Unfortunately, the list of factors that contribute to constipation is quite long.
Some causes include:
1. Inadequate Fiber Intake
Fiber is an indigestible carbohydrate that bulks up stool making it easier to pass through the digestive tract. You need approximately 30 gr of fiber a day to prevent constipation. According to Harvard health, the standard American diet (SAD) contains less than half of that.
2. Inadequate Fluid Intake
The colon receives approximately 1.5L of fluid from the small intestines daily. 200ml to 400ml of this fluid is excreted in stool. Without proper fluid intake, the large intestineabsorbs more fluid to prevent fluid loss. This makes stool drier and harder to pass.
3. Food Sensitivities
Food sensitivities, especially dairy, are a known contributor to constipation. Cow’s milk and dairy products contain a high amount of a protein called casein. A variation of this casein found in dairy products, β-casein A1, when acted on enzymatically during digestion, becomes β casomorphin 7. β casomorphin 7 delays bowel transit time. The ideal bowel transit time is anywhere from 12-24 hours. Delayed bowel transit time means that it takes longer for stool to move through the bowels and be eliminated contributing to constipation. Gluten has also been linked to constipation.
4. Lack of Exercise
How we choose to live has a great impact on whether we have constipation or not. Lack of physical activity is a huge contributor to constipation. Exercise helps to induce contractions of the large intestines to help move waste.
Stress is a major contributor to constipation. When we experience psychological stress, the HPA (hypothalamus-pituitary-adrenal) axis is stimulated. This causes the release of hormones like cortisol and ACTH which directly affect gut function through altering the cells of the gut mucosa and altering the gut microbiome.
6. Compromised Gut Microbiome
It is now widely recognized that we have more bacteria living within us than cells of the human body! Clearly our gut flora plays a huge role in our health, or the lack of it, and this is no different with constipation. The lack of helpful bacteria like Lactobacillus, Bifidobacterium, and Bacteroides species with the simultaneous arise of harmful bacteria like P. aeruginosa and C. Jeijuni is liked to chronic constipation. Possibly due to a decrease in intestinal motility.
7. Altered Serotonin Levels
Serotonin is a neurotransmitter that stabilizes mood and contributes to feelings of wellbeing. The majority of serotonin, up to 95%, is produced in the gut. Decreased levels of serotonin have been linked to constipation.
8. Medications and Supplements
The list of medications causing constipation is immense. Pain medications like opiates and nonsteroidal anti-imflammatory drugs (NSAIDs), calcium channel blockers for high blood pressure, diuretics like hydrocglorothiazide and furosemide , antidepressants, and even antacids are known to cause constipation. The most common supplement linked with constipation is iron.
Now that we have an idea of what constipation is and what causes it. How do we treat it?