Eating more fiber, drinking enough fluids, moving your body, and adjusting your toilet posture are the most consistently supported ways to get things moving. But “eat more fiber” is vague advice, and not every strategy works equally well for every person. Some approaches act within minutes, others take days, and a few are worth trying only if the basics have already failed. Here is what the research actually shows, organized roughly from simplest changes to more involved interventions.
Eat Specific High-Fiber Foods, Not Just “More Fiber”
Fiber is the classic recommendation, and it genuinely works, but the type matters. Soluble fiber absorbs water and forms a gel that softens stool, while insoluble fiber adds bulk and speeds transit. Both help, and their effects complement each other when consumed together in whole foods rather than in isolated supplements.
Kiwifruit has emerged as one of the best-studied single foods for constipation relief. A large international randomized controlled trial found that eating two green kiwifruits daily produced a clinically meaningful increase in complete spontaneous bowel movements and improved overall gastrointestinal comfort in people with functional constipation.
1PubMed Central. Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort—Results of an International Multicenter Randomized Controlled TrialA separate trial comparing green kiwifruit, psyllium, and prunes found that all three increased bowel movement frequency, but kiwifruit and prunes were better at softening stool consistency, and kiwifruit produced the most improvement in straining.
2PubMed. Exploratory Comparative Effectiveness Trial of Green Kiwifruit, Psyllium, or Prunes in US Patients With Chronic ConstipationGold kiwifruit performed similarly in another trial, reducing straining more effectively than psyllium and softening stool in both people with functional constipation and those with constipation-predominant irritable bowel syndrome.
3PubMed Central. Two Gold Kiwifruit Daily for Effective Treatment of Constipation in Adults—A Randomized Clinical TrialThe practical takeaway: two kiwifruit a day is a well-supported starting point. Prunes are a close second. Psyllium husk supplements are effective for frequency but may not reduce straining the way whole fruits do. If you tolerate kiwi or prunes, try those before reaching for a fiber supplement.
Coffee Can Work Fast
Plenty of people swear their morning coffee sends them to the bathroom, and there is real physiology behind it. A study measuring colon activity found that both regular and decaffeinated coffee increased motility in the distal colon within four minutes in about 60% of participants, and the effect lasted at least 30 minutes. Hot water alone did not produce the same response.
4PubMed Central. Effect of coffee on distal colon functionThe fact that decaf also worked means caffeine is not the sole driver. Compounds in coffee itself appear to stimulate colonic contractions. That said, roughly 40% of participants showed no response at all, so coffee is not a universal fix. If it works for you, timing your cup about 20 to 30 minutes before you plan to sit on the toilet can take advantage of the gastrocolic reflex, the wave of colon activity triggered by eating or drinking.
Hydration Matters, but Mostly if You Are Not Drinking Enough
You will see advice to “drink more water” for constipation everywhere, and it is partially right. A large cross-sectional analysis of U.S. adults found that higher total moisture intake was associated with roughly half the constipation risk when comparing the highest to the lowest intake groups.
5PubMed Central. The Association of moisture intake and constipation among us adults: evidence from NHANES 2005–2010But this association has an important caveat. Research on children found that adding water above their usual intake did not change stool frequency or consistency. The benefit appeared only when baseline fluid intake was already lower than normal.
6PubMed. Mild dehydration: a risk factor of constipation?In older adults, who tend to drink less and are more vulnerable to mild dehydration, a clear relationship between low fluid intake and constipation has been documented. The same review noted that reducing fluids from normal levels to very low levels directly worsened constipation in elderly subjects.
6PubMed. Mild dehydration: a risk factor of constipation?So if you are already drinking a reasonable amount, forcing extra glasses of water probably will not solve constipation on its own. But if you suspect you are on the low end, especially if you are older, increasing fluid intake is one of the easiest adjustments to try.
Magnesium-Rich Water as a Specific Strategy
Magnesium has a natural osmotic laxative effect, drawing water into the intestines. This is why magnesium sulfate (Epsom salt) has been used as a laxative for centuries.
7PubMed Central. Magnesium Sulfate-Rich Natural Mineral Waters in the Treatment of Functional Constipation-A ReviewA double-blind, placebo-controlled trial found that drinking about 500 mL of magnesium-rich natural mineral water daily significantly increased spontaneous bowel movements and improved stool consistency compared to placebo over six weeks.
8PubMed Central. Efficacy and safety of a natural mineral water rich in magnesium and sulphate for bowel function: a double-blind, randomized, placebo-controlled studyA more recent randomized trial confirmed that magnesium-rich mineral water softened stools and increased bowel movement frequency within just one to two weeks compared to regular soft water.
9PubMed Central. Magnesium-Rich Mineral Water Improves Stool Consistency and Bowel Habits in Healthy Subjects: A Randomized Controlled TrialThis is a gentler option than taking a magnesium supplement. If you want to try it, look for mineral waters that list a high magnesium content on the label. Over-the-counter magnesium citrate or magnesium oxide supplements work on the same principle but at higher doses, and it is easy to overdo them, so start low.
Get Moving
Physical activity speeds up the movement of material through your colon. A systematic review of cohort studies found that aerobic exercise and core-strengthening exercises reduce colonic transit time, with higher activity levels producing more significant reductions.
10PubMed Central. Physical activity and constipation: A systematic review of cohort studiesThe effect can be surprisingly immediate. A study measuring gut motility in real time found that indicators of peristaltic movement increased within one to two minutes after participants started walking, suggesting that even a short walk can stimulate the colon.
11Scientific Reports. Immediate effect of physical activity on gut motility in healthy adultsYou do not need intense exercise. A brisk 20-to-30-minute walk is enough to stimulate gut motility. Timing matters too: walking after meals, when the gastrocolic reflex is already active, can amplify the effect. If you have been sedentary and are newly constipated, this is one of the first things to change.
Change How You Sit on the Toilet
Standard Western toilets put your body at roughly a 90-degree hip angle, which creates a kink in the anorectal canal. Squatting straightens that canal. A study comparing body positions found that squatting increased the rectoanal angle to about 126 degrees, compared to 100 degrees in normal sitting, making the passage straighter and requiring less straining.
12PubMed. Influence of Body Position on Defecation in HumansYou do not need a squat toilet to get this benefit. Footstools marketed for this purpose work by elevating your knees above your hips while you sit, mimicking some characteristics of squatting. A study of healthy volunteers using such a device found that it improved the sensation of complete emptying and reduced the time spent on the toilet.
13PubMed Central. Implementation of a Defecation Posture Modification Device Impact on Bowel Movement Patterns in Healthy SubjectsLeaning forward and resting your elbows on your knees is a free version of the same idea. The key is getting your knees higher than your hips and your torso tilted forward.
Abdominal Massage
This is an underused technique that has surprisingly solid evidence behind it. A systematic review and meta-analysis found that abdominal massage increased weekly bowel movement frequency by about 1.5 additional movements per week compared to controls, cut gut transit time by roughly 21 hours, and significantly decreased constipation symptoms.
14PubMed. Effectiveness of abdominal massage on chronic constipation in adults: A systematic review and meta-analysisA randomized placebo-controlled trial found that people receiving abdominal massage saw about a 70% reduction in constipation severity scores, compared to roughly 28% in the control group, along with meaningful improvements in quality of life.
15Physical Therapy. Abdominal Massage in Functional Chronic Constipation: A Randomized Placebo-Controlled TrialThe technique is straightforward. Using moderate pressure, trace a clockwise circle around your abdomen, following the path of the colon: up the right side, across below your ribs, down the left side. Spend five to ten minutes on it. You can do this lying down or sitting. It is free, has no side effects, and you can do it daily. If you are skeptical, the evidence is more robust than you might expect for something so simple.
Over-the-Counter Laxatives When Lifestyle Changes Are Not Enough
If diet, fluids, exercise, and positioning have not solved the problem, over-the-counter laxatives are the next step. They fall into a few categories, and not all are equally well supported.
Polyethylene glycol (sold as MiraLAX and generics) has the strongest clinical evidence among OTC options. An updated systematic review rated it alongside senna as the only over-the-counter agents with the highest level of evidence and strongest recommendation grade. The review noted that polyethylene glycol was highly effective, with similar or better results compared to both other OTC products and prescription therapies, and was well tolerated even with long-term use.
16PubMed Central. Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic ReviewBisacodyl is a stimulant laxative that works differently from osmotic agents. It directly increases motility in the large bowel, reduces transit time, and increases water content in stool through a combined prokinetic and secretory action.
17PubMed Central. Bisacodyl: A review of pharmacology and clinical evidence to guide use in clinical practice in patients with constipationStimulant laxatives like bisacodyl and senna are effective for occasional use but are generally not recommended as daily long-term treatments. Osmotic laxatives like polyethylene glycol are better suited for ongoing management.
Stress and Your Gut
If constipation gets worse during stressful periods, there is a clear physiological reason. Stress activates the sympathetic nervous system (your “fight or flight” response) and suppresses parasympathetic activity (the “rest and digest” system). Research on people with constipation-predominant IBS has confirmed that this pattern of increased sympathetic and decreased parasympathetic activity is a core element of the stress response that drives gut symptoms.
18PubMed Central. Autonomic nervous system activity in constipation-predominant irritable bowel syndrome patientsWhen your body is in a stress state, it diverts resources away from digestion. Colonic contractions slow, and transit time increases. This is why travel constipation, work-deadline constipation, and anxiety-related constipation are so common. Addressing the stress directly through whatever works for you, whether that is exercise, sleep, or deliberate relaxation, can improve bowel function as a downstream effect.
When the Problem Is Pelvic Floor Coordination
Some people strain and push but cannot evacuate because the muscles of their pelvic floor are contracting when they should be relaxing. This is called dyssynergic defecation, and it is more common than most people realize. The frustrating part is that adding more fiber or laxatives typically does not solve it, because the problem is not about stool consistency. It is a coordination issue.
Biofeedback therapy, which uses sensors to teach patients how to relax the pelvic floor during straining, has been shown in randomized controlled trials to be more effective than both laxatives and muscle-relaxant medications for this specific type of constipation.
19PubMed Central. Biofeedback therapy for dyssynergic defecationOne trial found that 70% of people treated with biofeedback reported adequate relief of constipation at three months, compared to 38% with placebo and 23% with a muscle relaxant.
20PubMed. Randomized, controlled trial shows biofeedback to be superior to alternative treatments for patients with pelvic floor dyssynergia-type constipationSigns that pelvic floor dysfunction might be your issue include feeling like stool is “stuck” despite soft consistency, needing to press on the perineum or vaginal wall to help evacuate, or chronic incomplete emptying. If these sound familiar and fiber has not helped, asking your doctor about anorectal manometry testing and biofeedback referral is worth doing.
Check Your Medications
Constipation is a side effect of a surprisingly wide range of medications, and people often do not connect the two. An analysis of over 50 million adverse drug event reports to the FDA identified the 30 drugs most associated with constipation. The most common drug class linked to constipation was antineoplastic and immunomodulating agents (cancer drugs), but plenty of everyday medications made the list too.
21PubMed Central. Exploring the top 30 drugs associated with drug-induced constipation based on the FDA adverse event reporting systemFour drugs in the analysis, including orlistat (a weight-loss drug), showed constipation risk signals that were not even listed on their FDA-approved labels, suggesting that drug-induced constipation may be more widespread than prescribing information acknowledges.
21PubMed Central. Exploring the top 30 drugs associated with drug-induced constipation based on the FDA adverse event reporting systemOpioid painkillers are the most widely recognized culprits, but antihistamines, certain blood pressure medications, iron supplements, antacids containing calcium or aluminum, and some antidepressants can all slow the colon. If your constipation started around the time you began a new medication, mention it to your prescriber. Sometimes switching to a different drug in the same class, or adjusting the dose, resolves the issue without needing additional laxatives.
How Gut Bacteria Fit In
Your gut microbiome influences motility through the short-chain fatty acids (SCFAs) that bacteria produce when they ferment fiber. These SCFAs, particularly propionate and butyrate, can stimulate contractions in the colon and trigger the release of serotonin, which in turn speeds up transit.
22Advances in Nutrition. Mechanisms of Action of Probiotics and the Gastrointestinal Microbiota on Gut Motility and ConstipationThis is one reason dietary fiber works beyond simple bulk: it feeds the bacteria that produce motility-stimulating compounds. It also helps explain why probiotic supplements are sometimes recommended for constipation, though the evidence for specific probiotic strains is still inconsistent, and fiber-rich whole foods remain a more reliable way to support the microbial ecosystem your colon depends on for normal function.
Building a Routine That Respects Your Body’s Timing
Your colon has its own rhythms. The strongest propulsive contractions tend to occur in the morning and after meals. Habitually ignoring the urge to go, whether because of a busy schedule or an inconvenient location, can gradually blunt rectal sensitivity over time, making it harder to feel the signal when it comes. This desensitization, called rectal hyposensitivity, is associated with worsening constipation, though retraining through behavioral interventions can help restore normal sensation.
A practical morning routine that stacks several evidence-based triggers looks something like this: wake up, drink a glass of water or coffee, eat breakfast, and then give yourself unhurried time on the toilet with a footstool under your feet. You are combining hydration, the gastrocolic reflex from eating, the stimulatory effect of coffee, and optimal positioning. None of these steps alone is magic, but layered together they create the best conditions your colon is going to get. Consistency matters more than any single intervention; your body responds to routine, and after a week or two of the same morning pattern, many people find their gut starts cooperating on schedule.