(Woodpath is an education site focused exclusively on gut health. Our articles are researched by clinical nutritionists and contain citations at the end of the page.)
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Chronic constipation is a common gastrointestinal disorder that affects up to 18% of Americans. (Stewart, et al., 1999)
There is a long list of symptoms that can leave sufferers feeling debilitated. Fortunately, there are several ways to tackle these symptoms and get relief — including supplements. We make specific product recommendations at the bottom of this page.
But first, let’s learn about the science behind chronic constipation, so you know which supplements may be right for you.
What is Chronic Constipation?
Chronic constipation is defined as consistently having three or fewer bowel movements a week. Individuals often have difficulty emptying their bowels, which is due to having dry, hard stools.
Chronic constipation is most often seen in the elderly and women. Annually, it is responsible for 2.5 million doctors visits and up to 92,000 hospitalizations in the United States. (Sonnenberg & Koch, 1989)
Chronic constipation can disrupt an individuals quality of life as well as their social life, and ability to perform routine day-to-day tasks. (Belsey et al., 2010)
Chronic constipation can leave individuals feeling frustrated — the cause can be completely unfounded. This is known as idiopathic constipation.
Causes and Symptoms
Chronic constipation can be caused by slow colonic transit or pelvic floor dysfunction. (Leung et al., 2011)
Constipation can cause several issues within the GI tract:
- Reduced motility of fecal matter through the colon
- Incomplete evacuation of the fecal matter within the colon from the pelvis
- Or a combination of the two
Risk factors vary greatly and include:
Inactivity
Inactivity reduces blood flow and the strength of muscles within the digestive tract. (Johannesson et al., 2011)
Poor diet
Diets that are high in unhealthy fats, sugar, carbohydrates, alcohol, processed foods, and diets low in dietary fiber can contribute to infrequent bowel movements. (Dahl & Stewart, 2015)
Stress
Stress can alter the production of hormones as well as neurotransmitters. This can have a significant impact on your muscles, inflammatory processes, enzyme production, and digestive functioning. (Rao et al., 2016)
Medications
Some medications can contribute to constipation because they can slow down the central nervous system and inhibit proper digestion.
Opioids, antidepressants, antacids, anticholinergics, and anticonvulsants are some of the biggest offenders. (Prichard et al., 2016)
Poor gut health
Dysbiosis is often connected with constipation. Specifically, studies showed lower levels of Bifidobacterium and Lactobacillus in people who suffer from constipation. (Khalif et al., 2005)
Additionally, an overgrowth of Methanibrevibacter smithii is associated with constipation as it slows down transit time.
Magnesium deficiency
Magnesium is a vital electrolyte that aids in muscle functioning. When there isn't enough magnesium in your diet, it can cause muscle tension, which can cause constipation. (Siegel & Di Palma, 2005)
Dehydration
Your GI tract needs water so that stool can be bulked up and passed freely. When there isn't enough water, your feces become hard, dry, and painful to pass. (Manz & Wentz, 2005)
Poor bowel habits
Holding in your bowel movements for too long, or sitting uncomfortably, can contribute to incomplete bowel movements. (Sharma & Rao, 2017)
Medical conditions
Medical conditions — including the following — can lead to chronic constipation:
- Irritable bowel syndrome
- Hypothyroidism
- Menopause
- Anorexia
- Diabetes
- Parkinson's disease
A physical examination and an evaluation of your history can help a health care professional determine if you suffer from chronic constipation.
Symptoms of chronic constipation your physician will look for include but are not limited to:
- Functional decline
- Bleeding
- Unintended weight loss
- Rectal prolapse
- Abdominal pain
- Hard stools
- Anal fissures
- Infrequent bowel movements
- Bloating
- Excess gas
Treatment
Eat foods that are high in fiber
Raw fruits, vegetables, beans, nuts, grains, and seeds should all become part of your daily diet. Some of the best to include are:
- All beans
- Sweet potatoes
- Apples
- Pears
- Berries
- Avocados
- Chia
- Prunes
- Figs
If SIBO (Small Intestinal Bacterial Overgrowth) is present, some of the above foods may not be tolerated until that SIBO is effectively treated.
Eat green, leafy vegetables
Green, leafy veggies are a great source of magnesium. They are also high in water.
Drink warm liquids
Warm liquids stimulate digestion. This is especially true if you drink a warm glass of water or tea first thing in the morning.
Drink at least 64 oz of water daily
You need water so that the fiber you consume can move through the digestive system properly and effectively.
Too much fiber without enough water can make constipation much worse.
Supplement Recommendations
If you and your healthcare provider confirm that supplements are right for you, we recommend the following:
And, as always, you can get gut updates and stunning nature imagery from our popular Facebook page. Also, scroll down for our best gut articles.
Research Citations
- Stewart WF, Liberman JN, Sandler RS, et al. Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features. American Journal of Gastroenterology. 1999;94(12):3530–3540. https://www.ncbi.nlm.nih.gov/pubmed/10606315
- Sonnenberg A, Koch TR. Physician visits in the United States for constipation: 1958 to 1986. Digestive Diseases & Sciences. 1989;34(4):606–611. https://www.ncbi.nlm.nih.gov/pubmed/2784759
- Belsey J, Greenfield S, Candy D, Geraint M. Systematic review: impact of constipation on quality of life in adults and children. Alimentary Pharmacology & Therapeutics. 2010;31(9):938-49. doi: 10.1111/j.1365-2036.2010.04273.x. https://www.ncbi.nlm.nih.gov/pubmed/20180788
- Leung L, Riutta T, Kotecha J, Rosser W. Chronic constipation: an evidence-based review. Journal of the American Board of Family Medicine. 2011;24(4):436-51. doi:10.3122/jabfm.2011.04.100272. https://www.ncbi.nlm.nih.gov/pubmed/21737769
- Johannesson E, Simrén M, Strid H, Bajor A, Sadik R. Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. American Journal of Gastroenterology. 2011;106(5):915-22. doi: 10.1038/ajg.2010.480. https://www.ncbi.nlm.nih.gov/pubmed/21206488/
- Dahl WJ, Stewart ML. Position of the Academy of Nutrition and Dietetics: Health Implications of Dietary Fiber. Journal of the Academy of Nutritional Dietetics. 2015;115(11):1861-70. doi: 10.1016/j.jand.2015.09.003. https://www.ncbi.nlm.nih.gov/pubmed/26514720
- Rao SS, Rattanakovit K, Patcharatrakul T. Diagnosis and management of chronic constipation in adults. Nature Reviews: Gastroenterology & Hepatology. 2016;13(5):295-305. doi: 10.1038/nrgastro.2016.53. https://www.ncbi.nlm.nih.gov/pubmed/27033126
- Prichard D, Norton C, Bharucha AE. Management of opioid-induced constipation. British Journal of Nursing. 2016;25(10):S4-5, S8-11. doi:10.12968/bjon.2016.25.10.S4. https://www.ncbi.nlm.nih.gov/pubmed/27231750
- Khalif IL, Quigley EM, Konovitch EA, Maximova ID. Alterations in the colonic flora and intestinal permeability and evidence of immune activation in chronic constipation. Digestive & Liver Disease. 2005;37(11):838-49. https://www.ncbi.nlm.nih.gov/pubmed/16169298/
- Siegel JD, Di Palma JA. Medical treatment of constipation. Clinics in Colon and Rectal Surgery. 2005;18(2):76–80. doi:10.1055/s-2005-870887. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780140/
- Manz F, Wentz A. The importance of good hydration for the prevention of chronic diseases. Nutrition Reviews. 2005;63(6 Pt 2):S2-5. https://www.ncbi.nlm.nih.gov/pubmed/16028566
- Sharma A, Rao S. Constipation: Pathophysiology and Current Therapeutic Approaches. Handbook of Experimental Pharmacology. 2017;239:59-74. doi:10.1007/164_2016_111. https://www.ncbi.nlm.nih.gov/pubmed/28185025