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Constipation nation : what to know when you can't go
2025
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Colorectal surgeon Fong debuts with an informative guide to maintaining healthy bowel movements. She explains that the colon primarily serves to reabsorb water from food after it's been digested, and that constipation occurs when the colon either absorbs too much water or has trouble contracting. To keep things moving, she recommends consuming "at least sixty-four ounces of water" and 25--35 grams of fiber per day, noting that fiber helps with motility by bulking up stool while producing short-chain fatty acids that provide the colon with energy. She encourages readers to get their daily fiber through foods rather than supplements and includes recipes for roast broccoli, pumpkin pasta, and egg drop soup with spinach and chicken meatballs. Stressing moderation, Fong suggests that while "coffee stimulates enzymes in the saliva and stomach that help with digestion," too much can cause dehydration, and that while exercise generally aids motility, overly strenuous workouts can trigger a fight-or-flight response that "diverts blood flow from the gut to... the heart and the brain." Fong's conversational tone keeps things light without slipping into the scatological ("Poop or get off the pot"). It's everything readers always wanted to know about constipation but were too afraid to ask. (Nov.)
Summary

A definitive guide to the science and history of constipation across the nation.
Most Americans have had constipation symptoms at some point in their lives. Statistics show up to 30% of Americans are affected with chronic constipation. This number reaches 60% as we age. At any given time up to 100 million people in the United States experience constipation. During the pandemic, constipation and its related anorectal issues worsened because everyone was sitting at home.
Constipation has affected humans throughout history. Some called it "civilization's curse." Dr. John Harvey Kellogg (yes, of Kellogg's cereal fame) promoted cold cereal as a constipation cure. Today, we have more probiotics and diets than you can shake your tushy at, and social media has popularized the Blue Poop Challenge to diagnose gut health. But what does it all mean?
After seeing thousands of patients in her practice as a colorectal surgeon, Dr. Fong realized that she was repeating the same information, sometimes twenty times a day. Yet, this information was not common knowledge. What was found on the Internet was confusing and conflicting, leaving people who Googled their symptoms with more questions than answers. As an academic clinician who has written peer-reviewed publications, Dr. Fong sought information beyond even what the medical textbooks taught her.
Constipation Nation helps readers who would rather research information themselves before seeing a healthcare professional to troubleshoot their poop chute. Drawing from 200 evidence-based sources as well as historical texts, Dr. Fong addresses all aspects of constipation, combining medicine, physiology, anatomy, microbiology, nutrition, history, and social sciences to get to the bottom of it all to explain why we doo... and why we don't.

Table of Contents
Preface to the Prefacevii
Part IThe Scope of the Problem1
1Why Me? Read This Book3
2What Constipation Is: Why We Doo ... and Why We Don't7
3You Are Not Alone: Statistics15
4Constipation Is the Root of All Evils-or Is It?16
512 Seconds to Poop: A Bit of Natural History and How Pooping Works22
6Embryology, Anatomy, and Physiology25
7Anal Immune System: The Anus Cleans Itself31
8Trained to Contain: Potty Training and Poop Shaming33
9Pregnancy and Constipation37
10You Can't Poop Out a Bad Diet53
11A Bug Up Your Gut: Probiotics and the Gut Microbiome69
12Bearing the Load: Exercise77
13Coffee or Not Covfefe?80
14Nature Calls: "Natural" Supplements85
15Other Treatments People Have Tried: Warm water, Cyborb Pooping, and Constipation Myths91
Part IIWhy You Should Care: Hemorrhoids and Fissures, Oh My!101
16Monday Morning Hemorrhoids and Other Scenarios103
17Common Complaints and Takeaways109
18A Case Study of an Irregular Pooping Cycle: Parkinson's, Mental Health, and, What Else? Constipation114
19Diagnosis122
20The COVID Connection129
21When Surgery Is Necessary134
22The Flip Side of the Coin: Fecal Incontinence and Diarrhea139
23Bugs or Drugs?: Infections and Pharmaceuticals, Including Opioid-Induced Constipation142
24Mimics of Constipation: When to Get Medical Attention157
25Five Recipe Ideas for Constipation165
26Conclusion and Future Directions172
Appendix ATen Bowel Commandments175
Acknowledgments177
Notes179
Bibliography207
Index235
About the Author243
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