WHY AM I CONSTIPATED EVEN THOUGH I EAT PLENTY OF FIBER?

By Lora Jody, RDN,LD

Eating more fiber doesn't always solve constipation. If you are getting plenty of fiber but still struggling with hard stools, infrequent bowel movements, bloating or incomplete evacuation, the problem may involve the type of fiber your'r eating, hydration, gut motility, food intolerances, chronic stress or pelvic floor function.

If you're constipated, you've probably heard the same advice over and over: eat more fiber.

But what if you're already eating plenty of fiber and you're still constipated?

Constipation is more complicated than simply not eating enough fiber. While fiber can be extremely helpful, bowel function also depends on hydration, intestinal motility, pelvic floor function, medications, eating patterns, physical activity and underlying health conditions.

More Fiber Isn't Always the Answer

Fiber adds bulk to stool and, depending on the type, can also help retain water and influence the intestinal microbiome.

But adding large amounts of fiber when stool is already moving slowly can sometimes leave you feeling more bloated, uncomfortable and backed up.

The type of fiber matters, too.

Soluble fibers absorb water and form a gel-like substance. Foods containing soluble fiber include oats, chia seeds, beans, apples and many fruits and vegetables.

Insoluble fiber adds bulk and can help move material through the digestive tract. It's found in foods such as wheat bran, whole grains and many vegetables.

Some people tolerate one type much better than another.

Hydration Matters

Fiber and fluid work together.

Increasing fiber without adequate fluid can make stools harder or more difficult to pass in some people.

Rather than simply trying to drink enormous quantities of water, consider your overall hydration—including water, other fluids and water-rich foods.

Your Gut Has to Move

Your intestines rely on coordinated muscular contractions to propel their contents forward.

Factors that can affect gastrointestinal motility include:

• Physical inactivity

• Food sensitivities and intolerances

• Chronic stress

• Certain medications

• Changes in eating patterns

• Chronic under-eating

• Neurological conditions

• Hormonal and metabolic conditions

• Slow-transit constipation

Regular meals can also stimulate the gastrocolic reflex—the natural increase in colon activity that occurs after eating.

Your Pelvic Floor Could Be Involved

Sometimes the stool reaches the rectum normally, but the muscles responsible for allowing a bowel movement don't coordinate properly.

This is known as a defecatory or pelvic floor disorder.

People may experience excessive straining, incomplete evacuation, pressure or the sensation that stool is there but won't come out.

Adding more and more fiber won't necessarily correct this problem.

Look at Medications and Supplements

Constipation can also be related to medications and supplements.

Common contributors can include certain:

• Iron supplements

• Calcium supplements

• Opioid pain medications

• Anticholinergic medications

• Some antidepressants

• Some blood pressure medications

Never discontinue a prescribed medication because you suspect it's causing constipation without discussing it with your healthcare provider.

A Better Question Than "Do I Need More Fiber?"

Ask:

Why isn't my digestive system moving stool normally?

For one person, increasing fiber may solve the problem. Another person may need a different type of fiber, better hydration, increased movement, medication evaluation or assessment of pelvic floor function.

That's why nutrition should be individualized rather than reduced to a single recommendation.

Need help getting to the root cause?

Lora Jody, RDN,LD uses a personalized, functional nutrition approach to identify dietary and lifestyle factors that may be contributing to digestive symptoms.

Explore our Nutrition Resources, visit Shop Nutrition, or learn more about working with a Registered Dietitian Nutritionist.

This information is intended for educational purposes and is not a substitute for individualized medical care. Persistent or unexplained constipation, blood in the stool, significant abdominal pain, vomiting or unexplained weight loss should be evaluated by a healthcare professional.

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