How to Have a Bet­ter Poop

They may not be pretty, but bowel move­ments are a (hope­fully reg­u­lar!) fact of life. Un­der­stand­ing how to op­ti­mize the process de­liv­ers vi­tal health ben­e­fits.

Reader's Digest (Canada) - - Health - BY LISA BEN­DALL IL­LUS­TRA­TIONS BY SAM IS­LAND

THERE ARE MANY good rea­sons to im­prove your poops. For starters, main­tain­ing a healthy bowel rou­tine keeps your pelvic mus­cles fit and your time on the toi­let brief. It helps pre­vent chronic con­sti­pa­tion and di­ar­rhea, along with sec­ondary prob­lems like hem­or­rhoids, tis­sue tears and un­pre­dictable stools. Many of the life­style changes that pro­mote defe­ca­tion, such as eat­ing fi­bre and get­ting ex­er­cise, also re­duce your risk of col­orec­tal can­cer. Use our guide be­low to make your bowel move­ments the best they can be.

1. WHAT YOUR POO SAYS ABOUT YOU

KNOW YOUR TYPE

A stool scale de­vel­oped at the Univer­sity of Bris­tol, U.K., de­scribes seven stool for­ma­tions, from se­vere con­sti­pa­tion (hard lit­tle lumps) to se­vere di­ar­rhea (prac­ti­cally wa­ter). The ideal is type 3 or 4: sausage-like and S-shaped in the bowl, passed pain­lessly and with­out strain­ing or spend­ing too long on the toi­let. If your poop is lower on the scale (trend­ing to­wards con­sti­pa­tion) or higher and looser, chances are that di­etary changes and life­style strate­gies will help.

BE­LOW THE SUR­FACE

Poops that con­tain a lot of gas or are low in fi­bre may lack enough den­sity to sink. Don’t be too alarmed by floaters, which aren’t gen­er­ally a sign of dis­ease. But if

you also see fat droplets in the toi­let bowl that don’t flush away with the rest of your busi­ness, it could in­di­cate a mal­ab­sorp­tion dis­or­der, like celiac dis­ease, which needs in­ves­ti­ga­tion.

THE SMELL TEST

Frankly, stool stinks. The bad smell comes from short-chain fatty acids, a nor­mal by-prod­uct cre­ated by the bac­te­ria in your bowel as they fer­ment foods. The odour of your poop may also be in­flu­enced by var­i­ous spices or mari­nades in your foods and the di­ver­sity of your gut bac­te­ria. Stool will smell fouler than usual, how­ever, if you’re ex­cret­ing di­gested blood (which war­rants a doc­tor’s visit) or in­fec­tious di­ar­rhea (see your doc for this, too, if it’s se­vere or isn’t go­ing away af­ter three days), or if it con­tains an ex­cess amount of mal­ab­sorbed fat.

COLOUR COD­ING

Poop comes in al­most as many colours as a box of crayons. Its hues and shades vary widely de­pend­ing on what you’ve con­sumed, es­pe­cially if you’ve eaten a lot of it, or if it con­tains food dyes. Blue­ber­ries and stout beer can darken the colour, and green veg­eta­bles can turn it more of a shamrock shade. Beets can make it look red. How­ever, red can also sig­nify bleed­ing, a symp­tom of can­cer, in­flam­ma­tory bowel dis­ease or an­other prob­lem. Black, tarry stool may mean you’re bleed­ing some­where higher up, like the stom­ach.

It’s im­por­tant to seek med­i­cal at­ten­tion if you sus­pect bleed­ing. Same with very pale poop, which can be a sign of a bile duct prob­lem. Some med­i­ca­tions can tem­po­rar­ily change your stool colour, in­clud­ing iron sup­ple­ments and Pepto-Bis­mol, which make it look black. It’s worth not­ing that fe­cal blood can be mi­cro­scopic, so it may not be vis­i­ble. “If you have a fam­ily his­tory of colon can­cer or you’re over the age of 50, ask your doc­tor about screen­ing,” says Dr. Carlo Fal­lone, a gas­troen­terol­o­gist at McGill Univer­sity Health Cen­tre in Mon­treal.

WHAT’S THE FRE­QUENCY?

Is there such a thing as too many num­ber twos? What about move­ments that make only rare ap­pear­ances? “There’s a huge range of what’s con­sid­ered nor­mal,” says Dr. Dina Kao, a Univer­sity of Al­berta gas­troen­terol­o­gist. Some of us are on the throne three times a day, while oth­ers poop once ev­ery few days. There’s no need to worry about the fre­quency of your bowel move­ments if your stool ap­pears nor­mal and you feel well. But don’t dis­miss symp­toms like fever, pain or de­hy­dra­tion. “If there’s blood, any change in your usual pat­tern of bowel move­ments, or weight loss, or if you have any con­cerns, you should speak to your doc­tor,” says Fal­lone.

FACTS ABOUT FARTS

Flat­u­lence is in­evitable. The bac­te­ria in your bowel nat­u­rally gen­er­ate gases

as they fer­ment the bits of food your body can’t di­gest—and there’s only one way out. We tend to toot more fre­quently (or more pun­gently) de­pend­ing on our diet, which is prob­a­bly why some folks seem fartier than oth­ers. “Other than the in­con­ve­nience and em­bar­rass­ment of it, it’s prob­a­bly not due to any­thing se­ri­ous,” says Dr. Ge­of­frey Turn­bull, a gas­troen­terol­o­gist at Dal­housie Univer­sity in Hal­i­fax. Nev­er­the­less, you may be able to ad­just your out­put with the di­etary tweaks sug­gested be­low.

2. WHAT GOES IN MUST COME OUT

FOODS THAT MAKE US POOP

The high sor­bitol con­tent in dried fruits such as prunes, figs and dates acts as a nat­u­ral lax­a­tive. So does flaxseed. Fresh pears and ap­ples some­times do the trick. Eat­ing break­fast can in­crease your colon ac­tiv­ity and trig­ger a bowel move­ment.

OUR FRIEND, FI­BRE

Di­etary fi­bre pro­duces per­fect poo. Be­cause it isn’t di­gested, it bulks up and soft­ens stool, mak­ing it eas­ier to pass. Ac­cord­ing to Health Canada, most of us get just half of what we re­quire (women should have 25 grams a day, and men 38). “If you’re eat­ing whole grains, or about half your plate at each meal is fruits and veg­eta­bles, you’re likely meet­ing your needs,” says Whit­ney Hussain, a reg­is­tered di­eti­tian in Van­cou­ver who spe­cial­izes in gas­troin­testi­nal dis­or­ders. You can also choose ce­re­als with added fi­bre. Psyl­lium is a pop­u­lar sup­ple­ment, but watch out for in­ulin, which trig­gers a sore stom­ach in some peo­ple. Hussain sug­gests adding fi­bre to your diet grad­u­ally to pre­vent gas and bloat­ing. “Just have one serv­ing of a high­er­fi­bre food, and slowly in­crease it each day. Spread the fi­bre through­out the day, rather than hav­ing it all at once.”

STAY WELL-WA­TERED

With­out enough fluid, your stool will be dry and hard. Other signs that you

prob­a­bly need more wa­ter—or other sources of fluid, such as milk, juice, soup and tea—in­clude dry lips and mouth, dark urine and uri­nat­ing fewer than four times a day. The ideal amount of hy­dra­tion is dif­fer­ent for ev­ery­one and de­pends on fac­tors like your body size and ac­tiv­ity level.

FOODS TO FOR­SAKE

Pro­cessed foods con­tain­ing re­fined grain, such as white flour, may have a longer shelf life, but they won’t do you any favours in the fi­bre depart­ment. They’re also of­ten higher in fat, a com­mon con­sti­pa­tion trig­ger. White rice, as op­posed to its whole-grain brown coun­ter­part, can be an­other cul­prit. Car­bon­ated bev­er­ages may give you gas and bloat­ing, as can cer­tain foods like cab­bage, onions and lentils. “For some in­di­vid­u­als, drink­ing al­co­hol may cause gas­troin­testi­nal up­set and loose stools,” Hussain adds. (Can­dies and diet drinks sweet­ened with sor­bitol and other sugar al­co­hols, such as xyl­i­tol, can also have you run­ning for the bath­room.)

DON’T BLAME CAF­FEINE!

Many peo­ple re­port ur­gent bath­room vis­its af­ter their morn­ing brew, but both reg­u­lar and de­caf­feinated cof­fee ap­pear to have the same ef­fect. The warmth could be play­ing a role in speed­ing up the sys­tem. Cof­fee also con­tains about 100 dif­fer­ent com­pounds, one or more of which may trig­ger the pro­duc­tion of stom­ach acid and the re­lease of di­ges­tive hor­mones, and in­crease ac­tiv­ity in the large in­tes­tine.

MIND YOUR MANNERS

How you eat is just as im­por­tant as what you eat. Avoid gulp­ing your food or drink­ing through a straw, which can cause you to swal­low air and make you gassy. Same with talk­ing a lot dur­ing a meal. Eat on sched­ule—post­pon­ing a meal or snack can give you bloat­ing. Hussain has this tip: “Fo­cus on your hunger cue, so when you’re feel­ing full, stop eat­ing, rather than eat­ing un­til you’re su­per stuffed.”

3. PHYSICS AND PHYS­I­OL­OGY

GET AC­TIVE

You need to keep your body mov­ing in or­der to keep your bow­els mov­ing. Reg­u­lar phys­i­cal ac­tiv­ity, such as a brisk daily walk, can help pre­vent con­sti­pa­tion. Over­train­ing is thought to cause bowel symp­toms like flat­u­lence and loose poops in some peo­ple, es­pe­cially if they’re ex­er­cis­ing in­tensely in a hot en­vi­ron­ment, but that’s rare. Want to re­duce the risk of “run­ner’s di­ar­rhea,” pos­si­bly caused by al­ter­ations in in­testi­nal hor­mone lev­els and blood flow, and the bounc­ing of in­ter­nal or­gans? Avoid ibupro­fen, en­ergy bars and cof­fee be­fore run­ning, and wear loose cloth­ing that doesn’t con­strict your ab­domen.

EN­COUR­AGE CON­TAIN­MENT Fe­cal in­con­ti­nence—leak­age of stool— can be pre­vented. In some cases, di­etary changes to add more bulky fi­bre or re­duce gas will help. If it’s caused by over­stretched and weak mus­cles, a phys­io­ther­a­pist can show you pelvic floor ex­er­cises to strengthen them.

BOOST YOUR MI­CRO­BIOME

You share your gas­troin­testi­nal tract with about 100 tril­lion mi­crobes, and that’s a good thing; a di­verse ecosys­tem keeps you healthy. Some peo­ple take pro­bi­otic sup­ple­ments to pro­mote healthy bac­te­ria, but these prod­ucts typ­i­cally con­tain only a hand­ful of species. You’re more likely to en­cour­age a di­verse pop­u­la­tion— we’re talk­ing thou­sands of species—by eat­ing a va­ri­ety of fi­bre-rich foods. An­other way to build your bac­te­ria: a fe­cal mi­cro­biota trans­plant (FMT) from a healthy per­son. This treat­ment helps peo­ple whose gut mi­crobes have been wiped out af­ter re­cur­rent C. dif­fi­cile in­fec­tions, says Kao.

KEEP CALM AND CACA ON Stress has an im­pact on your poops. The gut lit­er­ally has a mind of its own—it’s lined with mil­lions of nerve cells that make up what’s known as the en­teric ner­vous sys­tem—and it sends sig­nals to the brain, and vice-versa. That’s why your feel­ings of anx­i­ety can pro­duce cramp­ing and di­ar­rhea. Con­versely, re­search has found that psy­cho­log­i­cal strate­gies to re­duce stress can im­prove these bowel symp­toms in peo­ple who have func­tional dis­or­ders like ir­ri­ta­ble bowel syn­drome. Their brains are more sen­si­tive to gut dis­com­fort, and it’s height­ened un­der stress.

OUR BOD­IES’ CHEM­ISTRY Hor­mone fluc­tu­a­tions also seem to af­fect your gut. About half of pre­menopausal women who aren’t on birth con­trol get con­sti­pa­tion or di­ar­rhea de­pend­ing on where they are in their monthly cy­cle. Hor­mones dur­ing preg­nancy serve to re­lax mus­cle con­trac­tions. “It may be a fac­tor in why a lot of women get con­sti­pa­tion in their third trimester,” says Turn­bull. Both men

and women ex­pe­ri­ence hor­monal shifts as we get older, thought to be a po­ten­tial in­flu­ence on the de­creas­ing di­ver­sity and ro­bust­ness of our mi­cro­biome as we age. Un­for­tu­nately, these bac­te­rial changes may weaken im­mu­nity and lower pro­tec­tion from the cog­ni­tive ef­fects of ag­ing.

UN­DER­STAND AD­VERSE EF­FECTS All kinds of drugs, from an­tide­pres­sants to nar­cotics to blood pres­sure pills, list di­ar­rhea or con­sti­pa­tion among po­ten­tial side ef­fects. “If your med­i­ca­tion is giv­ing you bowel prob­lems, talk to the doc­tor,” says Turn­bull. “It’s prob­a­bly best to try some­thing else. With some med­i­ca­tions you don’t have a lot of op­tions, but there are of­ten other drugs that can be used to off­set the symp­toms.”

TRY TO KEEP IT NAT­U­RAL

Be­fore re­sort­ing to drug­store lax­a­tives to re­lieve con­sti­pa­tion, con­sider life­style im­prove­ments such as in­creas­ing your fluid and fi­bre in­take, get­ting more ex­er­cise and avoid­ing foods that plug you up. “If this doesn’t work, lax­a­tives may be nec­es­sary, such as psyl­lium sup­ple­men­ta­tion, stool soft­en­ers or poly­eth­yl­ene gly­col,” says Fal­lone. “In gen­eral, one wants to avoid pro­longed use of agents that can dam­age the colon, such as senna prod­ucts.” Senna, made from the leaves and fruit of a plant, stim­u­lates bowel ac­tiv­ity. But even­tu­ally it can pre­vent your sys­tem from do­ing its job nat­u­rally and shouldn’t be used for more than a few days.

4. A TOI­LET TU­TO­RIAL

AS­SUME THE RIGHT PO­SI­TION

To adopt the per­fect poop­ing pos­ture, lean for­ward with your knees higher than your hips and your el­bows on your knees, and re­lax your belly. (If you’ve had re­cent hip surgery and are still us­ing an el­e­vated toi­let seat, con­sult your doc­tor about when it’s safe to raise your knees.)

The bot­tom of the rec­tum has a mus­cle that wraps around like a sling­shot, called the pu­b­orec­talis. “When it short­ens and con­tracts, it nar­rows the rec­tal open­ing and pre­vents stool from com­ing down,” says Gayle Hulme, a pelvic health phys­io­ther­a­pist in Cal­gary. “Putting the knees up al­lows for that mus­cle to re­lax and lengthen, and it opens the rec­tum.” Squat toi­lets may be un­com­mon in Canada, but toi­let stools like Squatty Potty, TURBO Stool and Squat-N-Go can as­sist with get­ting those knees up. (An or­di­nary footrest can also help.)

DON’T PUSH IT

Avoid hold­ing your breath and strain­ing to poop. The pres­sure can over­stretch mus­cles and weaken them, con­tribute to hem­or­rhoids and cause anal fis­sures. It can also close off your anus in­stead of al­low­ing it to re­lax and

open. You may end up with con­sti­pa­tion or more dif­fi­culty hold­ing in your bowel move­ments.

STICK TO A SCHED­ULE

Your colon has a sleep-wake cy­cle just like you do, and you can en­cour­age a daily morn­ing poop by eat­ing a proper break­fast and giv­ing your­self time to go. In gen­eral, try to an­swer the call of na­ture when it comes. The longer your stool sits in the large in­tes­tine, the more it dries out as wa­ter is ab­sorbed. “You can make con­sti­pa­tion worse by in­hibit­ing the urge to go,” says Turn­bull.

RE­LAX…

We poop more suc­cess­fully when we’re feel­ing com­fort­able, as that’s when our anal mus­cles are more likely to re­lax. Go in a fa­mil­iar en­vi­ron­ment if you can, and don’t rush the process. Give your­self a few min­utes, if you need it, to re­lease any ten­sion. (If no poop is forth­com­ing, be pre­pared to walk away, so you’re not tempted to force the is­sue.)

BE KIND TO YOUR BE­HIND

Your der­rière is del­i­cate. Too much wip­ing with pa­per can dam­age skin, caus­ing it to itch, feel sore and bleed. If you tend to get ir­ri­ta­tion around the area, try clean­ing with wa­ter and cot­ton pads in­stead of toi­let pa­per (or use a wet wipe, as long as it doesn’t con­tain harsh chem­i­cals). Rinse well and pat dry. You may get re­lief with a sitz bath—a shal­low, warm bath for just your bum—af­ter bowel move­ments. “Some foods, like cof­fee and citrus foods, tend to make

this ir­ri­ta­tion worse,” Turn­bull notes.

AVOID VA­CA­TION CON­STI­PA­TION

A dif­fer­ent time zone can throw off your sched­ule, and un­fa­mil­iar menus and limited food choices may mess with your di­ges­tion. Even the mi­cro­bial en­vi­ron­ment isn’t what you’re used to. Build a new bowel rou­tine early by es­tab­lish­ing set meal­times in your itin­er­ary. Re­mem­ber to in­clude fi­bre-rich fruits and veg­gies in your meals. On a long flight or train ride, get up and walk around to stim­u­late your sys­tem. And pack your prunes (or the dried fruit of your choice)!

AS­TRO­NAUTS NOR­MALLY LEAVE THEIR POOP TO BURN UP IN THE AT­MOS­PHERE.BUT SCI­EN­TISTS ARE WORK­ING ON A WAY TO RE­CY­CLE IT FOR FOOD, US­ING MI­CROBES. WASTE NOT, WANT NOT!

THE U.K.’S FIRST BUS TO RUN ON POOPHIT THE ROAD IN BRIS­TOL IN 2014. THE “BIO-BUS” WASFU­ELLED BY BIOMETHANE FROM HU­MAN AND FOOD WASTE.

ABOUT 12,000 KGS OF HU­MAN POO IS DE­POSITED AT THE BASE CAMP OF MOUNT EVER­ESTEV­ERY YEAR.

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