Good news for number two’s!

There are few things more relieving then knowing your bowels are in good nick (because let’s be honest, they do a pretty good job of telling us when they’re not).

Checking in with five experts… do we need to poo each day?

All experts agreed there’s nothing to worry about if you don’t go every day see below.

Christopher Heins – Gastroenterologist

The human body is complex, which helps to explain why so many “normal” functions differ among people, including sleep, urination and defecation. What is perceived as normal for many, is out of normal for others. Pooing is one such example of this range. What is normal is well defined yet broad. In many studies into normal ‘healthy’ defecation, normal pooing ranges from three times per day to three times per week. Less than 40% of healthy people poo once a day.

Pooing out of the normal for an individual might signify illness such as infection (pooing more) or cancer (pooing blood). Sometimes not pooing at all might indicate illness, such as a metabolic condition.

Damien Belobrajdic Research Scientist

Opening your bowels every day is not essential for the proper functioning of your digestive system. However, long periods without bowel movements (fewer than three stools per week) can cause a number of complications such as haemorrhoids, anal fissures or faecal impaction. Constipation can be caused by many factors, including a range of medical conditions, some medications (such as opioids, some antacids), nutritional supplements (such as iron) and of course, a diet low in fibre.

The best way to promote optimal digestive health and regular bowel motions is to drink plenty of water and consume high fibre foods at every meal. This can be achieved through a varied diet including wholegrain bread and cereals, legumes, nuts and seeds, vegetables and fresh fruits.

Dan Worthley Gastroenterologist

In a recent large study of 4,775 people reporting “normal” bowel patterns, it was found that about 95% of people move their bowels between three and 21 times weekly. So between three times a day and three times a week is what I like to call the “Goldilocks zone for pooing”.

But just as important as the frequency is form. To describe our stool consistency, we use the Bristol Stool Form Scale which uses a seven-point scale ranging from Type 1 “separate hard lumps, like nuts” to Type 7 “watery no solid pieces”. Type 4 (“Like a sausage or snake, smooth and soft”) is the Nirvana of all bowel actions, but 50% of normal patients report some variation from this.

Jakob Begun Gastroenterologist

Stool is the end product of our gut metabolising our food, and it consists of non-absorbed material, microbes and water. Each week the average person produces between 500 and 1,100 grams of stool. The frequency of defecation is governed by many factors including diet, the intrinsic motor activity of the gut, the rectal capacity, behavioural factors, as well as the gut microbiome. Studies have generally confirmed the “three and three” rule – that normal bowel frequency varies between three times a day, and once every three days.

When assessing whether people have constipation there’s an emphasis on symptoms in addition to stool frequency. So a person who moves their bowels less often than once a day, but does not have any discomfort, straining, or other symptoms, is normal.

Vincent Ho Gastroenterologist

Studies in the UK and Sweden found almost all patients had a frequency of bowel motions between three times per week and three times per day. So this is thought to be the normal range for how often you should go to the toilet. Experiencing temporary changes in bowel frequency or consistency is normal. Many non-disease factors are known to affect the frequency of bowel motions including fluid intake, physical activity, diet, age and social factors such as embarrassment in going to the toilet at work.

But.. what do we see at a Naturopath. Most clients feel good, if they go to the loo each day, some every other day. I also notice clients who will transition to a vegetarian or vegan diet will notice an increase in frequency.

Undoubtedly a balanced and varied diet high in vegetables is beneficial. However, it is more complicated when focusing on a single nutrient or single aspect, like stool size. Here is a balanced, albeit slightly dated (2001) discussion from Gut on this topic, https://gut.bmj.com/content/gutjnl/48/5/587.full.pdf.

If unsure about your digestion and things don’t seem to be moving along as well as they should or food seems to be speeding through your digestive tract, it could be helpful to make an appointment, contact the clinic here. 

Article originally sighted on The Conversation – We asked five experts: do we have to poo every day? September 5, 2018 6.03am AEST