Constipation | The 7 Warning Signs You’re Not Pooping Enough

Constipation | The 7 Warning Signs You’re Not Pooping Enough

… plus the Ayurvedic solution

One of my most popular TikTok videos of 2021 was titled “How to Poop Every Day.” The response was overwhelming, with so many people commenting and sharing their struggles with constipation. As America’s Gut Doctor, I knew that constipation was a big problem that was continuing to grow, but it wasn’t until that video that I realized how many people were struggling in silence with chronic constipation — many of whom didn’t even realize it!

That’s why this week, we’re diving into this common gut health issue, what you can do, and my favorite tips for beating constipation for good.

What is constipation, and how do I know if I have it?

Let’s get real. If we’re talking about your gut, we’ve got to talk about sitting on the toilet. Sometimes my patients are embarrassed to talk about their bowel movements, but your poop can actually give you some very helpful signals about your overall health, so it’s important to pay attention to how often you’re going, and any changes to your bowel movements. Constipation occurs when your digestion is essentially too slow. This causes your stools to dry up and become hard, making them difficult to pass.

Let me say it loud for people in the back — constipation is extremely common, and it’s nothing to be embarrassed about. In fact, this condition affects about 16 out of 100 people in the United States. Many of you have probably experienced occasional constipation, either while traveling, after you change your eating habits, or when you’re stressed. Occasional constipation happens, and it’s nothing to be too worried about. But chronic (or long-lasting) constipation is a sign that something’s awry and should be addressed.

So, how do you know if you have chronic constipation? It’s not always as obvious as you might think. In fact, you may still have chronic constipation EVEN IF you go every day. Many of my patients come to me thinking their digestion is normal, only for me to diagnose them with constipation. So without further adieu, here are 7 signs you’re not pooping enough.

7 Warning Signs You’re Not Pooping Enough

1. You’re not pooping every day

This one is simple! You should be having at least one bowel movement a day. In conventional medicine, they classify constipation as less than one bowel movement every 3 days but the truth is that for optimal health, you want to be pooping every single day. In fact, something called the gastrocolic reflex dictates that every time you fill your stomach with food, it signals your rectum to empty. So, technically, you could be having up to three bowel movements daily after meals, and that would be considered normal.

2. You’re straining

Straining indicates hard, dry stools and can contribute to other issues like hemorrhoids, which are swollen veins in your lower rectum that can bleed every time you have a bowel movement, and anal fissures, which are small tears in the lining of your anus that can make sitting on the toilet feel like misery. In other words, straining is a big “no, no.” Chronic straining can lead to pelvic muscle dysfunction that will further worsen ongoing constipation. It becomes a vicious cycle!

3. Pooping takes a LONG time

Your bowel movements don’t have to happen in an instant, but sitting on the toilet for 10 or 15 minutes is a sign that things aren’t quite flowing like they should. Oftentimes, these poops feel incomplete, even after pushing for so long. You may poop every day, but if your poops take a lot of time and effort, I have news for you—you’re constipated.

4. Your stool is hard

If your stool feels hard and sharp as it exits your body, it’s a sign that it’s too dry and has hardened on its way out of your body, pointing to constipation. When stool sits in your colon for too long, the body has more time to pull water out of the stool, desiccating it and leading to hard, painful poops.

5. Your pants don’t fit

Constipation is often accompanied by bloating and even gas pains that make it difficult to wear anything other than sweats. A lot of times patients think they’re bloated, when what is really happening is that they’re simply not pooping enough. It’s not excess gas in their abdomen; it’s too much stool.

6. Your bowel movements don’t feel complete

Constipation often leads to small bowel movements that don’t leave you with that light, empty feeling. Instead, you often feel like there is still fullness in your bowel. The reason is you’ve probably only eliminated less than half of the stool that is sitting inside your colon waiting to exit. Regular, small, but incomplete bowel movements still mean you’re constipated, even if they’re happening every day.

7. Your stool is pellet-like

This is one of the telltale signs that you’re dealing with serious constipation—rabbit pellets! On the Bristol stool chart, this would be type 1, which signifies severe constipation. Ideally, your stool should be soft and snake-like.
If you read the seven warning signs above and had an “Aha!” moment, you’re not the only one. It’s easy to get used to constipation and think of it as normal, or at least normal for you. But you shouldn’t have to live with the discomfort of constipation, even if you have for years. In my practice, I take a holistic approach to kicking constipation to the curb.

A Happy Gut Approach to Constipation

As America’s Gut Doctor, I treat constipation on an almost daily basis. I often use a combination of Eastern and Western medicine to get my patients quick relief from constipation, and help them correct underlying gut and lifestyle issues that are contributing to the problem.

For those looking for quick relief from occasional constipation I often suggest:

1. Magnesium

This mineral can help draw water into the intestines and relieve constipation fast. This increase in water not only softens the feces, but actually increases the volume, which promotes intestinal motility. In fact, a study of 64 elderly patients who were already using laxatives prior to the study showed that magnesium hydroxide caused more frequent bowel movements as well as more normal stool consistency than bulk-forming laxatives.

Pros : non-addictive.
Cons : can give you diarrhea; sometimes accidents do happen.

2. Senna

he herb senna, which is the active ingredient in “Smooth Move” tea, is an extremely effective constipation remedy and works by stimulating the muscles in your gut to produce a bowel movement. In one study, 69 percent of participants given 1 gram of senna experienced an improvement in constipation.

Pros : quick relief for occasional constipation.
Cons : addictive, can damage the colon, leading to dependency on laxative alone for bowel movements.
These remedies can be great for acute issues, but chronic constipation requires a more holistic, deeper approach. Oftentimes, constipation is caused by factors that need correcting before the constipation will resolve.

5 Tips for Relieving Chronic Constipation


Get moving : One of the best ways to “get things moving” is to literally get moving. Studies have shown that prolonged physical inactivity is a major risk factor for constipation. I recommend starting with yoga (check out the poses in my book, Happy Gut ® ) or a quick jog to ease into the physical activity. A morning run may be all you need to hit the toilet before work.


Correct underlying SIBO : SIBO stands for small intestinal bowel overgrowth, and it is an often overlooked cause of chronic constipation. SIBO occurs when there is an overpopulation of microbes in the small intestines, which can cause your gut to ferment the nutrients in your food before they can fully digested and absorbed, leading to gas and constipation. Many people think they have IBS, when what they really have is SIBO, which is one of the underlying causes of IBS. In this case, a low-FODMAP diet can help, but most importantly, working with a naturopath or functional medicine doctor to design a personalized treatment plan is the best approach. If you would like a private consultation with me, click here .


Avoid constipation-triggering foods : Certain foods are well-known constipation triggers, such as fried and fast food, red meat, and dairy products, particularly cheese. By avoiding these foods you are doing your overall health a favor — since many constipation-causing foods are also bad for your overall health too. Realize that combining more than one constipation trigger in one meal is a recipe for disaster.


Hydrate, hydrate, hydrate : If supplements like magnesium are able to draw more water into the intestines to relieve constipation, it makes sense that simply drinking more water would help keep stools hydrated and soft. Well, if you thought that you were correct! When you don’t get enough water, it can lead to sluggish digestion. Studies show the lower your water intake is, the more likely you are to struggle with constipation.


Lean on ayurvedic medicine : The ancient medicine system of India, called Ayurvedic medicine, has a unique approach to healing constipation. It involves balancing the three main elements of life (also known as doshas): Vata, which regulates the nervous system; Pitta, which maintains metabolic processes; and Kapha, which supports structural integrity. And this is a formula with a long-standing history of use in Ayurveda to successfully treat constipation. One special combination in particular, called triphala, is one of the most widely used botanical formulas in Ayurvedic medicine for constipation. It’s known for promoting smooth functioning of the bowels and relieving constipation.

Many of my patients, some of whom have struggled with chronic constipation for years, have had a ton of success with an Ayurvedic approach to resolving constipation. In fact, I saw so much success with these Ayurvedic herbs that I created my own supplement for constipation, called RELAX . This bowel regulating supplement contains powerful ingredients and is now one of the most popular supplements that I carry in my office in New York City. And that’s because it really works! RELAX features ingredients like magnesium hydroxide to draw water into the intestines as well as the Ayurvedic herbs amalaki,haritaki, and bibhitaki which all work to balance the doshas and support regular bowel function.

Here’s what one of my patient’s had to say about it:

“I had no idea how much my lack of energy and dull skin were tied to my constipation problem. I also had terrible bloating. After taking RELAX for just one week, I was amazed by the incredible difference it made. I had a flatter belly and after another week on RELAX my skin began looking so radiant. The best part so far has been the unexpected compliments! Lol”

– Liza

Constipation is a common issue, but that doesn’t mean you have to live with it! So many of my patients have found relief with this approach, and I know you will too!
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