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Chronic Constipation

Chronic constipation is a common gastrointestinal issue characterised by infrequent bowel movements and difficulty passing stools.

It is considered chronic when the symptoms persist for an extended period, typically three months or longer. While occasional constipation is normal and can be caused by factors like diet or travel, chronic constipation often requires attention and management to improve bowel function.



  • Low Fiber Diet: Not consuming enough fiber in the diet can lead to harder stools and difficulty passing them.

  • Inadequate Fluid Intake: Dehydration can make stools dry and difficult to pass.

  • Food Sentivities: Food sensitivities are adverse reactions to certain foods that are not caused by the immune system, unlike food allergies. Instead, food sensitivities can trigger various symptoms, including gastrointestinal issues like constipation, bloating, gas, and abdominal discomfort.

  • Gut Microbiome Imbalance: The complex community of microorganisms living in the digestive tract. When the balance of beneficial and harmful bacteria is disrupted, it can have various effects on gastrointestinal health, including constipation.

  • Hypothyroidism: An underactive thyroid gland can lead to changes in the gastrointestinal system, including slowed gut motility, which can result in constipation.

  • Lack of Physical Activity: A sedentary lifestyle can slow down bowel movements.

  • Medications: Certain medications, such as opioids, antacids with calcium or aluminum, and some antidepressants, can contribute to constipation.

  • Hormonal Imbalances: Hormonal changes, especially in women during pregnancy or menopause, can affect bowel movements.

  • Intestinal Conditions: Conditions like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or intestinal obstruction can cause chronic constipation.

  • Neurological Disorders: Some neurological conditions can affect the nerves that control bowel movements.

  • Impaired Vagal Activity: The vagus nerve plays a crucial role in regulating various bodily functions, including gastrointestinal motility and digestion.

  • Psychological Factors: Stress and anxiety can influence bowel function.

  • Ignoring the Urge: Ignoring the natural urge to have a bowel movement can lead to constipation over time.


Chronic constipation, if left untreated or inadequately managed, can lead to various long-term effects and complications that can negatively impact an individual's overall health and well-being. Some of the potential long-term effects of chronic constipation include:

  • Toxin Overload: and Hormonal Imbalance When stool remains in the colon for an extended period due to chronic constipation, it can lead to reabsorption of some waste products, including certain metabolic byproducts, toxins and hormones, back into the bloodstream. The longer stool stays in the colon, the more time these substances and hormones have to be reabsorbed.


  • Large Intestinal Bacterial Overgrowth (LIBO): LIBO is a less common condition in which there is an abnormal increase in the number of bacteria in the large intestine (colon). Like SIBO, LIBO can also result in symptoms such as bloating, gas, and changes in bowel habits, including constipation.

  • Hemorrhoids: Straining during bowel movements, which is common in chronic constipation, can lead to the development of hemorrhoids, which are swollen and inflamed veins around the anus or lower rectum.

  • Anal Fissures: Chronic constipation can cause small tears in the lining of the anus, known as anal fissures, which can be painful and may lead to bleeding.

  • Rectal Prolapse: In severe and prolonged cases of chronic constipation, the rectum may protrude from the anus, known as rectal prolapse.

  • Fecal Impaction: Chronic constipation can lead to the formation of hard, dry stool that becomes difficult to pass. This can result in fecal impaction, where the stool becomes lodged in the rectum, making it extremely challenging to have a bowel movement.

  • Bowel Obstruction: In some cases, chronic constipation can lead to a partial or complete blockage of the intestines, known as a bowel obstruction, which requires immediate medical attention.

  • Increased Risk of Diverticular Disease: Chronic constipation is associated with an increased risk of diverticular disease, where small pouches (diverticula) form in the colon and may become inflamed or infected.

  • Nutritional Deficiencies: Chronic constipation may lead to poor absorption of nutrients in the intestines, potentially resulting in nutritional deficiencies over time.

  • Impact on Quality of Life: Chronic constipation can significantly impact an individual's quality of life, leading to discomfort, pain, anxiety, and reduced social activities.

  • Impaired Bowel Function: Long-term constipation can affect the natural reflexes and muscle coordination involved in bowel movements, leading to a cycle of ongoing constipation.

  • Impact on Mental Health: Chronic constipation can cause frustration, stress, and embarrassment, affecting a person's mental well-being and potentially leading to depression or anxiety.

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Chronic Constipation & SIBO

Chronic constipation and Small Intestinal Bacterial Overgrowth (SIBO) can be connected, especially in certain cases. SIBO is a condition where there is an overgrowth of bacteria in the small intestine, which can lead to various gastrointestinal symptoms, including constipation.

The relationship between chronic constipation and SIBO can be explained in the following ways:


  • Motility Issues: SIBO can disrupt the normal movement of the intestines, which is known as gut motility. When the motility is affected, it can slow down the transit of stool through the intestines, leading to constipation.

  • Bacterial Fermentation: In SIBO, the excessive bacteria in the small intestine can ferment carbohydrates and produce gas. The gas production can cause bloating and discomfort, which may contribute to a sensation of constipation.

  • Intestinal Inflammation: SIBO can trigger inflammation in the small intestine, which may affect the overall function of the digestive system, including bowel movements.

  • Nutrient Absorption: SIBO can interfere with nutrient absorption in the small intestine, and this can affect the muscle contractions that propel stool through the intestines.



It's important to note that not everyone with SIBO will experience constipation, as individual responses can vary. Some people may have diarrhea or a combination of both diarrhea and constipation.

If you suspect you have chronic constipation and SIBO or are experiencing persistent gastrointestinal symptoms, get in touch with us. 

We can perform the necessary test, which involves a breath test to investigate for SIBO and support you accordingly.


How We Can Help You

Our approach to chronic constipation involves a comprehensive and individualised assessment of the individual's health and lifestyle to identify the root causes of the condition.

The goal is to address these underlying factors rather than merely treating the symptoms.

Here are the key principles and steps involved in our approach to chronic constipation:

  • Thorough Intake History: We take a detailed history, including past and current health issues, medications, diet, lifestyle habits, stress levels, and any other relevant information.

  • Lifestyle Assessment: We assess the individual's lifestyle factors, including sleep patterns, physical activity, and stress management. These aspects play a significant role in overall digestive health.

  • Diet Analysis: We evaluate the diet to identify potential trigger foods, nutrient deficiencies, and dietary patterns that may contribute to constipation.

  • Gut Health Evaluation: This may include tests to assess gut microbiota balance, gut inflammation, intestinal permeability (leaky gut), and any potential infections or imbalances.

  • Nutritional Assessment: We evaluate the individual's nutrient status, as deficiencies in certain nutrients can impact gut function and contribute to constipation.

  • Hormonal Evaluation: Hormonal imbalances, such as thyroid dysfunction or hormonal imbalance, can influence bowel movements and may be investigated.

  • Identification of Triggers: We work with the individual to identify potential triggers, such as food sensitivities or intolerances, that may be contributing to constipation.

  • Personalised Treatment Plan: Based on the findings, a personalised treatment plan will be created to address the underlying imbalances. This may involve dietary changes, nutritional supplementation, lifestyle modifications, and possibly stress reduction techniques.

  • Elimination Diet: In some cases, an elimination diet may be recommended to identify and remove potential food triggers that could be contributing to constipation.

  • Regular Follow-up: Functional medicine is often an ongoing process, and follow-up appointments are essential to monitor progress, make adjustments to the treatment plan if necessary, and support the individual on their healing journey.

  • Addressing Underlying Conditions: We work with the individual  to identify and address any underlying medical conditions or factors that may be contributing to constipation.

Our approach to chronic constipation considers the interconnectedness of various bodily systems and aims to provide personalizsed care to address the unique needs of each patient.

By focusing on root causes and promoting overall health and well-being, functional medicine can offer a comprehensive and effective approach to managing chronic constipation.


If you are experiencing chronic constipation, get in touch with us. We can help you identify the underlying causes and provide a comprehensive and individualised treatment plan to support your gut health and overall well-being.

"Good gut health is the foundation of

overall well-being."

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