Stop Band-Aid Solutions: Uncovering the 13 Hidden Root Causes of Your Chronic Constipation

By Leah Barack, Gut Health Expert & Functional Nutritionist

If you’ve ever sat on the toilet for what feels like forever, struggled with small, hard stools, or gone days (sometimes even a week) without a bowel movement—you know the frustration of chronic constipation.

As a functional gut health nutritionist, I help women eliminate constipation and bloating for good. Constipation is one of the most common yet rarely talked-about digestive problems I see. And while the standard advice is “drink more water” or “eat more fiber,” the truth is: long-term constipation almost always has deeper root causes.

The secret to achieving easy, daily bowel movements isn’t another quick-fix laxative. It’s identifying and addressing what’s actually slowing your digestion. For most people, it’s not just one cause—many of my clients are dealing with 3–4 root causes at the same time.

In this blog post you’ll learn the 13 most common root causes of constipation—and the functional nutrition strategies that can help.

Discover the hidden root causes of constipation.

Why It’s Important to Find the Root Cause of Constipation

Constipation isn’t just uncomfortable—it can affect your energy, mood, hormones, and overall gut health. When stool sits too long in the colon, toxins can be reabsorbed into the bloodstream, methane gas can worsen bloating, and the whole digestive process slows down.

That’s why finding the “why” behind your constipation is key. Let’s break down the hidden causes into three main categories:

• Digestive mechanics (what’s happening in your stomach, pancreas, and microbiome)

• Lifestyle & systemic factors (stress, hormones, thyroid, hydration, routine)

• Hidden roadblocks (medications, structural issues, inactivity)

The 13 Hidden Root Causes of Constipation

1. Low Stomach Acid

Your stomach needs to be highly acidic to break down food properly and trigger digestive “dominoes” downstream (like bile release and enzyme production). Without enough acid, digestion slows, food lingers, and methane-producing microbes worsen constipation.

What helps: Eat slowly, chew thoroughly, and avoid drinking lots of liquid with meals. Try digestive bitters or a splash of apple cider vinegar before meals to naturally encourage stomach acid production.

⚠️ Only supplement with HCl under the guidance of a practitioner, especially if ulcers or H. pylori are possible.

2. Low Pancreatic Enzyme Output

Your pancreas makes enzymes to break down fats, proteins, and carbs. When output is low, food doesn’t digest well, which slows motility. Stress, nutrient deficiencies, or weak signaling from low stomach acid are common culprits.

What helps: Prioritize stomach acid support first. Eat in a relaxed state, not while rushing or stressed. Digestive enzyme supplements can offer temporary relief while working on the underlying cause.

3. Gut Dysbiosis (Imbalanced Microbiome)

Your gut bacteria play a huge role in motility. Too few beneficial microbes—or too many “bad” ones like parasites, yeast, or overgrowths—can slow things down.

What helps: Aim for a diverse diet of at least 30 different plant foods weekly. Load up on polyphenol-rich foods like berries, dark chocolate, and green tea. Functional stool testing can reveal imbalances so you can target them more precisely.

4. Stress & Nervous System Dysregulation

When you’re stressed, your body enters “fight-or-flight” mode, diverting blood away from digestion. Stomach acid drops, enzymes slow, and constipation follows. It’s one of the biggest reasons people get backed up during travel, deadlines, or major life stressors.

What helps: Try deep breathing, gentle yoga, or short outdoor breaks. Stimulating the vagus nerve with humming, gargling, or singing helps switch your body back into “rest-and-digest” mode.

5. Lack of Rhythm or Routine

Your bowels thrive on consistency. If you’re constantly changing your schedule—late nights, skipped meals, or irregular mornings—your digestion can lose its natural rhythm.

What helps: Anchor your mornings with a simple routine. Go to bed and wake up at consistent times, eat meals regularly, and give your body cues that it’s safe and ready to eliminate.

6. Not Enough Fiber (With Caveats)

Fiber is essential—it bulks up stool and feeds your good gut bacteria. But if motility is already sluggish, adding too much fiber too fast can backfire, leaving you even more bloated and constipated.

What helps: Increase fiber gradually and pair it with plenty of water. Aim for a balance of soluble fiber (softens stool) and insoluble fiber (adds bulk).

7. Dehydration

Water is what makes stool soft and easy to pass. Without enough, things dry up and slow down.

What helps: A good rule of thumb is to drink about half your body weight in ounces daily. Sip throughout the day instead of chugging all at once.

8. Low Mineral Status

Magnesium and potassium are critical for motility. Potassium powers peristalsis (the wave-like contractions that move stool), while magnesium helps relax the intestines or draw water into them (depending on the type).

What helps: Eat potassium-rich foods like potatoes, bananas, and avocados. Boost magnesium with nuts, seeds, legumes, and dark chocolate.

9. Hypothyroidism (Low Thyroid Function)

Your thyroid is your body’s “metabolic thermostat.” When it runs low, everything slows—including digestion. Other signs include feeling cold, thinning hair, fatigue, or weight gain.

What helps: Ask for a full thyroid panel (not just TSH) and work with someone who knows how to look at optimal—not just conventional—ranges. Support thyroid health with stress management, balanced nutrition, and adequate rest.

10. Hormonal Imbalances

Hormonal shifts can directly affect motility. For example, progesterone slows digestion in the second half of the menstrual cycle and during pregnancy.

What helps: Focus on a hormone-supportive lifestyle: balanced blood sugar, enough protein, stress reduction, and reducing exposure to hormone-disrupting chemicals (like plastics).

11. Medications

Many common medications list constipation as a side effect: opioids, antidepressants, antihistamines, iron supplements, calcium, and antacids with calcium or aluminum.

What helps: Never stop medication without your doctor’s guidance, but do ask about alternatives or strategies to offset side effects.

12. Structural or Mechanical Issues

Sometimes constipation isn’t about food, hormones, or stress—it’s a physical roadblock. Pelvic floor dysfunction, scar tissue, or rectoceles can all make elimination difficult.

What helps: Pelvic floor therapy can be life-changing. Many clients see the best results when combining pelvic floor work with nutritional and motility support.

13. Sedentary Lifestyle

Your intestines need movement to move. Sitting for long stretches slows things down, while physical activity encourages the gut muscles to contract.

What helps: You don’t need to run marathons—daily walks, yoga, or even gentle stretching with twists can stimulate digestion.

Final Thoughts: Stop Band-Aid Fixes, Start Root Cause Healing

If you’ve been constipated for years, you know by now that drinking more water or eating more fiber isn’t the full solution. Real healing comes from identifying your unique combination of root causes and addressing them step by step.

You don’t have to figure it out alone. Working with a practitioner who specializes in gut health and constipation can save you years of frustration and help you finally feel comfortable and confident in your body.

👉 Ready to stop chasing quick fixes and uncover your root causes? Book a free fit call with me here