Struggling to Pass Stool: Finding Relief from Constipation-Predominant Irritable Bowel Syndrome

The concepts of qi stagnation and fluid deficiency in Donguibogam align closely with modern scientific mechanisms underlying irritable bowel syndrome, particularly constipation-predominant irritable bowel syndrome. A central concept is the gut-brain axis. The brain and gut communicate continuously along a shared pathway. When emotional states such as stress, anxiety, or low mood register in the brain, corresponding signals travel to the gut via the autonomic nervous system and neuropeptides. In the same way Donguibogam describes emotional distress hindering bowel function through qi stagnation, modern clinical science shows that the stress hormone cortisol and neurotransmitters like serotonin and dopamine directly affect intestinal peristalsis, contributing to constipation. Serotonin plays an essential role in modulating intestinal motility, and disturbances in this system can manifest as either constipation or diarrhea. Intestinal movement is coordinated by the enteric nervous system, the complex neural network often described as the second brain. Enteric nervous system dysfunction can abnormally slow intestinal peristalsis or disrupt coordination between the anal sphincter and pelvic floor muscles, resulting in dyssynergic defecation where stool cannot be passed. The classical observation in Donguibogam that stool cannot travel when qi stagnates corresponds to this hypomotility linked to enteric nervous system dysfunction. A deficiency of body fluids closely parallels reduced intestinal hydration. Insufficient fluid intake causes stool to become dry and dense. Imbalances in the gut microbiome also shape bowel patterns. When beneficial bacteria decline and harmful bacteria multiply, overall gut health suffers, altering stool volume, water content, and intestinal motility. Endocrine diseases such as hypothyroidism or certain medications can also reduce bowel motility and produce constipation, showing that chronic bowel difficulty involves broader physiological factors beyond daily diet alone.