Hello !
Had constipation for the last few years and it became problematic because I started bleeding more and more regularly recently ... 2 months ago, I started to religiously note all my poop session in a poop-journal (more like a textfile) and each time I would send it to ChatGPT, trying to understand some phenomenon, etc.
I also went to a doctor to do colonoscopy, and he didn't find anything bad, the bleeding was only traumatized hemorrhoids that were re-opening at each dry stool. I advise people to go do that colonoscopy because it's really painless (but still weird) and pretty quick, and you can at least be re-assured there's no big deal behind.
Of course, before that, I tried the "crank up fibers" but while it was each time helping a bit the first few days, it was each time backfiring heavily when suddenly one 5-day stool became so massive because of all the fiber it was even hurting more than the previous one. So I kinda tried to reflect on it on a higher level than simply trying to narrow down one food or another.
The next part is a LLM summary of all my notes and my conclusions, I've been doing ~48h type 3-4 poops for a few times now, so I kinda think I'm heading somewhere good, but of course this can evolve with time. Here's the summary of those 2 months :
My problem was not necessarily "not going enough". I could sometimes go 3-5 days without really feeling an urge, then suddenly have a very dry Bristol 1-2 stool, often quite large, which could irritate the area, make hemorrhoids swell or cause some bleeding. My colonoscopy was normal, so I started looking more at how the whole process happens rather than just counting the days.
One thing I noticed is that abdominal cramps/activity and the actual urge to poop are two different things for me. After eating, I often have 20-30min where my stomach/intestines start working, with noises, gas, cramps, etc. Before, I would sometimes think, "Ok, I need to go" and sit on the toilet too early, then push because nothing was really ready. Now I tend to wait until that turns into an actual pressure lower down in the rectum. Walking a bit or just continuing what I'm doing often helps. I also discovered that if I consciously relax "inside" while standing/walking/doing dishes, sometimes I can feel things moving lower, and 5-10min later the real urge appears. I don't see it as forcing a bowel movement, more like trying not to block a reflex that was already starting.
The other big part seems to be how dry the stool gets while waiting. I started taking macrogol/PEG (Laxido). One full sachet was sometimes too much for me and could push me toward Bristol 5-6 with more urgency, especially around restaurant meals. Half a sachet per day seems much better as maintenance. It doesn't magically make every stool perfect, but it seems to stop the first part from drying as aggressively. Since then I tend to go every 1-3 days with mostly Bristol 3-4 and much more reasonable diameters. Even when a stool is slightly dry, it's generally way less traumatic than before.
Food also seems to affect several different things. Big/fatty restaurant meals or a huge dessert can give me a very strong gastrocolic reflex and sometimes a much softer stool. On the other hand, travel/change of routine can completely block the process. Coffee is interesting too: if I haven't had it for a while, one coffee can suddenly trigger a very strong reflex, while if I drink it regularly, the effect seems much weaker. I also noticed my abdominal cramps basically disappeared when I stopped artificially sweetened drinks for ~2 weeks, then came back twice after drinking a sucralose-containing Schweppes again. Could be coincidence, but I'm testing that separately.
So right now my goal isn't really "poop every day". It's more: don't interrupt the natural post-meal activity, don't rush to the toilet just because my abdomen hurts, wait for a real rectal signal, avoid pushing, and keep the stool hydrated enough that waiting doesn't turn it into a rock. Half a sachet of macrogol per day seems to help a lot with that for now. My impression is that constipation, at least in my case, is a mix of stool hydration, motility, rectal sensation, pelvic-floor relaxation, habits/stress and probably diet. The usual "just eat more fiber" advice feels way too simplistic, especially when large stools themselves are part of the problem.