Can Constipation Cause Fatigue?

Constipation and fatigue often go together. They don't cause each other, but they can both be symptoms of many things. 

With constipation, bowel movements are more difficult or less frequent than usual. Fatigue makes you tired, lethargic.

When you have both, it could be from dehydration or malnutrition. Or a medication or medical condition may be to blame. 

In this article, you’ll learn the possible causes of constipation and fatigue, the link between fatigue and irritable bowel syndrome, and what treatment and prevention methods may help.

Constipation and Fatigue

Both constipation and fatigue have to be judged against what’s “normal” for you. 

Medically speaking, constipation is defined as fewer than three bowel movements a week. If you regularly go less than that, it’s considered chronic constipation.

But if you typically have three or four bowel movements a day, your personal benchmark is different. Pay attention to your normal patterns, and watch for changes that may signal a problem.

Symptoms of constipation include:

• Painful, difficult bowel movements
• Abdominal pain
• Feeling bloated
• Sluggishness

Fatigue can also be tricky to gauge. If you regularly don’t get enough sleep or have chronic stress, you may be fatigued a lot of the time. If you tend to sleep well and feel energized most days, you’re likely to notice a new cause of fatigue much faster than someone who’s always yawning.

Base your assessment on your normal. A new symptom or significant change is something worth paying attention to.

Constipation and Fatigue Causes

Fatigue isn’t a constipation symptom. But the two symptoms can come from many of the same medical problems.

Malnutrition and Dehydration

Malnutrition may be caused by:

• Poor nutrient absorption
• Poor diet
• Some medical conditions

Dehydration can be caused by:

• Inadequate fluid intake
• Excessive heat exposure
• Excessive exercise
• Fever
• Vomiting
• Drinking alcohol
• High blood sugars (hyperglycemia)
• Diuretic medications (water pills)

Certain Medications

Medications that can cause fatigue and/or constipation include:

• Opioid painkillers
• Antacids
• Anti-seizure drugs
• Iron supplements
• Parkinson’s disease drugs
• Some antidepressants

Autoimmune/Autoinflammatory Diseases

Autoimmune and autoinflammatory diseases involve an immune system disorder that attacks healthy parts of your body. Fatigue is a major symptom of many autoimmune and autoinflammatory diseases.

Some diseases directly affect the digestive system, including celiac disease and autoimmune GI dysmotility.

Many other diseases have systemic effects that may include digestive problems and constipation. They include:

• Lupus
• Multiple sclerosis
• Parkinson’s disease
• Scleroderma

Fibromyalgia and ME/CFS

Fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are classified as central sensitivity syndromes. Some causes may involve autoimmunity.

Fatigue is a defining symptom of both conditions. They also can involve bowel problems, including constipation.

Alterations in gut microbiota may play a role in constipation and other bowel problems in people with ME/CFS, but more research is needed to see if there is a casual relationship.

The Link Between IBS and Chronic Fatigue

Irritable bowel syndrome (IBS) often involves constipation. It comes in four subtypes:

• Constipation-predominant (IBS-C)
• Diarrhea-predominant (IBS-D)
• Mixed (IBS-M)
• Unclassified (IBS-U)

Only IBS-D doesn’t involve constipation.

Research suggests that about 55% of people with IBS have fatigue. The link isn’t fully understood. It may be due to genetic abnormalities that affect serotonin, a neurotransmitter and hormone that deals with digestion and sleep.

Serotonin dysregulation is also linked to fibromyalgia, ME/CFS, and other central sensitivity syndromes. Those conditions frequently overlap with IBS.

Treatment

Treatments for constipation and fatigue may vary depending on the cause. If they’re caused by an underlying illness, that illness should be treated.

Meanwhile, you may get symptom relief from other treatments. Work with your healthcare provider to get a diagnosis and find treatments that help.

Some places to start include changing your diet, taking or changing medications, and improving your sleep schedule.

Diet Changes/Supplements

Dietary changes may help both constipation and fatigue. For constipation:

• Drink more water and other fluids
• Eat more fiber and/or take a fiber supplement
• Focus on a plant-based diet
• Eat magnesium-rich foods or take a magnesium supplement

For fatigue, ask your healthcare provider to check for nutritional deficiencies. Correcting those is an easy place to start. 

Certain herbs and nutrients may increase your energy levels or help you sleep. It can be hard to get enough through diet alone, though. Supplements can be a more consistent and reliable method. However, there is little in the way of hard research that proves supplements will give you more energy or improve your sleep. If you're thinking of taking a supplement, talk to your healthcare provider first, only take the recommended dosage, and watch for side effects and drug interactions.

For energy, you may want to try:

• B vitamins, especially B12
• Vitamin C
• Iron
• Magnesium
• Zinc
• Rhodiola rosea
• Acetyl-L-carnitine
• Coenzyme Q10 (CoQ10)
• Creatine

Supplements that may help with sleep include:

• Melatonin 
• Magnesium
• Valerian root
• L-theanine 
• GABA
• Lavender
• Chamomile

Note that magnesium is in all of the above lists, which could make it an ideal supplement for treating constipation and fatigue.

Medication

You and your healthcare provider should look over your current medications and supplements. Something may be causing or contributing to your symptoms. If so, you may want to adjust your dosage or switch to a different medication.

You have a few medication options for treating constipation:

• Laxatives
• Enemas
• Stool softeners, over-the-counter (OTC), or prescription
• Medications that speed digestion (linaclotide and prucalopride)

Talk to your healthcare provider about the proper way to use laxatives. If you over-use them, they can make constipation worse.

Fatigue can be treated with medications that keep you awake, those that help you sleep, or both. Stimulant medications include:

• Provigil (modafinil)
• Amphetamines
• Sunosi (solriamfetol)
• Wakix (pitolisant)

You can get sleep aids OTC or by prescription. Prescription sleep medications include:

• Ambien (zolpidem)
• Lunesta (eszopiclone)
• Rozerem (ramelteon)
• Sonata (zaleplon)
• Silenor (doxepin)
• Restoril (temazepam)
• Halcion (triazolam)

Antidepressants are sometimes used to improve sleep, as well. These include:

• Amitriptyline
• Nortriptyline
• Trazodone

However, although these medications may help you get to sleep, they may make your constipation worse.

Sleep Schedule

Improving your sleep schedule can relieve fatigue, and maybe constipation, too. A study suggests sleeping for longer or shorter periods than average can increase constipation rates.

To get better sleep, you can establish a few healthy habits:

• Go to bed and get up at the same time each day, including days off.
• Create a quiet, dark, relaxing bedroom.
• Keep the temperature comfortable.
• Leave electronics (TVs, computers, tablets, phones) out of the bedroom.
• Don’t have large meals, alcohol, or caffeine before bed.
• Get exercise during the day, but not close to bedtime.

If these steps don’t help, talk to your healthcare provider about the possibility of sleep disorders.

Prevention

You may be able to prevent bouts of constipation. Things to try include:

• Getting enough fiber and fluids in your diet
• Exercising regularly
• Trying to move your bowels at the same time every day
• Not ignoring the need to have a bowel movement

When to See a Healthcare Provider

You should get medical attention for constipation plus:

• Rectal bleeding
• Bloody stools
• Constant abdominal pain
• Inability to pass gas
• Vomiting
• Fever
• Low back pain
• Unintended weight loss

Also, make an appointment if your constipation doesn’t clear up with self-care. If you have a family history of colon or rectal cancer, always get constipation checked out.

Summary

Constipation and fatigue are symptoms of many medical conditions. They can also be caused by malnutrition, dehydration, and medications. Treatment involves dietary changes, supplements, medications, and better sleep habits. Prevention involves fiber, hydration, being active, and going when you need to.

Don't just live with constipation and fatigue. See a healthcare provider to figure out what's causing them and if you have prolonged or severe symptoms.