Chronic constipation

Chronic constipation is a condition that many people face once in their life. Chronic constipation affects 15% of women and 5% of men1.

“Many people face chronic constipation once in their life”

Having chronic constipation can be quite annoying, as this often means spending much time on the toilet and living with the frustration that often the result is not what you expect. Also stool passage can be difficult and can is often accompanied by painful bowel movements for people with chronic constipation.

What is constipation?

Constipation is a condition where stools are infrequent or hard to pass. The stool is often very solid and dry. Generally, people with constipation have only three (or less) stools a week. A difficult stool passage includes a sense of difficulty passing stools, straining, incomplete evacuation, hard or lumpy stool, prolonged time to stool, painful bowel movements, or even the need for manual manoeuvres to pass the stool2.

“People with constipation have only three (or less) stools a week”

What is chronic constipation?

The main difference between acute and chronic constipation is how long your constipation lasts. Acute constipation starts suddenly and lasts for several days, whereas chronic constipation means infrequent stools or a difficult passage of stools that persists for several weeks or longer.

“Chronic constipation is constipation
that persists for several weeks or longer”

Causes of chronic constipation

Constipation is often caused by physical inactivity, certain drugs, blockage, dehydration, or missing intestinal contractions. Other risk factors for constipation include older age, low-fibre diet, low caloric intake, high medical use and female sex3.

The most common type of chronic constipation is caused by the side effects of drugs or by another underlying disease. Side effects from antidepressants, anticonvulsants, morphine, certain diuretics,  and a prolonged use of laxatives are the most common drugs that cause chronic constipation3.

“Side effects from drugs often cause chronic constipation”

Chronic constipation can be caused by many different factors. Sometimes the cause of constipation remains unknown, or there are anatomical or functional issues in the intestines that cause constipation.

A disbalanced gut flora can cause chronic constipation

Also, chronic constipation can be the result of a disbalanced gut flora. If you are not using drugs regularly and don´t have an underlying disease that can explain your chronic constipation, chances are high a disbalanced gut flora is causing your constipation. This type of chronic constipation is also called “Chronic idiopathic constipation” (CIC).

“Chronic constipation can be the result of a disbalanced gut flora”

Improving chronic constipation

Lifestyle factors

Constipation is in part caused by aspects of people´s lifestyle. Among them, the trio of insufficient dietary fibre, dehydration, and insufficient exercise plays a prominent role in the development of chronic constipation4, 5. That means you can improve constipation by simply eating more fruits and vegetable, increasing the amount of water you drink per day and exercise.

“You can improve constipation
by eating more fruits and veg,
drinking more water, and by exercising

Gut restoration

If you are not using drugs regularly and don´t have an underlying disease that can cause chronic constipation, chances are high you have got “Chronic idiopathic constipation” (CIC). Chronic idiopathic constipation is often the result of a disbalanced gut flora6.

For the development and persistence of chronic idiopathic constipation, the relative quantity of certain bacterial groups in your gut flora is crucial6.  People with chronic idiopathic constipation are often infected with different types of bad pathogenic bacteria species, like clostridia and enterobacteria7.

The good news is that you can improve chronic idiopathic constipation by using certain probiotic products. There is substantial evidence of the beneficial effects of certain probiotic strains – mainly Bifidobacteria and Lactobacilli – on chronic constipation. In order to introduce these beneficial probiotic strains into our gut flora you should do a gut restoration to restore a healthy gut.

Can probiotics improve chronic idiopathic constipation?

The answer is yes! Several clinical studies have shown that chronic constipation can be positively influenced by the intake of probiotics7. Certain probiotic strains have shown substantial beneficial effects in people with chronic constipation7-10.

Those most widely studied probiotic genera are Bifidobacteria and Lactobacilli7. These probiotic bacteria – which are also called lactic acid bacteria – lower the pH in the intestines due to the production of short-chain fatty acids (butyric acid, propionic acid, and lactic acid)7. A lower pH enhances peristalsis (intestinal contractions) and thus decreases intestinal passage time.

Gut restoration

If you have chronic idiopathic constipation, you should therefore consider doing a gut restoration to increase the level of lactic acid bacteria in your gut flora.

Gut restoration involves two steps,

  • Gut cleansing and
  • Rebuilding your gut flora

By gut cleansing you create space in your gut for new (good) bacteria to settle. By rebuilding your gut flora you are giving your gut what it needs: lactic acid bacteria for improving chronic constipation.

Rebuilding your gut flora

Rebuilding your gut flora involves the use of probiotics and prebiotics.

For rebuilding your gut flora fermented milk products containing lactic acid bacteria such as probiotic yoghurts and kefir can be used. Also, Sauerkraut contains hundreds of different probiotic bacteria, among them bifidobacteria and lactobacilli. These are especially helpful for people with chronic constipation.

Also, dietary fibres are highly beneficial for people with chronic constipation. Dietary fibres or roughage are parts from plants that can´t be directly digested. They serve as useful nutrients for numerous probiotic bacteria of the gut flora. That is why dietary fibres are also called prebiotics. Prebiotics are highly beneficial for people with chronic constipation. One reason is that they feed lactic acid bacteria in your gut that positively influence chronic constipation.

The 30 DAYS GUT RESTORATION PROGRAM for improving chronic constipation

If you want to perform a gut restoration yourself, visit the website On this website, you will find a 30 DAYS GUT RESTORATION PROGRAM for improving chronic constipation, that exactly uses those probiotic strains that have shown substantial beneficial effects in the treatment of chronic constipation in clinical trials.


  1. Schulze, J. S., U. Ölschläger, T. Kruis, W. Probiotika : Mikroökologie, Mikrobiologie, Qualität, Sicherheit und gesundheitliche Effekte (Hippokrates, Stuttgart 2008).
  2. Gray, J. R. What is chronic constipation? Definition and diagnosis. Can J Gastroenterol 25 Suppl B, 7B-10B (2011).
  3. Jamshed, N., Lee, Z. E. & Olden, K. W. Diagnostic approach to chronic constipation in adults. Am Fam Physician 84, 299-306 (2011).
  4. Leung, L., Riutta, T., Kotecha, J. & Rosser, W. Chronic constipation: an evidence-based review. J Am Board Fam Med 24, 436-51 (2011).
  5. Portalatin, M. & Winstead, N. Medical management of constipation. Clin Colon Rectal Surg 25, 12-9 (2012).
  6. Krammer, A. in “Wissen, Einstellung und Konsumverhalten in Bezug auf probiotische Milchprodukte” am Institut für Ernährungswissenschaften 176 pages (Universität Wien, Wien (Vienna), 2011).
  7. Chmielewska, A. & Szajewska, H. Systematic review of randomised controlled trials: probiotics for functional constipation. World J Gastroenterol 16, 69-75 (2010).
  8. Yang, Y. X. et al. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women. World J Gastroenterol 14, 6237-43 (2008).
  9. Koebnick, C., Wagner, I., Leitzmann, P., Stern, U. & Zunft, H. J. Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation. Can J Gastroenterol 17, 655-9 (2003).
  10. Mollenbrink, M. & Bruckschen, E. [Treatment of chronic constipation with physiologic Escherichia coli bacteria. Results of a clinical study of the effectiveness and tolerance of microbiological therapy with the E. coli Nissle 1917 strain (Mutaflor)]. Med Klin (Munich) 89, 587-93 (1994).