Trying to “Go” but Can’t? Here Are 6 Types of Constipation That Could Be the Culprit

Constipation is more than just "trouble going"—it's a common digestive issue where bowel movements feel infrequent, difficult to pass, or incomplete. Because a variety of symptoms can result from constipation, it stands to reason that not all constipation is the same. In fact, there are several unique types of constipation—all with different causes and treatments.

If one of your goals this year is to prioritize your gut health, figuring out the type of constipation that you are dealing with is a great way to start. To help unpack the different types and what might be causing them, we spoke with a gut health dietitian and gastroenterologist. Read on to hear their advice—especially on how to get your gut moving again.

6 types of constipation and how to treat them

Before this article, you might not have even known that different types of constipation exist—but they do! In medicine, the subtypes are broken down by a checklist called the ROME IV criteria, which healthcare providers use to determine whether people have a disorder relating to the gut-brain connection, such as irritable bowel syndrome (IBS). Conditions like IBS are tricky to diagnose because scans and tests (such as endoscopies or colonoscopies) don't show that anything is wrong with the gastrointestinal tract. This is where criteria like the ROME IV checklist help; it goes over the very real symptoms that people with these gut disorders experience.

According to the ROME IV criteria, there are four main types of constipation, which include:

• Functional constipation: What we typically think of when we talk about constipation (infrequent, hard stools).
• Irritable bowel syndrome—constipation subtype (IBS-C): Where constipation is present with pain as a predominant feature.
• Medication-induced constipation: Constipation induced by medications such as opioids (a class of drugs that slow the bowels down).
• Constipation caused by defecation disorders¹: Constipation caused by the dyscoordination of muscles needed to have a proper bowel movement.

However, Andrea Hardy, RD, a registered dietitian, gut health expert, and author of Backed Up—The Ultimate Guide to Overcoming Constipation, adds that there are two other types of constipation worth considering, which include:

• Slow transit constipation²: Constipation caused by slow movement of food and stool through the intestines.
• Constipation caused by inadequate energy intake: Constipation caused by not eating enough food, which yes, can 100 percent happen.

Curious to know which type you have? We've broken down the most common symptoms of each to help you figure it out.

1. Functional Constipation

"Functional constipation is constipation to which we don't actually have an explanation," says Hardy. She notes that while a low-fiber diet and lifestyle factors (like not getting daily exercise) can cause it, some people's bowels are inherently slower, which leads to constipation symptoms like straining, hard and lumpy stools, a feeling of incomplete evacuation, or blockage of the bowels.

How to treat it

"With all types of constipation, but especially functional constipation, I like to start with eating more fiber, incorporating a "constipation superfood" (more on that later), and adding a fiber supplement," says Hardy. She adds that while these strategies give you the most bang for your buck, some people need to layer on other strategies.

Sarah Robbins, MD, a gastroenterologist and gut health expert and consultant, says one additional strategy is using osmotic laxatives (i.e., laxative medications that draw water into the bowels) such as polyethylene glycol (PEG 3350), which is sold under the brand name MiraLax.

If this does not work, Dr. Robbins notes that providers may prescribe other types of medication like linaclotide (a medication for IBS-C that draws fluid to the bowels) or prucalopride (a chronic constipation medication that stimulates the muscles in your gut to get poop moving more efficiently) may be necessary.

2. IBS-C

Irritable bowel syndrome—constipation subtype, also known as IBS-C, is when constipation and pain are the predominant symptoms of your IBS, says Hardy. "IBS is considered a diagnosis of gut-brain interaction," she explains. Our gut and brain are highly connected through our nervous system. "In IBS, how we regulate and sense digestion via our nervous system is not working as it should," she notes.

Hardy notes that there are many reasons for this, but the dysregulation can lead to the perception of pain—especially if your gut is full of stool, which is essentially what happens when your intestines are backed up since stool hasn't moved as it normally should.

How to treat it

Hardy says IBS-C is treated similarly to functional constipation, but another avenue to consider is trying the low-FODMAP diet. This specialized diet, which involves reducing the amount of gas-producing foods you consume (think: beans and broccoli), has been proven effective for managing IBS-related pain³ in recent studies. Another option for managing IBS-C pain is to use medications that specifically work to reduce pain perception in the gut alongside resolving constipation, says Hardy.

Dr. Robbins adds that taking a daily probiotic can help some people with IBS-C, while other people might benefit from things like talk therapy, as stress⁴ can be a huge trigger for IBS symptoms. This is why dealing with stress—through therapy or things like meditation and exercise—may help improve your gut health.

3. Medication-induced constipation

Medication-induced constipation is exactly how it sounds—constipation caused by medications that slow the bowels down, such as opioids, anticholinergics (drugs that can help relax muscles in diseases like Parkinson's disease or calm an overactive bladder), or calcium channel blockers (medications used to lower blood pressure), says Dr. Robbins.

How to treat it

Hardy explains that while diet and lifestyle can be helpful, most often, medications are needed to manage this type of constipation. "A type of medication called 'opioid receptor antagonists' is most often used because they block opioids from having their slowing effects on the bowels," she adds.

Dr. Robbins also says that laxatives can be used to treat this type of constipation, too, as long as it doesn't negatively interact with what you're already taking. That said, always check in with your healthcare provider before adding laxatives to your routine.

4. Constipation caused by defecation disorders

"This subtype of constipation is often caused by the discoordination of the muscles needed to have a proper bowel movement," explains Hardy. She adds that while this subtype of constipation isn't often talked about, it's actually extremely common.

To have a bowel movement, many body systems have to work together. "From generating proper pressure in the abdomen (i.e., intra-abdominal pressure⁵) to relaxing the pelvic floor muscles and coordinating the sphincter that helps move stool through—all of it is important for having a bowel movement," says Hardy. So if these systems are not working properly, your gut motility may take a hit.

How to treat it

Diet and lifestyle can help this type of constipation, but it's not often enough to completely solve the issue. Instead, "treatment that emphasizes pelvic floor therapy, such as biofeedback training to retrain muscle coordination, or behavioral strategies, such as using a foot stool to elevate the feet during a bowel movement, are also helpful," says Dr. Robbins.

Dr. Robbins also says that while laxatives may provide temporary relief, they're not a long-term solution for this type of constipation. Your healthcare provider can help you come up with other relief options.

5. Slow transit constipation

While not part of the ROME IV criteria for constipation, Hardy explains that constipation caused by slow movement of food and stool through the intestines is important to consider. "While this type can overlap with defecation disorders and functional constipation," she explains, "slow transit constipation can also be caused by structural abnormalities like an extra long colon⁶ or organ prolapses." These types of issues are most often discovered through tests like colonoscopies, endoscopies, or MRI scans.

How to treat it

Hardy explains that for most people with this type of constipation, proper nutrition (such as eating enough high-fiber foods and drinking plenty of fluids) and in some cases, medication, can be effective treatments. Treating other underlying causes, like prolapse, will also require visiting with your healthcare provider.

6. Constipation caused by inadequate food intake

"Not eating enough can exacerbate constipation and deserves its own spotlight," says Hardy, "as the management differs from other subtypes." She explains that with the rise in popularity of restrictive diets, high levels of exercise, and certain weight-loss medications, she's also seeing a lot more constipation in her clients, mainly due to this lack of nutrition.

"Our intestines move by way of muscle, and we need to ensure that muscle is getting adequate energy to function," she explains. She adds that when people are following extremely restrictive diets, they often struggle to hit their fiber targets, which can slow the bowels and worsen constipation.

How to treat it

Making sure you are properly nourishing your body is the first line of treatment for this type of constipation. If you are having trouble meeting your daily intake goals, visiting a registered dietitian, who can offer guidance and support, is helpful. They can even help you build a meal plan that focuses on fiber and other top nutrient goals. Remember: Food is fuel—not just for your digestive system, but your entire body.

Note: If you or a loved one is dealing with disordered eating or body image issues of any kind, help is available. Visit the National Eating Disorder Alliance (NEDA) website to find resources and support near you. Or, call or text 988 for the national Suicide and Crisis Lifeline.

Other tips for staying regular

When Hardy works with clients who have constipation, she uses three main strategies to help them poop more regularly: fiber supplements, "constipation superfoods," and a structured bathroom schedule.

For fiber supplements in particular, Hardy says two specific types—psyllium and partially hydrolyzed guar gum (PHGG)—are like sponges. "They hold onto water so [waste] can move through quickly and at the right consistency." But if fiber supplements end up worsening your bloating and constipation, you could be too backed up with stool, in which case she recommends talking with your healthcare provider to help resolve this.

There's also the option of incorporating more "constipation superfoods," i.e., any fiber-filled food that's going to help your bowel move more easily. Hardy says these include:

• 5 to 6 prunes
• 2 kiwifruit
• 2 tablespoons of ground flax seeds or chia seeds
• 1 pear with the skin

"When adding these in, don't forget to hydrate!" Hardy recommends. Staying properly hydrated can help prevent the extra fiber from causing gas or bloating.

Finally, Hardy recommends developing a bathroom routine. "About one hour before a bowel movement, your gut motility starts picking up," she explains. She notes that this typically happens in the morning after you first eat. When you first notice the sensation to "go," Hardy recommends taking a moment to do the following:

• Take five deep belly breaths. This stretches your diaphragm down and relaxes your pelvic floor to prepare your body for a bowel movement. She adds that if you can do this in a sumo squat position, it can be even more effective.
• Get a stool or a Squatty Potty ($25). These devices help ensure your knees are above your hips, which can help facilitate a bowel movement more easily, says Hardy.

Another strategy that is often overlooked when it comes to constipation is stress management, says Dr. Robbins. "While we don't often realize it, psychological factors, including stress and anxiety, can significantly impact our bowel habits," she explains.

Dr. Robbins says that techniques such as mindfulness, meditation, and deep-breathing exercises can help reduce stress levels and may improve bowel function. "Cognitive behavioral therapy has also shown promise in managing constipation related to psychological factors," she adds.

When to see a healthcare provider

"While occasional constipation can often be managed with lifestyle and dietary changes, persistent or severe constipation may indicate an underlying condition that requires professional evaluation," says Dr. Robbins. She recommends speaking with a healthcare provider if your constipation lasts longer than three weeks, or if it's accompanied by any of the following symptoms:

• Severe abdominal pain, bloating, or discomfort that doesn't improve when you have a bowel movement.
• Blood in the stool.
• Unexplained weight loss.
• Persistent nausea or vomiting.
• Sudden changes in bowel habits.
• Hard, painful stools that cause tears or hemorrhoids.
• Dependence on laxatives.
• Underlying health conditions like diabetes, Parkinson's disease, or hypothyroidism.
• Unresponsive to lifestyle treatments.
• Significant impact on your quality of life.

If you've been constipated for longer than three weeks, or if any of the above symptoms accompany your constipation, it's best to speak with a healthcare provider to rule out serious causes of your constipation, such as colorectal cancer or inflammatory bowel disease.