Constipation Nation: What to Know When You Can’t Go

A definitive guide to the science and history of constipation across the nation.

Most Americans have had constipation symptoms at some point in their lives. Statistics show up to 30% of Americans are affected with chronic constipation. This number reaches 60% as we age. At any given time up to 100 million people in the United States experience constipation. During the pandemic, constipation and its related anorectal issues worsened because everyone was sitting at home.

Constipation has affected humans throughout history. Some called it ＂civilization’s curse.＂ Dr. John Harvey Kellogg (yes, of Kellogg’s cereal fame) promoted cold cereal as a constipation cure. Today, we have more probiotics and diets than you can shake your tushy at, and social media has popularized the Blue Poop Challenge to diagnose gut health. But what does it all mean?

After seeing thousands of patients in her practice as a colorectal surgeon, Dr. Fong realized that she was repeating the same information, sometimes twenty times a day. Yet, this information was not common knowledge. What was found on the Internet was confusing and conflicting, leaving people who Googled their symptoms with more questions than answers. As an academic clinician who has written peer-reviewed publications, Dr. Fong sought information beyond even what the medical textbooks taught her.

Constipation Nation helps readers who would rather research information themselves before seeing a healthcare professional to troubleshoot their poop chute. Drawing from 200 evidence-based sources as well as historical texts, Dr. Fong addresses all aspects of constipation, combining medicine, physiology, anatomy, microbiology, nutrition, history, and social sciences to get to the bottom of it all to explain why we doo... and why we don’t.

Carmen Fong, MD, FACS, is a Chinese American writer and colorectal surgeon. She’s a New York City transplant who now lives in Atlanta, Georgia, with her wife, daughter, and two cats. Fong is co-director of the Hemorrhoid Centers of America and specializes in office-based proctology, and most recently was an assistant professor at the Icahn School of Medicine at Mount Sinai. She sees patients with constipation every single day. During her training, Fong won multiple awards and presented at national meetings. She’s a member of the Society of Gastrointestinal and Endoscopic Surgeons, where she sits on the Ethics and Health Advocacy Committees, and she’s a member of the American Society of Colon and Rectal Surgeons, where she’s active on the Young Surgeons Committee. She has been an ambassador for Fight Colorectal Cancer!, a national advocacy group.