By Dr. Mercola
It’s easy to take a bodily function like your bowel movements for granted… that is, until a problem arises. Whether your bowel movements come too frequently or not often enough, it can make you uncomfortable, bloated, or even interfere with your body’s ability to absorb enough nutrients from your food.
Staying regular is crucial for staying healthy. It plays a major role in how you feel (physically and emotionally) while removing waste from your body. For such a common bodily function, surprisingly little has been known about how a bowel movement actually occurs, so new research from Canada, which claims to have uncovered the “secret,” is well worth sharing.
How You Poop: Secrets Revealed
When you eat a meal, the food moves through your intestine by peristalsis. During this movement, your muscles contract and relax, allowing food and liquids to be mixed together and move through your digestive tract. Peristalsis acts much like ocean waves, and helps move fecal matter through your digestive tract for elimination.
Another type of movement, segmentation, occurs mostly in your large and small intestines and is thought to facilitate absorption of nutrients. How segmentation works has remained a mystery, but it had been theorized that alternate excitation and inhibition from the enteric nervous system was responsible. The new study revealed this is not the case and segmentation may occur “after total nerve blockade.”
Instead, researchers found segmentation patterns emerge when two sets of “pacemakers” work together to create a rhythm. The process involves both nerves and muscles working together to generate a rhythmic movement that allows for nutrient absorption.1 The study’s lead researcher compared it to the movements generated when you drop a stone in water:2
“It’s like when a stone is dropped in water, it creates waves or motion that pushes things along, but when a second stone is dropped in the water, the movement changes to up and down, appearing to stay in the same place.”
The finding could help open doors to treat conditions in which people have trouble absorbing nutrients from their food. It also sheds light on how irregular bowel movements occur. Specifically, with diarrhea segmentation activity is too low while with constipation it is too high. Abnormal segmentation activity may also be related to pain while eating.
Your Bowel Movements Offer Important Clues to Your Health
If you have a tendency to flush in a rush, you can get clues about your overall health by noting characteristics such as shape, color, consistency, frequency, and smell of your bowel movements.
First, you’ll need to know what’s normal in a stool, which can actually vary quite dramatically. One of the most common questions relates to frequency, although there is no one right answer for this; normal bowel habits vary. When we talk about regularity, what we’re really talking about is what’s regular for you. Three bowel movements per day to three per week is considered the normal range.
What’s more important than frequency is the ease with which you move your bowels. If you need to push or strain, something is off – moving your bowels should take no more effort than urinating or passing gas.
You should keep an eye out for any sudden changes in your bowel habits, which might signal a problem. Many factors can affect regularity from day to day, such as diet, travel, medications, hormonal fluctuations, sleep patterns, exercise, illness, surgery, pregnancy and childbirth, stress, and more.
As for appearance, the Bristol Stool Chart is a handy tool to help you learn what healthy stool looks like. Ideally, your stool should approximate Types 3, 4, and 5, “like a sausage or a snake, smooth and soft” to “soft blobs that pass easily.” Type 4 is the Holy Grail.3
Poop: What’s Normal and What’s Not
What you see in the toilet can give you clues about how your gastrointestinal tract is functioning and even signal serious disease processes that could be occurring, like infections, digestive problems, and even cancer. This is true of both your urine and your stool. As for the latter, the following table will help you narrow down what to look for, so that you aren’t needlessly alarmed. Of course, there are a few signs that are cause for concern, and those are listed, too. If you have a change in stools accompanied by abdominal pain, please report this to your physician.
Medium to light brown
Stool that is hard to pass, painful, or requires straining
Smooth and soft, formed into one long shape and not a bunch of pieces
Hard lumps and pieces, or mushy and watery, or even pasty and difficult to clean off
About one to two inches in diameter and up to 18 inches long
Narrow, pencil-like or ribbon-like stools: can indicate a bowel obstruction or tumor – or worst case, colon cancer; narrow stools on an infrequent basis are not so concerning, but if they persist, definitely warrant a call to your physician
S-shaped, which comes from the shape of your lower intestine
Black, tarry stools or bright red stools may indicate bleeding in the GI tract; black stools can also come from certain medications, supplements, or consuming black licorice; if you have black, tarry stools, it’s best to be evaluated by your healthcare provider
Quiet and gentle dive into the water… it should fall into the bowl with the slightest little “whoosh” sound – not a loud, wet cannonball splash that leaves your toosh in need of a shower
White, pale, or gray stools may indicate a lack of bile, which may suggest a serious problem (hepatitis, cirrhosis, pancreatic disorders, or possibly a blocked bile duct), so this warrants a call to your physician; antacids may also produce white stool
Natural smell, not repulsive (I’m not saying it will smell good)
Yellow stools may indicate giardia infection, a gallbladder problem, or a condition known as Gilbert’s syndrome – if you see this, call your doctor
Presence of undigested food (more of a concern if accompanied by diarrhea, weight loss, or other changes in bowel habits)
Floaters or splashers
Increased mucus in stool: This can be associated with inflammatory bowel disease like Crohn’s disease, or ulcerative colitis, or even colon cancer, especially if accompanied by blood or abdominal pain
Very bad odor: If your stool has an extraordinarily bad odor, it should not be ignored. I am referring to an odor above and beyond the normally objectionable stool odor. Stinky stool can be associated with a number of health problems, such as a malabsorptive disorder, Celiac disease, Crohn’s disease, and chronic pancreatitis
The Healthiest Pooping Position You Probably Aren’t Using
A conversation about bowel movements wouldn’t be complete without a mention of position, as this can impact the ease with which you eliminate and even increase your risk of bowel and pelvic problems, including constipation, hemorrhoids, and more. Most of you reading this probably sit to evacuate your bowel, but this requires you to apply additional force (straining), which has some unwanted biological effects, including a temporary disruption in cardiac flow.
Sitting on a modern toilet is designed to place your knees at a 90-degree angle to your abdomen. However, the time-honored natural squat position (which is still used by the majority of the world’s population) places your knees much closer to your torso, and this position actually changes the spatial relationships of your intestinal organs and musculature, optimizing the forces involved in defecation.
Squatting straightens your rectum, relaxes your puborectalis muscle, and allows for complete emptying of your cecum and appendix without straining, which prevents fecal stagnation and the accumulation of toxins in your intestinal tract. It is instructive that non-westernized societies, in which people squat, do not have the high prevalence of bowel disease seen in developed nations; in some cultures with traditional lifestyles, these diseases are uncommon or almost unknown.
If you have trouble with bowel movements, especially constipation, I urge you to give the squat position a try. Squatting does involve strength and flexibility that adults tend to lose over time (but children have naturally). Special toilets and stools that get your body into a more “squatty” position can help you get closer to the ideal even if you’ve been sitting for decades.
Constipated? Here’s What Can Help
Constipation is one of the most common bowel problems. It’s defined as passing hard, dry stools that you have to strain to move, and it’s typically accompanied by decreased frequency of defecation. Straining is not normal, nor is experiencing feelings of incomplete elimination, bloating, crampiness, or sluggishness after going number two. If you’re over the age of 65, your risk of becoming constipated increases significantly.
If you’re constipated, tweak your diet so that it includes plenty of whole foods, particularly fresh, organic vegetables and fruits that provide good nutrients and fiber. However, most of your fiber should come from vegetables, not grains. Grains actually contain anti-nutrients that may damage your health, as well as sticky proteins like gluten (literally, Latin for “glue”) in the prolamine class, which are highly constipating to some individuals. Ironically, since we’re often told that whole grains are one of the best sources of fiber for our health, the net effect of eating them will likely be constipating versus eliminative, and if it does have the latter effect, it may be due to its irritant properties – hardly a “wholesome” food.
Assuming your gut is generally healthy, I believe most people need upwards of 32 grams of fiber a day. Most Americans get nowhere near this amount. If your diet could use more fiber, resist the urge to fortify it with whole grains. Instead, focus on eating more vegetables, nuts, and seeds. In addition to modifying your diet as described above, other effective constipation relief and prevention strategies include: