, which can cause constipation for some.
If you are taking a medication or supplement that is making you constipated, Dr. Bulsiewicz says it could be helpful to take a magnesium supplement, a nutrient linked to helping with constipation. In fact, he says most calcium supplements have magnesium in them already.
2. You're sitting too much.
If you have a job that requires spending the majority of the day sitting, Dr. Bulsiewicz says this could be another constipation cause. (Unfortunately, you probably can't get any workers comp for this one.) "Your gut moves when you move," he says.
Going for a walk after eating lunch—or really just anytime that fits into your workday—can help rev up the digestive process. The key takeaway is simply to get moving to get things moving.
3. Hypothyroidism can cause constipation.
Hypothyroidism is when your thyroid gland isn't producing enough of certain important hormones and one side effect of this is... you guessed it: constipation. In fact, Dr. Bulsiewicz says it's one of the most common symptoms of the condition. Hormones play a crucial role in digestion, so if your thyroid isn't producing enough of what you need for your body to function properly, that means the gut isn't going to function properly either.
If you are experiencing constipation on a regular basis and wondering if it is connected to your thyroid, it's worth booking some facetime with your primary care doc or an endocrinologist who can check your hormone levels through blood tests.
4. It could be because of your pelvic floor.
Pelvic floor dysfunction is a really sneaky cause of constipation and it's one Dr. Bulsiewicz says he sees in patients pretty often. "If someone is straining to go or feeling like they aren't fully getting everything out, it could be a sign that there's something going on with their pelvic floor," he says. "It shouldn't take a great effort to pass just a small bowel."
To truly know if pelvic floor dysfunction is causing your constipation, it requires a diagnosis from a doctor, so book an appointment for tests instead of attempting to self-diagnose yourself. As with the other constipation causes on this list, this is one that has simple solutions, which can include pelvic floor exercises or medication.
5. Pregnancy can cause constipation.
The last sneaky constipation Dr. Bulsiewicz wants more people to know about is pregnancy. Just like having to pee more, constipation is something else you can expect to experience when you're growing a human. One reason why pregnancy can cause constipation is changes in hormones. "Progesterone in pregnancy causes muscle relaxation, and your bowels are composed of smooth muscle. So the high progesterone leads to relaxation of the smooth muscle in the colon and to reduced activity, thus increasing the likelihood of constipation," OB/GYN Temeka Zore, MD, previously told Well+Good. Another reason is increased iron intake. While it's important to up the intake of this nutrient during pregnancy, it can lead to some constipation.
If you're pregnant and experiencing constipation, Dr. Zore recommends making sure you're drinking plenty of water, going on short walks (if you're able to), and considering a magnesium supplement.
As you can see, the causes of constipation are quite varied and don't always come down to what you eat. And just remember, you don't have to play detective on your own. Booking an appointment with a gastroenterologist can also help you get to the bottom of your constipation causes. A doc can help pinpoint exactly what's causing the discomfort and offer up solutions. Then you can spend less time sitting on the john and more time actually living life.
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