Constipation Despite a Healthy Lifestyle: Causes and Solutions

Normal lifestyle but still experiencing constipation?

Hello Doctor, in the past, my bowel movements were very regular, but this year I have occasionally experienced constipation, sometimes not being able to have a bowel movement for more than three days.
Generally, my daily routine is very normal; I go to bed early and wake up early (getting up at 5 AM and going to bed at 10 PM), I eat a healthy diet (currently following a meal plan arranged by a nutritionist), I exercise regularly (going to the gym three times a week for about an hour each time, and walking for 30 minutes during lunch breaks on weekdays), and I drink plenty of water (definitely over 2000 cc daily).
However, I still experience constipation, which has become severe enough to cause hemorrhoids, resulting in significant pain.
I have tried many methods to relieve constipation, including taking probiotics, eating bananas, drinking olive oil, consuming dried black dates, using plum extract, and massaging my abdomen, but none have been effective.
What could be the problem? I am truly suffering and really want to return to the days of having regular daily bowel movements.

Angela, 20~29 year old female. Ask Date: 2019/01/18

Dr. Chen Qifeng reply Gastroenterology and Hepatology

It is advisable to rule out any structural abnormalities of the intestines, and then focus on dietary and lifestyle modifications.
If there is no history of abdominal surgery or other medication use, appropriate treatment with medications such as stool softeners should be considered.

Reply Date: 2019/01/18

More Info

Constipation can be a frustrating and painful condition, especially when you are already leading a healthy lifestyle. Despite your efforts in maintaining a balanced diet, regular exercise, and adequate hydration, you are still experiencing episodes of constipation. This situation can be perplexing, but it’s essential to understand that constipation can have various underlying causes, even in individuals who appear to be living healthily.

Potential Causes of Constipation
1. Dietary Fiber: While you mentioned that you are following a nutritionist's plan, it’s crucial to ensure that your diet is rich in dietary fiber. Fiber helps to bulk up stool and promotes regular bowel movements. The recommended daily intake of fiber is about 25 grams for women and 38 grams for men. If your diet lacks sufficient fiber, it could contribute to constipation.

2. Hydration: Although you are drinking more than 2000 cc of water daily, it’s important to consider the balance of electrolytes in your body. Sometimes, dehydration can occur even with adequate fluid intake if your electrolytes, particularly sodium and potassium, are imbalanced. This can affect bowel function.

3. Physical Activity: Regular exercise is beneficial for digestive health. However, if your workouts are primarily strength training, you might want to incorporate more aerobic activities, such as walking, jogging, or cycling, which can stimulate bowel movements.

4. Stress and Anxiety: Psychological factors can significantly impact bowel function. Stress and anxiety can lead to changes in gut motility, potentially causing constipation. If you have been experiencing increased stress, it might be worth exploring relaxation techniques, such as yoga or meditation.

5. Medications: Certain medications can lead to constipation as a side effect. If you are taking any medications, it’s worth discussing with your healthcare provider to see if they could be contributing to your symptoms.

6. Underlying Health Conditions: Conditions such as hypothyroidism, diabetes, or irritable bowel syndrome (IBS) can also lead to constipation. If your symptoms persist, it may be beneficial to consult with a healthcare professional for further evaluation.

Solutions and Recommendations
1. Increase Fiber Intake: Aim to include a variety of fiber-rich foods in your diet, such as fruits (berries, apples), vegetables (broccoli, carrots), whole grains (oats, quinoa), and legumes (beans, lentils). Gradually increase your fiber intake to avoid bloating.

2. Hydration Check: Ensure that you are not only drinking enough water but also consuming foods with high water content, such as fruits and vegetables. Consider electrolyte-rich drinks if you suspect an imbalance.

3. Regular Physical Activity: Incorporate more aerobic exercises into your routine. Activities like brisk walking, cycling, or swimming can help stimulate bowel movements.

4. Stress Management: Engage in stress-reducing activities. Techniques such as mindfulness, deep breathing exercises, or even talking to a therapist can help alleviate anxiety that may be affecting your digestive health.

5. Review Medications: Consult with your doctor to review any medications you are taking to determine if they may be contributing to your constipation.

6. Probiotics: While you have tried various methods, consider discussing with your healthcare provider the possibility of a specific probiotic strain that may help with gut health.

7. Consult a Specialist: If your constipation persists despite these measures, it may be beneficial to consult a gastroenterologist. They can perform tests to rule out any underlying conditions and provide tailored treatment options.

In conclusion, while it’s commendable that you are maintaining a healthy lifestyle, constipation can still occur due to various factors. By addressing dietary habits, hydration, physical activity, stress levels, and potential underlying health issues, you can work towards alleviating your symptoms and restoring regular bowel function. Remember, it’s essential to be patient and persistent in finding the right combination of strategies that work for you.

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