Everyone Poops!

Let's talk about something that some people have trouble discussing with their doctors. Most people wouldn't even dream of discussing bowel movements with their chiropractor so I'll start the conversation here. 

While reviewing a patient's history, something they say might make me question them about their bowel habits. Most of the time, people tell me that they are "regular". When I ask for details, they very often tell me that they "go once or twice a week". While that may be common for them, it is certainly not normal. I then explain the gastrocolic reflex to them: it is a reflex that controls movement of the gastrointestinal tract after you eat. The result is that the colon has increased movement in response to food entering the stomach and causing it to stretch and release specific hormones. For some people with IBS/IBD (irritable bowel syndrome/disease), this reflex can be overly strong and exaggerated. 

In some cases, the decreased frequency of bowel movements is a byproduct of their own doing. How many times have you felt the need to go but wanted to finish one last project or the end of an episode on Netflix? What about those people who won't "go" in public. They spend their day waiting to use their own private bathroom at home. Public bathrooms can definitely be a place to avoid but delaying and ignoring the urge to go frequently can and does affect how well your gastrointestinal system functions. The longer the waste sits in your body, the more water content it loses as your body absorbs it thus making it harder to go when you do take the opportunity. This leads to harder to pass stools and constipation. Straining to have a bowel movement can lead to hemorrhoids or anal fissures. 

There is no set rule to normal frequency of bowel movements but it is generally agreed that three times per day to three times per week is acceptable. If you fall into this timeline, this is your usual routine, and you are feeling well, all sounds good. Feeling well means that you don't feel bloated, gassy, or uncomfortable. Bowel movements shouldn't take a long time and you shouldn't have to strain to finish. They also shouldn't be too loose, black in color, or tinged with blood. If any of these problems are present, or it hurts to pass your bowels, it's time to see your doctor. 

Some changes in your bowel habits can be explained by changes in your diet, hormone fluctuations, increased stress, travel, certain medications/supplements, and changes in your activity levels. If none of these apply to you, then it is also time to see your doctor, especially if you have a family history of colon disease. The American Cancer Society (ACS) recommends that "people of average risk of colorectal cancer start regular screenings at the age of 45". The age was lowered from 50 due to rising rates of people younger than 50 being diagnosed with colorectal cancer. If you do have a family history of colorectal disease, you should start your regular screenings at a younger age, around the age of 40, or 10 years prior to the age the family member was when they were diagnosed with colorectal disease. Please speak to your doctor about when you should start your regular screenings. 

The good news is that there are several ways to improve your bowel habits. Staying hydrated is an easy one (see my previous blog, "You Probably Need More Water" for more information). Certain high fiber foods will help you pass stools more easily including: beans, seeds, nuts, broccoli, whole grains, berries, apples, and avocados. Manage your stress levels and become or stay active for your physical health, mental health, and bowel health. 

The bottom line is...take care of your bottom!