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Causes of Constipation

By Dr Ananya Mandal, MD

The exact cause of constipation is not clear. However, there are several factors that may lead to an increased risk of constipation.

Some of these are irreversible for example age, pregnancy status and post-operative constipation. Some of these, however, are preventable by adopting life style and dietary modifications.

Risk factors for constipation

Causes and risk factors associated with constipation include:-

  • Lack or inadequacy of fibres and fluids in diet. Fibres are included in fruit, vegetables and cereals
  • Avoiding or delaying urge to pass stools. Having limited privacy for passing stools and using a community toilet (in schools, hostels or dormitories etc.) could be a reason for exacerbation of constipation.
  • Certain medications may lead to constipation as a side effect. Some of the medications that may cause constipation as a side effect include aluminium containing antacids, antidepressants, antiepileptics, tranquillizers, opioids like codeine, morphine etc., antipsychotics used in schizophrenia and other mental health conditions, calcium and iron supplements, diuretics etc.
  • Mental ailments like anxiety disorders and depression. Psychiatric problems, such as ones that result from sexual abuse, violence or trauma may also lead to constipation in the short as well as long run. Mental retardation, Down’s syndrome and other congenital conditions that lead to mental retardation are also associated with constipation.
  • Elderly over the age of 55. Older people are five times more likely than younger adults to get constipated. This is due to slow bowel movements, use of multiple medications as well as a relatively sedentary life.
  • Pregnant women - Approximately 40% of pregnant women experience constipation during their pregnancy.
  • Sedentary life and lack of exercise. Regular activity and physical fitness is important for normal bowel motions.
  • Recent abdominal or pelvic surgery
  • Terminally ill patients
  • Being underweight or overweight is also a risk factor for constipation
  • Travelling involves change in dietary habits and this may lead to constipation
  • Abuse of Laxatives is a common cause of recurring constipation
  • Constipation may also result due to gastrointestinal conditions like inflammatory bowel disease, irritable bowel syndrome, colon or rectal cancer and anal fissure.
  • Diabetics, those with high blood calcium levels, underactive thyroid functions, muscular dystrophy, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis or spinal cord injury may also develop constipation

Constipation in infants and children

Constipation is common among infants and young children. Possible causes include lack of fluids in diet, lack of fibres, over feeding, malnutrition etc.

Another problem is inadequate and faulty toilet training. The child should not feel stressed or pressured about using the toilet. Constantly intervening while the child is using the toilet interferes with passing stools and may lead to constipation.

Phobia of toilets and using the toilets also plays a role in childhood constipation. The fear may result from the pain when passing stools. This leads to poor bowel habits when the child ignores the urge to pass stools and withholds the stools for fear of experiencing pain and discomfort. This worsens the condition.

Some disease conditions also lead to constipation among which is Hirschsprung’s disease, anus and rectum deformities at birth and spinal cord abnormalities at birth and cystic fibrosis.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Mar 20, 2013

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