Constipation is a common digestive issue defined by infrequent bowel movements, difficulty passing stool, or the feeling of incomplete evacuation. Chills are sensations of coldness accompanied by shivering, which the body uses to generate heat, often indicating a fever or an internal temperature regulation issue. When these two seemingly separate symptoms occur together, the combination rarely points to simple constipation as the direct cause. Instead, the simultaneous experience of constipation and chills frequently signals the presence of a secondary medical problem or an underlying systemic condition.
The Constipation-Chills Connection
Simple mechanical constipation, which involves only the slow movement of stool through the colon, does not typically cause a fever or the true, sustained chills associated with infection. However, a temporary, non-fever related sensation of chilliness can sometimes be experienced during a bowel movement, colloquially known as “poop shivers.”
Straining during a difficult bowel movement can stimulate the vagus nerve, which runs from the brainstem down to the abdomen. This nerve is a primary component of the parasympathetic nervous system. Intense stimulation can briefly trigger a drop in heart rate and blood pressure, a response known as vasovagal syncope. This sudden systemic change can momentarily manifest as lightheadedness or a brief, cold shiver.
This temporary sensation differs from true chills because it lacks the accompanying fever and is not sustained beyond the bowel movement. True chills are the body’s response to an elevated core temperature, signaling the presence of an inflammatory or infectious process. When constipation and persistent chills occur together, the focus must shift to identifying the infectious or inflammatory complication.
Infectious Complications Arising from Constipation
The most concerning reason for constipation and chills to co-occur is the development of an infection stemming from severe or prolonged intestinal blockage. Severe constipation can lead to fecal impaction, where a mass of hardened stool becomes lodged in the colon or rectum. This impaction can cause pressure against the intestinal wall, leading to complications that introduce bacteria into the bloodstream or abdominal cavity.
One such complication is diverticulitis, which occurs when small pouches in the colon wall (diverticula) become inflamed or infected. Constipation and the resulting high pressure inside the colon contribute to this inflammation. The subsequent infection often triggers a systemic immune response, causing fever and the shaking chills that accompany it.
In rare but serious cases, chronic impaction can lead to stercoral colitis, where the hardened stool mass causes pressure necrosis. This pressure can cut off blood flow to a portion of the colon wall, leading to ulceration and potentially a bowel perforation. A perforation allows intestinal contents to leak into the sterile abdominal space, resulting in a severe infection called peritonitis. This progression quickly leads to sepsis, characterized by high fever and intense, shaking chills.
Shared Underlying Conditions
Constipation and chills may arise together because they share a common systemic underlying cause. These conditions affect the entire body, manifesting symptoms in multiple systems simultaneously.
Severe dehydration is a frequent culprit. A lack of sufficient fluid intake causes stool to become hard and difficult to pass, resulting in constipation. Dehydration also disrupts the body’s ability to regulate temperature, which can sometimes lead to fever and chills.
Inflammatory Bowel Disease (IBD), including Crohn’s disease and ulcerative colitis, is another systemic condition that links these symptoms. IBD is characterized by chronic inflammation of the digestive tract, which can slow intestinal transit time and cause constipation during a flare-up. The systemic inflammation inherent to IBD can also trigger a fever and chills.
Endocrine disorders, such as severe hypothyroidism, also connect these symptoms through metabolic slowing. An underactive thyroid reduces the body’s overall metabolism, slowing intestinal movement and leading to chronic constipation. Since thyroid hormones help regulate body temperature, their deficiency can cause an increased sensitivity to cold.
Warning Signs and When to Seek Immediate Help
The combination of constipation and chills is a strong indicator that simple bowel sluggishness has progressed to a more serious inflammatory or infectious process. Immediate medical attention is necessary if the chills are accompanied by a high fever, typically defined as a temperature above 101°F (38.3°C). Shaking chills, or rigors, are particularly concerning as they often signal a significant bacterial infection.
Other red-flag symptoms that warrant an immediate visit to the emergency room include:
- Severe, worsening abdominal pain that is localized or causes the abdomen to feel rigid to the touch.
- Persistent nausea and vomiting, especially if it prevents keeping fluids down.
- Confusion or lethargy.
- Inability to pass gas or stool for several days despite treatment.
- The presence of blood in the stool.
These signs suggest potentially life-threatening conditions like sepsis, bowel perforation, or acute diverticulitis that require prompt diagnosis and treatment.