It happens every year. By day two of Passover, thousands, maybe millions of Jews begin to feel a little … stuck. You know, constipation. 

While no formal, peer-reviewed studies have been published on the link between Passover and constipation, there is ample science to back up what many suspect: matzo literally gums up your digestive tract.

“There’s certainly a lot of logic to there being problems if you eat too much matzo,” said Stan Drake, a recently retired Jewish gastroenterologist who used to practice in Virginia. “Matzo is basically white flour and water and there’s like zero fiber.”

Fiber is composed of parts of food that aren’t absorbable into the body’s bloodstream and play a vital role in keeping things moving in the colon, Drake explained. It also helps to feed the bacteria in your intestines known as the gut microbiota, which is also essential to properly breaking down food. Fiber also helps pull water into the small intestines. All this helps to contribute to a healthy stool.

On the eight days of Passover, observant Jews don’t eat chametz, or leavened bread, to commemorate the Jews’ Exodus from slavery in Egypt. The Torah recounts how the Jews, on the run from Pharoah, ate unleavened bread. Exodus 12:14 proscribes: “You shall eat nothing leavened; in all your dwelling places you shall eat unleavened bread.”

The treatment

Many constipated Jews have joked about matzo as the bread of affliction. But Drake said some of that suffering can be alleviated by switching to whole wheat matzo, which has a higher fiber content. He also recommends limiting the serving size to a single square per day, as well as increasing fluid intake to compensate for matzo’s relatively low water content compared to bread, which will help lubricate the works.

Tanya Rosen, a New York-based nutritionist whose clientele is largely composed of Orthodox Jews, echoed Drake’s calls to cut back on the matzo, saying it would be best to stick to the minimum required by Judaic law.

While matzo is a key culprit to Passover constipation, the situation is amplified for many Orthodox Ashkenazi Jews, who are obliged to refrain from other high-fiber foods during the holiday, such as rice, beans and other legumes. (In 2016, however, the Conservative movement relaxed those restrictions.) Drake recommended substituting quinoa, a grain that meets the kosher for Passover requirements, as a good source of fiber.

Rosen recommended eating root vegetables like sweet potatoes and beets to replace grain starches like rice, noting that they are filling while still being kosher.

She had other suggestions for noshes during a time when many snacks are literally off the table.

“I recommend having almonds or cashews because first of all, that’s a very filling, wholesome snack, but also because it has a high fat content — good healthy fats that help with constipation.”

Rosen noted that her practice gets a major influx of clients after Passover, to the point where her phone feels like “the diet emergency hotline, like, ‘Oh my God, help, I gained so much weight,’” she said. Counterintuitively, she said, many Jews pack on the pounds during the holiday, despite having to abstain from many of their favorite foods. 

“It’s a lot of late-night, heavier meals, and also, when you have your favorite foods available, you eat however much you need, and you’re good,” she explained. “When you’re trying to get full on things you don’t really like, you even sometimes end up eating more, not less.”

Drake also wants Jews to remember that Passover is only eight days, and how we eat during the holiday should not be carried over to the rest of the year.

“A traditional Ashkenazi Jewish Passover fare,” he said, “is the opposite of what we docs would advocate people eating on a regular basis.”

This article was originally published on the Forward.

| RELATED: How a coffee company and a marketing maven brewed up a Passover tradition