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16% Of Adults (Globally!) Are Chronically Constipated, And This Gastroenterologist Says The #1 Thing They're All Doing Is Making It Worse
Written by
Dr. Rachel Simmons, MD
Fact checked by
Anahit Harutyunyan, MD
Diet
9 min read
Jan 18, 2026
16% Of Adults (Globally!) Are Chronically Constipated, And This Gastroenterologist Says The #1 Thing They're All Doing Is Making It Worse
"I'm Dr. Rachel Simmons. I've spent 17 years in gastroenterology, and the patients I see most often aren't the ones with dramatic diagnoses. They're the ones who quietly suffer through the same thing day after day, they can't go to the bathroom.
That might sound minor. It's not.
An estimated 16% of adults globally deal with chronic constipation[1]. Among people over 60, it's closer to one in three[1]. In the U.S. alone, constipation accounts for roughly 8 million doctor visits every year[2].
And still, nothing moves the way it should. For months. Sometimes years.
I can't tell you how many patients have sat across from me, frustrated to the point of tears, saying:
'I've done everything right. Why is my body not working?'"
New research from gastroenterology departments at major institutions is starting to answer that question, and the answer has almost nothing to do with what you're eating.
We asked Dr. Simmons to walk us through three things:
What's actually causing chronic constipation that most treatment plans completely miss?
Why does the standard advice — more fiber, more water, take a laxative — fail so many people?
And what's the emerging approach that's helping her patients restore natural regularity, often within weeks?
Here's her explanation.
The Part of Constipation Nobody Talks About
"Here's what I wish every patient understood before they walked into my office.
Your colon isn't a passive tube. It's a muscular organ. It contracts in coordinated, wave-like patterns to push waste through and out.
That process is called peristalsis, and when it's working, you don't think about it at all.
You just… go.
When patients come to me with chronic constipation, most assume the machinery is fine and they just need to give it better fuel. More fiber. More bulk. That's the logic.
But what I actually find, over and over, is that the machinery itself is compromised.
And it starts with something most doctors don't even look at: the intestinal barrier.
Your intestinal lining is a single-cell-thick wall. It's held together by protein structures called tight junctions[3]. Essentially, these are microscopic locks that control what passes through and what stays out.
But these locks are fragile. Chronic stress breaks them down. So do antibiotics, alcohol, ultra-processed diets, and simply getting older[3].
Once those junctions start failing, you've got a compromised barrier. Fragments of undigested food, bacterial toxins, and inflammatory compounds begin leaking into surrounding tissue and your bloodstream[4]. It’s a condition known as leaky gut.
Your immune system treats this like an invasion. It responds with persistent, low-level inflammation[3]. The kind you can't feel directly, but the kind that quietly damages everything it touches.
And here's the part that connects it all to constipation: that chronic inflammation interferes with the nerves embedded in your gut wall[5]. These are the nerves responsible for telling the muscles when and how to contract.
When those nerve signals get disrupted, your colon essentially loses its rhythm. Transit slows. Waste sits in the colon far too long, water gets reabsorbed, stool hardens, and what should be an effortless daily process becomes a painful ordeal.
The longer this goes on, the worse it gets[6][7].
That's the cycle. And no amount of salad is going to break it."
The Reason Conventional Approaches Keep Failing
"Once you understand the cycle, it becomes painfully obvious why the standard playbook doesn't work.
Fiber. Doesn’t work.
Fiber adds bulk.[8]. And if your colon's muscular contractions are functioning normally, bulk helps move things along.
I've had patients tell me they felt more backed up after increasing fiber. That's because they were.
Laxatives. Don’t work.
Stimulant laxatives force the colon to contract. Osmotic laxatives pull water into the bowel. Either way, you get a result, temporarily.
But you haven't addressed the reason your colon stopped contracting on its own.
Worse, research suggests chronic stimulant laxative use may further weaken the colon's natural motility over time[9].
Generic probiotics. Don’t work.
This is where I really push back. Patients come in spending $40, $60 a month on probiotic capsules that have done absolutely nothing.
Here's the issue: if your intestinal barrier is already compromised, the environment inside your gut is hostile[10]. Inflamed. Permeable. It's not an environment where beneficial bacteria can survive, let alone colonize and reproduce.
On top of that, standard capsules release their contents in the stomach, where acid destroys the vast majority of bacteria before they reach the intestines. Studies estimate up to 90% loss[11].
You end up with an expensive product that largely dies in your stomach, and whatever survives lands in an environment that can't support it.
The sequence matters enormously. You need to restore the barrier first. Create an environment where beneficial bacteria can actually take hold. Then introduce the right strains. Almost nobody does it in that order."
What The Research Now Points To
"Gastroenterologists and microbiome researchers have been circling the same compound for years now. It's a short-chain fatty acid called butyrate.
Butyrate is the primary fuel source for the cells that make up your colon lining[12].
Without adequate butyrate, those cells can't regenerate, can't maintain tight junctions, and can't keep the barrier intact.
But butyrate does something else that's directly relevant to constipation: it activates the network of nerves in your gut that orchestrates colon contractions[13]. In other words, helps things get moving.
So when butyrate levels are sufficient, those nerve-muscle signals fire properly. Transit normalizes. Bowel movements become regular and comfortable.
But when butyrate is depleted?
The barrier erodes. Inflammation escalates. And the nerves that drive motility go quiet.
Your body produces butyrate naturally when gut bacteria ferment dietary fiber.
It’s an elegant system, when it works.
But roughly 95% of Americans don’t have an adequate fiber intake[14]. That means the bacteria responsible for butyrate production are essentially starving.
And here's the frustrating paradox: you need butyrate to maintain a healthy gut lining, but you need a healthy, balanced microbiome to produce butyrate[15].
If both are already depleted, neither can rescue the other without outside intervention.
Fermented foods? They contribute some beneficial bacteria, but not the specific strains or therapeutic concentrations needed to repair a damaged barrier, and they don't deliver butyrate directly[16].
In laboratory settings, when butyrate is supplied directly to intestinal cells, tight junctions begin reassembling within hours. Barrier integrity improves. Inflammatory markers decline. And peristaltic activity (colon contractions) resumes[17][18].
That finding changed how I approach chronic constipation entirely."
How This 5-in-1 Formula Addresses All Five Layers of the Problem
"What I recommend to my patients is Bioma Digestive & Gut Repair Probiotics. And I'm specific about why.
Because it's the only formulation that I've personally found that tackles this in the correct sequence, across five distinct mechanisms."
Dr. Simmons walked us through each one:
Layer 1: Seal the barrier — CoreBiome® Tributyrin
This is a patented, fermented form of butyrate engineered to survive digestion and reach the colon intact.
It's not the same as taking a generic butyrate supplement that breaks down in your upper GI tract.
CoreBiome® delivers the raw material your colon cells need to rebuild tight junctions and quiet the inflammatory response that's disrupting your motility.
Research demonstrates that direct butyrate delivery supports barrier reassembly and reduces intestinal permeability[17][18].
"This single ingredient is what separates Bioma from everything else on the market. Without this step, nothing that follows can work."
Layer 2: Nourish the ecosystem — Fructo-Oligosaccharides (FOS)
Once the barrier starts stabilizing, you need to cultivate the bacteria that will sustain it long-term.
FOS is a targeted prebiotic that selectively feeds Bifidobacteria and Lactobacilli, the two families most critical for microbiome balance and regular bowel function.
A meta-analysis of randomized controlled trials confirmed that FOS supplementation meaningfully improves stool frequency and consistency in people with constipation[19].
"This is the bridge between short-term repair and long-term independence. You're building a self-sustaining colony that eventually produces its own butyrate."
Layer 3: Repopulate with precision — Howaru® Restore Probiotic Blend
This is a clinically studied blend of four strains — Lactobacillus acidophilus NCFM, Lacticaseibacillus paracasei Lpc-37, Bifidobacterium lactis Bl-07, and Bifidobacterium lactis Bl-04 — delivering 10 billion CFU per dose.
Because the barrier has already been reinforced in Layer 1, these bacteria arrive in an environment that can actually support them.
Clinical data shows this blend supports microbial diversity and digestive regularity across varying conditions, like antibiotic recovery[20], diet changes, travel, stress.
Layer 4: Immediate digestive support — Bromelain & Papain enzymes
Derived from pineapple and papaya, these proteolytic enzymes assist with the breakdown of protein-heavy meals in real time[21].
"This is what patients feel first. Within days, the sensation of food sitting like a rock in their stomach starts fading. Meals digest more completely, which also means less undigested material sitting in the colon contributing to that backed-up feeling."
Layer 5: Immune and metabolic reinforcement — Holistiq® Mushroom Beta-Glucans
Six organic, USA-grown mushroom varieties — Cordyceps, Reishi, Lion's Mane, Shiitake, King Trumpet, and Turkey Tail.
Given that approximately 70% of immune function originates in the gut[22], a compromised intestinal barrier means a compromised immune system.
These beta-glucans support immune modulation, feed barrier-protective bacteria, and aid in converting food into usable energy rather than letting it stagnate[23].
Dr. Simmons emphasized one final technical point:
"Bioma uses delayed-release capsule technology.
The capsule is designed to resist stomach acid and dissolve in the lower intestine[11], where the bacteria and active compounds are actually needed.
It's a detail that sounds small but changes everything. Delivery is half the battle with any oral probiotic."
Bioma Digestive & Gut Repair Probiotics is manufactured in an FDA-registered, GMP-certified facility in the United States. Every batch undergoes third-party testing for purity, potency, and safety.
"I'll tell you what surprises my patients most," Dr. Simmons said.
"They come in for the constipation. But within a few weeks, they start reporting other things. More energy throughout the day[24]. Clearer skin[25]. Less mental fog[26].
That's not a coincidence. When you resolve chronic intestinal permeability, you're removing an inflammatory burden that was affecting everything, not just digestion.
Patients tell me they feel like a different person. And honestly? Physiologically, they kind of are. Their body finally stopped fighting a war on the inside.
That's the difference between managing a symptom with another laxative and actually repairing the system that was broken."
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Restore Natural Regularity with Bioma Digestive & Gut Repair Probiotics
*Individual results may vary.
Comments (3)
RegularAgain_Karen
January 5, 2026 at 9:12 pm
I haven't had a normal bowel movement in probably 3 years. Tried Miralax daily, fiber gummies, magnesium, you name it. My doctor kept saying "drink more water" which honestly made me want to scream. The part about the gut lining needing to be repaired BEFORE probiotics can work was the first thing that actually made sense to me. Started Bioma about 6 weeks ago. By day 10 I noticed things were… moving. By week 3 I was going almost every morning without straining. I genuinely forgot what that felt like. The bloating is way down too. I'm not exaggerating when I say this changed my daily life.
Dave_T_53
January 11, 2026 at 2:35 pm
55 year old guy here. Constipation has been my "thing" since my late 40s. Would go 3-4 days sometimes without a bowel movement and then it was painful when it finally happened. Tried every OTC laxative, fiber supplement, even did a colonoscopy (came back normal which was almost more frustrating). My wife sent me this article and I figured what's one more thing to try. About 5 weeks in now. I'm going every day or every other day, stool is softer, and I don't have that constant heavy feeling in my gut anymore. Energy is better too which I didn't expect. Wish I'd found this years ago honestly.
Jess_momof2
January 18, 2026 at 7:48 am
postpartum constipation absolutely wrecked me and it never fully went away even 2 years later. I was scared to eat because I knew I'd just feel more backed up. Tried psyllium husk, probiotics from Costco, even prescription stuff that gave me horrible cramps. The whole "repair first then replenish" approach made so much sense. I'm on week 4 of Bioma. The first thing I noticed was the digestive enzymes helping — meals didn't sit like a brick anymore. Then around week 3 things just started… working? Like regularly? I actually look forward to eating again. My stomach is flatter and I have so much more energy to keep up with my kids. Already ordered the 3-month supply.
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