“Let’s talk about bowel movements,” said no one ever. Even when talking to your doctor, issues around digestion and what constitutes normal or abnormal can be an uncomfortable topic. But they’re worth paying attention to.
“People should consider their bowel movements more closely — they give you a lot of information about your digestive health,” says Dr. Bill Rawls, M.D., medical director of Vital Plan. For example, research in the journal Gut reports that formed stools and regular bowel movements are strongly associated with a more diverse microbiome, which is a key marker of gut health.
But no one’s digestion or stools are perfect all the time, and that’s OK. Everyone passes gas — 10 to 20 times per day is the norm. Diarrhea is a common symptom of PMS. And occasional bouts of bloating, stomach pain, loose stools, or constipation are perfectly normal and usually nothing to worry about. That’s especially true if you can trace the problem back to something you ate or did.
In those cases, the fix is easy — simply avoid the triggers in the future. After all, most of us have overindulged during a holiday or given in to the temptation of certain foods or drinks we know don’t sit well with us. You can also overdo it on healthy foods that are known to cause gas and bloating when eaten in excess, like broccoli and Brussels sprouts. Plus, we all get stressed at times or veer off normal sleep and exercise schedules, all of which can trigger or exacerbate digestive issues.
So the real question is, are your stools and your digestive process normal and regular the majority of the time? Or have abnormal and irregular just become your new normal? Here’s some help in answering those questions, plus advice for taking control of your digestive health as much as you can.
What does normal digestion look like, anyway?
For one, you should generally feel good. Nothing about the digestive process should impact your quality of life, leave you embarrassed, or keep you from doing the things you want to do. Otherwise, here are the clues to look for in your bowel movements:
- Color: Healthy, normal stools should be a medium-dark brown, not grey, Dr. Rawls says. “Brown means your body is producing sufficient amounts of bile during digestion.” Absence of bile and grey stools suggest your liver is congested.
- Consistency: You want stools that look mostly smooth and are solidly formed yet soft. Very hard, lumpy, or pellet-like stools can indicate a sluggish colon and that stool isn’t moving through properly, so too much water is being extracted from the stool. On the other hand, loose or watery stools are generally a reaction to a buildup of bacteria with toxins that damage the mucosal lining of the colon, causing it to leak fluid, Dr. Rawls says.
- Frequency: If you pass stools spontaneously, once or twice per day, without having to strain nor with significant urgency, you’re in good shape. After using the restroom, you should also feel as if you’ve eliminated all waste; you don’t want any lingering sensation of fullness in your rectum.
- Odor: Normal stools actually only have a mild odor. “You shouldn’t have putrefaction; if the smell is running you out of the bathroom, that’s not good,” Dr. Rawls says. “It can happen when people eat a lot of meat, for instance — that may lead to an overgrowth of bacteria that causes stools to smell horrible.”
If you’re not experiencing those hallmarks of healthy number twos on the regular, and instead experience digestive symptoms, it’s probably your body’s way of telling you something is not right in your gut or with your diet. Some clear signs that something is off include constipation, defined as hard-to-pass or small stools and fewer than three or four bowel movements per week, or loose and frequent stools (more than two a day). An on-off cycle of the two is another red flag – which Dr. Rawls says is very common — as are bloating, stomach cramps, or excessive gas.
Unfortunately, GI issues have become so commonplace that many people come to expect them. “Unless a GI problem is really bad, most people just accept it and live with it,” Dr. Rawls says. But there are simple steps you can take to help support a happy, healthy gut and digestion, not only to maintain regularity but also to feel your overall best. (For serious symptoms, such as blood in your stool or severe and persistent GI upset or systemic symptoms, consult your healthcare provider.)
7 ways to normalize digestion
1. Fill your diet with fruit and veggies
“We are living in the golden age of food; access to excellent food that can make people extraordinarily healthy is more available now than any other time,” Dr. Rawls says. Ready access to a range of fresh produce is a big part of that. And when it comes to improving digestion, you can’t beat fruit and veggies.
One of the main benefits is their fiber content. Not only has it been shown to help reduce risk of various diseases, fiber also feeds the gut’s good bacteria, which keeps your GI and other systems healthy, your gut lining strong, and your digestion normal. And that’s especially true of the fiber from fruit and veggies as opposed to fiber in grains, Dr. Rawls says.
Produce contains both soluble and insoluble fiber, which are equally important and work together to move food through the digestive system, and then waste through your colon. Insoluble fiber — found in high amounts in foods like apples, strawberries, and peas — attracts water and forms a gel-like substance that slows down digestion. Soluble fiber, abundant in broccoli, greens, and asparagus, adds bulk to prevent loose stools.
Yet Americans get only about 15 grams of fiber a day — significantly less than the 25 to 30 grams experts recommend. So, if you’re not meeting that guideline, replace more grains and meats with fruits and veggies. A review in the World Journal of Gastroenterology found that doing so improves stool frequency. Just make sure to gradually up your intake and spread it out over the course of the day, which gives your body time to adapt. (Too much fiber all at once can cause gas and bloating.)
Fruit is your digestive system’s friend for a few other important reasons. “Beyond supporting gut bacteria, the fiber in fruit helps protect you by promoting a normal mucus layer that coats the gut,” Dr. Rawls says. There’s also a lot of water trapped inside the cells of fruit and veggies, which slowly release it during digestion. That not only keeps you well hydrated, it also aids in the digestive process and moves stool through your colon.
2. Eat slowly
If you inhale your food (like so many of us who eat on the run), chances are you’re getting a big side of air with your meal, which can cause burping or flatus (gas in the stomach or intestines), Dr. Rawls says. Try resting your fork on the plate between bites and taking extra time to chew.
A leisurely, well-chewed meal has other digestive benefits, too. Chewing sends the signal that food is coming, helping to prime your digestive system for action. The act of chewing also starts to break down food before it even reaches your stomach, so there’s less work to do once it arrives.
Eating slowly also gives your brain time to pick up fullness signals, helping to prevent overeating and the bloat and indigestion that can follow. One study even found that when women ate more slowly, they consumed less but were more satisfied than when they were told to eat quickly.
3. Get some exercise
Add gut health to 625,457 or so other reasons to take a hike or walk, swim, or bike ride: Exercise can change the composition of your gut’s microbiome for the better. A study in Medicine & Science in Sports & Exercise showed that when sedentary people exercised three times a week for 6 weeks, they showed increases in the type of bacteria that produce short-chain fatty acids, which help reduce inflammation in the gut.
In the short term, taking a simple 15-minute stroll after dinner can help your gut do its job. Researchers in Germany report that walking after consuming a large meal improved the rate of gastric emptying compared to when people sipped an espresso or alcoholic digestif.
4. Go for bitters to feel better
When you eat something bitter (such as dandelion greens, arugula, and radicchio), take aromatic bitters (herbal extracts in an alcohol base), or swallow bitter herbal supplements, bitter taste receptors in your mouth and throughout your digestive tract send the message to your body to start making enzymes that help break down food.
Bitter-tasting foods and herbs aid in smooth, healthy digestion in other ways, too. That’s likely why bitter plants, herbs and aromatic bitters are widely used in traditional medicine to help support healthy digestion. In fact, bitter artichoke leaf extract was found to improve bloating, stomach pains, gas, and other symptoms of indigestion in up to 85 percent of study subjects, according to a review in the International Journal of Food Sciences and Nutrition.
5. Supplement a healthy diet with gut-friendly herbs
Most herbs are bitter by nature, so they naturally help with digestion by triggering bitter taste receptors. But they have additional properties that help balance the digestive tract and aid in healthy digestion, Dr. Rawls says. A few to look for:
- Berberine helps stimulate bile and support good-for-digestion microbes in the gut. It’s been used in ancient medicine as a treatment for diarrhea and to treat other gastrointestinal and inflammatory conditions, plus aid gastrointestinal function, according to a paper in the American Journal of Chinese Medicine.
- Slippery elm bark contains mucilage, a soothing compound that may help keep the lining of the GI tract healthy. It’s also known to help soothe heartburn and upset stomach. A small study in the Journal of Alternative and Complementary Medicine found that two formulas that contained slippery elm bark helped improve constipation, plus stomach pains and other symptoms in people with inflammatory bowel syndrome (IBS).
- Dandelion root and extract are particularly bitter; it’s recognized as a digestive stimulant and for its mild laxative properties that may help regulate bowel movements.
- Cardamom seeds are rich in phytochemicals that may help soothe the intestinal tract and support healthy gut microbes.
- Fennel is known to relax smooth muscles along the GI tract, plus the seeds help encourage the flow of bile needed to adequately break down food.
6. Up your supply of enzymes
Digestive enzymes such as amylase, protease, lipase, lactase, and others are proteins you can sometimes get from food, but which are mainly produced in the pancreas, stomach, small intestines, and mouth. They act sort of like a team of miners, helping to break down food in order to get at the valuable and usable nutrients. Different enzymes help digest different types of food and nutrients — fats and oils, carbohydrates, proteins — so you need a range. In addition to supplementing, a healthy diet and lifestyle can also ensure an adequate supply.
7. Think twice before taking pharmaceuticals
Many people who suffer from acid reflux turn to drugs called proton-pump inhibitors (PPIs), which stop cells in the stomach from producing the hydrochloric acid that bubbles up and causes discomfort. In fact, they’re among the top 10 most widely used drugs in the world.
But popping these pills seems to come with some serious potential side effects. For one, while the drugs reduce stomach acid, if taken long-term, there can be a rebound effect once you stop taking PPIs, potentially leave you worse off than you started.
Research has also found that PPI users tend to have a less healthy gut microbiome. And a recent review of 56 studies published in the World Journal of Gastroenterology found that PPI use is associated with an increased risk of infection with C. difficile, a bacterium that causes severe diarrhea and inflammation in the gut. The thinking: Suppressing acid production makes the stomach less acidic, which may lower your body’s natural defenses against C. diff and other threatening microbes.
Try to incorporate as many of these gut-supporting tips into your daily routine as possible, and you’ll find that you may develop a new definition of normal – one that’s much more in line with the goal of feeling good most of the time.
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