7 Sneaky Reasons You're Constipated That Have Nothing to Do with Food, According to a Dietitian

Eating a high-fiber diet but still can’t go? An expert shares the surprising culprits—and what to do.

Reviewed by Dietitian Emily Lachtrupp, M.S., RD

Backed up, and not sure why? If you're having a harder time in the bathroom these days, but your healthy diet hasn't changed much—plenty of high-fiber foods? check!—then we're here to validate your confusion. It can happen to all of us, though.

"Nutrition definitely plays a huge role in both the causes and relief of constipation," says Maggie Michalczyk, RDN, a cookbook author and founder of the blog Once Upon a Pumpkin. "A diet low or lacking in fiber is one of the primary culprits for constipation, since fiber adds bulk to the stool, making it easier to pass through your digestive system. On the other hand, foods low in fiber, such as those that are heavily processed and refined, can contribute to fewer bowel movements and difficulty passing stools. That said, constipation can also be caused by other factors, including diet, lifestyle habits, like stress, and certain medical conditions."

Constipation is defined as having less than three bowel movements a week, as well as experiencing dry, hard stools. So if it's not food causing constipation, what could it be? We asked Michalczyk to share a few of the sneaky reasons you may be backed up, and how to get some much-needed relief.

1. You're Not Exercising Enough

"Lack of physical activity can contribute to constipation, because regular exercise helps stimulate the muscles in your intestines, promoting healthy bowel movements," says Michalczyk.

On top of that, the muscles in your abdomen and your diaphragm are important for digestion, and if they're weak, it can cause issues. In particular, the muscularis—a layer of muscle in your belly—helps squeeze your abdominal walls together and digest your food. Regular exercise can improve bowel movement, especially for those who are older or tend to be more sedentary.

2. You're Taking Certain Medications or Supplements

"Certain medications, such as opioids, antacids and some antidepressants, can have constipation as a side effect," says Michalczyk. "Additionally, iron and calcium supplements, which are commonly taken for various health reasons, may cause constipation in some individuals." She advises talking with your doctor or a registered dietitian if you have questions or concerns about side effects tied to the drugs or supplements you're taking.

3. You're Menstruating

While some women may have more frequent bowel movements—or even diarrhea— during their period, others may experience just the opposite. Both diarrhea and constipation can be related to progesterone. This hormone—which causes the growth and thickening of your uterine wall—increases when you're menstruating and can also influence the digestive tract by disrupting the muscle cell service and contraction relaxation pathways that make it easier to pass a bowel movement, according to Physiological Research.

4. You're Not Drinking Enough Water

Staying hydrated is crucial for a variety of health reasons, including good digestion. If you're blocked up and you haven't been drinking as much water recently, increasing your intake could change things for you quickly.

"Not consuming enough fluids can lead to dehydration that makes stools hard and difficult to pass—especially when combined with a low-fiber diet," says Michalczyk.

Soluble fiber needs water to dissolve, so without adequate water intake, it can cause someone to become blocked up. If you've been eating plenty of fiber-rich foods like whole grains, vegetables, fruits and legumes, be sure to also increase your water intake.

5. You're Stressed

That's right. That bout of stress you're feeling—whether it's from work, things happening at home, or even anxiety about what's happening in the world—could impact your digestive tract, says Michalczyk.

According to an article published in Expert Review of Gastroenterology & Hepatology, psychological stress has been known to disrupt the digestive system, and your gut microbiota may be connected to it all. The bacteria in your GI tract help to break down your food and create stool. However, under stress, those gut bugs can alter the digestion process, resulting in getting blocked up. Stress can also weaken the barrier in your GI tract, per research published in Current Opinion in Behavioral Sciences, resulting in a "leaky gut" where bacteria seeps into your bloodstream and creates an inflammatory response. No wonder gut inflammation has been linked to bowel diseases.

6. You Changed Up Your Routine

Even if you don't feel stressed, putting your body through something it's not used to—like traveling across multiple time zones or even staying up late—can actually cause strain that could impact your digestive system and bowel movement regularity, according to Michalczyk.

That's because your circadian rhythms are actually connected to the digestion process. Circadian rhythms are usually associated with sleep; they're your body's internal clock that regulates how your hormones respond to light and darkness within a 24-hour cycle. But because your digestion is connected to your psychological systems, if you change your usual day-to-day routine, whether it be as small as shifting your sleep schedule, or as big as taking a trip to Florence, you might feel constipated until your body sets a new rhythm or gets back to its usual one.

7. You're Dealing with a Medical Condition

A variety of health issues can cause constipation, depending on how your body reacts to the particular illness. For example, people living with diabetes can also have constipation because it can affect your pancreatic hormones (like insulin) and metabolism. When this happens, a person with diabetes may develop gastroparesis, a reduction in the motor function of the digestive system that causes the movement of food to slow or stop moving, resulting in a blockage, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Pelvic floor disorders and gastrointestinal conditions have also been known to lead to irritable bowel syndrome, a disorder that affects the stomach and intestines and disrupts the gastrointestinal tract. Other health issues such as stroke, Parkinson's, Alzheimer's or a spinal cord injury can cause constipation, as well.

How to Relieve Constipation

If none of these reasons resonate, you could be dealing with a case of chronic constipation—a condition that impacts roughly 4 million people in the United States. And the likelihood of dealing with constipation increases with age, according to the National Institute on Aging.

If you're looking for some immediate remedies to relieve your constipation, Michalczyk suggests making these three lifestyle changes.

Increase Your Fiber Intake

Fiber is important for increasing the size of the stool, as well as softening it, which allows you to pass it smoothly through your digestive tract and colon. The Dietary Guidelines for Americans recommends that men get at least 30 to 38 grams of fiber a day from their diet, while women should aim for 21 to 25 grams. While it may feel like you're getting enough fiber from your fruits and vegetables, the average American only consumes around 10 to 15 grams of fiber a day.

"Including high-fiber foods like fruits, vegetables, whole grains, legumes and nuts in your diet can help alleviate constipation," says Michalczyk. "These foods add bulk to your stool, making it easier to pass through the intestines. Gradually increasing fiber intake and staying hydrated is important to avoid discomfort."

Stay Hydrated

"Drinking an adequate amount of water throughout the day helps soften the stool, making it easier to pass," says Michalczyk. The National Academy of Medicine says men should consume 13 cups of liquids, and women should aim for 9 cups. But since you get a lot of fluid through the fruits, veggies and other foods you eat, Michalczyk recommends aiming for at least eight 8-ounce glasses of water a day. (Other unsweetened or low-sugar beverages are also fine.)

Exercise Regularly

Because movement does play a significant role in digestion, engaging in regular exercise could really get you moving in another way. Michalczyk says activities such as walking, jogging or yoga can help stimulate the muscles in the digestive tract and promote regular bowel movements. Doing exercises to strengthen your abdominal muscles (including planks and crunches several days a week), as well as cardio that works your core (think power yoga or jogging for at least 30 minutes, most days of the week), may reduce bloating and gas buildup and aid digestion.

Bottom Line

While constipation is generally related to fiber and dietary intake, there are other lifestyle factors that can play a role. "Maintaining proper hydration, keeping stress in check and engaging in regular exercise are effective ways to relieve constipation," says Michalczyk. "Remember, a balanced diet, an active lifestyle and self-care play crucial roles in maintaining optimal digestive health."

However, if you've taken all of these steps and are still experiencing constipation, it may be wise to talk to a medical professional to see if there are other medical issues to blame.

Originally appeared: EatingWell.com, July 2023