Constipation
A bowel disorder marked by infrequent, hard or difficult-to-pass stools, often linked to diet, hydration, a sedentary lifestyle and the microbiota.
Constipation is medically defined as fewer than 3 bowel movements a week, and/or hard stools, difficult passage, or a feeling of incomplete emptying. It is very common, especially in women and older people.
The original angle (beyond fibre, the forgotten quartet): the reflex “eat more fibre” is incomplete. Four levers work together:
- Fibre: yes, but both types. Insoluble fibre (bran, vegetables) adds bulk; soluble fibre (oats, psyllium, prunes) softens. An excess of insoluble fibre without water can PARADOXICALLY make things worse
- Water: fibre absorbs water, so without enough hydration it hardens stools instead of softening them. Fibre and water go together
- Movement: physical activity stimulates peristalsis (the contractions of the gut). A sedentary lifestyle slows transit
- The microbiota: a balanced microbiota supports good transit (short-chain fatty acids stimulate gut motility)
The gastrocolic reflex and listening to your body: eating naturally triggers contractions of the colon (the gastrocolic reflex), especially in the morning. Ignoring the urge to go (through lack of time or discomfort with public toilets) is a common and underestimated cause: the body “learns” to hold on, and constipation sets in.
Toilet position: a little-known detail: squatting (or raising your feet on a small stool) aligns the rectum better and makes passing stools easier, unlike the “90°” seated position of modern toilets.
Aggravating factors: stress (the gut-brain axis), certain medicines (opioids, iron, some antacids), dehydration, a low-fibre diet, and travel (a change of routine).
Natural allies: prunes (fibre + sorbitol), kiwi (convincing studies), psyllium, water, activity, fermented foods.