My patient Barbara is a fifty-seven-year-old judge who in the last several years has been very careful about her food: no trans fats, nothing processed, no red meat, organic fruits and vegetables from the farmer’s market, and at least 20 grams of fiber a day. Given her healthy eating habits, she was completely perplexed as to why she was spending the better part of her day in the bathroom. Having a bowel movement had become a full-time job. The morning would get off to a reasonable start: a smallish log right after her morning tea, but things would deteriorate steadily after that with multiple, small, stuttering, pellet-sized poops that looked like rabbit droppings. Each movement was accompanied by an annoying feeling of incomplete emptying. She could feel she had more stool inside, but she couldn’t get it to come out. Invariably, within half an hour, it was back to the…