For some of us, our morning cup of coffee transitions seamlessly to our daily defecations. But if you’re struggling to poop, evacuating your bowels can remain elusive, achieved only through a studied regimen of straining, grunting, and camping out on the john.
There’s no “right” number of bowel movements you should have a week, but if you’re producing fewer than three, you might be constipated, says Dr Ron Schey, an associate professor of medicine in the gastroenterology department at Temple School of Medicine.
Along with the inability to dump, you may also experience hard, dry, stools, bloating, lower abdominal pain, and even increased risk of hemorrhoids or anal fissures—painful tears that occur in the lining of the lower rectum.
Most of the time, there’s no known cause for constipation. But there are some factors that may be responsible for clogging up your colon—check out the 10 reasons why you can’t poop.
1. Resisting the urge to go
When you’re in wall-to-wall meetings all day, you can’t always fit in some toilet time when the urge to drop a deuce hits. But frequently putting the brakes on that impulse can actually worsen constipation, says Dr Gregory Thorkelson, of the UPMC Digestive Disorders Center.
When the last part of your intestines fills up with stool, they send a message to the brain that it’s time to go to the bathroom. If you don’t send the stool out, the gut continues to draw fluid out of it for as long as it remains there. That makes the stool harder and dryer, which can make it more difficult to pass when you finally get some throne time. Going when necessary will prevent you from struggling to poop later in the day.
2. Calcium supplements
Taking too much calcium can slow down your gut motility, or the movement of food through your digestive system, says Dr. Schey. If the transit is too slow, that means the stool is hanging around too long, giving your gut more opportunity to suck fluid out if it. This makes the stool hard, dry, and difficult to pass.
Guys should aim to get their 1,000 mg a day of calcium through foods like cheese, milk, yogurt, sardines, or fortified whole grains. But if you must take a supplement, take calcium citrate instead of calcium carbonate—the latter is more concentrated, so it can end up affecting your motility even more, says Dr. Schey.
3. Iron Supplements
Like calcium, taking in too much iron supplements can make it hard to go. That’s because high concentrations of iron can slow down your colon’s motility, says Dr. Schey.
Guys should take in 8 mg of iron a day, and most do a good job getting all they need from their diets (think lean meats, seafood, spinach, and beans). In fact, if you’re coming up as iron deficient in your lab work, that’s not something for which you should just blindly pop pills.
“Iron deficiency anaemia in a man really requires an evaluation,” he says. It can signal gastrointestinal bleeding, so it’s important your doc is on the case.
4. Pelvic Floor Dyssynergia
To successfully evacuate your bowels, you must contract your abdominal muscles while relaxing your pelvic floor muscles, says Dr Spencer Dorn, of the UNC Center for Functional GI & Motility Disorders. But people with pelvic floor dyssnergia can’t successfully coordinate these activities—they either don’t generate enough abdominal force or they fail to relax their pelvis enough.
You end up straining your anal sphincter—which opens to discharge your waste—instead of relaxing it, says Dr. Schey. As a result, the stool can’t pass adequately.
Most guys who have this don’t even know they’re pooping wrong, says Dr. Schey. If you haven’t responded to other treatments of constipation, you might want to get checked for this. Tests include something called an anorectal manometry, which evaluates your bowel function.
Your doctor can also look for it during a regular rectal exam. You’ll be asked to bear down, as if you were trying to pass a bowel movement. If you have the condition, your doc will be able to feel you squeeze those muscles instead of relaxing them, says Dr. Schey.
Nearly 1 in 3 diabetics suffer from constipation, a 2014 study from Brazil found. So how exactly does spiking blood sugar relate to stopped-up stool?
Over time, people with diabetes develop nerve damage throughout their bodies. And when this nerve damage affects the gut, you can experience slow transit time in your intestines, as well as problems with rectal sensation, says Dr. Schey. As a result, you may find yourself struggling to poop.
6. High fat / low fiber diet
There may be at least a little truth to those anecdotes that eating cheese can stop you up for days. But that may be more due to its high fat/no fiber composition than anything else.
“We know that fat could decrease gut motility, and if you add to that a low fiber diet, you could probably continue more with these constipation symptoms,” says Dr. Schey.
Fiber is important because it takes out some of the struggle of trying to go. That’s because it draws water into the gastrointestinal tract, which bulks up the stool and make it easier to evacuate, says Dr. Dorn.
7. Laxative dependence
Taking a laxative to move things along every once and awhile isn’t a problem, but people who habitually pop large doses of stimulant laxatives—which trigger contractions of the muscles in your intestines so stool can pass—can actually become dependent on them to go, says Dr. Schey.
So they continue increasing their doses to feel the effects, and as a result, their intestines may become desensitized and stop working properly when they don’t use them. And that, of course, can leave them struggling to poop.
Feeling the blues can be a punch to your gut—33 percent of patients with constipation screened positive for depression, a study from Iran found. It’s possible that depression literally slows down processes in your body, which may include that transit time in your intestines, says Dr. Thorkelson.
But it’s probably more likely that depression impacts your lifestyle in ways that could clog up your colon. For instance, you may find yourself eating differently, choosing less healthy, less fibrous foods, sleeping on erratic schedules, or even feeling too unmotivated to trek to the toilet when the urge to go strikes, he says. And all that can result in you struggling to poop.
Not only is depression linked to constipation, but the very meds used to treat it might be causing their own delay in dropping a deuce. That’s likely due to their anticholinergic properties—especially in the older groups of meds called tricyclic antidepressants, says Dr. Thorkelson.
Anticholinergic meds block the neurotransmitter acetylcholine from binding to its receptors. And that’s a problem for your belly, since acetylcholine is involved in the contraction of your gut as it moves food down your intestines. So if your gut is not squeezing as much as it should, your food is staying trapped in there longer—leaving you unable to expel it as stool.
10. Opioid painkillers
Approximately 50 percent of patients who use opioid pain relievers suffer from some form of constipation, says Dr. Dorn. That’s because these prescription meds affect the gut in a number of ways.
First, opioids reduce something called forward peristalsis, a series of automatic muscle contractions that push food through your digestive system. Motility slows down, leading to more absorption of water and fluid from the stool.
Opioids also hamper the secretions of fluids into the gastrointestinal tract. “The combination of reduced gastrointestinal motility and reduced secretion of fluid results in a harder stool that is more difficult to expel,” he says.