 Hippocrates, the father of Western medicine, believe that all diseases begin in the gut. Of course, he also thought women were hysterical because of their wandering uterus. So much for ancient medical wisdom. But something like constipation can have a major negative impact, and physical, mental, and social well-being gets often overlooked in healthcare. This may be because poop talk is taboo, but it can have a severe influence on their everyday living, both psychologically and physically. Constipation can hurt, causing abdominal discomfort and pain straining, hard stool, and frequent bowel movements, bloating, and nausea. No wonder laxatives are among the most commonly used drugs. Most are safe when used judiciously and intermittently, but because of the frequency of their use, they do end up being one of the most common causes of adverse drug reactions. Perhaps treatment should instead address the underlying problems, such as lack of dietary fiber. You probably don't need a meta-analysis to demonstrate that dietary fiber can obviously increase stool frequency. Populations in most Western countries must be considered by world standards to be almost universally constipated. Here, it's an epidemic among the elderly, but simply not a problem among those centering their diets around fiber-rich foods. Where is fiber found? This patient's summary in the AMA's Journal sums it up with an illustration of whole, unrefined plant foods. Now for those of us smug in our intake of fruits and vegetables, we need to realize that fruits and leafy vegetables are the poorest whole food sources of fiber. Why? Because they're 90% water. Fruit vegetables have more, but the fiber superstars are legumes, which means beans, split peas, chickpeas, and lentils, as well as whole grains. And gram for gram, fruit fiber doesn't seem to have the same effect. It may take 25 grams of fruit fiber to double stool output, something just 10 grams of whole grain fiber, or vegetable fiber can do. And that's not all fiber can do. If you eat some whole grain barley for supper, by the next morning your good gut bacteria are having it for breakfast, releasing butyrate into our bloodstream, a compound that seems to exert broad anti-inflammatory activities, which could help explain why significant decreases in the province of inflammation are associated with increasing dietary fiber intakes. Check it out. And the highest group here was just getting the minimum recommended daily intake of fiber. So what, if you have knee pain or something, you should eat more fiber-rich foods? We didn't know until now. Dietary fiber intake in relation to knee pain trajectory. Thousands of patients were followed, and a high intake of dietary fiber, which is to say just the minimum recommended intake, was associated with a lower risk of developing moderate or severe knee pain over time. And two Framingham studies found that higher fiber intake was related to a lower risk of having symptomatic osteoarthritis in the first place. But wait, don't a variety of diseases have an inflammatory component? How about fiber consumption and all-cause cardiovascular and cancer mortality? They found that compared to those who consumed the least fiber, those who consumed the most had 23% less cardiovascular disease mortality, 17% lower risk of dying from cancer, and 23% lower mortality from all causes put together. Unfortunately, most persons in the United States consume less than half the recommended intake of dietary fiber daily. These researchers suggest all sorts of potential mechanisms for which fiber could be life-saving, from improving cholesterol, immune function, and blood sugar control, but there also may be more of a direct cause. If you ask people to bear down as if they're straining on stool, you can get a rapid increase in intracranial pressure inside your skull. And indeed, if you look at trigger factors for the rupture of intracranial aneurysms, if you ask hundreds of people who had strokes, bleeds within their brains, one of the biggest trigger factors noted was straining for defecation, multiplying risk sevenfold.