Donna is a 46-year-old woman with a long history of severe endometriosis, for which she has had multiple surgeries. She is well-controlled with long-cycle oral contraceptives (OCs), and has just had a normal annual examination. As you prepare to leave the room, she says, "Oh, by the way...I get constipated a lot, particularly when I travel, and lately I've been taking a lot of business trips. What should I do?"

What Donna needs is counseling on basic bowel hygiene. Advise her to:  

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Quite often, the expectation of what is 'normal' leads patients to question their own gastrointestinal physiology.