Constipation – What’s causing it and how to feel better
Did you know you can be constipated, even if you go to the toilet every day? Constipation often shows up in not feeling an urge to open your bowels, having to strain for a long time to get anything out, or hard dry stools like rabbit droppings.
NB: If your constipation is new or has suddenly worsened, always check in with your doctor first to rule out anything more serious.
There are different types of constipation and it can be caused by poor diet, pelvic health issues, microbes in the gut or nervous system issues.
What’s causing your constipation?
There are three main types of constipation:
Normal transit
This type of constipation shows up with straining, difficulty with evacuation, bloating, abdominal pain or discomfort and hard stools. Typical causes are a low fibre high fat diet, not eating enough food, or medications.
Slow transit
Slow motility means the muscles of the intestine and large bowel don’t work properly leading to slow movement of contents through the bowel down to the rectum. You might not often feel an urge to poo, and could get hard stools. Slow transit time could be linked to issues with low serotonin or high levels of methane gas.
Pelvic floor dysfunction
If the pelvic floor muscles are unable to coordinate with the surrounding muscles and nerves you can’t produce a normal bowel movement. A pelvic health physio can be useful. Testing the strength and weakness of the anal muscles is necessary for a diagnosis of dyssynergic defecation.
What constipation really feels like
Is this you?
- You need at least half an hour on the toilet each morning to have a poo, and you still don’t feel like you’ve properly emptied your bowels.
- In the mornings you rarely feel hungry and can wake up feeling nauseous.
- You’re scared in case you need the toilet out of the house because it takes so long to go each time.
In constipation you might rarely feel an urge to have a poo, and feel like nothing is moving. Or you could open your bowels daily, but only produce hard pellets or dry stool that is very painful to pass.
Other issues with constipation include fissures, haemorrhoids and severe bloating.
Get the basics right
Constipation isn’t just caused by food, so you need to consider your symptoms from multiple angles, not just your diet.
You may feel you’ve already tackled all the basic advice for constipation but are there any on this list you’re not yet doing?
- Hydration – If you’re dehydrated your body starts to absorb more water from the large intestine. When more liquid is removed this can lead to harder, drier stools.
- Fibre – Eating foods containing fibre increases the size of the waste in the intestines which signals to your body you need to go to the toilet. Fibre also helps retain water making the stools softer and easier to pass.
- Balanced diet – A high protein or high fat diet could slow down the gut, causing constipation, especially if you don’t eat enough fibre.
- Eat enough food – If you don’t have enough volume of food coming through the digestive system you will have fewer poos.
- Movement – Exercise can stimulate a bowel movement and keep your digestive system healthy.
- Poo when you need to – If you are someone who can’t ‘go’ out of the house then you may be ignoring signals from your bowels. Over time this might reduce your ability to feel the urge to have a poo.
- Gut–brain connection – Ongoing stress, anxiety or emotional upheaval can take its toll on your digestion. If you’re holding a great deal of stress, it may be slowing your gut transit time.
These activities would be the first things I’d suggest you work through if you are constipated. You might feel they are too basic, but they often get skipped in favour of taking supplements or giving up.
You don’t have to keep guessing
Book a consultation today and take the first step towards calmer digestion and more energy
Gut-brain connection in constipation
Have you noticed that symptoms appear when you eat while upset, rushed, or anxious? Stress diverts blood flow away from the gut, reduces stomach acid, and slows (or sometimes speeds up) motility. That’s why bloating, urgency, or constipation are common during stressful times.
Everyday situations can cause this response: grabbing lunch at your desk, family arguments at dinner, or constant worrying about work. The brain perceives stress as a threat, and the gut reacts accordingly.
- A food trigger could cause bloating, but catastrophising thoughts and worry further upsets your digestion.
- Emotional or mental stress could increase bloating or stomach pain, which leads to poor digestion when you do eat.
The more time we spend in fight or flight mode, the harder it is for digestion to function normally. Learning ways to activate the rest and digest state, such as eating slowly, relaxation, breathing, or low intensity movement, can help break the cycle.
Some clients don’t think of themselves as stressed, but when we talk more about their lives and daily routines it appears they are feeling chronic low-level anxiety.
Everyday habits that make constipation worse
Getting your eating routine set up for better bowel movements can make a big difference. If you’re doing any of these you might need to make some changes:
- Skipping meals, especially breakfast – You’re most likely to have a poo in the morning, and eating can stimulate the need to go.
- Low fibre diet – Fibre might feel like it slows things down, but if you get the combination of gel forming fibre and bulk forming right, it can aid an easier poo.
- No exercise – Movement can help get the gut moving, and also allows gas to escape reducing bloating.
I help my clients to tweak these small habits, which can sometimes make a surprisingly big difference.
Undereating & constipation
If you’ve been avoiding a lot of foods to reduce digestive symptoms like bloating and gas, you might find the volume of food you eat has decreased.
When you don’t have three regular meals passing through the gut it can slow down. To increase your motility you often need to eat more than you are now, including more fibre. If fibre has been something you struggle with try lower FODMAP fibres like carrots, green beans, kiwi, potato, pineapple or spinach.
Is IMO driving your symptoms?
An overgrowth of methane in the large intestine is called Intestinal Methanogen Overgrowth. (Methane positive SIBO has recently been renamed IMO.)
Methanogens are microbes that produce methane gas. The more methane someone produces the more severe their slow gut transit time is likely to be. If you know you have IMO you can treat it to reduce the microbes, and therefore the gas levels.
See how more about IMO and SIBO
What you can do next
❌ Myth: My diet is making me constipated
✅ Reality: Food is only one aspect of a slow transit time, but with the right help you can test evidenced interventions that move you forwards.
If constipation is making you feel stuck, then let’s get things moving.
