An Introduction
You’re probably reading this because you can’t poop—or at least not as easily as you’d like. Maybe you’ve had issues on and off, cycling between being regular and being backed up, with no clear explanation. Or maybe right now you just have a hunch about what could be at the root of your struggles.
Now, let’s be honest: we shouldn’t shy away from poop talk. Sure, it can feel a little uncomfortable, but we do it in the name of science, of longevity, and of true healing. If the eyes are the window to your soul, then your poop is the window to your health.
In this article, we’ll dive into the real culprits behind constipation, exploring our posture, microbiome and of course, some foods and supplements that can bring relief. The goal? To finally understand why your body is having such a hard time at the bowl.
As we dive into the practical steps for effortless pooping, I want to address the elephant in my bathroom. My health journey started over 12 years ago and has included just about every fad diet under the sun. Years of weight cycling, on-and-off skin issues, autoimmune flare-ups, and microbiome imbalances eventually brought me to a place where I finally feel the most comfortable I’ve ever felt in my own body.
But getting here wasn’t easy. It came through constant failures, listening to every guru with a podcast, and reading countless articles — only to realize that experience is the highest form of knowledge. It was through those struggles that I learned how to truly operate my body and, more importantly, how to get out of its way.
Looking back on what often felt like hell on earth, I noticed a clear pattern: I was always at my worst when my bowels weren’t moving. That’s not to say I never struggle anymore — my bowel health still depends heavily on factors like stress (Gozali et al. 2023) , hydration, diet (low-carb, intermittent fasting, etc. as zero fiber translates to zero poops), exercise, posture, and even my emotional state. But I can confidently say those old 2–5 day stretches without a bowel movement (sometimes even a full week) are far behind me.
I share this because I don’t want this article to just be another quick-fix constipation guide. I want it to be what I wish I had 10 years ago — a clear, honest resource that I can now confidently pass along to help you on your own journey.
The “Joys” of Constipation
Now, most people think constipation is just a plumbing problem, a matter of things getting stuck. But that’s too simplistic. Constipation is really an ecosystem problem. Your gut, liver, nervous system, microbes, even your emotions — they’re all part of a living web that either keeps waste moving or grinds it to a halt. Once you see it through that lens, the puzzle pieces start to fit together.
As we all know, there’s nothing more frustrating than being unable to release your bowels day after day. Beyond the discomfort, it’s literally one of the most harmful things you can do to your health. Think about it, when stool lingers in the colon, it doesn’t just sit there, it begins to ferment and putrefy. Compounds that should have been excreted can leak back into circulation, forcing your liver to re-process waste it already worked hard to eliminate (Pizzorno J. 2014).
Over time, this backlog is a recipe for disaster as it interferes with one of your body’s primary detox pathways: your stool. This is how we clear excess hormones (like estrogen), bile acids, heavy metals, and metabolic byproducts that are accumulating (Flores et al. 2012). When elimination slows, these compounds are reabsorbed, placing an extra burden on the liver and disrupting hormonal balance, which in-turn negatively affects all other organ systems.
Research shows that chronic constipation is associated with increased intestinal permeability (“leaky gut”), which allows inflammatory molecules like Lipopolysaccharide (LPS) to enter the bloodstream and trigger low-grade, system-wide inflammation (Pan et al. 2022). Left unchecked, this process may contribute to everything from skin issues, to brain fog, to autoimmune conditions.
In more advanced cases, long-term constipation raises the risk of diverticulitis, hemorrhoids, and anal fissures, which are all painful complications that further discourage regular bowel habits (Forootan et al. 2018). Beyond physical symptoms, there’s also the mental toll. People who struggle with constipation often report higher states of anxiety and depression (Huang et al. 2025), anxiety around food, social embarrassment and lack of self-confidence, and a sense that their digestion controls their daily life rather than the other way around.
This is why constipation deserves more than a quick fix with laxatives (which weakens your colonic muscles over time). The solution lies in addressing the root cause: the gut environment itself. By restoring microbial balance and mucin production, our exercise habits and posture, and of course, understanding the stress and emotional side to this, we can help the colon regain its natural rhythm and make our bowel movements effortless again.
So if constipation is really an ecosystem problem, how do we even begin to measure it? What does it actually look like in day-to-day life? That’s where the Bristol Stool Chart comes in, a simple but surprisingly accurate window into your gut’s inner world.
The Bristol Stool Chart and Understanding Your Poop.
Constipation has many faces. For some, it’s going days without a bowel movement. For others, it’s the frustrating feeling of an incomplete evacuation, like your body just can’t finish the job. And while occasional constipation is common, chronic constipation affects up upwards of 20% of adults worldwide, with women being most prone “28.4% of the respondents considered themselves to be constipated. Stratified by sex, significantly more females (37.5%) than males (19.1%)” (Tamura et al. 2016).
Before we get into the possible culprits on why these numbers on the rise, we must first understand what a healthy poop should look like. And for this, we have the trusty, Bristol Stool Chart. Developed at the University of Bristol, it categorizes stool into seven types, from hard pellets to watery diarrhea. This is something to pin up on the bathroom wall for future reference.
• Type 1–2: Hard, dry, lumpy stools, a clear sign of constipation and slow transit time. This typically reflects dehydration, low fiber intake, or electrolyte imbalances (sodium, potassium, magnesium). Malabsorption may play a role here if the stool is dry despite adequate hydration (e.g., poor fat absorption). Constant stools hovering around this type is often linked to issues with the gut–brain axis (stress, nervous system dysregulation), or poor motility from medications (opioids, iron, anticholinergics).
• Type 3–4: Smooth, soft, sausage-shaped stools, considered the “gold standard” of healthy, easy-to-pass bowel movements. This typically indicates balanced motility, hydration, and fiber intake. Something that we should all be striving for and come on, excited about.
• Type 5: These are the softer blobs with clearer edges. Definitely on the looser side of normal stool. This can indicate shortened transit time (food moving too quickly through the gut) and is often linked to mild food intolerances and sensitivities (like certain sugars/FODMAPs).
• Type 6-7: These are your mushy, watery stools and diarrhea that reflect rapid transit time. It’s important to note that this is extremely common in gut inflammation (Crohn’s, ulcerative colitis, celiac, etc.), infections, or autoimmunity. Consistent stools in this range is also linked to IBS, food intolerances, or bile acid malabsorption and in severe cases, chronic diarrhea leading to electrolyte loss and overall malnutrition.
These are common guidelines and not should not be taken strictly as fact since stool type alone isn’t the end all-be-all. However, this can serve as a fantastic diagnostic tool that allows you to better understand the state of your health.
General Note on Floaters vs. Sinkers: All healthy stool should sink. If your poop constantly floats, that’s a red flag for fat malabsorption. When your body isn’t breaking down dietary fats properly, those undigested fats end up in the stool. The technical name for this isn’t “floater” – it’s steatorrhea (fatty stool) (Azer et al. 2025). This often looks greasy, shiny, and may even leave an oily film where the water meets the bowl.
This means your body isn’t absorbing fat-soluble vitamins like A, D, E, and K, all nutrients that are critical for hormonal balance, your immune system and a fog-less brain. Since this blog is about constipation, I won’t go too deep here, but the main culprits lead back to your liver and gallbladder. These organs produce and release bile acids, which act like soap to emulsify fats so they can be digested and absorbed. If your liver is overloaded with toxins, your bile ducts are congested, or your gut microbiome has been disrupted (say, by antibiotics), bile flow suffers and so does fat absorption.
Why Constipation is Rising & What Are The Main Culprits?
You should have a bowel movement every single day, preferably in the morning, and before you eat your first meal. As we know, this doesn’t always go according to plan. For many reading this, it’s safe to say your transit time — the time from when you eat to when it’s excreted — is much slower than the norm. So this begs the question: what’s causing this constant backlog?
It’s important to remember: there is no single “smoking gun.” No panacea. Constipation almost always comes from multiple overlapping inputs: posture, diet, stress, medications, and gut imbalance (Rao et al. 2016) all converging on the same loop of slowed motility, inflammation, and dysbiosis. Constipation is one of those problems people love to oversimplify. “Drink more water.” “Eat more fiber.” “Take magnesium.” Sure, those things matter, but if it were that simple, millions of people wouldn’t still be struggling. So let’s go a bit deeper and break it down with our main culprits.
Culprit 1: Your Toilet is Working Against You (Diagram)
Yes, you read that right. The modern toilet, that “precious invention” of convenience, is actually restricting the natural flow of your bowels. We evolved to release in a squatted position, not a seated one “Squatting toilets are shown to lead to better puborectalis muscle relaxation, a wider anorectal angle (ARA), and require less straining, all of which lead to an easier, prompt, and complete fecal evacuation compared to sitting toilets.” (Buldukoğlu et al. 2024).
When you sit on a toilet at a 90-degree angle, two things happen:
• Your puborectalis muscle stays tight. This sling-like, U-shaped pelvic floor muscle wraps around your rectum, keeping it kinked like a garden hose so stool doesn’t leak out prematurely. The problem is that when you’re sitting, the kink never fully relaxes, meaning you’re pushing against your own anatomy. Pooping shouldn’t be about forcing; it should follow the path of least resistance, like most things in life.
• Your ileocecal valve gets compressed. This valve controls the flow of digested food from the small intestine into the large intestine. Sitting upright creates abdominal pressure that jams it shut. This slows motility, triggers bloating and pain near your right hip, reflux into the small intestine, and even contributes to SIBO (small intestinal bacterial overgrowth).
Now picture a squatted position: thighs pressing into your abdomen, knees rising above your hips, and your spine tilted forward. This posture straightens the rectum, relaxes the puborectalis, and relieves pressure on the ileocecal valve. Suddenly, elimination becomes what it should be…quick and effortless.
Does this mean we should all rip out our toilets and start squatting in the woods? Not exactly. A simple footstool (think Squatty Potty) mimics the squatting posture by elevating your legs and letting you work with your biology, not against it (Modi et al. 2019).
And posture matters beyond the bathroom. If you sit at a 90-degree angle for 6–8 hours a day at work, then add more sitting on the toilet, your pelvic floor muscles stay locked in tension. The easier stool passes, the less stagnation, inflammation, and dysbiosis have a chance to build up.
Image adapted from: Olalere, F. E. (2018). Enhancing cultural practices through well-being-driven design. The International Journal of Designed Objects, 12(1), 1–9. https://doi.org/10.18848/2325-1379/CGP/v12i01/1-9
Key Takeaway: Improper posture slows motility and makes evacuation incomplete, setting up constipation.
Culprit 2: Your Diet is Fueling Dysbiosis
Modern diets are dominated by ultra-processed foods stripped of their natural fiber matrix. Honestly, many of these are no longer “food” but “food-like products.”
A key concept here is the difference between cellular and a-cellular carbs:
• Cellular carbs (whole fruits, vegetables, grains, legumes) keep sugar locked inside plant cell walls. These structures slow digestion, release polyphenols gradually, and feed beneficial microbes like Bifidobacteria.
• A-cellular carbs (table sugar, high-fructose corn syrup, refined grains) have been stripped of their natural matrix. These “naked” sugars are highly accessible to dysbiotic bacteria, especially certain members of the Clostridia family, which pump out lipopolysaccharide (LPS). “After consumption of acellular flour and sugar-based foods … it is proposed that the effects of these enhanced carbohydrate concentrations will include a more inflammatory GI microbiota” (Spreadbury 2012).
Image taken from: Spiller, A. L., Costa, B. G. D., Yoshihara, R. N. Y., Nogueira, E. J. Z., Castelhano, N. S., Santos, A., Brusco De Freitas, M., Magro, D. O., & Yukie Sassaki, L. (2025). Ultra-Processed Foods, Gut Microbiota, and Inflammatory Bowel Disease: A Critical Review of Emerging Evidence. Nutrients, 17(16), 2677. https://doi.org/10.3390/nu17162677
When these harmful bacteria flourish, they produce more LPS, a bacterial wall fragment that damages the gut lining, leaks into the bloodstream, and ignites inflammation. Once circulating, LPS triggers immune cells and cytokines such as TNF-α, IL-1b, and IL-6 (Page et al. 2022). These inflammatory signals weaken motility, inflame the mucosa, and make stools harder to pass.
Seed oils are another modern culprit. High in omega-6 fats that oxidize easily, they stress the gut lining, favor inflammation, and tip the microbial balance toward dysbiosis (Ghosh et al 2013). Combined with a-cellular carbs, they amplify LPS production, deteriorate mitochondria, impair insulin receptors, and slow transit times.
Put together, a diet heavy in processed sugars and fats locks you in a vicious cycle: inflammation drives constipation, constipation feeds dysbiosis, and dysbiosis drives more inflammation.
Key Takeaway which is highlighted from the research image above: Processed diets -> dysbiosis -> inflammation -> poor bowel habits.
Culprit 3: Your Gut Microbiome is Screaming for Help!
As we saw with diet, the microbiome is central to motility as constipation is deeply tied to the TRILLIONS of bacteria living in your digestive tract.
Certain bacteria, like Bifidobacteria and Lactobacillus, promote stool consistency and motility, mainly by producing short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate. “Lactobacillus and Bifidobacterium can shorten the migratory myoelectric complex period and accelerate small intestine transit” (Mitelmão et al. 2022). SCFAs draw water into the colon, fuel gut lining cells, and signal muscle contractions (peristalsis) (Pan et al. 2022). They even activate receptors in the enteric nervous system, maintaining that natural “wave-like” rhythm of bowel movements!
But in dysbiosis, things go sideways. Harmful microbes produce toxic metabolites like ammonia, phenols, or hydrogen sulfide that slow colonic motility. Inflammation damages the gut lining, serotonin signaling (95% of serotonin is made in the gut) gets disrupted, and bowel coordination breaks down.
Multiple studies show that people with chronic constipation have lower levels of Bifidobacteria “levels of Bifidobacteria and Lactobacillus were significantly decreased in adult patients with constipation” (Zhao et al. 2016). Without them, the colon loses rhythm, stool dries out, and transit time slows, creating another vicious cycle of straining, discomfort, and more imbalance.
So if constipation is tied to the microbiome… the real question is: how do we restore balance?
Key Takeaway: Dysbiosis -> less SCFAs -> weaker motility.
Culprit 4: You’re Under More Stress Than Your Biology Can Handle
Of course, food and microbes don’t tell the whole story. You could be eating perfectly and still find yourself locked up if your nervous system is overloaded. The gut listens to the brain as much as it listens to bacteria, and stress has the power to override everything else. This is where Chinese Medicine offers some beautiful insight.
When your body is stuck in fight-or-flight mode, cortisol rises (our stress hormone), blood flow gets shunted away from the gut, and digestion becomes “low priority” (Rusch et al. 2023). Motility slows to a point of standstill.
From the perspective of Chinese Medicine, each organ system is rooted to a specific emotion. In the case of the colon, it is deeply tied to the emotional state of fear. Fear contracts, fear tightens, fear holds. When fear is unresolved, whether subtle daily anxiety or deep-rooted stress, it creates stagnation in the gut. Over time, this emotional contraction can manifest physically as constipation. Perhaps struggling to let go of your poop is really a mirror of how we hold on to things emotionally.
Modern science echoes this. Stress hormones alter serotonin signaling, weaken the gut barrier, and directly impair the peristaltic waves that move stool forward ‘Serotonin influences various aspects of gut function, including peristalsis (intestinal muscle contractions) and secretion of digestive enzymes’ (Akram et al. 2023). In other words: the more stress and fear you carry, the harder it is to let go…literally. Think about it: when your fight-or-flight system is activated—rapid chest breathing, racing heart, tension in your body, your brain can’t tell if you’re sitting at your desk or running from a lion. Either way, the message is clear: ‘You’re not safe. Don’t relax. Don’t let go.’ In this state, resources are shunted away from ‘rest and digest,’ the parasympathetic system that governs gut motility, bowel movements, and the subtle waves of peristalsis. The colon simply isn’t getting permission to do its job, and your body holds on tight, both physically and emotionally. It’s a vivid reminder that the mind and gut are inseparable, fear contracts, tension builds, and what we don’t release internally can manifest very tangibly in the body.
Culprit 5: Medications — Especially Antibiotics
Of course, stress isn’t the only thing keeping your colon stuck in a state of tension. Just as fear and anxiety can override the gut’s natural rhythm, certain medications can sabotage it from the outside. Antibiotics, painkillers, antidepressants, and even common supplements like iron or calcium can all tip the microbial ecosystem out of balance, slow motility, or dry out stool. It’s another reminder that constipation isn’t just about the food on your plate or the poop in the bowl, it’s about every signal and influence, internal and external, converging on the same delicate system. Let’s dive into how medications become silent saboteurs of your gut ecosystem.
The biggest offender? Antibiotics. While lifesaving, they wipe out beneficial bacteria, including those responsible for recycling bile acids (Theriot et al. 2016). This matters because bile acids don’t just digest fats; they act as natural laxatives, stimulating the colon and keeping stool moving. Without them, motility slows.
Image taken from: Mamieva, Z., Poluektova, E., Svistushkin, V., Sobolev, V., Shifrin, O., Guarner, F., & Ivashkin, V. (2022). Antibiotics, gut microbiota, and irritable bowel syndrome: What are the relations?. World journal of gastroenterology, 28(12), 1204–1219. https://doi.org/10.3748/wjg.v28.i12.1204.
Other medications and supplements are also known to cause constipation:
• Opioid painkillers (oxycodone, morphine) — drastically reduce motility
• Iron supplements (ferrous sulfate) — poorly absorbed, bind to stool
• Calcium supplements (carbonate) — reduce colonic contractions
• Antidepressants (tricyclics, some SSRIs) — alter serotonin signaling
• Antacids (aluminum-based) — dry out stool
• Antihistamines — block smooth muscle contraction
• Diuretics — deplete fluid, hardening stool
• Parkinson’s drugs (anticholinergics) — slow peristalsis
• Blood pressure meds (calcium channel blockers) — impair motility
• Chemotherapy agents — disrupt gut rhythm
The bottom line: medications can dry out stool, disrupt neurotransmitters, or dismantle the microbiome itself. Antibiotics deserve special mention because they not only slow motility but also set the stage for dysbiosis, opening the door for more LPS, more inflammation, and more constipation. It’s a vicious cycle.
Seeing the BIG Picture
HOWEVER, when you begin to step back and look at the full picture, a pattern emerges (we are here to get to the root cause, not just simply fixes). Constipation isn’t just about stool sitting too long, it’s about the cycle underneath it all: the slowed motility, the gut barrier damage, the inflammation, and the microbial imbalances feeding into each other.
Whether it’s posture, diet, stress, or medications, every culprit we’ve covered pushes on that same loop. But here’s where we can finally have some good news. If there’s a cycle driving constipation, there’s also a cycle that can reverse it. The key is rebuilding balance in the gut ecosystem, restoring healthy our microbes in feeding bifidobacteria, strengthening the mucus barrier, and reviving short-chain fatty acid production. This is where targeted tools like HMOs, Akkermansia, and other microbiome centric tools can begin to flip the odds back in our favor. Instead of managing constipation symptom by symptom, we can finally get to the ROOT and retrain the gut to move the way it was designed to.
Previously, I mentioned there being no single “smoking gun” when it comes to identifying the main causes of constipation as it almost always comes from multiple overlapping inputs. The same goes for finding the solution. In this section we will learn how feeding the microbiome correctly, incorporating key foods and fibers, and finding practical ways to lower stress can all put your bowels on track to be a champion like it once was (I remember those times as a kid where I could eat ice cream and cookies and still have a Bristol 4).
How to Get Things Moving Again
Solution #1: Retraining the Microbiome – Targeting Constipation at Its Root
At the heart of chronic constipation lies a disrupted gut ecosystem, with the microbiome orchestrating everything from motility to immune signaling. When harmful microbes dominate, they produce lipopolysaccharides (LPS) and other metabolites that inflame the gut lining, slow peristalsis, and harden stool. LPS, in particular, is a bacterial endotoxin that, once absorbed into the bloodstream, triggers systemic low-grade inflammation and disrupts serotonin signaling, slowing the natural wave-like contractions responsible for smooth bowel movements.
Fortunately, the gut microbiome is malleable. By using targeted strategies, we can restore balance, reduce inflammation, and reignite the colon’s natural rhythm. This begins with selective prebiotics, which are nutrients designed to feed beneficial bacteria without fueling harmful species.
Bifidobacteria: The King of Stool Consistency
Bifidobacteria are among the most important bacterial species for constipation relief. In fact, in infants, the gut is dominated by these microbes, upwards of 80–90% of the microbiome — primarily fed by Human Milk Oligosaccharides (HMOs) in breast milk (Dinleyici et al. 2023). As we age, these populations naturally decline due to factors like aging itself, antibiotic use, prolonged IBS, or a processed diet. As bifidobacteria drop, constipation rates tend to rise alongside them.
Why does this matter so much? Bifidobacteria are major fermenters of short-chain fatty acids (SCFAs) such as butyrate, acetate, and propionate. But SCFAs aren’t just metabolic byproducts, they’re molecular messengers that regulate colon motility, hydration, immune function, and even communicate with the brain. ‘Short-chain fatty acids (SCFAs) are the primary source of energy for colonocytes. Butyric acid stimulates the expression of the MUC2 gene, increasing mucin production, and helps maintain intestinal barrier integrity’ (Markowiak-Kopeć et al. 2020). Here’s how they help:
• Motility Stimulation: SCFAs activate G-protein–coupled receptors (GPR41 and GPR43) on enteroendocrine cells and enteric neurons, triggering the release of peptides like peptide YY (PYY) and glucagon-like peptide-1 (GLP-1). These peptides coordinate the wave-like contractions of peristalsis, moving stool efficiently through the colon (Kimura et al. 2014).
• Stool Hydration: SCFAs draw water into the colon, softening stools and preventing them from hardening and compacting.
• Epithelial Barrier (Gut Lining): Butyrate serves as the primary energy source for colonocytes (the main cells that line the colon), supporting the integrity of the gut lining. A healthy lining allows proper absorption while protecting against harmful compounds like a strong castle wall keeping invaders out (Markowiak-Kopeć et al. 2020).
• Pathogen Defense & LPS Protection: SCFAs acidify the colonic environment, making it inhospitable for LPS-producing, pathogenic bacteria, and reduce the translocation of endotoxins into circulation (den Besten et al. 2013), lowering systemic inflammation!
Bottom Line: In individuals with chronic constipation, studies consistently show a depletion of Bifidobacteria. Without these microbes, SCFA production drops, peristalsis slows, and LPS-driven inflammation rises, creating a vicious cycle of sluggish transit, hard stools, and ongoing dysbiosis.
HMOs: Your Ultimate Prebiotic
Not all fibers are created equal. While standard prebiotics like inulin and FOS feed a broad spectrum of microbes, Human Milk Oligosaccharides (HMOs) act as a precise tool. They are naturally found in breast milk (not to worry, this is fermented from cows milk), HMOs such as 2’-fucosyllactose (2’-FL) and lacto-N-neotetraose (LNnT) selectively feed Bifidobacteria longum subsp. infantis, this is important to note as this species is crucial in promoting SCFA production without fueling harmful species that generate LPS (Goehring et al. 2014).
There have been many clinical research studies performed on adults shows that supplementation with HMOs can:
• Increase Bifidobacteria abundance, helping to restore the microbial populations responsible for motility and stool hydration.
• They have been shown to Improve stool frequency and consistency, resulting in softer, easier-to-pass bowel movements…think Bristol 4s!
• Reduce digestive discomfort, which includes less bloating, cramping, and gas, by lowering LPS-driven inflammation, especially after meals.
By selectively feeding these the bifidobacteria species, HMOs are shown to shift the microbial ecosystem away from LPS producers and towards a SCFA-rich, anti-inflammatory environment, addressing constipation at the biochemical and microbial root! If you have not tried HMOs for constipation as of yet, then please let this be your sign and I promise you will not regret it.
I’ll be honest—this whole idea of “feeding your gut the right things” really clicked for me when I first tried HMOs. My journey actually started with baby formula that contained small amounts of 2’-fucosyllactose. To my surprise, it made a real difference. The downside is that baby formula is ridiculously expensive and packed with all kinds of unnecessary additives (which is sad, considering it’s what so many infants rely on).
Thankfully, we have some now clean and targeted blends designed specifically for gut health. One I’ve personally used is Constipiotic, which combines HMO 2’-FL with fibers like GOS and inulin. This mix allows for better fermentation in the gut, and for me, it’s been a huge help with regularity (a big reason why I even wrote this blog). Constipation had always been a quiet struggle, but this blend gave me some of the most consistent support I’ve found.
Akkermansia: Next Generation Gut Lubrication
Stool consistency is only half the battle. The gut’s mucin layer, which is known as a “glycoprotein” coats the inner lining of the intestinal walls. This is essential for smooth stool passage and protection against LPS penetration. Akkermansia muciniphila is a mucin-degrading bacteria that paradoxically strengthens and regenerates the mucin layer when properly fueled by literally eating the mucus lining itself (Belzer et al. 2012). The interesting thing is, HMO supplementation feeds bifidobacteria which produces more mucins for akkermansia to feed correctly. Meaning there is a positive reciprocity in this relationship and both must be fed simultaneously to achieve a healthy ecosystem.
A heathy ecosystem and mucin layer achieves multiple things:
• It reduces friction for stool transit, making bowel movements more effortless.
• It protects the gut lining from LPS translocation (LPS seeping into the bloodstream), lowering systemic inflammation that slows motility.
• It supports microbial balance, as a healthy mucin environment, it favors SCFA-producing bacteria over harmful, pro-inflammatory species.
Together, Bifidobacteria and Akkermansia orchestrate a dual approach to constipation: softening stools through SCFAs and improving passage through a healthy mucin barrier (Nian et al. 2023).
Why Fiber and Laxatives Often Fall Short
Fiber supplements can increase stool bulk, and laxatives can provide temporary relief, but neither addresses the underlying dysbiosis, LPS-driven inflammation, or impaired mucin layers. Fiber may even exacerbate bloating if the microbiome is not prepared to ferment it properly, while laxatives bypass the natural signaling of the gut “Even when used judiciously, fiber can exacerbate abdominal distension, flatulence, constipation, and diarrhea” (Eswaran et al. 2013). Even probiotics alone often fail to colonize effectively without the right prebiotic fuel. Think of prebiotics as the soil and probiotics as the seeds.
HMOs, by contrast, work upstream, reshaping the gut ecosystem so that motility, hydration, and stool formation occur naturally. They reduce LPS load, enhance SCFA signaling, and restore the gut mucin barrier. All of which address constipation from the inside out rather than forcing a solution from the outside.
The Bottom Line: Constipation is not a necessarily a plumbing issue, it’s an ecosystem and terrain problem. When harmful microbes dominate and LPS inflames the gut, peristalsis slows, stool hardens, and the colon’s rhythm falters. By feeding Bifidobacteria and Akkermansia with HMOs, we can restore SCFA production, reduce LPS-mediated inflammation, reinforce mucin layers, and reignite natural bowel movements. This approach doesn’t just mask symptoms; it reprograms the microbiome to function as it was designed, providing a sustainable, root-cause solution to chronic constipation. I can promise you that.
Solution #2: Beyond the biome – Support Through Food
Once we’ve restored the key players and species in the gut, Bifidobacteria softening stools, Akkermansia lubricating the mucin layer, the next step is to support the ecosystem with foods and nutrients that complement these microbes. Even a thriving microbiome benefits from targeted interventions that enhance motility, stool hydration, and gut resilience. But this is an order of operations as the fiber you consume will be better utilized when you have the right bacteria available in your gut to digest it.
1. Aloe Vera: The Digestive Soother
Aloe Vera is far more than a substance we put on sun burns, it is a potent gut-supportive plant. Its primary bioactive compound, acemannan, is a polysaccharide with remarkable anti-inflammatory, immunomodulatory, and mucosal healing properties. Within the digestive tract, acemannan modulates macrophage activity (immune cells), shifting them from the pro-inflammatory M1 state to the anti-inflammatory M2 state (Liu et al. 2019), fostering a gut environment conducive to tissue repair and reducing inflammation.
This is particularly relevant in chronic constipation, where low-grade intestinal inflammation slows motility and hardens stool. Aloe also slows the release of sugars from carbohydrate-rich meals, preventing rapid glucose spikes that can feed pathogenic bacteria and exacerbate dysbiosis. Whether taken before a large meal or in the fasted state, Aloe works on two fronts: soothing and repairing the intestinal lining, while subtly regulating gut motility, making it an ideal natural intervention for both constipation relief and digestive health.
2. Magnesium: The Colon Relaxer
Magnesium plays a critical role in neuromuscular function, including the smooth muscles of the colon. It acts as a natural muscle relaxant while simultaneously drawing water into the colon via osmotic effects, softening stool and supporting regular peristalsis.
Different magnesium forms offer specific benefits:
• Magnesium citrate: Highly osmotic, excellent for immediate stool softening and improved transit time.
• Magnesium glycinate: Better absorbed, gentler on the gut, ideal for long-term maintenance without diarrhea.
• Magnesium malate: Supports cellular energy metabolism in addition to muscle relaxation, indirectly aiding motility.
When combined with adequate hydration, magnesium ensures colonic muscles contract and relax efficiently, reducing any strain and discomfort while working on other microbiome-focused interventions.
3. Coffee Enemas: A Rapid Reset
Coffee enemas are a unique tool that combines local stimulation of the colon with systemic support of liver detoxification and bile flow. Compounds such as cafestol and kahweol activate the enteric nervous system, triggering colonic contractions, strengthening the peristaltic muscles and promoting easier poops. Simultaneously, coffee enemas enhance bile secretion, which improves fat digestion and serves as a natural intestinal laxative.
While not necessary for daily use, coffee enemas can support individuals experiencing slow transit or stagnation, particularly when combined with microbiome restoration through the use of our prebiotics and dietary interventions, offering both motility and detoxification benefits.
It’s important to note that for coffee enemas, you must use certified organic coffee. Specific brands like S.A. Wilsons for example, have product and instructions for this exact application.
4. Osmotic Agents: Vitamin C & Water Balance
Certain nutrients act as osmotic agents, which means, they draw water into the colon to soften the stool. Vitamin C is highly effective in this role. In higher doses, unabsorbed ascorbic acid creates an osmotic gradient that pulls water into the intestinal lumen, improving stool hydration, shortening transit time, and alleviating occasional constipation (Mouly et al. 2005).
Optimal results require adequate hydration as Vitamin C is water soluble. Meaning, water will amplify the osmotic effect, ensuring stools remain soft. When combined with prebiotics, HMOs, and other microbiome-supporting strategies we’ve covered, osmotic agents address constipation both chemically and microbiologically, giving you way better motility.
5. Bulking Agents: Chia & Psyllium
Bulking agents provide your structural support, ensuring proper volume, hydration, and consistency, ultimately aiming to achieve that Bristol 4. Soluble fibers like psyllium husk and chia seeds absorb water in the colon, forming a gel-like stool that is way easier to pass. These fibers also can act as prebiotics, feeding beneficial microbes in the process and boosting SCFA production, which as we know, further supports motility and hydration (van Der School et al. 2022).
Unlike insoluble fibers that only add bulk, soluble bulking agents work in unison with the microbiome, supporting both the formation of stool and your microbial health. Including these as part of your regular routine, especially when paired with HMOs, GOS, and inulin-type prebiotics, will have you pooping effortlessly in no time at all.
Putting It All Together
When combined with a microbiome-centered approach, restoring Bifidobacteria, Akkermansia, and SCFA production, these functional foods and nutrients form a multi-layered solution to constipation. Aloe Vera reduces gut inflammation and promotes mucosal healing. Magnesium ensures smooth muscular function. Coffee enemas stimulate motility. Osmotic agents like vitamin C hydrate the stool, and soluble fibers maintain stool volume while feeding beneficial microbes.
Together, these interventions address constipation at nearly every level: microbial balance, mucosal health, muscular coordination, hydration, and stool structure. This approach goes beyond quick fixes, targeting the root causes of constipation and restoring the gut’s natural rhythm.
Solution #3: Unlocking the Gut-Body Connection
Even after restoring the microbiome and supporting it with specific key foods and nutrients, excretion can still be slowed if the body’s mechanics and nervous system are working against you. This is where movement, posture, and stress management step in as essential allies.
Stress: Fear, Cortisol, and the Gut-Brain Axis
Even after restoring the microbiome and supporting it with key foods and nutrients, excretion can remain sluggish if the nervous system is working against you. Chronic stress is one of the most overlooked drivers of constipation. When the body is locked in fight-or-flight mode, cortisol rises, blood flow is redirected away from digestion, and peristalsis slows dramatically.
From the perspective of Chinese Medicine, the colon is tied to the emotion of fear. Fear contracts. Fear holds on. Over time, this emotional contraction translates into physical stagnation in the gut. Addressing stress, therefore, is not optional—it is essential to restoring natural bowel rhythm.
The following practices offer practical ways to calm fear, reset the nervous system, and help the colon regain its natural capacity to let go.
Belly Breathing (Activating the Rest-and-Digest State)
Sit or lie down in a comfortable position. Place one hand on your chest and the other on your abdomen. Inhale slowly through the nose for a count of four, allowing the belly—not the chest—to rise. Exhale through the mouth for a count of six to eight, ensuring the exhale is longer than the inhale. Repeat this cycle for two to three minutes. This breathing pattern lowers cortisol and activates the vagus nerve, directly supporting motility.
Abdominal Massage (Following the Colon’s Path)
Lie on your back with your knees bent. Place your hands just above the right hip bone and use gentle, firm circular motions to massage upward along the right side of the abdomen (ascending colon), across the top (transverse colon), and down the left side (descending colon). Repeat for two to five minutes. This technique mirrors the natural path of stool through the large intestine and can help release abdominal tension.
Spinal Twists (Encouraging Release)
Sit cross-legged on the floor or upright in a chair. Place your right hand on your left knee and gently twist your torso to the left, holding for five breaths before switching sides. Twisting creates a gentle compression and release in the intestines, which can stimulate peristalsis and relax the pelvic floor.
Acupressure for Flow
A point commonly used in Chinese Medicine is Conception Vessel 6 (CV6), located about two finger widths below the navel. Applying gentle, steady pressure here while practicing slow belly breathing for one to two minutes helps strengthen and move energy in the lower abdomen, supporting motility and relieving stagnation.
Reframing Fear into Release
When you notice your gut tightening or your body holding on, pause and place a hand on your abdomen. With each inhale, repeat silently: “I am safe.” With each exhale, repeat: “I can let go.” Practicing this for several breaths links emotional release with physical release, retraining the nervous system to allow both body and colon to relax.
These practices integrate modern science with the wisdom of Chinese Medicine. By creating safety in the nervous system and addressing the emotional root of contraction, the colon is given permission to move again. This not only relieves constipation in the moment but helps restore long-term rhythm and resilience in the gut.
Posture Matters: Why the Squatty Potty Works
As we’ve covered, even with a balanced microbiome and good nutrition, constipation can persist if the body’s mechanics are working against you. Over time, constant poor posture and prolonged sitting can tighten the hips and psoas muscles, compressing the colon, slowing transit, and reinforcing constipation. Addressing posture is therefore essential for restoring natural bowel rhythm.
The following practices can offer practical ways to optimize posture, release tension in the pelvic floor, and support smooth bowel movements. Remember, the practice here is persistence as fixing our gut and posture is not an overnight fix, so stay patient, and remember the goal!
1. Foot Elevation and Forward Lean (Mimicking a Squat)
Elevating the feet on a small stool while seated on the toilet tilts the bod forward, straightening the rectum and relaxing the puborectalis muscle. This adjustment opens the angle of the rectum and reduces pressure on the ileocecal valve, allowing stool to move more easily from the small to large intestine. Even small changes, such as a 4-8 inch footrest, can make elimination faster, smoother, and less strenuous.
2. Core Activation
Prolonged sitting, hunching, and even driving for long periods tightens the psoas and hip flexors, indirectly influencing the pelvic floor and colon. A little bit of added movement throughout the day will help stimulate the parasympathetic nervous system (remember rest and digest) which promotes healthy movement of the colon. Short walks, yoga twists, light rebounding, or pelvic tilts activate the abdominal muscles to massage the intestines, improve lymphatic drainage, and release tension in the hips and the psoas muscle. Even brief bouts of movement after meals, just five to ten minutes, will help greatly in mobilizing the bowels.
3. Belly Breathing
Activating the lower abdominal muscles and practicing diaphragmatic breathing help balance your pelvic floor, allowing those tight muscles to relax. It may seem basic but its a true foundation here. Exercises such as bridges, pelvic tilts, or gentle core contractions combined with slow belly breathing relax the colon, ease the puborectalis, and support the proper angle of the rectum to help achieve the perfect poop.
4. Intentional Bathroom Habits
This is intuitive pooping, which is the act of allowing yourself to respond as quickly as possible to your body’s natural urge to release. It may seem obvious but think of all the times we may hold it in based on convenience to our situation. When we do listen to the urge, remember to lean slightly forward, and massage your lower abdomen to allow the stool to pass much easier. A mindful posture will help your colon work with gravity rather than against it which in-turn reduces strain.
By integrating foot elevation, activating your core, movement, and intentional bathroom habits, you begin to create conditions for the colon to function efficiently more consistently. This will allow us to continue working with our body’s natural anatomy and mechanics, reducing constipation and improving motility.
Concluding Remarks
Here’s the bottom line: constipation is not a random inconvenience. It’s a signal. Every culprit we’ve looked at, posture, diet, microbiome, stress, medications, all funnels back into the same loop: inflammation, dysbiosis, and stalled motility.
That’s why just piling on more fiber or chasing the next laxative rarely works long-term. If you don’t address the why, the gut-brain signals, the bile flow, the microbial balance, then all you’re doing is treating symptoms, not the root.
The good news? These loops can be broken! Your body wants rhythm, it seeks balance, and to regain a natural flow. With the right inputs, your hydration, nutrients, microbial support, and especially stress reduction, you can retrain your gut to remember its natural flow.
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