Can Lifestyle Factors Cause Constipation?
Constipation is one of the most common digestive complaints, and for many people the cause lies in everyday habits — diet, physical activity, sleep, stress, and how the urge to defecate is managed. 1-3
Can lack of sleep cause constipation?
Colonic motility follows a circadian rhythm, with colonic activity suppressed when asleep in healthy individuals. Insufficient or disrupted sleep interferes with this pattern leading to increased colonic motility and contractions in sleep periods. 1 A clinical study in patients with functional constipation found sleep deficiency was associated with significantly worse symptoms, impaired anorectal function, and autonomic dysfunction compared with patients who slept adequately. 4 Poor sleep also amplifies visceral hypersensitivity. 4
Can my daily habits be making my constipation worse?
Yes — several modifiable habits can worsen constipation. 2
Ignoring the urge to defecate. Habitually deferring the urge can raise the rectal sensory threshold; rectal hyposensitivity has been observed in approximately 25% of patients with intractable functional constipation. 3,5
Not moving enough. A systematic review of cohort studies found moderate-to-high physical activity was associated with reduced constipation risk (relative risk 0.69 for high versus low activity). 2
Eating a low-fibre diet. Fibre adds bulk and increases frequency. The recommended intake is 25g daily for women and 38 g daily for men, which most adults do not reach. 5 Not drinking enough fluid. Fibre requires water to work effectively, and adequate fluid intake remains a standard recommendation alongside fibre. 5
Stress. Psychological stress, anxiety, and depression are each associated with increased constipation risk in studies. 6-8
Who is at higher risk?
Risk is highest where several factors combine: low physical activity; a low-fibre diet; insufficient sleep; chronic stress, anxiety, or depression; older age, where reduced activity, polypharmacy, and comorbidities tend to coincide; and female sex, with women reporting constipation more often than men in population studies. 1-6,9 Chronic constipation is almost always multifactorial, and most of these factors are modifiable. 6
Can constipation be a side effect of a medication I am taking?
Yes — drug-induced constipation is estimated to account for approximately 11% of all treated constipation cases. 10
Opioid analgesics are the most potent cause. Tolerance does not develop to the constipating effect, so the problem persists for the duration of treatment, and opioid-induced constipation affects up to 60% of patients with chronic non-cancer pain and over 80% of those with cancer pain. 11 Anticholinergic drugs — including some bladder medicines, antispasmodics, skeletal muscle relaxants and antidepressants— are also commonly implicated; a systematic review across studies including over 207,000 patients confirmed an association between anticholinergic burden and constipation. 12 A pharmacovigilance analysis of over 50 million adverse drug events from the United States Food and Drug Administration (FDA) Adverse Event Reporting System database reports identified the top 30 drugs associated with constipation. 10
Never stop a prescribed medicine without first speaking to the prescriber.
What you can do
Increase fibre gradually toward approximately 25g daily for women and 38 g daily for men, with adequate fluid to support its effect. 5 Regular physical activity, even gentle walking, helps stimulate colonic contractions. 2 Respond promptly to the urge to defecate to preserve normal rectal sensitivity. 3
If lifestyle changes are insufficient, a pharmacist or doctor can advise on whether a laxative such as lactulose (an osmotic laxative that draws water into the bowel to soften stool), bulk-forming laxatives, stimulant laxatives or newer agents. 2,3,9 If you suspect a medicine is contributing, raise this with the prescribing doctor before making changes. 10
Conclusion
Low fibre intake, physical inactivity, inadequate sleep, urge suppression, and psychological stress are each independently associated with constipation risk and frequently occur together. 2,3,5,7 Drug-induced constipation is also significant, particularly with opioids and anticholinergic medicines. 11,12 Most lifestyle-related constipation is addressable through gradual, targeted changes. 5
FAQ
Yes — sleep deprivation disrupts the circadian rhythms that govern gut motility, 1 and clinical studies show sleep deficiency is associated with worse symptoms and impaired anorectal function in patients with functional constipation. 1,4
Yes. Habitually ignoring the urge to defecate, physical inactivity, a low-fibre diet with insufficient fluids, and high stress can all worsen constipation. 5,8 These factors are often cumulative.
A lifestyle characterised by low physical activity, low fibre intake, poor sleep, and high psychological stress carries a significantly elevated risk. 4,5,8 Female sex and older age also increase the likelihood. 6,10 Most of these factors are modifiable. 5
Chronic constipation is almost always multifactorial. The most commonly identified contributors are insufficient dietary fibre, physical inactivity, and — particularly in older adults — medication use. 9,10 Habitual urge suppression and underlying health conditions are also frequently implicated. 3,9
Yes — drug-induced constipation is estimated to account for approximately 11% of all treated cases. 10 Opioids affect up to 60% of patients with chronic non-cancer pain, with the effect persisting for the duration of treatment. 11 Anticholinergic drugs and certain antidepressants are also commonly implicated. 12 Speak with your prescribing doctor or pharmacist before making any changes.
This article was written with the assistance of generative AI technology and reviewed for accuracy.
