You know those people…they have a perfect bowel movement at the same time of day. Every single day. They feel like magical unicorns, viewed with wonder, and often envy. How does that happen? And how do the other 1 in 4 people suffering with chronic constipation become one of those magical unicorns?

There are a lot of reasons for being constipated and having healthier bowel movements will often take working with a well-trained healthcare provider. But there are a few things that I’ve seen that can affect not having regular, properly formed or easy to pass bowel movements. And hint: having rabbit pellet stools, even if it’s every day, is still constipation.

1. You are what you eat

A lot of people have focused on what they’ve taken out of their diet more than what is in their diet. In the quest to not feel pain or lose weight or stop feeding the gut in wrong ways, social media may have convinced you that you need to limit your diet in extreme ways. We know this inherently has the risk of constipation.

Many people will find their elimination or low carb diet may help with certain things, but it may worsen other things including constipation (or they’ve become constipated since starting). We commonly see that many diets that people think are good diets for the bowels aren’t actually great – we’ll see that high protein diets are inherently low in fiber and many vegetables aren’t nearly as high in these important nutrients as people think. A common style of eating that I see looks like this:

Breakfast: A protein smoothie with Greek yogurt, a banana, a half tablespoon of flaxseeds, half cup of spinach and protein powder + a couple scrambled eggs (on the side…not in the shake!) – about 7 grams of fiber

Lunch: A salad with 2 cups of leafy greens, 8” of cucumber, some red onion, 6 cherry tomatoes, feta, olives and chicken breast – about 4 grams of fiber

Dinner: Grilled salmon with a half cup of rice, a cup of broccoli and cut up carrots – about 3 grams of fiber

Snack: Rice crackers with cheese & sliced watermelon – about 0.5 grams of fiber

This results in a daily total of 15 grams or less of fiber – not enough for healthy bowel movements.

 2. All fibers are not equal

We’ve all heard the message of ‘eat more fiber’ – but that message has treated all fibers as equal. Which they are not – different fibers have different properties to them and will affect your bowel movements differently.

Thinking they’re all the same would kind of be like saying your bones need calcium, you should just increase your minerals – and then you’d just go out and find a whole lot of selenium and manganese-rich foods. We wouldn’t do that because all minerals do not have the same action. And neither do fibers.

Not only will some fibers not help with constipation–some can actually make you feel worse. For many people, rapidly fermentable fibers will not have any action on the bowels because they’re consumed by the bacteria and quickly turned into gases. This doesn’t help with the formation of a bowel movement and can increase the sensations of bloating and fullness. These fibers can be often found in foods labeled ‘high fiber’ – especially if you think they taste too good to be true!

The addition of what we call ‘functional fibers’ like inulin can be extremely aggravating, but give the impression of health because of the high fiber label. This can make it feel like all fibers are dangerous and can result in more food restrictions. Working with a trained professional can help slowly expand your diet and help you find the right type of fibers for what you need!

 3. When you eat matters too

Our gastrocolic reflex – the bodily response that controls the movement of waste through the colon so you can have a bowel movement – happens most strongly in the morning and after meals.

The best timing to take advantage of this is after breakfast. But if you’re not eating breakfast or you just have a small, non-fat breakfast like a banana, the trigger won’t be as strong. For people who enjoy intermittent fasting, ending the fast earlier in the day may be better if you’re constipated – it will let you take advantage of your gastrocolic reflex by just changing your timing.

Working on finding the right dietary balance can be difficult with longstanding food patterns – but it might be worth being curious about whether one of our most basic human requirements (eating) could be affecting your struggle with your bowel movements.

And maybe you too can be one of the magical unicorns!

Dr. Kim Bretz believes that health doesn’t have to be so hard and that science can make it easier – she supports using the best research available, along with clinical experience and combining it with patient preference.