Why Can't I Poop? Constipation Symptoms, Causes, and Treatment

What Is Constipation?

The term constipation refers to three issues, which can be caused by a variety of causes including hormones and diet. The first issue is infrequent bowel movements. For most people, "normal" activity can range from three times a day to once every three days, said Anish Sheth, MD, a gastroenterologist at Penn Medicine Princeton Health, and author of What's Your Poo Telling You?. Being constipated can also mean that your stool is dry and hard, or that it is difficult to pass. So if your bowel movements are more spaced out than usual—whatever "usual" is for you—and especially if the backup is causing you discomfort, then you are constipated.

How Is Food Digested?

To understand why constipation happens, it helps to know how poop is made. From start to finish, the process takes 24 to 72 hours.

1. The food you eat enters your stomach, where it's ground into small particles.

2. The particles move to the small intestine, where enzymes break down fats and proteins so they—along with other nutrients—can be absorbed.

3. What's left (a liquid mix of fiber, bacteria, undigested fats, and mucus from your digestive tract) moves to the large intestine. Your large intestine pulls out water from the mixture, making a more solid stool.

4. The stool passes into the rectum, at the end of your large intestine, where it becomes compacted.

5. Once your rectum reaches capacity, your brain gets a signal to release your stool. When you are ready to push, the abdominal and rectal muscles tense while the sphincter muscles relax.

Causes of Constipation

Constipation can be caused by a variety of factors. Sometimes it can be a symptom of other health conditions⁠ or diseases—this is called secondary constipation. Otherwise, you could just have constipation from your diet or lifestyle.

Your Muscles

Sometimes there's a mechanical reason why you are constipated, said Gina Sam, MD, a gastroenterologist in New York City. For example, the muscles inside your intestines may have trouble moving waste at a normal rate. The longer stool sits, the more water your large intestine absorbs. Then, your stool becomes increasingly complex and dry (and more difficult to push out). Alternatively, there could be an issue with your rectal or sphincter muscles.

Other Health Conditions

Constipation can also be a symptom of other health conditions. These include diseases that affect the nerves, like multiple sclerosis or Parkinson's; rectal issues like fissures (small tears) or hemorrhoids; irritable bowel syndrome; and cancerous growths, which can block your bowels. However, short episodes of constipation often are not caused by these conditions.

Stress

"The neurotransmitters that the brain releases when we're stressed also interact with receptors in the colon wall," said Roshini Rajapaksa, MD, Health's contributing medical editor and a gastroenterologist at NYU-Langone Medical Center. Ongoing anxiety can cause the muscles in your colon to become sluggish.

Traveling

"Maybe your diet isn't as healthy, or you're not drinking as much water as usual," Dr. Rajapaksa said. "You might be sitting still in a car or a plane instead of moving around." Changing time zones can also disrupt your bowel habits. Finally, you just might not feel comfortable using the toilet in a different environment.

Medications

If you suspect that a medication is causing your condition, talk to your healthcare provider. You can discuss what you can do to offset this side effect or ask if there's another drug that might work better for you.

Hormone Changes

Any fluctuations in hormone levels—due to your period, pregnancy, or perimenopause—can affect your bowels. "Many women who are premenstrual report episodes of constipation, and then they develop looser movements when they get their period," Dr. Sam said. Health conditions that impact your hormones, like thyroid disease or diabetes, can also lead to constipation.

Check Whether Your Poops Are Healthy or a Sign of Constipation

Take a look in the toilet and give your stool a quick check-up. Your stool's appearance can indicate whether you are constipated and how severe your constipation might be.

Color

What's normal:

Any shade of brown.

What's not: Red or black, which can indicate blood—though black stools may also be caused by Pepto Bismol, and red can sometimes occur if you eat lots of beets, Dr. Sam noted. Whitish or yellow stools could be signs that your body isn't absorbing enough nutrients from food.

Smell

What's normal:

Some odor. "The gases result from the breakdown of the foods you eat, so a smell is unavoidable," Dr. Sam said.

What's not: A super-intense foul odor. "Most of the time, a very strong smell is due to a high-fat, high-sugar diet," according to Dr. Sam, though it could also signal an infection.

Shape

What's normal:

One long sausage shape.

What's not: Persistently thin, pencil-like stools—especially if they become skinnier over time—can indicate cancerous growths inside your colon, Dr. Rajapaksa said.

Consistency

What's normal:

Soft and smooth enough to pass easily, but still compact.

What's not: Small, hard rabbit pellets mean you're probably not getting enough fiber. A mushy or liquidy consistency is a sign of inflammation, which could be caused by certain medications, food intolerance, allergies, or an infection. The Bristol stool chart shows what consistency of stools is normal.

How Can I Treat Constipation?

Getting your bowel contents moving again may seem daunting, but it doesn't have to be. Stop eating the following foods and quit these bad habits to improve your bowel movements.

Eat Fiber

Fiber can't be fully broken down by your digestive system, so it passes relatively quickly through your gut—keeping the rest of your food moving, too. Some of the best sources of fiber are fruits, vegetables, whole grains, legumes, and nuts.

Drink Water

You need plenty of fluids to flush waste out of your body and to hydrate your stools so they stay soft.

Avoid Regularly Using Laxatives

"Regularly relying on over-the-counter laxatives can mask the real cause of your constipation, whether it's a poor diet, a medication side effect, or even a serious health issue," Dr. Rajapaksa said. Repeated use can also destroy the balance of healthy bacteria in your gut, Dr. Sheth added.

Still, if you have to use a laxative, make sure to use osmotic laxatives. These are gentler on your body and do not irritate your colon. Talk to your healthcare provider before taking laxatives regularly.

Exercise Regularly

The muscles in your gastrointestinal system follow the rest of your body's lead. The more you move during the day, the more often those muscles contract, propelling waste through your digestive system.

Don't Hold in Your Stools

Delaying bowel movements can lead to a cycle of constipation, Dr. Sheth said. "Over the long term, it can actually slow down the functioning of your bowel."

Try Probiotics

These "good" bacteria in probiotics contribute to healthy gut flora and thereby improve digestion. A 2014 study in the American Journal of Clinical Nutrition suggested that taking probiotic supplements could help increase BM frequency and soften stools.

Don't Use Your Phone on the Toilet

"Even if you're not straining, sitting there for a long time puts increased pressure on your rectum," which can weaken muscles, Dr. Sheth said. If passing stools takes long enough that you need to bring your smartphone, that can be a warning sign of bad gastrointestinal health. Pushing out a poop should be a reasonably quick, effortless process.

Summary

If you think you have constipation, contact your healthcare provider. Observing your stools and lifestyle choices can help you when discussing causes and treatments for your constipation.