Travel Constipation Is Real. A Doctor Explains How to Prevent It.
Constipation during travel is widely reported and thinly studied, and an obesity medicine physician says most of what causes it is set in motion before the traveler leaves the house.
“We hear about this all the time and we know it’s real,” said Dr. Jessica Duncan, Chief Medical Officer at Ivim Health.
Duncan said two forces act at the same time, and neither necessarily begins at the destination. One is physical, involving the connection between the gut and the nervous system. The other has to do with the loss of a daily routine that most people never think about until it is gone.
The published research is thinner than the familiarity of the problem suggests. Estimates of how many travelers are affected vary widely, and the studies that have measured it are small, old, or reliant on self-reporting.
Why it happens
The gut does not operate independently of the rest of the nervous system, which is why it registers changes in schedule and environment.
“The gut is part of the nervous system, and it’s very sensitive to change,” Duncan said.
Travel stress compounds the effect by engaging the wrong branch of that system. “The general anxiousness and stress around travel activates the sympathetic nervous system, whereas the parasympathetic nervous system is what’s needed for the digestion process,” Duncan said.
Routine accounts for much of the rest. Bowel habits are among the most fixed daily patterns people have, and they do not always transfer well to a hotel room.
“Going to the bathroom is personal. It’s a routine. It’s typically done at the same time every day for most. It’s in your own bathroom where you feel comfortable,” Duncan said. “Even those who normally go at work tend to have a particular bathroom that they use, even the same stall. It’s part of that natural routine.”
Several ordinary habits also change at the same time. Travelers drink less water, move less and eat more processed food than they do at home. Not everyone is affected, Duncan said, and the people who are tend to be the ones whose routines were most consistent to begin with.
“Normally you’re on a steady routine with how you hydrate, how you move your body, what you’re eating. All of that is completely thrown off,” Duncan said. “Even if you try your best to control it, chances are you’re eating more processed foods than you typically do at home. Chances are you’re not drinking as much, or moving as much.”
The risk is higher for patients taking GLP-1 medications, Duncan said, and for two reasons that compound each other.
“Somebody on a GLP-1 is already at higher risk for experiencing constipation,” she said. The second reason has less to do with the drug than with the person taking it.
“Someone who’s on a GLP-1 has probably adapted a pretty consistent routine with how they’re eating, how they’re supplementing, how they’re moving,” Duncan said. “So when they travel, there’s a pretty good chance that gets disrupted. Those two things come into play at the same time.”
Duncan said the first day may determine the pattern for the rest of the trip.
“In my personal experience, and from what people have told me, that first day of travel sets the tone,” Duncan said. “If you struggle on day one, it’s so much harder to get back on track.”
She described the sequence that starts it. “If you typically wake up at seven and by eight you have a bowel movement, and you’re in the car or airport catching an early flight, you may not get to go to the bathroom at your normal time,” she said. “Now you’re sitting on an airplane and maybe you’re not comfortable using the airplane bathroom, and then by the time you deplane, you don’t have the urge anymore.”
What to do about it
Duncan’s advice comes down to three things, and two of them start before departure.
1. Fiber, beginning a few days before
The shift toward higher-fiber food is the step Duncan said travelers tend to skip and the one she treats as fixed for herself.
“About three days before travel I’m making sure my diet is focused on fiber-rich foods,” she said. “The greens and other fruits and vegetables that have a high fiber content, like kiwis, and also fiber-rich whole grains.”
She continues the pattern on the road where the food allows and supplements where it does not, though she is clear about the ranking. Asked whether a fiber-rich diet or a supplement works better, Duncan answered in six words: “Diet is always going to be the way to go.”
Foods she looks for while traveling include kiwi, pears, lentils, black beans and chia seeds. Green peas made her list on the merits and rarely on availability. Berries are a great choice too, especially raspberries, and may be easier to find. Kiwi comes with instructions attached.
“Kiwi is fantastic,” Duncan said. “Many don’t know that the skin is edible and increases the overall fiber content, so I always remind people to eat it with skin on for the extra fiber.”
She does not expect travelers to eat the way they do at home, and recommends substitution over restriction.
“It’s very natural for people to choose both higher carbohydrate and higher content of ultra-processed foods when they’re traveling,” she said. “Sometimes with travel food becomes about convenience or availability.” Her advice is to think about a swap rather than a sacrifice. “For exmaple, if you have a potato option, a sweet potato is going to have a bit more fiber than a white potato.”
2. Hydration, beginning the day before
Added fiber only works with the water to move it. “If you’re increasing your fiber, you have to be even more mindful of your water,” Duncan said.
That means hydrating before departure rather than at the gate. Her floor is at least 16 ounces of water before boarding a flight or setting out on a drive, on top of a well-hydrated day before.
“Before you even leave your house, you should already be hydrating,” she said. “Even better, be sure you had a good day of hydration the day before.”
Order matters at the airport. “Some people reach for coffee. They’ll be more concerned that they’re going to get their coffee. I don’t worry about that,” Duncan said. “I can always get a cup of coffee on the plane or when I’m at my first rest stop if I’m on a road trip. Water comes first.”
She adds electrolytes to her own water while traveling, with a caution. “I particularly like to add electrolytes to my water when I’m traveling, but of course you would need to consult your doctor and make sure that’s safe for you to do,” she said.
Alcohol works against all of it, and through more than one mechanism. Dehydration is only the first. “It’s not just that the alcohol itself is dehydrating. It’s also that when you’re drinking alcohol, you’re not drinking water, most likely,” Duncan said. It also slows digestion.
The third mechanism is the one she said travelers underestimate. “I don’t think people really have a full appreciation for the impact of alcohol on the gut microbiome,” Duncan said. “You’re in that fine-tuned balance of the healthy bacteria that are in your gut, and alcohol changes that composition to some extent.”
She stopped short of recommending abstinence. “I think it’s unrealistic to tell people who enjoy drinking on vacation not to drink,” Duncan said. “My advice would be a one-to-one ratio on the alcohol to water.”
3. Movement, every day of the trip
“Intentional movement every day. I prefer walking,” Duncan said.
“A nice walk is going to actually aid in digestion,” Duncan said. “It also helps with some of the blood sugar spikes after eating. That’s why I prefer to walk after a meal.”
And she builds it into the travel day itself. “I intentionally get to the airport early. I walk to the furthest terminal and then back to my gate,” Duncan said.
Twenty minutes on arrival counts too, she said, as does a loop at a rest stop where it is safe to walk. “You have to be intentional and plan your movement every day when you’re on vacation,” Duncan said. “Most types of travel allow you to at least get that in every single day.”
If it has already started
Duncan’s first intervention for constipation already underway requires nothing more than a hotel room kettle or lobby restaurant.
“Warm lemon water is a great go-to. Almost like tea, but with no tea,” she said. ” Warm water may help things move along and, added bonus, it helps you meet your hydration goals too.”
Availability is why it ranks first. “Pretty much no matter where you are, you can get some warm water with lemon,” Duncan said.
Her second recommendation is the one she said travelers almost never think about. There are great online resources for pelvic floor exercises or massage for constipation relief that can be done in a hotel room.
“There are great exercise and massage techniques out there,” Duncan said. “I’ve had a few friends who’ve texted me while traveling and in the throes of vacation constipation and this has worked wonders for them.”
She set expectations directly. “It may not be instant relief, but it can be very helpful,” she said.
Duncan builds her advice around what works when no pharmacy is nearby. For a travel kit, she suggests packing electrolytes or a magnesium supplement.
“Magnesium can work well for constipation relief, but you should check with your doctor to make sure it’s a safe option for you,” she said.
Dr. Jessica Duncan is an obesity medicine physician and the chief medical officer at Ivim Health.
