We tell everyone with constipation the same thing: eat more fibre. In 2012 a team of surgeons actually tested it, and it turns out we have had it backwards for decades.
Singapore. 63 patients, all badly and chronically bunged up, all cleared by colonoscopy so nothing sinister was hiding. The surgeons did the unthinkable. They took the fibre away entirely. Zero. For two weeks, then as little as each person could tolerate.
Six months later the scoreboard was brutal.
The no-fibre group went from a bowel movement once every three or four days to once a day. Straining gone. Bloating gone. Pain gone. The bleeding stopped too.
The patients who kept dutifully eating their fibre like good citizens? Nothing. Not a flicker. Every last one still bloated at six months, still straining, still doing exactly what the cereal box swore would fix them.
The authors, in the strangled tone of people who know they are about to annoy an entire industry, concluded that stopping fibre improves constipation. Contrary to popular belief, they wrote, which is medical-journal speak for "sorry about the last fifty years."
The mechanism is almost too stupid to say out loud. Constipation is a colon already packed too full to empty. The expert fix was to pack it fuller. That is unblocking a drain by posting more down it.
Two generations of straining on the toilet, one bran flake at a time, because nobody thought to try the obvious thing and simply take it away.
Odd, isn't it, that the man living on nothing but steak is never the one white-knuckling the bathroom at dawn.
