Constipation Confusion: Understanding the Role of Fiber in Gut Health

In a recent live conversation, Dr. O sat down with board-certified gastroenterologist Dr. Frances Horenstein to break down what constipation really is, why so many people struggle with it, and how fiber plays a central role in gut health. What followed was a practical, eye-opening discussion filled with everyday strategies you can actually use.

Here are the key takeaways.

What Is Constipation—Medically Speaking?

Constipation is more than just “not going every day.”

Medically, constipation is defined as:

Having fewer than three bowel movements per week
Passing stools that are hard or difficult to pass
Needing to strain or use laxatives regularly
Feeling bloated, gassy, or heavy in the abdomen

Occasional constipation can happen—especially during travel or disruptions in routine. But when constipation becomes chronic (lasting more than three months and requiring laxatives), it’s something that should be discussed with a healthcare provider.

Is Constipation Dangerous?

Many people assume, “This is just my normal.” But chronic constipation should not be ignored.

When stool sits in the colon for too long, more water is absorbed from it. This makes it harder and more difficult to pass. Over time, this can lead to persistent discomfort, bloating, and dependency on laxatives.

Constipation may be common, but it is often a sign that something in your routine—diet, hydration, movement, or stress—needs attention.

Why Do So Many People Struggle With Constipation?

There are several common reasons:

1. Low Fiber Intake

Most modern diets are low in fiber. Processed snacks, convenience foods, and grab-and-go meals provide calories but very little fiber.

2. Busy Lifestyles

Many people skip breakfast or rush through their mornings. Teachers, nurses, and other professionals who cannot easily take bathroom breaks often ignore the urge to go.

3. Ignoring the Urge

When you feel the urge to have a bowel movement and ignore it, you may miss the opportunity. The urge does not always return quickly.

4. Bathroom Avoidance

Some people avoid public restrooms and wait until they get home. Repeatedly holding stool can contribute to long-term constipation.

Listening to your body matters. When the urge comes, it is best to respond.

The Role of Fiber in Gut Health

Fiber is essential for healthy digestion. It adds bulk to stool and supports regular movement through the colon. It also feeds the beneficial bacteria in your gut.

The general recommendation:

Women: At least 25 grams per day
Some guidelines suggest up to 30–35 grams daily

However, most people fall far below this.

Common Fiber Sources

Apples (4 grams per medium apple)
Bananas (4 grams per medium banana)
Avocado (5 grams in half an avocado)
Beans (black beans, pinto beans, black-eyed peas, honey beans)
Lentils and legumes
Oats and bran cereals
Chia seeds
Nuts
Berries
Green peas

An important reminder: not all “healthy” foods contain fiber. For example, yogurt may contain probiotics, but it has zero fiber unless you add something like chia seeds or fruit.

Why People Struggle to Get Enough Fiber

Fiber-rich foods are filling. You may feel full quickly after eating fruit or vegetables and assume you have eaten enough, when you have not met your daily target.

In addition, many convenient foods—chips, crackers, packaged snacks—contain little to no fiber.

Reaching 25 grams in a day requires intention.

How to Increase Fiber Without Feeling Miserable

One of the biggest mistakes people make is increasing fiber too quickly.

Do not jump from low fiber to 25 grams overnight. That can cause bloating, gas, and discomfort.

Instead:

Increase fiber by about 5 grams every 3–5 days
Pay attention to how your body responds
Choose fiber sources you actually enjoy

Building sustainable habits is more important than forcing foods you dislike.

Also, fiber must be paired with adequate water intake. Adding fiber without increasing fluids can worsen constipation.

The Importance of a Morning Routine

Your digestive system needs a signal to get moving. Eating breakfast stimulates the “gastrocolic reflex,” which encourages bowel movement.

A helpful strategy:

Eat breakfast regularly
Allow time in the morning for your body to respond
Avoid rushing out the door immediately after waking

Creating a consistent morning routine can significantly improve bowel regularity.

Movement Matters

Physical movement stimulates colon motility.

You do not need intense workouts. Even:

Walking
Stretching
Short movement breaks throughout the day

can support healthy digestion.

Already Constipated? What Can Help?

If you are currently backed up, certain foods may help:

Prunes or Prune Juice

Prune juice contains sorbitol, which stimulates colon movement. Research has shown it can be comparable to some over-the-counter osmotic laxatives.

Pears and Kiwi

These fruits are commonly recommended and may help support bowel movement.

However, if constipation persists or becomes chronic, it is important to speak with your healthcare provider.

A Helpful Perspective

The average colon is about six feet long. When stool remains in the colon for too long, that is a significant amount of retained waste.

Regular bowel movements are not just about comfort. They are part of maintaining overall gut health.

Key Takeaways

Constipation is common but not normal when chronic.
Fewer than three bowel movements per week may indicate constipation.
Increase fiber slowly—about 5 grams at a time.
Drink more water when increasing fiber.
Eat breakfast to stimulate digestion.
Do not ignore the urge to go.
Incorporate daily movement.
Prunes and prune juice can help if you are already constipated.

Start with one change. Implement it consistently. Your gut will thank you.

Watch the full video HERE