Plus, what to do about it.

Christabel Lobo; Reviewed by Victoria Seaver, M.S., R.D.
July 31, 2020
Advertisement

Being constipated is hard, to put it quite literally. And having to deal with the associated symptoms of bloating, abdominal pain and hard stools that are often painful to pass is even worse. But, take comfort in know that you're not alone. According to the U.S. Department of Health and Human Services, constipation—which is defined as pooping fewer than three times a week—affects 16 percent of American adults and doubles as you age. Approximately 33 percent of adults 60 and older deal with chronic constipation.

It's important to know that constipation is not considered a disease, but a symptom of an underlying problem. Changes to your lifestyle, mental health and diet are just some of the reasons you may feel backed up. Here are six sneaky reasons you can't poop, including tips from registered dietitians on what you need to do to help keep things regular.

1. You may be dehydrated.

From plump, elastic skin to increased energy levels, staying hydrated offers numerous benefits to our body's various organs, the digestive tract included. In fact, according to the U.S. National Library of Medicine, not drinking enough water every day is one of the key reasons why people experience constipation.

"At least a liter of water usually enters our colon during digestion, but only a small portion of that is excreted as part of our stool," says Nashville-based registered dietitian Grace Goodwin Dwyer, M.S., M.A., R.D., L.D.N. "Poop that has had too much water removed from it, either because you're dehydrated or because you're pooping infrequently, is going to be pretty hard."

While daily water intake requirements vary from one person to the next—with activity level and surrounding environment all playing a role in how much you need to drink—the Institute of Medicine of the National Academies does offer general recommendations for staying properly hydrated. For men, that's achieved by consuming approximately 3.7 liters of total water per day (about 15 cups), and women average around 2.7 liters daily (about 11 cups). And, it's not just from drinking glasses of plain ol' water. Beverages—including juices, sodas, coffee, milk and tea—and food sources also count towards a person's total water intake. (Psst—here are some of our favorite hydrating foods to help you meet your water goals!)

2. You're stressed and feeling anxious.

Everybody experiences stress and anxiety differently. For some, it may cause mental or emotional symptoms like panic or fear. Others develop more physical responses, ranging from rapid heartbeat and dizziness to sleeplessness and, you guessed it, constipation.

"Stress can drastically influence our hunger, leading some people to emotionally eat and others to avoid eating," says Kristen Carli, R.D. and owner of Camelback Nutrition & Wellness. "It can also greatly influence our gastrointestinal function."

According to recent research, there's a direct link between mental health and gut health. Chronic stress not only affects the gut microbiota, but it can also lead to the onset of digestive issues such as irregular bowel movements and irritable bowel syndrome. Stress can result in the digestive process of peristalsis abruptly stopping as the body moves from a relaxed state into a fight-or-flight sympathetic nervous response, ultimately being a sneaky reason you can't poop.

Learning what stress management techniques work for you can really help. "It can be as simple as relaxing in a bath with a glass of tea and a good book or more high intensity like a spin class," explains Carli. "I just guide patients on identifying what self-care activities appeal to them and suggest seeking these behaviors out instead of turning to food to cope with stress."

3. You're not eating enough fiber.

Integral for balancing blood glucose levels, gut health and preventing the onset of chronic diseases, fiber is an essential macronutrient that we often unfortunately overlook. In fact, if you've been struggling with constipation, Dwyer recommends assessing your daily dietary fiber intake levels. "It's helpful to know what's going on in our bodies, and sometimes boosting a specific type of fiber may help sort out a bowel movement issue."

For healthy adults, the 2015–2020 Dietary Guidelines for Americans recommend a dietary fiber intake of 22 grams to 34 grams per day. Adult men typically require more fiber—between 28 grams to 34 grams—than women. But despite the obvious benefits of incorporating more fiber-rich foods in your diet, most American diets fall short, averaging approximately 14 grams of dietary fiber a day.

"Sometimes people think they need to add a supplement like a powder or drink to increase their fiber intake," explains Carli. "But I recommend starting with fiber from whole food sources because in addition to tasting better, whole food sources also provide additional nutritional benefits like vitamins, minerals, and antioxidants."

And, that's not all foods rich in fiber have to offer. Whole grains like brown rice, nuts, seeds and vegetables are great sources of insoluble fibers, which Dwyer says help to add bulk to your stool, so they are larger in size, promoting a sense of fullness and preventing them from hardening. "Soluble fibers, like those found in oats, beans and chia seeds, help to stabilize blood sugar and can actually lower your blood cholesterol by binding to bile in the GI tract," adds Carli.

4. You've had a recent change in diet.

Although upping your daily fiber intake will no doubt be beneficial in the long run, a drastic change in diet can often result in short-term side effects like constipation as your gastrointestinal tract takes time to adapt. "If you do not eat much fiber and you suddenly consume lots of fiber, you will likely have some uncomfortable gastrointestinal symptoms, like bloating and gas," explains Carli. "Start with 1/4 cup of legumes per day, for example, for a few weeks before increasing to 1/2 cup per day for a few weeks. Very slow increases will prevent these uncomfortable symptoms."

Processed foods that are high in sodium, as well as high-fat, low-carb diets like the ketogenic diet, are also the culprits for irregular bowel movements. Eating too much salt causes the water balance in the intestines to shift, resulting in harder stools that are difficult to pass.

"If you're specifically struggling with constipation, I'd incorporate foods that have laxative effects, such as flax seeds, chia seeds, berries and stone fruits—peaches, plums, apricots," adds Dwyer. "Start with 2 tablespoons for the seeds and 1 cup for the fruit per day. And, don't forget that you'll need to also increase your water intake to help your body move this fiber along."

5. You need to up your exercise routine.

Your lifestyle choices just maybe the sneaky reason you can't poop on the regular. In addition to losing muscle strength, decreasing bone density and poor circulation, a sedentary lifestyle also increases the occurrence of irregular bowel movements. According to Harvard Health Publishing, regular exercise—even something simple as a daily walk—can promote good muscle tone, not just in the colon, but throughout the entire digestive tract.

For women who partake in moderate exercise daily, that can mean a 44% reduction in constipation as abdominal and diaphragm muscles strengthen. Results of a recent April 2019 study published in Nutrients show a direct correlation between an increase in physical activity and the improvement of gut health—for healthy women above the age of 65, daily brisk walks are responsible for increasing intestinal Bacteroides, an essential type of microbiome bacteria.

6. You're on a new medication or supplement.

Too much of a good thing can sometimes turn bad, as is the case with food supplements. While iron and calcium are important nutrients required by the body for blood and skeletal health, having too much can slow down bowel functions, thus leading to constipation.

The same can be said for certain medications like antihistamines, opioids, blood pressure medicines and even antidepressants, all of which play a role in the regularity (or lack thereof) of your bowel movements. Some work by slowing down the time it takes for food to pass through the digestive tract, while others draw too much fluid from the GI tract. Both essentially increase the incidence of constipation, a risk that gets higher as you get older.

This is why doctors and nutritionists recommend increasing not just your dietary fiber levels, but your daily water intake as well. "I strongly urge people to remember that water is a part of this equation, too," says Dwyer. "Many people who struggle with constipation are dehydrated and find that upping their fluid intake, especially in the morning, can make a world of difference."