Dog reading the newspaper on the toilet.

This picture is only here to make you smile.
© Can Stock Photo

What it is – What causes it – What to do about it

Chronic constipation is like regular constipation, but it keeps coming back. We’ll look at some of the reasons why in the causes section.

First let’s have a look at what you’ve been dealing with.



Constipation Symptoms

Frustrated, constipated, fat man on the toilet with a big pile of magazines.

Chronic constipation is NOT GLAMOROUS and can make you feel bad about yourself. You’re NOT ALONE.

Okay first you get all the regular constipation symptoms:

  • Straining during a bowel movement
  • Bloating
  • Gas
  • Weakness
  • Low energy
  • Abdominal discomfort
  • Feeling like you didn’t get it all out (a feeling of incomplete evacuation)

If you get weak, tired, or feel faint also see: Abdominal Pain and Fatigue

Constipation and IBS

With IBS You’ll get some or all of the symptoms above, plus:

Abdominal pain from cramps and bowel spasm,


Two or more of the following:

  • Problems improve when after you defecate (also known as poop).
  • Changes in how often you can defecate.
  • Hard lumpy stool, that’s hard to get out.

What Causes Constipation?

Constipation happens when stool (or feces, or poop) moves too slowly through the large intestine.

The large intestine absorbs the water (part of it’s job) leaving a hard, lumpy stool that’s difficult to pass.

There are many things that can cause constipation. I’ve listed the most common ones below.

What Causes Chronic Constipation?

Any of the following items that are a regular part of your life may lead to chronic constipation.

Of course, I’m assuming you’ve been to the doctor to rule out something serious.

Sorry, just a friendly reminder.  I care :).

So, here are some of the main causes of constipation:

IBS and Constipation

Young woman holding her belly in discomfort.

Chronic constipation can make you feel just MISERABLE!
© Can Stock Photo

If you HAVE been to the doctor, and he or she didn’t find anything medically wrong with your bowels, you probably got an IBS diagnosis.

Here is the current theory on how IBS causes constipation:

The large intestine moves stool along by a rhythmic squeezing known as peristalsis.

Bowel spasms, (like painful muscle cramps) in the large intestine can trap stool and gas.

The stool gets hard as the water is absorbed into the large intestine, making it harder to move.

This causes pain and more cramping as your bowels struggle to move the hard dry stool.  This can continue in a vicious cycle.



Our modern lifestyle of too much fat, too little fiber and for many of us, too little exercise (the dreaded E word) just about guarantees an occasional bout of constipation.

But with chronic constipation, the picture is a little more complicated.

Foods That Cause Constipation

Many foods in the modern diet are high fat and low fiber.  Your bowels need fiber to move the food through your digestive tract.  Here are some other dietary items that can cause constipation.

Fats – Fats can make matters worse by giving the intestines even less to grab on to.  Fats can cause bowel spasms in people with IBS, which leads to abdominal pain, and constipation (or diarrhea).

Dairy Products – Eating large amounts of dairy products can cause constipation.  My mother always said cheese was “binding.”

Dehydration – Having enough liquids (preferably water) can help keep things moving.  Without enough water, things can come grinding to a halt inside.

Caffeine and Alcohol – Both of these can contribute to dehydration.  For people with IBS, alcohol or caffeine can cause bowel spasms, pain, constipation or diarrhea.

Medicines That Cause Constipation

Lots of medications can cause constipation.  If you regularly take medication, you should find out if constipation is one of the side effects.

Here are some well known ones:

Narcotic Pain Medications

Business man working on the toilet with a laptop.

It’s bad enough to have to bring work home. You shouldn’t be doing overtime on the toilet!
© Can Stock Photo

These kinds of medications can make your bowels sluggish.  Here are some of the common ones:

  • Codeine
  • Oxycodone
  • Dilaudid
  • Etc.


Such as: Elavil or Imiprimine, and others.

Stimulant Laxatives

Some people in the medical community believe that stimulant laxatives  can actually damage the colon.

Others believe that certain laxatives can weaken the colon.

Either way most experts recommend that stimulant laxatives be used as a last resort (or as directed by your medical professional).

How is Constipation Treated?

This is a large topic which I’ll talk about elsewhere.  But the short answer is:

Changes in Diet – Increased fiber from vegetables, fruits and beans can be a huge help.   Also reducing meat, dairy and processed foods.

Lifestyle Changes – Drinking more water, and less caffeine helps prevent dehydration.

Getting regular exercise – especially abdominal exercise stimulates the bowels and helps keep things moving.

Learning to de-stress and relax – People sometimes use the expression “my stomach is tied up in knots” when they are nervous, worried or anxious. It’s actually their bowels that are “tied in knots.”

Learning to relax can help keep your bowels from cramping up.  That can help prevent constipation.

Medicines and Dietary Supplements
Supplements such as peppermint oil capsules, osmotics or stool softeners can help ease constipation.  There are also some medications your doctor can recommend.

More info coming soon!

Can Chronic Constipation Cause Other Problems?

Man with a funny grimacing strained look.

Straining hard on the toilet can cause other problems.

Though serious problems from typical constipation are rare, there can be some complications from chronic constipation.

Straining to have a bowel movement can cause some problems, such as:

Anal fissures – Hard stool can stretch or tear the skin around your anus.  This can cause a small amount of bleeding (red streaks on the stool).

Rectal prolapse – When some of the intestine comes out through the anus because of all the straining.

Hemorrhoids or piles – These can occur from straining.  Hemorrhoids are bulging veins on or around the rectum.

Amazingly, to three quarters of all people in developed nations develop hemorrhoids.

Impaction – When the stool gets so hard it won’t come out of the rectum.  Then either mineral oil taken by mouth, or an enema (up the other end) are used to soften the stool.

The doctor may then clean it out with fingers (Sorry, I thought you should know :).

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