So, what are the causes of constipation? This is a question we frequently get asked. There are two main causes, or two main categories I should say, of causes for constipation. The first is primary involvement of the colon. And the second is secondary causes that result in constipation that are outside of the colon primary involvement of the colon. We are speaking of things like slow transit constipation, in which the muscles of the colon itself is sluggish, or irritable bowel syndrome, which is a functional disorder of the colon, or finally something like pelvic floor dysfunction, which the muscles of the pelvic floor move abnormally and thus result in constipation. Secondary causes can be multi-factorial, but they can include things such as diabetes, thyroid disease, specifically an underactive thyroid, neurologic conditions, such as Parkinson’s or multiple sclerosis. We often see constipation during pregnancy as well. And finally, mechanical obstructions such as colon cancer or adhesions or scar tissue can also result in symptoms of constipation. The real mainstay of treatment in this category is to treat the underlying cause and thus create improvement with the symptoms of constipation.