Can't Poop: Why You’re Backed Up and Constipated
Medically reviewed by Robert Burakoff, MD
Constipation is having fewer than three bowel movements a week, straining when going to the bathroom, and passing small hard stools. It can involve feeling like not all the stool has been eliminated.
Constipation has many possible causes, including diet, dehydration, diabetes, pregnancy, travel, irritable bowel syndrome (IBS), stress, or other medical conditions.
This article will discuss some of the common reasons for constipation and how to manage constipation when it doesn’t get better with simple at-home remedies.
Aleksandr Zubkov / Getty Images
11 Reasons You Can’t Poop
It might be challenging to determine an exact cause of constipation, because there are so many. For some people, there could be more than one cause.
Constipation can either occur every so often or be chronic. Here are some of the more common causes of not being able to pass stool.
Diabetes
Constipation is a common problem for people who live with diabetes. Diabetes can cause the muscles in the intestines to be less effective at moving stool through. It may also affect the amount of water and electrolytes (charged minerals and compounds) that are absorbed, which could affect stool.
It’s important for people with diabetes to seek care for constipation. Understanding the causes is important for developing a treatment plan.
Related: Diabetic Stomach Pain: Causes and Treatment
Endometriosis
In endometriosis, tissue that is similar to the lining of the uterus grows in other parts of the body. This can cause a variety of symptoms. If this tissue is found in or near the bowel, it could contribute to constipation. This is because the growth of the tissue may compress or partially block part of the bowel. Complete obstructions, however, are uncommon.
Related: How Do I Know If I Have Bowel Endometriosis?
Travel
Some people develop constipation while traveling. The change in routine can lead to a disruption in the digestive system. Even the most experienced and conscientious travelers can find they are backed up for a time.
Constipation while traveling can occur for a variety of reasons, including:
Changes to activity level
Delaying bowel movements because of a lack of bathroom access
Drinking less water
Eating new/different foods
Jet lag
Stress
Related: Over-The-Counter Remedies for Travel Constipation
Something You Ate
Sometimes new foods or eating foods you don't usually have can lead to constipation. Foods that don’t contain much fiber, such as dairy, fatty meats, eggs, and foods high in sugar, may cause or worsen constipation.
For most people, a high-fiber diet of between 22 and 34 grams (g) of fiber a day is recommended. This may help avoid constipation because fiber keeps stool soft, easy to pass, and moving through the digestive system well.
Drinking enough liquids is also important. Eating a lot of fiber without drinking enough water could worsen constipation.
High-Protein Diets
Eating a diet high in animal protein may lead to digestive issues. People who eat a balance of fruits and vegetables and protein sourced from plants may have a lower risk of developing constipation.
Pregnancy
Pregnancy brings many physical changes that could lead to constipation.
Pregnant people are at risk of not eating enough fiber and of becoming dehydrated. It’s recommended that pregnant people eat high-fiber foods and drink plenty of fluids (especially water) in order to avoid constipation.
It’s also thought that hormonal changes could lead to the digestive system slowing down. This might be more common in the first and second trimesters.
Being less active might also contribute to constipation during pregnancy. Plus, the fetus compressing the digestive organs, especially in late pregnancy, could also cause constipation.
Related: What Can I Take for Constipation While Pregnant in the First Trimester?
Dehydration
Fluids are important to keeping stool moving through the large intestine. Without enough fluid, stool may become too hard and not move through easily.
Related: An Overview of Dehydration
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is a functional gastrointestinal disorder thought to be associated with miscommunication between the brain and gut. IBS-C is the form of IBS associated with constipation. It can also cause symptoms of bloating, discomfort, and the feeling that the rectum isn’t empty, even after a bowel movement.
Treatment may start with laxatives and an increase in fiber. There are also prescription medications that might be tried under the guidance of a healthcare provider.
Related: What Is Irritable Bowel Syndrome With Constipation (IBS-C)?
Stress
Stress can be caused by anything from a change in daily routines to the concern of being overheard while on the toilet. Stress can also come from positive events, such as a new job or dating a new partner.
Whatever the reason, stress can have an effect on the digestive system. For some people, this can mean constipation. Getting back to routines and ensuring there’s enough water and fiber in the diet may be helpful.
Some people may also want to consider stress-relieving practices such as yoga or meditation. For extreme stress or when depression or anxiety are also a concern, seeking care from a mental health professional may also help.
Related: 3 Ways Stress Can Make You Sick
Medications
Medicines can cause constipation. Opioids are probably the most commonly known cause of drug-induced constipation, but there are many others as well.
Drugs that might cause constipation include:
Antacids that contain aluminum and calcium
Anticholinergics (antispasmodic medications)
Anticonvulsants (to prevent seizures)
Calcium channel blockers (blood pressure medications)
Diuretics (water pills)
Opioids (narcotics used for pain)
Parkinson’s disease medications
Diverticulitis
Diverticular disease is the presence of pouches in the lining of the large intestine called diverticula. These weakened areas look like bulges or outpouchings in the intestine. They usually don't cause any issues. However, if they become inflamed, it is called diverticulitis.
It's thought that about half of people who have diverticulitis are also experiencing constipation. Diverticulitis can be painful and also cause other digestive symptoms. It's important to get medical attention if you suspect you have developed diverticulitis.
Related: The Link Between Diverticulitis and Constipation
Other Health Conditions
Several other health conditions may lead to constipation. This could be due to how the condition affects the body or as a side effect of treatments.
Health conditions that could cause constipation include:
Conditions or injuries that affect the brain and/or the spine, such as a stroke, Parkinson’s disease or multiple sclerosis
Celiac disease (an autoimmune condition with symptoms triggered by eating gluten)
Depression or anxiety
Proctitis (inflammation in the rectum)
Hypothyroidism (low thyroid hormone)
Complications of Constipation
Constipation that goes on too long may lead to more serious problems such as fecal impaction. For that reason, people shouldn’t wait too long to seek help for constipation that isn’t getting better with diet, lifestyle, supplements, or laxatives.
Still Can’t Poop After Laxatives
Relieving and preventing constipation may take several steps. It may help to begin with less invasive home remedies before moving on to other methods.
Many people start with over-the-counter (OTC) treatments, including laxatives and stool softeners. Most laxatives and stool softeners can be used for the long term. They tend to work fairly quickly. Several different forms are available to treat hard stools.
But laxatives don’t always work. In this case, you may have chronic constipation. Or, your constipation could be severe enough that more intensive methods are needed to resolve it. People should seek help from a healthcare provider if lifestyle changes and laxatives aren’t working.
Posture on the Toilet
Sitting on the toilet hunched over may not be optimal to relieve constipation. For some people, sitting with their feet elevated may help in having an easier bowel movement. Footstools are marketed to elevate the feet while on the toilet. This may be a better position for some people who are experiencing constipation.
Pain From Chronic Constipation
Constipation can cause pain. The pain could be from bloating in the abdomen. It could also be in the rectum or bottom from straining to have a bowel movement. There could also be lower back pain.
When pain becomes severe or doesn’t get better after the constipation resolves, it’s time to see a healthcare provider. Constipation can be associated with developing hemorrhoids or even a tear in the anal canal (a fissure). These might need more treatment, and a healthcare provider can help.
Steps to Take If You Have Trouble Pooping
Drinking more water, eating some foods that contain fiber, and going for a walk or doing some other type of gentle exercise are good places to start for managing constipation. If taking any medications that cause constipation, talking to a healthcare provider about how to minimize the constipating effect is another first step.
Fiber supplements (which are also called bulk-forming laxatives) may be the next step. These products contain various forms of fiber, can be used every day, and make stool softer and easier to pass. They work by bringing more water into the stool.
Some people may need to try a few different forms in order to find the right one for them. They can cause symptoms like bloating at first, so read the instructions on how to start. They may take a day or more to work.
Some types of bulk-forming laxatives include:
FiberCon (calcium polycarbophil)
Benefiber (dextrin)
Citrucel (methylcellulose)
Metamucil (psyllium)
Next, people may want to try stool softeners (osmotic agents) or a lubricant like mineral oil. These products draw water into the stool and make them easier to pass.
Some brands of stool softener laxatives include:
Colace, Correctol, Peri-Colace, Surfak (docusate)
Lubricants (mineral oil)
MiraLAX or generics (polyethylene glycol)
The next step may be stimulant laxatives. However, they can become habit-forming. That is to say, the bowel muscles get used to them, and it becomes difficult to have a bowel movement without taking them.
For that reason, people should take care when using stimulant laxatives, using them for brief periods, and talk to a healthcare provider if they’re needed for longer periods of time.
Some common brands include:
Bisacodyl (Correctol, Dulcolax, Ex-Lax Ultra)
Casanthranol (Dialose Plus, Peri-Colace)
Cascara (Naturalax)
Senna (Ex-Lax, Fletcher's Castoria, Senokot)
Your healthcare provider may also recommend using a tap water enema. With enemas, it’s important to following product directions. Enemas can also be habit-forming, so they’re not for use long-term in relieving constipation.
Prescription medications can be used to relieve constipation. A healthcare provider will help in sorting out the reason for the constipation and determining the treatment. The treatment might look like changes to diet and lifestyle. However, it also could include changes to medications or therapies for other conditions if they are causing chronic constipation.
Pelvic Floor Dysfunction
In some cases, chronic constipation could be due to the muscles in the pelvis. Diet, lifestyle, and laxatives might not help with these issues. In some cases, for instance, those muscles can be tight, which may make having a bowel movement more challenging.
When constipation doesn't respond to other treatments, it may be worth asking a healthcare provider about pelvic floor disorders. People of all sexes have a pelvic floor, so this cause of constipation can happen to anyone. A specialist healthcare provider that administers pelvic floor therapy might be needed.
When to Notify Healthcare Provider of Symptoms
Constipation is common. It may resolve on its own or with some changes that people can make themselves at home. Some people may also find temporary relief with different forms of laxatives.
Some signs and symptoms related to constipation are a reason to seek care right away. These can include:
Blood in or on the stool
Fever
Passing no stool or gas
Severe abdominal pain
Severe lower back pain
Unexplained weight loss
Vomiting
Summary
Constipation is a common problem. It is usually short-lived and will improve with diet and lifestyle changes. For some, the use of bulk-forming laxatives or stool softeners may help resolve the problem.
Preventing constipation will be important to those who tend to experience it more frequently. Severe pain or blood in the stool are some of the symptoms to seek care right away for constipation.
Read the original article on Verywell Health.
