Hard to Diagnose Causes of Constipation: Stress, Shame, and Embodied Trauma 

Constipation is a common digestive issue, but there are many potential causes. The easy to find causes get checked because, well…  they’re easy to check. The hard to find causes can plague people for decades due to healthcare access, cost, and a lack of understanding in the medical-insurance complex. It took me years of experimenting after I had already given up on a solution from the medical  profession. This is not a criticism of my doctors. They have saved my ass at other times and are doing the best they can within a broken system. *JUMPS DOWN FROM SOAPBOX*

Why is constipation hard for doctors to diagnose?

Constipation can sometimes be challenging for doctors to diagnose because it is a symptom rather than a specific disease or condition. There are numerous potential causes of constipation, and they can vary widely among individuals. The most difficult factors contributing to constipation include psychological and emotional causes: Stress, anxiety, trauma, and depression can have an impact on bowel function and contribute to constipation. These factors are not discovered on MRIs, during a colonoscopy, via motility tests, in blood tests, or on XRays. It takes time, which doctors don’t have, and personal awareness, which you are gaining by educating yourself. Good job!

Since constipation can result from a combination of factors, the diagnostic process and treatment require a multidisciplinary approach. In my case, this included my primary care physician, a gastroenterologist, a chiropractor, a physiologist, a therapist, and several “alternative” healthcare practitioners.

Constipation can be caused by stress, shame, and trauma

Stress can have a profound effect on your bodily functions, including digestion/elimination. During periods of high stress, your body's fight-or-flight response is activated, which can slow down or disrupt digestive processes. This response can cause the muscles in your intestines to tighten and contract irregularly, ultimately leading to constipation. Constant background stress can “feel normal” if you have gotten used to it, but this results in the same dysregulation of your poop cycle. I had normalized my chronic stress, and spent too much time in fight-or-flight mode. The opposite mode is rest-and-digest. 

Feelings of shame can negatively impact your bodily awareness and the natural rhythms of digestion. When you're engulfed by shame, it's possible to become disconnected from your body's needs, including the urge to go to the bathroom, thereby contributing to constipation. From years of working retail, conditioning from school, and other circumstances, I had dissociated from my bowel urge response, and was unconsciously  “holding it in” until there was a safe time to poop.

Embodied trauma - the physical holding of past traumatic experiences within the body - also plays a role in constipation. Trauma can alter the way your body senses and responds to internal signals, including those related to bowel movements. The tension and unresolved stress associated with trauma can cause chronic disruption in the gut, manifesting as constipation. I could rub my belly and feel hard spots of tense muscle in my gut. Just like shoulder tension can cause a headache, my gut tension was contributing to a poop blockage. Understanding these emotional and psychological factors is essential for recognizing and addressing the full scope of causes behind constipation.

Key Takeaways

• Stress disrupts normal digestive processes, potentially leading to constipation.
• Feelings of shame can cause disconnection from bodily needs and contribute to a painful gut.
• Embodied trauma can alter bodily responses and lead to chronic gut disruption.