What Goes In Must Come Out: How You Can Keep Your Bowel Healthy

Healthy bowel movements mean a healthy you. Here's how to avoid or fix problems

Lisa Bendall with Naorem Anuja Published Aug 8, 2020 00:00:00 IST
What Goes In Must Come Out: How You Can Keep Your Bowel Healthy Illustration by Sam Island

There are many good reasons to improve your bowel movements. 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 diarrhoea, along with secondary problems like haemorrhoids, 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.

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. “In India, most people visit a doctor for what they consider is constipation or a feeling of incomplete evacuation,” says Dr Ashwini Setya, a gastroenterologist and programme director at Delhi’s Max Super Speciality Hospital.

While not all changes are cause for worry, there are some red flags you should not dismiss. “The first is if someone experiences a recent change or alteration in bowel habits. Second, if there is blood in your stool. Third, if there is a loss of appetite and consequently an appreciable loss in weight. Under all these circumstances, you must go to a doctor and get your problem investigated,” says Setya. Don’t ignore symptoms like fever, pain or dehydration either. Use our guide below to make your bowel movements the best they can be.

Foods That Help Regularity

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. Dietary fibre is important for your bowel movements. Because it isn’t digested, it bulks up and softens stool, making it easier to pass. Most of us get just half of the fibre that we require.

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. Whitney Hussain, a registered dietician in Vancouver, Canada, who specializes in gastrointestinal disorders, suggests adding fibre to your diet gradually to prevent gas and bloating. “Just have one serving of a higher-fibre food, and slowly increase it each day. Spread the fibre throughout the day, rather than having it all at once.”

flaxseeds-and-apples-and-pears_080720093212.pngFlaxseeds can lead to healthy bowel movements, as can apples and pears (Photos courtesy Pikist and Public Domain Pictures)

Says Delhi-based clinical nutritionist Lovneet Batra, “Ensure that you eat five servings of different kinds of vegetables. This dietary requirement is fairly easy to achieve for us, as traditional Indian meals usually include 2 to 3 servings of vegetables. Also, make sure you incorporate two servings of fruits in your daily diet.” Stressing on the need to eat whole grains and healthy fats, Batra says, “To delete calories from our diets, most people tend to cut out carbohydrates and fat, and resort to protein-heavy meals and low-fat dressings. But, to avoid constipation and boost gut health you need to eat whole grains and incorporate healthy fats such as ghee and coconut oil.”

Liquid Intake

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. 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.

Foods and Drinks 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 unhealthy fats, a common constipation trigger. White rice, as opposed to its wholegrain brown counterpart, can be another culprit. Carbonated beverages may give you gas and bloating, as can certain foods like cabbage, onions and lentils.

carbonated-beverages_080720093637.jpgCarbonated beverages are strictly to be avoided to ensure healthy bowel habits. (Picture courtesy wallpaperflare.com)

“While alcohol may or may not affect your bowel movement, it definitely affects your digestion and impacts your liver. Non-vegetarian food, bereft of fibre, may also lead to constipation,” says Setya.

Candies and diet drinks sweetened with sorbitol and other sugar alcohols, such as xylitol, can also have you running for the bathroom.

Mindful Eating Helps

How you eat is just as important as what you eat. Batra suggests that our food eating patterns could be adding to our gut issues. “Most of us do not put food first or practise mindful eating. Our hectic lifestyle means that we often push mealtimes back, to accommodate work and deadlines.” Her advice: Chew your food properly, take time to savour your food and avoid erratic meal timings. Postponing a meal or snack can lead to bloating. 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.

Get Active

You need to keep your body moving in order to keep your bowels moving. Regular physical activity, such as a daily brisk walk, can help prevent constipation. Bengaluru-based Dr Issac Mathai, founder and medical director, SOUKYA International Holistic Health Centre, recommends the same. “Mild to moderate exercise increases blood flow towards the muscles and digestive tract, which can help move food through it. Exercise also raises the heart rate, which reduces intestinal sluggishness by stimulating the muscles. This helps push digestive waste through the body.”

exercise_080720094323.jpgExercise can reduce intestinal sluggishness. (Picture: PxHere)

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 diarrhoea’, 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.

Stay Calm

Anxiety and stress have 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 diarrhoea. 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 diarrhoea 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 Dr Geoffrey Turnbull, a gastroenterologist at Dalhousie University in Halifax, Canada. Both men and women experience hormonal shifts as we get older, and these are thought to be a potential influence on the decreasing diversity and robustness of our microbiome (the microorganisms that live inside the human body) as we age.

Try to Keep It Natural

If you are having trouble with bowel movements, natural laxatives can get you back on track. “Try natural laxatives such as triphala choornam—take one teaspoon at bedtime with warm water. This remedy helps improve vision, immunity and has anti-ageing benefits too,” says Mathai. “Castor oil can also help treat constipation—one teaspoon of pure castor oil, or processed with herbs, taken at bedtime, normally helps solve constipation troubles,” he adds.

triphala_080720094908.jpgTriphala choornam can help with bowel movements, as it is a natural laxative (Image: Pikist)

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, such as psyllium supplementation, stool softeners or polyethylene glycol, may be necessary,” says Dr Carlo Fallone, a gastroenterologist at McGill University Health Centre in Montreal. “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.

Understand Adverse Effects

All kinds of drugs, from antidepressants to narcotics to blood pressure pills, list diarrhoea or constipation among potential side effects.

Setya advises against using strong purgatives (which completely purge your system). Laxatives such as isabgul are better alternatives that should help with normal stool.

—With inputs from Kritika Banerjee
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