When Constipation Isn’t Just about Fiber: A Functional Nutrition Approach to Constipation

Ever have a client experience that CHANGES how you approach things?  Listen to my story about the simplest change that addressed a decade+ of chronic constipation in one of my clients. And no - it wasn’t fiber or a supplement. This experience opened my eyes to a more thorough way to approach constipation - so, of course, I want to share it with you!

It’s Not Just About “Fiber” 

If we’re being honest, most of us think of “fiber” and supplements when it comes to improving constipation. But what if that’s just scratching the surface? In my practice and experience working with clients over the years, I’ve found that a full functional nutrition approach to constipation is far more effective. This means casting a wider net of interventions: looking at the whole picture of a person’s lifestyle, nervous system, stress, daily habits, and even posture to unearth more tools to help create change with our clients.

…. also Not Just About “Supplements”

Sometimes in clinical practice, it's easier to go for a pill than lifestyle and diet changes.  The latter takes work!  Clients are often looking for over-the-counter constipation relief.  Redirecting folks to small, gentle, yet effective lifestyle tweaks that get to the root cause is so critical.

I want to share the story of a client who had struggled with constipation for nearly a decade. She tried all the conventional routes. And then experienced a profound shift. Not because of a miracle supplement or even my amazing gut protocol, but because she leaned into daily practices, rhythm, and self-care.

A 10-Year Struggle Turned Around By Daily Rituals and Care

• Background  - 34 yo woman with chronic constipation (going every 3-4 days) with straining and hemorrhoids. She had multiple colonoscopies and MRIs and was about to start a pharmaceutical prescription for constipation.

• Stress / Trauma Layer - High stress levels, lack of self-care, and a history of trauma — all of which impact the gut (and gut motility) via nervous system dysregulation.

• Foundational Work  - While we awaited the results of a GI Map, we started by tweaking her diet to avoid trigger foods and diving into stress and trauma support. She made some space for self-care, and the impact was HUGE.  She adopted a small morning ritual: 10 minutes of calm, sipping warm lemon water, and simply being present.

• Outcome - She went from going every 3-4 days with effort, to daily elimination and easier bowel movements — even during travel! That one habit unlocked BIG change  — even before we dialed in and addressed underlying GI dysbiosis as evidenced on her GI Map.

When I say it unlocked BIG change - it wasn’t just for her. This experience profoundly changed how I approach supporting constipation. 

Why “More Fiber” Isn’t Always the Answer, or at least not the ONLY answer.

This client forever changed my clinical approach. I’ve broken out a few reasons why a foundational daily ritual approach often yields a BIGGER impact:

• Stress -> We know that nervous system activation - staying in fight-or-flight - impacts gut motility and can slow it down. When emotional stress or trauma is unresolved, we know it can keep the body in this state. Supporting stress resilience and creating a safe time and space for elimination can reestablish or retrain bowel habits. I think of this like resetting circadian rhythms for better sleep. 

  
  

• Toilet Anxiety -> I’ve encountered clients who, after years of painful and difficult elimination, would experience anxiety JUST AT THE IDEA of going to the bathroom. It was an actual stress response. This often stems from the ongoing struggle and is what happens when the brain and body associate one place/time with discomfort. The struggle is REAL, and it can become so wired that it’s hard to teach the body a different response. So, breaking this cycle and creating a “safe space” for elimination can be a BIG piece of the puzzle.

  
  

• Position and posture -> This is an underrated factor! Raising the feet a few inches off the floor with knees above hips changes alignment and can significantly increase the ease of passing stool. I love this tip because it is one of the most overlooked things to try — and is also one of the simplest and least invasive.

  
  

• Hydration -> This is likely already on your radar, but worth noting that increasing fiber always needs to be in sync with optimizing hydration to avoid adding too much bulk without hydration to ease elimination.

SO YES! I totally incorporate fiber, magnesium, etc into protocols as they ABSOLUTELY have their place. Supplements are a HUGE part of the work we do, and a full GI protocol is almost always key to healing. But from my experience, those are far more powerful when paired with foundational, daily, holistic tools (and in fact the daily tools often start to make the BIGGEST difference).

Whole-Person Tools for Constipation Relief

Here are tools (beyond supplements) that tend to unlock change:

Tool	What it does	How to use / first steps
Morning Ritual	Helps establish a regular rhythm, timing, and safe space for “go time”.	Create a 5-10 minute habit each morning -> warm lemon water, stretch or gentle movement, breathing, or even just sitting quietly. What does your client need?
Abdominal Massage for Constipation	Manually stimulates movement along the large intestine. Can soothe discomfort and reduce pain or bloating.	Share a “how-to” video on this studied massage method. Encourage trying this lying down as part of a morning wake-up routine.
Hydration	Softens stools + gentle stimulation of gut motility.	Add a warm beverage such as lemon water or herbal tea to a morning ritual. Check in on overall water intake, timing, and absorption
Squatty Potty	Raising the elevation of feet/legs reduces strain and supports easier evacuation.	Add a footstool or squatty potty to the main bathroom. This SIMPLE add can really make a difference.
Stress management	Supporting the vagal nerve with stress and mindfulness exercises is essential for gut motility	Techniques: breathwork, mindfulness, journaling, therapy, humming/singing.. Even two deep diaphragmatic breaths before sitting on the toilet.

Final Thoughts 

I am certainly NOT dismissing supplements. They’re often essential tools in our protocol development. But as practitioners, it’s important not to miss the quieter, foundational contributors to symptoms that we may gloss over with clients. We’re in the business of helping clients connect the dots: how something as simple as a rushed morning routine, poor hydration, or chronic stress might be showing up as constipation. When we share a WHY that is directly connected to a client’s goal, they are more likely to engage—and to stick with the changes.

If you find yourself (or your client) defaulting to “more fiber” as the solution, consider widening the lens. Try layering in one small, strategic lifestyle adjustment and watch how the body responds. These strategies from a functional nutrition approach to constipation strategies help uncover the moments where clients begin to feel empowered—and that’s when real momentum starts.