Have a bowel movement

HOW OFTEN SHOULD YOU POOP?

We all know pooping is an important and natural part of life, but do you know how often you need to go to maintain digestive health?

In general, you should have a bowel movement between three times a day and three times a week.(1) But how do you know if the bowel movements you have are good or not?

THE “PERFECT” BOWEL MOVEMENT

The ideal bowel movement is:

  • Strain-free
  • Pain-free
  • A “ghost wipe,” leaving no mess on the toilet paper
  • One long piece or a few short pieces

If you are not having the “perfect” bowel movement, there could be many reasons why. Stress, travel, and diet can all affect the size, shape, and mess of stool. If you’re experiencing less-than-ideal bowel movements, the fiber in Metamucil can help promote digestive health and maintain regularity*, leaving you feeling lighter and more energetic**.

If you have questions or are concerned that your constipation may be more than just occasional, consult with your healthcare provider.

METAMUCIL CAN HELP

If you’re concerned you’re not having the right amount of bowel movements for your digestive health, the fiber in Metamucil can help you stay regular. Metamucil is the only leading fiber supplement brand^ that contains psyllium, which gels in your system to trap and remove the waste that weighs you down.

You can sign up today for the Metamucil Two-Week Challenge to receive a $2 off coupon and daily emails filled with tips and reminders to help you start having the perfect poops!

Everybody poops. Yeah, we got that knowledge from the classic kids book. But the real question is: How frequently should you be dropping a deuce? Because if you always go once a day, and your roommate regularly visits the loo for a number two four times in 24 hours…well, one of you must have a problem, right?

Relax, say experts. A wide range of pooping frequencies is considered totally normal. “Some adults may have a bowel movement three times a day, while others may have one just three times a week,” says Jennifer Inra, M.D., a gastroenterologist at Brigham and Women’s Hospital in Boston.

Related: Your Complete Guide To Keeping Your Butthole Healthy

Exactly how often you catch up on your bathroom reading (c’mon, we all do it!) is influenced by factors like your genetics, your diet—the less fiber it includes (the average woman should aim for 25 to 30 grams a day), the less often you’ll probably go—and how often you break a sweat. Regular exercise can make you, well, more regular, because it increases muscle contractions in your colon, says Inra. (These cutting-edge barre techniques target every inch of your body — including those stubborn, hard-to-tone zones!)

Catch up on more fascinating facts about the female anatomy:

What’s more, stressing out that you’re pooping too much or too little could actually make things worse. That’s because your brain and your gut are tightly linked by a network of nerves and neurotransmitters. When you’re anxious, the body directs blood to vital organs like the heart and lungs, and away from your digestive system—which can leave your gut in turmoil, according to Satish Rao, M.D., Ph.D., chief of gastroenterology and hepatology and director of the Digestive Health Center, Augusta University. That can lead to either constipation or more frequent BMs.

Related: This Is What Happens To Your Body When You Hold In Your Poop

In fact, the only time you should worry about how often you visit the porcelain throne is if your habits suddenly change, in either direction. “For example, if you have a bowel movement every other day and you suddenly starting having three a day, you may want to talk to your doctor,” says Inra. Ditto if you’re having the opposite problem and are abruptly constipated.

In many cases, your doc will ID a non-serious cause, like a change in diet or the meds you’re taking, if you’ve been traveling, or that you’ve been exercising more or less than usual—all factors that can alter your frequency. If none of those apply, she can suggest dietary changes like adding more low-fiber foods to firm up your stool if you’re having diarrhea, or upping your fluid and fiber intake if you’re constipated, says Inra.

Other reasons to see an M.D., even if you poops stick to their regular schedule: You see blood in the bowl or on the TP, your stools become narrow and ribbon-like, or you have pain or cramping when you try to have a BM. “These symptoms may be due to many causes including irritable bowel syndrome, celiac disease, inflammatory bowel disease or even colorectal cancer,” says Inra.

Tracy Middleton Tracy Middleton, the Health Director of Women’s Health, has more than 20 years’ experience covering health and wellness.

How Often Should You Poop?

This post may contain affiliate links. Please read my disclaimer for more info.

I can understand how this topic on poop may seem a bit uncomfortable to some, but based on my experiences with patients and students, I’m going to tell you that many people have similar questions.

Heck, Dr. Oz did a whole episode on this topic a few years back.

In fact, I still remember when I was in school, when we were covering the digestive system module, a friend of mine asked our professor about bowel movement frequency. At the time, my friend was following the “Eat every 3 hours, 6 meals a day” plan. And he asked the professor “So, how often SHOULD we be having a bowel movement?”

Our professor paused for a moment and said, “Ideally after every meal.”

My friend then blurted out, “6 times a day?!”

Luckily, for my friend, this was one of the very few times my professor was incorrect.

Listen to Dr. Neal address this topic on Episode 845 of the podcast Optimal Health Daily.

What is Normal Bowel Frequency?

There have been studies that examine bowel frequency and disease risk, like colon cancer for example. There are even studies that look at bowel movement frequency and Parkinson’s disease.

This is because there’s the theory that the health status of the gut influences the health status of the brain (also known as the gut-brain connection).

Most studies have found that one bowel movement each day is about right. In some, one bowel movement every 2 to 3 days may be fine, as well. Unfortunately, when we look at some of the largest studies on this topic, their findings differ.

One large study performed in the U.S. found that those with 2 or more bowel movements each day did not have an increased risk for colon cancer when compared to those that experience 1 each day. However, a recently published Japanese study couldn’t replicate these results. They found that having a bowel movement once every 6 days or so had the highest risk for developing colon cancer.

So, it seems that, depending on the person, having anywhere from 3 bowel movements a day to 3 per week may be considered normal. So, luckily for my colleague back in school, our professor was incorrect: 6 times a day would NOT be considered normal!

What Determines Stool Frequency?

Now, what actually determines healthy poop frequency? So many factors — age, gender, hydration, medications, stress, diet of course, body weight, and physical activity to name a few. I’m not going to discuss specific disease states like Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD) because that would need a separate episode on its own.

If we think about age for a moment, for those parents out there — even parents of baby animals — you probably have noticed that these young ones often have more frequent bowel movements when compared to adults, or even when compared to their older siblings. As we move from young adulthood into middle age and beyond, stool frequency also tends to decrease.

Do Men Have More Bowel Movements Than Women?

Women, on average, have fewer bowel movements than men. But that may just be because men eat a higher volume of food. Those that have a higher Body Mass Index may have more frequent bowel movements as well.

It seems that walking or jogging may lead to more frequent bowel movements. It’s believed that walking and jogging stimulate the colon to push its contents along a little more quickly (what healthcare practitioners call peristalsis).

Do Medications Cause Constipation?

As for medications, a strong pain reliever like a narcotic or anti-depressant may slow down peristalsis and lead to constipation.

When you take antibiotics, they may temporarily wipe out the good bacteria in your colon which can change the number of times you poop. You may experience diarrhea or constipation…it just depends.

This is because antibiotics are built to kill bacteria. They don’t know which ones are good or bad — they just kill all bacteria.

Stress can absolutely play a role, too. In some, stress stimulates peristalsis which causes more frequent bowel movements. In others, it can lead to constipation.

I wish I had more definitive answers. There are just so many variables that may influence how often you poop. When it comes to diet and maintaining stool frequency, the scientific community mostly agrees that staying adequately hydrated (drinking enough water so that your urine is a pale yellow color and getting 20 to 35 grams of dietary fiber each day (ideally from whole foods like fruits and vegetables) appear to be most important. Both of these will help keep the gut microbiome healthy which we agree definitely influences bowel frequency.

Tags: health

Neal Malik

Dr. Neal Malik leads the Master of Science in Nutrition for Wellness program and teaches core courses at Bastyr University California. He has a Doctorate in Public Health from Loma Linda University and is a Certified Exercise Physiologist from the American College of Sports Medicine.Send in your health related question and Dr. Neal will answer it on the Optimal Health Daily show!

    October 11, 2019

    The ‘Three and Three’ Rule of Pooping Tells You If You’re Normal or Not

    Some days you might find yourself in and out of the toilet, and some days might go by without a single visit for a Number Two. Should this be a cause for concern?

    We asked five experts if we have to poop every day.

    Five out of five experts said no

    Here are their detailed responses:

    Christopher Hair, gastroenterologist, Deakin University

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

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

    Damien Belobrajdic, research scientist at CSIRO, Australia’s national science agency

    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 hemorrhoids, anal fissures, or fecal impaction. Constipation can be caused by many factors, including a range of medical conditions, some medications (such as opioids and some antacids), nutritional supplements (such as iron) and, of course, a diet low in fiber.

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

    Watch More Form VICE News:

    Dan Worthley, gastroenterologist, South Australian Health & Medical Research Institute

    In a recent, large study of 4,775 people reporting “normal” bowel patterns, it was found that about 95 percent 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 pooping.”

    But just as important as 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 percent of normal patients report some variation from this.

    Jakob Begun, gastroenterologist, University of Queensland

    Stool is the end product of our gut metabolizing 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, behavioral 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, Western Sydney University

    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. 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.

    This article was originally published on The Conversation. Read the original article.

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    How do I know if I have normal potty habits?

    When talking about potty habits (known in high society as bowel habits), your “normal” is whatever is normal for you. Confused? You’re not alone.

    Many well-meaning people will tell you what they think are supposed to be normal bowel habits. However, studies show having a bowel movement happens at a different frequency for everyone. If, for most of your life, you have a bowel movement every day, that’s YOUR normal. Some people have a bowel movement about three times a week, while others, only once a week. So, after all these years, you should know what’s normal for you. (Please note: there ARE some “unhealthy normals” discussed later in this article.)

    Healthy bowel movements are those that allow you to empty your colon (sometimes called your intestines) often enough that you don’t feel bloated or in pain, and you don’t have to strain hard to get the job done. There’s even a chart describing what you should see before you flush the toilet (called the Bristol Stool Scale). Don’t worry! It’s alright if you don’t want to have to look at this visually-stimulating chart.

    Here is the summation: if your poop looks like pebbles, you’re constipated (if you aren’t an infant), and if your poop is practically a liquid, you have diarrhea. What you want is soft, easy-to-push-out poop (hereafter referred to as “stool”).

    I just realized I only experience unhealthy bowel movements!

    So, what if you DO have abdominal pain and bloating, and constipation, and this is how it’s been for years. Talk to your doctor. You may just need to add a laxative to your routine, and this will help you get to a comfortable, new “normal.”

    You may need to also adjust your lifestyle to get into a healthier routine (more about this later in this article). Your doctor will also advise you on whether medical testing should be done to rule out diseases affecting bowel movements. Some of these colon diseases are only inconvenient, while others can be life-threatening, so don’t delay talking to your doctor.

    Why have things changed for me?

    Now that you know the normal frequency for your bowel movements, what should you do if your bowel movements become abnormal?

    There are a lot of things that can upset your colon. First, let’s be sure we’re all talking about the same body part. Where is your colon?

    The colon is in the lower part of your abdomen, and it’s the last place the food you eat travels before it exits the body. If you look at the picture, you’ll see where the colon (large intestine) is compared to where your stomach sits. Most of us know where the stomach is if we’ve gone for a while without eating.

    Food poisoning or eating a lot of an unfamiliar food (especially high-fiber foods) can cause colon irregularity for a while. But if neither of these things are the problem, there are several easy-to-determine things that can cause your colon problems. Vacations and other types of traveling often cause changes in your bowel habits. This is because you are often eating a lot of different types of food instead of your “at home” diet, and you may not be drinking as much water as you usually do.

    Additionally, if you’re hurrying around having fun, you might not be taking time for a good, old-fashioned “rest” in the restroom. So don’t be surprised if you lose your “normal.” The good news is, when you get back to your work and home life, you’ll soon revert back to your normal self.

    Another common reason for changes in your bowel movements are new medications. Many medications have a side -effect of constipation. On the other hand, antibiotics are commonly associated with diarrhea. If either of these happen, consult with your doctor so you can get back to normal.

    What diseases and disorders can give me abnormal bowel movements?

    Many diseases and disorders can cause abnormal bowel movements. In the following examples, your “normal” is actually “abnormal,” and you should see a doctor if you have any of the following:

    • Blood in your stool
    • Inability to have a bowel movement for seven to 10 days (this may actually be a “normal” for you, but you should talk to your doctor to be sure)
    • Being constipated, then having diarrhea, then experiencing the same cycle over and over, when there’s no obvious cause for these changes
    • Severe pain in the very end of your large intestine (the anus)
    • Diarrhea that lasts for more than a few days, especially when accompanied by vomiting

    What can I do to increase my colon health?

    The most important way to be sure your colon is healthy, especially if you’re over the age of 50 and/or have a family history of colon disease, is to get a colonoscopy. Before and after the age of 50, there are many studies on how to avoid cancer of the colon or at least reduce your risk factors. However, one of the most frequently asked questions is: Does a colon detox work, and if so, how does it cleanse your colon? The answer is: We really don’t know. There haven’t been enough scientifically-broad studies on the effect of a colon cleanse.

    Before using any of the following scientifically-studied suggestions, consult your doctor to see if any of your medical conditions would prohibit you from following these rules provided by the American Heart Association:

    • Eat fruits and vegetable that are high in fiber to help your colon move waste products out of your system. Eat about two cups of fruit and three cups of vegetables daily. Good sources of fruits and veggies with high fiber include (but aren’t limited to): artichokes, apples, pears (with skin), berries (blackberries, blueberries, raspberries), dates, figs, prunes, beans (baked, black, lima, pinto), broccoli, chick-peas, lentils, parsnips, peas, pumpkin, winter squash. This list was provided by American College of Gastroenterology.
    • Eat a lot of high-fiber grains (about three servings a day). Also, eat another three servings of quality grain products, such as pasta and oatmeal.
    • Eat two to three servings of low-fat dairy products, especially yogurt with an “active culture.” This active culture helps the natural bacteria in your digestive system do its job, and the calcium in the dairy products helps increase colon health.
    • Exercise (at least a brisk walk for 30 minutes five times a week). Interestingly enough, when we move our muscles, it helps our colon move waste products as well.
    • Lose weight, as needed.
    • Drink lots of water.
    • Don’t use tobacco of any type.

    Maintaining good colon health is easy, and important, because not only can it help you avoid preventable colon issues, but the things that are good for your colon are also good for your heart, brain, kidneys, liver, skin, hair, and overall well-being. Keeping your colon healthy is really a one-size-fits-all recommendation for almost all bodily functions – even those that aren’t as awkward to talk about.

    Let’s look on the bright side: Of all the digestive issues out there, constipation isn’t necessarily the worst thing your stomach could do to you. But that still doesn’t make it pleasurable, and you deserve real relief.

    Luckily, there are a few ways you can speed things up, if, say you’re heading out for a morning run or have a long car ride ahead of you. The best part: Most are totally natural things you likely do every day anyway—and they’re doctor-recommended methods for how to make yourself poop.

    Try one of these 10 tricks the next time you’re feeling more backed up than usual, and are hunting for answers for how to relieve constipation fast.

    1. Load up on foods with fiber.

    Fiber-rich foods with a high water content, such as raw carrots, apples with the skin or peel on, and avocados, are all great sources of fiber to help get things moving, says Christine Lee, MD, a gastroenterologist at the Cleveland Clinic.

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    “When consumed, these foods create an osmotic gradient,” says Dr. Lee—that means they force more water to be pulled into the colon during digestion, which then helps ease and prevent constipation by helping things flow a little more smoothly.

    2. Or, take a fiber supplement.

    You can get the same effects from a psyllium husk fiber supplement, says Dr. Lee. Look for a daily supplemental dose of 6 to 9 grams of fiber, which are available over the counter.

    Just remember: Eating a nutritious diet (which should naturally include some natural fiber found in food) is key, even if you decide to take a fiber supplement. You can’t just add a spoonful of Metamucil to your bottle of cola and expect your digestive system to work properly.

    3. Drink some coffee—preferably *hot.*

    This is often the first idea that comes to mind if faced with the dilemma of how to make yourself poop. Warm beverages in general, particularly a hot cup of coffee or tea, in the morning, can help to get things moving, says Dr. Lee.

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    But coffee in particular is a must for anyone looking for how to poop immediately in the morning (especially runners, Dr. Lee notes, as it’s much more convenient to empty your stomach before you hit the pavement). The heat from the coffee can stimulate movement, but the coffee itself and its high levels of caffeine are also “known to stimulate colon motility,” says Dr. Lee.

    Coffee can work warm or cold. But other cold caffeinated beverages like iced tea or caffeinated sodas won’t have the same effect.

    4. Get a little exercise in.

    Ever been in the middle of a run when you needed a bathroom—STAT? You’re not alone. That’s because “hiking, walking on uneven grounds, jogging, and biking can all increase your metabolism, which in turn increases intestinal motility,” says Dr. Lee.

    Also important: If you’ve been busier than usual and have gotten into an exercise dry spell (and you’re noticing some bathroom issues) it might be a clue as to why you’re not pooping as much as you’d like. Making sure to incorporate even short regular workouts into your routine could be the secret solution you need, she says.

    5. Try massaging your perineum—no, really.

    A technique in which you massage your perineum (the stretch of skin that separates the vagina from your anus), by pushing repeatedly on the skin with your index and pointer finger, can help to ease constipation because of the pressure points contained in that area, according to a 2015 study in the Journal of General Internal Medicine. (Similarly, massaging the same area can help promote down-there relaxation during childbirth to prevent tearing, per the study.)

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    In the study, participants who massaged the area to promote bowel movements experienced improved bowel function, compared to the group that didn’t do the hands-on technique. Also: 82 percent of those who did use the technique said they’d continue to use it long after the study was over. While more research is needed, it’s definitely worth a try the next time you’re backed up and at your wit’s end trying to figure out how to make yourself poop.

    6. Try an over-the-counter laxative.

    Polyethylene glycol 3350 (you might recognize it as MiraLAX) is made up of compounds that are not digestible and not absorbable—which means they cause a diarrheal effect, says Dr. Lee.

    At lower doses, it can help prevent constipation, and at higher doses, it can induce diarrhea. So you can adjust the dose you take if you want to get things moving just slightly without them getting disastrous, she says.

    7. Or try a prescription laxative if things get really bad.

    Lee also recommends talking to your doctor about trying prescription laxatives if none of the other methods have worked. “Prescription drugs are effective, but they can be expensive, so they should generally be left as a last resort after you’ve tried these other methods,” she says.

    Another downside of laxative medications: Your body can get used to them, so eventually you might not be able to go poop without them if you use them too often.

    8. Try squatting over the toilet when you think you might be ready to go.

    The squatting position can be mimicked by putting a stool under your feet to raise your knees up, says Peyton Berookim, MD, a gastroenterologist and director of the Gastroenterology Institute of Southern California in Los Angeles.

    Squatting modifies the anatomy by relaxing the muscles in that area while also elevating the part of your colon that makes for easier emptying of the bowel. “The closer you are to a full squat, the easier it will be to poop,” he says.

    9. Give yourself a belly rub.

    No really—applying moderate pressure and massaging your abdomen in a clockwise direction can help you move your bowels, says Dr. Berookim. Colonic massage has been shown to improve constipation, he says.

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    This can be performed by applying moderate pressure along the horseshoe shape of the colon in your right lower quadrant. Then continue moving up to the rib cage, across the stomach and underneath the ribs to your left lower quadrant, which is the point where stool is emptied.

    10. Make sure you’re properly hydrated.

    “One of the most common causes of constipation is dehydration,” Dr. Berookim says. “When the body is poorly hydrated, it will compensate by withdrawing water from the large intestine (colon) resulting in hard stools.”

    A good rule of thumb is to drink 1 ounce of water for every 2 pounds of your body weight, he says.

    What About Laxatives?

    A box of laxatives shouldn’t be the first place you turn to relieve constipation. Reserve laxatives for constipation that doesn’t improve after you’ve added fiber and water to your diet.

    See your doctor for long-term constipation, because a medicine you’re taking or a medical condition could be the cause. In that case, stopping the medicine or treating the problem should relieve your constipation.

    If your doctor recommends laxatives, ask what type is best for you, and for how long you should take them. Laxatives are best taken short-term only, because you don’t want to start relying on them to go to the bathroom. Also ask how to ease off laxatives when you no longer need them. Stopping them too abruptly can affect your colon’s ability to contract.

    Laxatives come in several forms:

    • Bulk-forming fiber supplements include Citrucel, FiberCon, and Metamucil. Unlike other laxatives, you can take these every day. They make the stool bigger and softer. Although they are safe to use regularly, fiber supplements can interfere with your body’s ability to absorb certain medicines, and they may cause bloating, cramps, and gas. Drink a lot of water with them.
    • Lubricant laxatives, including Zymenol, help the stool pass more easily through the colon. In general, doctors do not recommend using mineral oil or castor oil. Mineral oil can cause problems such as vitamin deficiencies, and castor oil can lead to long-term constipation.
    • Osmotic laxatives such as lactulose, Miralax, Milk of Magnesia, and Sorbitol help fluids move through your intestines. If you have diabetes, ask your doctor before taking osmotics because they can cause electrolyte imbalances.
    • Stimulant laxatives such as Dulcolax and Senokot make the muscles in your intestines contract to help push stool out. These laxatives work quickly, but they can cause side effects, including cramping and diarrhea, so use them for as short a period of time as possible.
    • Stool softeners such as Colace and Surfak make stools easier to pass by adding fluid to them. Having softer stool can prevent you from having to strain during bowel movements. Your doctor may recommend one of these products if your constipation is due to childbirth or surgery.
    • Prescription medications such as lubiprostone (Amitiza) and linaclotide (Linzess) work by drawing water into your intestines and speeding up the movement of stool. Plecanitide (Trulance) changes stool consistency by increasing the amount of water into the GI lumen and increases gastrointestinal movement. Note that Amitiza is approved for use only in women.

    Jump to Topic

    • Biofeedback
    • Bowel Retraining
    • Dietary Fiber
    • Fruit Juice
    • Laxatives
    • Newer Medications
    • Tips on Finding a Doctor

    Bowel training or retraining refers to behavioral programs designed to help people with bowel disorders establish or reestablish control. Individuals with symptoms of inability to control bowel movements, incomplete emptying, or chronic constipation may benefit from these programs. Bowel retraining works by teaching new skills or strategies to develop a routine and predictable schedule for evacuation. This prevents constipation and decreases unpredictable elimination.

    Health care professionals that are skilled in evaluating and treating bowel disorders include physicians who specialize in gastroenterology, colorectal disorders, or physical medicine and rehabilitation. Nurses who specialize in gastroenterology, rehabilitation, or enterostomal therapy are also proficient in this area.

    An evaluation prior to beginning a bowel training program should include a comprehensive bowel history, which looks at past and present bowel elimination patterns, medical history, diet, and medication. It should take into consideration the effect the disorder has on a person’s life, as well as his or her goals for bowel management. A physical exam may include special tests to assess the various factors involved in bowel control. A helpful tool in devising an individualized treatment program is a symptom diary that records times of voluntary and involuntary bowel movements and other symptoms related to the disorder. A food diary may be kept simultaneously. The type of food and fluid ingested helps determine the consistency of the stool.

    Bowel training programs generally take these three basic principles into account:

    1. Improve consistency of stool.
    2. Establish a regular time for elimination.
    3. Stimulate emptying on a routine basis. Prior to initiation of a program, it is important to rule out fecal impaction. This needs to be remedied or attempts to train the bowel will be frustrated.

    Normalize Stool Consistency

    The optimal goal for stool consistency is a formed, soft stool. Hard stools are difficult to evacuate and leakage is more likely if stools are liquid. One should eat well-balanced, regularly timed meals that are high in fiber. Dietary fiber refers to the parts of the food that humans are unable to digest. This includes whole grains, legumes, fresh fruits, and vegetables. Fiber adds bulk to the stool, eliminates excess fluids, and promotes more frequent and regular movements. With increasing fiber it is important to drink enough fluids. If fluid intake is inadequate, the stool becomes hard because less water is retained in the large intestine. The amount of fiber and fluids necessary for optimal bowel function varies among individuals. Dietitians are experts in evaluating and adjusting diets.

    Learn more about dietary fiber

    Establish a Regular Time for Elimination

    A bowel training program needs to occur at the same time each day. The goal is to establish a routine and predictable time for elimination. When choosing an appropriate time a person should consider his or her past pattern of bowel elimination and present lifestyle. The time should be convenient and not rushed. Planning the program after meals allows one to take advantage of the wave-like movements that propel the fecal material through the colon to the rectum, which occur 20-30 minutes after a meal.

    Stimulate Emptying on a Regular Basis

    A stimulus of some kind may be needed to help empty the rectum. The stimulus will vary from individual to individual. The stimulus creates peristalsis or wave-live movements of the colon. A meal or hot drink may stimulate some persons. Others may need to use suppositories, enemas or laxatives (only under the advice of a physician) or a combination of the above. One should use the least stimulus that is effective to promote evacuation.

    Did This Article Help You?
    IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders.
    Our original content is authored specifically for IFFGD readers, in response to your questions and concerns.
    If you found this article helpful, please consider supporting IFFGD with a small tax-deductible donation.

    Adapted from IFFGD Publication: Strategies for Establishing Bowel Control by Mary K. Plummer, OTR, WI.

    How Often Should You Poop a Week? A Doctor Weighs In

    Everybody poops. It’s a vital biological function that rids the body of bacteria, fiber, cells, water, and indigestible plant matter (see: corn poops). But while everybody does it, we don’t all do it with the same frequency. While some may have a meeting with the bathroom every morning at the exact same time, others may have poop schedules that are less predictable.

    So how often should you poop? Jean Marie Houghton, MD, who practices gastroenterology with UMass Memorial Health Care in Worcester, Massachusetts, tells Health the “average” frequency is between three times a day and every three days—“and everything in between!” Dr. Houghton says that most people have their routine pretty well established, “and although it may vary over time and with activity or diet, it is pretty predictable.”

    She stresses that if you feel good, your “ideal” poop frequency is probably right on track. Her rule of thumb: Don’t get too hung up on the number. “If you go three times a day and feel great—perfect!” she says. However, if you’re going that often and feel bloated, uncomfortable, or an urgent need to poop, this isn’t normal, and should be addressed with a medical professional. And if you’re pooping more than three times a day but that’s pretty usual for you, you’re probably just fine, but make sure your doctor agrees just to be safe, Dr. Houghton suggests.

    RELATED: What the Color of Your Poop Can Tell You About Your Health

    What if your regular poop routine changes?

    You may experience a change in schedule for a variety of reasons. Dr. Houghton says hormone changes—think: during your period, during pregnancy, or around menopause—can affect your poop cadence. And as you age, things tend to slow down in general, which also might be true for your number of bathroom breaks, she says.

    Changes in your diet could also be making your poops unpredictable or uncomfortable. To get more regular, Dr. Houghton suggests avoiding processed foods and loading up on natural sources of fiber—foods like beans, nuts and seeds, and veggies. Staying hydrated with water and getting plenty of exercise should also help move things along.

    However, if you’re suddenly pooping more or less than usual, it’s worth a check-in with your doctor, Dr. Houghton says.

    RELATED: There Are 7 Types of Poop—Here’s How to Tell If Yours Is Normal

    Signs your poop is trying to tell you something

    We can learn a lot about our health through our poop, no matter how often we go number two. There are a handful of warning signs to be mindful of when you spot them. Get checked out if you ever see blood in your stool; experience a significant change in size, color, or frequency in your poops; or if you feel pain while pooping, Dr. Houghton says. And if you have a family history of GI diseases, it’s always wise to share this information with your doctor.

    RELATED: 15 Foods That Help You Poop

    Summit Medical Group Web Site

    What is a good bowel habit?

    Bowel habit is the term used for how often you have bowel movements. There is no “best” number of daily or weekly bowel movements. Some people have a bowel movement twice a day and others twice a week. What’s more important than having frequent bowel movements is having regular and soft bowel movements. Your bowel habit is good as long as the frequency of your bowel movements stays about the same and your stools are soft enough to pass without straining.

    Most people have temporary changes in their bowel habit, such as diarrhea or constipation, from time to time. For example, many people notice that some foods, like nuts and corn, make their bowel movements loose. These temporary changes usually are not a sign of a serious medical problem. However, a change in bowel habit that does not go away may be a sign of a problem.

    How do bowel habits change as I get older?

    As you get older, you are more likely to have constipation.

    • As your lifestyle changes, your diet may change. You may have less fiber in your food or simply not eat as much as you used to.
    • You may drink less fluid and get less exercise.
    • You may take medicine that can cause constipation.
    • If you have been using a laxative often, it may cause constipation when you stop using it.

    What are the symptoms of a possibly serious problem?

    Symptoms that may signal a problem include:

    • Any change in normal bowel habits that lasts for 2 weeks or more
    • A change in the texture of stools, for example, stools that are much harder or looser
    • A change in the color of stools, for example, much paler or very dark
    • Stools that are narrower than before and stay that way for 2 to 4 weeks
    • Bowel movements that float and look fatty or greasy
    • Bowel movements that are painful or hard to pass
    • Stomach cramps, pain, bloating, and no bowel movement for more than 3 or 4 days (normal frequency ranges from 3 a day to 1 every 3 days)
    • Blood in the stools, on your clothes, or on toilet paper

    If you have one or more of these changes and they do not go away, tell your healthcare provider.

    How can I take care of myself?

    • Check your diet. In general, try to increase your fiber and vegetables and drink fluids.
      • You can increase your fiber by eating 2 cups of fruit, 2 and 1/2 cups of vegetables, and at least 3 servings of whole-grain breads and cereals each day. Drink plenty of fluids throughout the day
      • Eat 14 grams of fiber for every 1000 calories every day. This is lots of fiber! Work up to this amount over a month, adding more fiber every couple of days. If you don’t have that much appetite, try fiber supplement capsules containing psyllium, bran, or methylcellulose. There are many brands.
    • Reestablish or keep a regular bowel habit. Many people feel better if they go to the bathroom about the same time each day. Other people feel better just going whenever they feel the need.
    • A fiber laxative such as Metamucil is often helpful for a more regular bowel habit. Follow the directions for taking the laxative carefully.
    • Be sure you get some exercise every day. For example, walk at least a mile every day. If you have joints that hurt, try exercising in a swimming pool instead.
    • Using a suppository once in a while can help to stimulate the bowel movement. Do not use laxatives on a daily basis.
    • Some medicines can cause diarrhea or constipation. Ask your healthcare provider to review your medicines.
    • If you have followed these recommendations and you are still concerned about your bowel habit, consult your healthcare provider in case there is a more serious underlying cause.

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