Constipation is no longer a digestive complaint.
It is a scheduling problem.
In my clinic, it arrives daily, politely disguised as lifestyle confusion.
“Doctor, I don’t drink water.”
Why not?
“Bangalore weather, doctor. You don’t feel thirsty.”
This is said with the confidence usually reserved for meteorologists, as if the kidneys have subscribed to the weather channel and decided to take the day off. What no one realises is that cooler climates blunt the perception of thirst. Add air-conditioning, coffee, and long screen hours, and dehydration becomes invisible. The colon notices. Quietly. It always does.
Another patient leans forward and confesses, “Doctor, honestly, I forget. I have better work to do than drinking water.”
This is remarkable. People forget water, but never forget tea, WhatsApp, or office gossip. Hydration requires intention. And intention is in short supply.
Then comes the absolute truth.
“Doctor, I avoid drinking water because I am scared of the office washroom.”
Now we are talking.
Indian offices have traumatised the bowel. Broken latches. Missing mugs. A civilisation capable of global software exports but still negotiating toilet paper. So people choose dehydration over embarrassment. The colon responds by reabsorbing water from stool, slowly turning it into a material resembling building material. This is not cruelty. This is basic physiology.
I suggest salad.
Immediate chaos.
“Doctor, who will cut?”
This is not symbolic. This is logistical despair. Carrots require commitment. Cucumbers demand planning. Someone else adds, “Every day, who will bring? No one in my family likes salad. How can I eat alone?”
I understand. In Indian homes, eating differently is an act of rebellion—digestive democracy rules. If everyone eats rice, you eat rice. If everyone is constipated, solidarity matters.
One gentleman looks offended and says, “Doctor, I feel like a grazing animal.”
I resist asking him why grazing animals don’t seem constipated.
Sleep is next.
“You must sleep earlier,” I say.
He sighs. “Doctor, I come home tired. I watch TV till 1 am.”
Why?
“Such a costly TV. I can’t keep it like a showpiece.”
Fair enough. EMI must be honoured. The colon, unfortunately, does not respect purchase receipts. The gut works on a circadian rhythm. Late nights delay the natural morning bowel reflex. This reflex—the gastrocolic reflex—is triggered by waking, eating, and routine. Miss it repeatedly, and the colon learns to stop knocking.
A woman once told me confidently, “Doctor, I don’t think sleep timing affects bowel movement.”
She then explained her routine. She waits until everyone sleeps. Then she scrolls till 2 am. “My mind needs relaxation, no?”
The mind relaxes. The gut tightens. Dopamine is entertained. Peristalsis is cancelled.
Walking is suggested.
“Doctor, where will I walk in Bangalore? Dogs, potholes, vehicles.”
True. Our footpaths resemble archaeological sites. “Okay,” I say, “park?”
“So many people there, doctor. Everyone wants to talk.”
Conversation, it seems, also causes constipation.
Morning walking is impossible because waking up is impossible. Evening walking is impossible because children exist. “Doctor, I have to watch them like a policeman, otherwise they won’t study.”
At this point, the bowel has slipped to the bottom of the priority list. Work, family, screens, safety, politeness—everything matters. Except the colon quietly waits its turn.
Modern constipation is rarely about fibre alone. It is about postponed urges. The colon is a creature of habit. When you repeatedly tell it, “Later,” it eventually stops asking. The stool sits longer. More water is absorbed—hardness increases. Fibre added on top only worsens the traffic jam.
Another quiet truth: drinking all your water at night does not undo a dry day. The gut needs steady hydration, not a midnight flood. And salads don’t need heroism. Even cooked vegetables count. The intestine is not asking for Instagram food. It is asking for cooperation.
The most honest line I hear usually comes last.
“Doctor, I get time for myself only after everyone sleeps.”
Most constipated patients are not careless. They are tired.
Constipation is not ignorance. People know what to do. They don’t believe their body deserves time before everything else is finished.
In my experience, bowel movements are not emergencies. They are appointments. Miss them daily, and one day they quietly cancel themselves.
The colon is patient. But it has an excellent memory.
Ignore it long enough, and it will return the favour—politely, efficiently, and with consequences that no app, reel, or television can scroll past.
I have written a book.
If this blog spoke to you, the book will stay with you longer.
