"Drink more water and eat more fiber" is the advice I hear patients repeat most often — and for a lot of people, it works. For others, it doesn't move the needle at all, which is extra frustrating when it's supposed to be the simple fix.
Why the standard advice sometimes doesn't work
Fiber has real, well-studied evidence behind it for constipation. Water is a more common assumption than a proven fix on its own — Mayo Clinic notes there's no strong evidence that mild under-hydration causes constipation, or that extra fluid resolves it, unless someone is actually dehydrated. So "drink more water" often isn't doing as much as people assume, which is one reason the advice can feel like it stalls. For some people, an underlying digestive or microbiome imbalance plays a bigger role than fiber or fluid intake ever will. Piling on more fiber when that's not the actual bottleneck can even make bloating worse without improving regularity.
What else can be part of the picture
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Digestion upstream of the problem
If digestion earlier in the process isn't working efficiently, that can affect regularity further down the line — which is part of why I put digestive support earlier in the protocol, not something to skip in favor of jumping straight to a regularity product.
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Microbiome balance
A resilient, balanced microbiome plays a role in day-to-day motility and regularity for many people, separate from fiber and water intake alone.
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Gentle, targeted regularity support
Once the earlier pieces are addressed, a fermentable prebiotic fiber (xylooligosaccharides) can be layered in last. Clinical research shows this type of fiber improves stool frequency by feeding beneficial gut bacteria — a different mechanism than a stimulant laxative.
Why "just add fiber" has a real ceiling
Clinical reviews classify chronic constipation into primary causes (normal transit, slow transit, or a defecatory disorder) and secondary causes (medications, other health conditions, or structural issues) — and note that roughly half of patients don't get satisfactory relief from standard treatment, fiber included. That's not a failure on the patient's part — it's a sign the actual cause often sits outside what fiber and water can reach, which is exactly why a broader digestion- and microbiome-focused approach can matter more than piling on more fiber.
Where this fits in the protocol
Velisoma's Regulate step is designed to come after Soothe, Digest, and Rebuild — not as the first thing to reach for. See why the sequence matters.
Sources
- Mayo Clinic. Increasing Fiber Intake for Constipation Relief.
- Mayo Clinic. Nonprescription Laxatives for Constipation: Use With Caution.
- Role of gut microbiota-derived signals in the regulation of gastrointestinal motility. National Library of Medicine (PMC9354785).
- American Academy of Family Physicians. Chronic Constipation in Adults.
- Xylo-oligosaccharides improve functional constipation by targeted enrichment of Bifidobacterium. National Library of Medicine (PMC10867466).
Dr. Kayle Martinsen
In clinical practice since 2008, functional-medicine based, working with patients on reflux, IBS, and digestive dysfunction.