The list of conditions that can cause constipation is long. The following are some of the more common causes:

• dehydration/not drinking enough fluids- when your body is low on fluids, your intestines will draw more fluid from stools (or add less water to stools), making them harder to pass
• not enough fiber in your diet- many of us fail to eat enough fiber in our diets (women should consume about 21 to 25 grams of fiber; men should consume about 35 to 38 grams of fiber per day)
• sedentary lifestyle- older people and people who do not get enough exercise are more likely to become constipated
• medications- many medications can cause constipation, including narcotic pain medications, certain blood pressure medications, antidepressants and others
• ignoring the urge to “go”/delaying the urge- sometimes we ignore the urge to have a bowel movement because it isn’t convenient (i.e., you’re too busy at work to stop what you are doing); ignoring the urge may lead to constipation

• changes in routine/lifestyle- pregnancy, aging, travel and other changes in your regular routine can lead to constipation
• laxative abuse- ironically, using laxatives too often can lead to a lazy bowel that won’t work well without more laxatives, thus creating a viscious cycle that can be difficult to break
• specific medical conditions- stroke, diabetes, Multiple Sclerosis, Parkinson’s disease and other health conditions can affect bowel movements
• bowel problems- diverticulosis, bowel obstruction and other bowel conditions may have constipation as one of the major symptoms
• IBS– IBS is a functional bowel disorder that results in diarrhea, constipation or a combination of the two; IBS is a functional bowel disorder which is very common
• hormonal disturbance- thyroid gland dysfunction and other disorders of the glands may cause constipation
• spinal cord injury- many spinal cord injury patients suffer from constipation due to damage to nerves that innervate the bowel
• hemorrhoids/anal fissures- painful rectal or anal conditions may cause constipation because these conditions are painful, and sufferers may be reluctant to have a bowel movement due to pain; in addition, anal sphincter muscles may spasm, making it difficult to have a bowel movement

As we discussed, passing fewer than 3 stools per week or passing hard stools/straining at stools are part and parcel of constipation. If you are constipated, you might also experience:

• a sensation of stool in the rectum/rectal blockage
• a sense of incomplete evacuation
• bloating/cramping/abdominal discomfort
• mild nausea

If you are constipated and experience any of the following symptoms, you should come in as soon as possible to be assessed:

• blood in your stool
• weight loss
• fever
• vomiting
• inability to pass flatus (gas)
• severe abdominal pain
• increasing abdominal girth (your abdomen seems to be growing steadily and you’re not pregnant)
• thin, ribbon-like stools
• pain in the rectum

If you suffer from constipation, there are several things you can do to try to regulate your bowels:

• increase the amount of water/fluids you are drinking
• avoid caffeine and caffeinated beverages, as these may worsen constipation (caffeine is a mild diuretic)
• try drinking a cup of warm water first thing in the morning (you can flavor with lemon if desired)
• do not ignore the urge to have a bowel movement
• increase your activity- walking is an excellent bowel stimulant
• increase the amount of fiber you are eating