What are the risk factors for constipation?

From the Guidelines

Constipation is primarily caused by physiological, hormonal, and medication-related changes, as well as dietary and lifestyle factors.

Risk Factors for Constipation

The following are established risk factors for constipation:

• Hormonal changes: Increased levels of progesterone can slow GI motility, contributing to constipation, particularly in pregnant individuals 1
• Medication-related changes: Opioid use is a significant risk factor for constipation, with certain opioids inducing more constipation than others 1
• Dietary factors: Low dietary fiber intake, inadequate fluid consumption, and excessive fiber or osmotic laxative use can contribute to constipation 1
• Physiological changes: Age-related changes, such as decreased muscle tone and slower transit time in the colon, can increase the risk of constipation 1
• Lifestyle factors: Lack of regular moderate exercise, infrequent toileting, and straining during bowel movements can also contribute to constipation 1 It is essential to note that stimulant laxatives should be avoided due to conflicting safety data 1, and lifestyle modifications, such as increasing fluid intake and regular exercise, are an appropriate first step for managing constipation 1.

From the Research

Risk Factors for Constipation

The following are some of the risk factors associated with constipation:

• Demographic factors:
  • Female gender 2, 3
  • Advancing age 2, 3
• Lifestyle factors:
  • Poor diet 4, 2, 5
  • Lack of exercise 4, 2, 5
  • Insufficient physical activity 2
  • Low fluid intake 2, 5
  • Inadequate dietary fiber intake 2, 5
• Health-related factors:
  • Certain medical conditions 4, 3
  • Medications such as opioids, diuretics, antidepressants, antihistamines, antispasmodics, anticonvulsants, and aluminum antacids 4
  • Obesity 2
  • Residential location 3
  • Self-rated health 3
  • Certain surgeries 3
• Other factors:
  • Dehydration or hypohydration 5
  • Fluid restriction 5

Medications Associated with Constipation

Certain medications have been found to be associated with an increased risk of constipation, including:

• Opioids (OR = 1.6, population attributable risk [PAR] = 2.6%) 4
• Diuretics (OR = 1.7, PAR = 5.6%) 4
• Antidepressants (OR = 1.9, PAR = 8.2%) 4
• Antihistamines (OR = 1.8, PAR = 9.2%) 4
• Antispasmodics (OR = 3.3, PAR = 11.6%) 4
• Anticonvulsants (OR = 2.8, PAR = 2.5%) 4
• Aluminum antacids (OR = 1.7, PAR = 3.0%) 4

Prevention and Management

Maintaining a healthy lifestyle, including a balanced diet, regular physical activity, and adequate fluid intake, can help prevent constipation 4, 2, 5. Additionally, managing underlying medical conditions and avoiding certain medications can also help reduce the risk of constipation 4, 3.