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What You Need To Know About Chronic Constipation and How To Deal With It

Talking about chronic constipation is not really a subject for polite company. It is a deeply personal matter that we might, at some point, discuss with our healthcare practitioner. Awkwardly. But while talking about chronic constipation may prove something you feel uncomfortable with, it is still something you need to take care of. And it's important not to let the awkwardness of the subject stop you from getting more insight into why it occurs or what you can do about it.

Many of us try to blame our constipation issues on a meal we had or something else. But the truth is that constipation may have numerous causes. You may not even be aware of them. And so while you are busy trying to resolve the suspected problem, you may still have constipation due to other factors.

One of the main things you need to remember about chronic constipation, however, is that while common and uncomfortable, it is rarely dangerous and can usually be prevented or resolved.

When Is Constipation Chronic?

An image of a woman in a red shirt holding a picture of a frowning faceThere is a difference between constipation and chronic constipation. Ordinary constipation is usually due to a digestive issue or other factors that last a short time.

Chronic constipation, on the other hand, happens over a longer period where the problem persists and possibly even intensifies. If this is the case for you, you may need to do something a little more drastic about chronic constipation because it could indicate a more serious underlying cause.

You may need to do something about chronic constipation if you only find relief after using prescribed medication, it lasts for three months or more, it does not get better after improving your diet, or it has an effect on your quality of life.

How Chronic Constipation Is Identified

If going to a healthcare practitioner about chronic constipation, they identify the condition based on if your symptoms include three or more of the following within three months:

  • You pass no more than two stools a week
  • The stools passed have a hard and lumpy appearance
  • Emptying your bowels is difficult
  • You feel as if your rectum is blocked
  • It feels as if your rectum is never empty even after going to the bathroom
  • You have to manually remove your stool

Other symptoms associated with chronic constipation include the following:

  • Pain in the abdominal area
  • Feeling bloated all the time
  • Feelings of nausea
  • You have no appetite

You need not have all these symptoms to have chronic constipation.

What Your Stools Say About Chronic Constipation

Your stool consistency can tell a lot about your gut health. For example:

  • When your stools are made of hard, separate lumps, you are very constipated.
  • If your stools are lumpy and resemble a sausage, you may be slightly constipated.
  • Normal stools have a sausage shape with surface cracks.
  • Similarly, normal stools may have a smooth surface and a sausage shape.
  • You lack fiber if your stools consist of softer blobs with clear edges.
  • When stools are mushy or have a liquid consistency, they indicate the presence of inflammation.

The Causes of Chronic Constipation

What many people do not know about chronic constipation is that it could have many causes. We will look at a few of these.

Inappropriate or Inadequate Diet

An image of a hamburger with deep fried side dishes all around itOne of the most important things to note about chronic constipation is your diet. A diet high in meat, carbohydrates, and dairy products may contribute to the condition due to a lack of fiber. Processed foods, too much caffeine, or alcohol may also contribute, as does not enough water intake.

If your diet is to blame and you want to do something about chronic constipation, there is much you can do to remedy the situation.

  • Increase your fiber intake by eating more fruits, whole grains, and vegetables.
  • Drink the recommended eight glasses of water a day.
  • Drastically reduce your caffeine and/or water intake.

Lack of Exercise

Doing very little or no exercise could increase your constipation risk. Exercise hastens your digestive process and speeds up the time between eating and the next time you need to express a stool. It also means that less water is absorbed from stools, thereby easing the process. Inactivity results in longer times between stools with more water absorption.

Exercise also speeds up your heart rate as well as your breathing. In so doing, it promotes the contraction of intestinal muscles that, in turn, help with better stool flow.

If you suffer from adrenal fatigue, however, please remember that you should opt for gentle exercises like walking or yoga, as examples. High-intensity exercise may overstress your body in this cause and could contribute to an adrenal crash.

Parkinson’s Disease

Parkinson’s disease is the result of a dysfunctional autonomic nervous system (ANS). The ANS involves a vast network throughout your body. This includes your gastrointestinal tract, your body’s ability to regulate temperature, your cardiovascular system, and many more. It is also responsible for the regulation of smooth muscle activity which plays an important role in your defecation process.


What many with diabetes do not know about chronic constipation is that their health issue could cause constipation in several ways.

Firstly, diabetes can result in constant high blood pressure levels because of your body’s inability to produce sufficient insulin. This hormone helps to process sugar in your blood.

People with diabetes also often suffer from autonomic neuropathy, or nerve damage, particularly to the nerves that control the digestive tract. This can lead to constipation.

Another way diabetes can influence stool consistency is due to the medications used and dietary issues.

Common symptoms of diabetes include:

Thyroid Issues

Your thyroid produces thyroid hormone which plays an important function in your body’s metabolic processes. Hypothyroidism happens when your thyroid does not produce enough of these hormones and results in a slowing down of your metabolism. And a slow metabolic process could encourage chronic constipation.

Symptoms commonly associated with hypothyroidism include many of those associated with adrenal fatigue. These include:

  • Thinning hair
  • Memory issues
  • Dry skin
  • Brittle fingernails
  • Menstrual problems in women
  • Weight gain for no apparent reason

If you suspect you have thyroid issues, please see your healthcare practitioner as soon as possible.

Irritable Bowel Syndrome (IBS)

An image of a woman holding her stomach in painIBS, a condition commonly associated with stress and adrenal fatigue, is a gastrointestinal condition often associated with bloating, abdominal pain, and irregular bowel movements. The altered communication between your brain and bowel may result in the slowing down of your body’s ability to release stools regularly. This may result in chronic constipation. It could also, however, result in a speeding up of normal stool transition time.

Common IBS symptoms include:

  • Bloating
  • Anxiety
  • Abdominal cramping/pain
  • Excessive flatulence


Stress comes in many shapes and forms and may lead to a host of various health issues. It could result from what you eat, from your work environment, from chemicals around you, from relationships, or it could also come as a result of health issues. Stress not only affects your brain chemicals, but it also affects every bodily function. This is done through your NeuroEndoMetabolic (NEM) stress response, which is a multi-organ system your body uses to handle stress.

Stress can also affect gut health due to the brain-gut connection. In this way, it can modify your gut microbiome, alter nerve reactions in your intestinal tract, and even contribute to IBS and chronic constipation. Stress and gut issues may also result in anxiety and depression. Interestingly enough, research about chronic constipation shows that it affects approximately 65% of people with psychological issues.


What many people do not realize about chronic constipation is that it may result from the use of both prescription and over-the-counter medications.

Antidepressants, for example, treat the nerve endings in your brain. Your brain, however, also has nerve endings in your gut. This could thus affect your gut health and the passing of stools.

Another medication that may cause constipation, opioids have a narcotic effect that affects the nerves in your gut, thereby inhibiting gut movement and thus influencing the frequency of stool expression.

Calcium-channel blockers could also influence your stool frequency and consistency. For example, while they lower blood pressure by relaxing the smooth muscles in your blood vessels, they also relax gut muscles and thereby promote constipation.

Commonly bought over the counter at drug stores, anticholinergics block the effect of acetylcholine (ACh). ACh is a neurotransmitter throughout your body that plays an important role in central nervous system function. One of its roles includes that of ensuring proper muscle function. Blocking the effect of ACh impairs muscle movement. In the gut, this could promote constipation.

Other Possibilities

Many other conditions could be connected to chronic constipation as well. Some of these include:

  • Pelvic floor dysfunction
  • Hypercalcemia
  • Stroke
  • Bowel cancer or bowel obstruction
  • Pregnancy
  • Multiple sclerosis

About Chronic Constipation and Chronic Stress

Your NeuroEndoMetabolic (NEM) stress response describes how your organs and systems help your body deal with stress. Chronic stress is not uncommon these days, but if not properly handled, could lead to various health issues that mostly relate to overtaxed adrenal glands. Many factors contribute to this situation. If not addressed, you could end up with adrenal fatigue, a condition with many symptoms that seemingly contradict each other.

Unfortunately, modern medicine tends to address the symptoms of adrenal fatigue and not the root cause. In many instances, these methods could ultimately make you feel better in the short term, but do nothing about the root cause of the condition. This can lead to long-term problems that arise unexpectedly. Chronic constipation is one of these possible problems.

What You Can Do About Chronic Constipation?

There are many ways to go about addressing chronic constipation.

Address Gut Health and Food Sensitivities

An image of the intestines surrounded by various foodsIf IBS causes chronic constipation, it makes sense to look at supporting gut health. It's a good idea to look at your diet and try and cut down on any foods that may contribute to the condition. Food sensitivities may be the culprits, as well. Following a diet that takes this into account may not only provide gut support but also promote good stool passing.

Foods containing short-chain carbohydrates often cause gut problems. We find these in grains, vegetables, fruits, legumes, and sweeteners. They cause digestive issues and constipation because your small intestine finds it difficult to digest them and they ferment once they reach your bowel.

Check Your Fiber Intake

You get two types of fiber: soluble and insoluble. You find soluble fiber in fruit, vegetables, and various grains. They make up the bulk of your stool and help reduce constipation.

Insoluble fiber can increase constipation, so it may be a good idea to cut down on these if you have bowel movement issues. Foods containing this type of fiber include beans, lentils, nuts, seeds, and various root vegetables. While fine for someone who does not have constipation, this type of fiber may slow down stool movement if you do.

Increase Your Water Intake

By increasing your fluid intake, you may notice a marked improvement in stool consistency and bowel movements. This means increasing your water intake as well as that of moist foods like soup, for example. Besides possibly promoting stool health, increasing your fluid intake also has other health benefits.


Probiotics may help with IBS symptoms as well as chronic constipation. These living organisms help promote gut health by helping to balance your gut flora composition and process food in your gut. This helps promote proper gut function.

A good probiotic option is B. lactis which, according to research, when used on people with constipation, resulted in a marked improvement in their symptoms. You can also get probiotics from foods such as kefir, yogurt, kombucha, and sauerkraut.

Address Your Stress

Addressing your stress means addressing anything that affects you psychologically as well as physiologically. Physiological issues may need addressing with the help of a healthcare practitioner, and while therapy or medications may help with the results of psychological stress, you can also incorporate other avenues in your healing process. These include mindfulness meditation and yoga, although many other therapies and practices may help.

Engage In Physical Activity

Low-impact physical activity such as a brisk walk, for example, may help with digestive function. Do not overdo the exercise though, especially when also dealing with adrenal fatigue as it could worsen the condition. Exercise also helps improve heart health, helps with depression, and keeps your body in shape.


Certain massage techniques in the abdominal area may stimulate intestinal movement and thereby promote stool passing. This technique is widely employed when dealing with people with physical disabilities.

Drugstore Medications

Certain drugstore medications may help. Some soften your stool and increase stool bulk size, making it easier to pass. These are called bulk-forming laxatives. Softening laxatives, or surfactant laxatives, also soften stools, but they do so by allowing for water or oil absorption into the stool. Lastly, stimulant laxatives trigger certain nerves in your colon and promote colon contractions.

If thinking about using laxatives to address chronic constipation, please note that, in the long-term, they could end up promoting constipation instead of addressing it. You should never use them long-term.

Using Supplements

Many natural supplements on the market may help with chronic constipation. These include, amongst others, magnesium, mineral oil, aloe, fig paste, buckthorn, senna, and slippery elm.

It's always a good idea to talk to your healthcare practitioner about chronic constipation and whether a natural supplement will work for you. They are best able to determine whether a certain supplement is suitable for you because they will take your general health and other possible existing health issues into account.

When To Get Professional Assistance About Chronic Constipation

An image of an alarm clock and roll of toilet paperAs mentioned, constipation need not necessarily require the assistance of a healthcare professional. Do, however, consider getting help if you experience any of the following symptoms as they may point to a more serious underlying health issue:

  • Sleeping becomes an issue.
  • Bowel disease tends to run in your family.
  • Constipation is something you frequently deal with.
  • You have a sudden onset of chronic constipation and are over the age of 50.
  • You are feverish/experience bleeding from your rectum, or you lose weight.
  • When going to the bathroom you feel a mass in either your rectum or abdomen.
  • Symptoms of vomiting and abdominal pain appear.
  • You notice you seldom pass gas.

In Closing

While many people experience constipation on occasion, there is something you can do about your situation.

  • Consider making lifestyle changes that include looking at your diet or exercise regime.
  • Using natural supplements under the advisement of a healthcare practitioner may help with the situation.
  • Talk to your healthcare practitioner if your symptoms persist or become worse.

Dr. Lam Coaching helps people deal with their gut health issues as well as the many health issues resulting from adrenal fatigue. If you would like some help regarding constipation or any other related issues, please call us at 626-571-1234 for a free initial consultation. You can also request a callback here.

© Copyright 2016-2022 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

Fortunately, you can do a lot about chronic constipation. Making lifestyle changes like changing your diet, drinking more water, or considering gentle exercise may help, as does the use of certain natural supplements. It's always a good idea to talk to your doctor about it though.

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