10 Sneaky Signs You Could Be Constipated, According to a Gut Health Doctor

We get it: The topic of poop isn't nearly as beautiful or Instagram-friendly as something like hot chocolate bombs or jarcuterie.

But one of our favorite docs, @theguthealthmd, is trying to change the conversation. Will Bulsiewicz, M.D., a Charleston, South Carolina-based gastroenterologist and the New York Times bestselling author of Fiber Fueled particularly caught our eye with this post last week:

ICYMI in the caption, Dr. Bulsiewicz reveals, "As a gastroenterologist, I see tons of patients who are suffering from constipation and don't even know it...they get tripped up because they think constipation only occurs in people who poop once every three days. Not true! Heck, you can have rip roaring, blast your toilet you're about to launch a rocket to the moon diarrhea and be constipated."

That was definitely news to us, so we reached out to the self-declared "Poop Whisperer," Dr. Bulsiewicz himself, for the scoop.

About 16 in 100 adults suffer from constipation, and that number goes up to 33 in 100 in adults 60 and up. So it's important for many of us to improve our poops, and in turn our digestive health. Many people think that eating enough fiber (38 grams per day for men, 25 grams per day for women) will automatically keep your bowel movements regular.

"That's simply not true," Dr. Bulsiewicz says. "When your bowels are moving, fiber is your friend and will keep them moving. But if you are backed up with constipation, fiber won't necessarily fix the issue and in some cases can make you feel worse. In that setting, the emphasis needs to be placed on getting the bowels moving again so that fiber can get back to being your friend that helps keep things moving through."

You can actually poop everyday, sometimes even several times a day, and still be constipated if you have incomplete emptying. This manifests with the feeling of incomplete evacuation, a second bowel movement less than an hour after the first, or having itty-bitty poops. You can even have diarrhea and be constipated, which is also known as "overflow diarrhea." So how do you actually know if you're constipated? Virtually all patients Dr. Bulsiewicz sees who are struggling with constipation have gas and/or bloating.

Other symptoms of constipation (besides incomplete emptying, gas and bloating) might include:

• Abdominal pain that migrates to different locations and is often worse with meals
• Nausea or queasiness
• Loss of appetite
• Feeling full quickly after eating
• Acid reflux
• Fatigue
• Brain fog

If we feel like we might fall into the constipated camp but now know fiber may not be the answer, what's up, doc?

5 Ways to Help Relieve Constipation, According to a Gastroenterologist

1. Drink more water. "You need to float the log down the river," Dr. Bulsiewicz explains.
2. Move your body. When your body moves, your colon moves, and "you need your colon to move to have a bowel movement," he says.
3. Maintain a habit. Your digestive tract is best at being regular when, well, you're regular about the timing. "The body does best having a bowel movement at the same time each day. One way to establish a habit is to sit on the toilet after coffee and breakfast each morning for five minutes, even if you don't feel like you need to go," Dr. Bulsiewicz suggests.
4. Assume the position. The normal American toilet set-up does not orient pelvic muscles for proper pooping, Dr. Bulsiewicz says. To counteract this, try elevating your feet on a stool, leaning forward and putting your elbows near your knees. (No wonder the Squatty Potty, which helps you form a better poop squat by elevating your feet, scored Shark Tank funding!)
5. Consider magnesium before bedtime. The mineral is "good for sleep, good for mood, good for headaches and also good for healthy bowel movements," Dr. Bulsiewicz says. Try incorporating more of these magnesium-rich foods into your diet.