There’s a reason why people say they go to the toilet to relieve themselves - emptying your bowel completely and easily is extremely satisfying! We had such a great response to a previous blog we wrote “5 Tips For A Perfect Poo
”, we thought we would follow up by answering some of our commonly asked questions about bowels. This may help you get that feeling of relief on the toilet!
“How often should I empty my bowel?”
It’s often surprising for people to realise there is actually quite a large variation in what is considered ‘normal’. Normal ranges from three times per day to three times per week. Everyone has their own usual pattern and not everyone will empty their bowel every day. It’s also perfectly ok to miss a day or two between bowel movements, and sometimes, you might empty more often than usual on a particular day. This can often be due to a change in diet, change in fluid intake or a change in your daily routine ie going on holiday or having to leave the house earlier in the morning than usual.
It is important to recognise what your regular routine is and to seek advice for an assessment from a health professional if:
- There appears to be changes to your pattern of emptying without a reason
- Your normal pattern is to empty your bowel more than 3 times per day or less than 3 times per week.
“How long should I spend on the toilet to empty my bowel?”
Generally speaking, you should empty your bowel when you feel an urge to go. However, there is a difference between feeling:
- “I could go” versus
- “I should go” versus
- “I have to go”
Waiting until you feel like you should or have to go will help to ensure that the stool (poo) is ready to be emptied. If your stool is well formed and soft, you should empty your bowel quickly, without straining and have a sense of complete emptying. If you find that you can’t empty without straining, don’t feel like you have emptied completely or if it is taking you longer than 5-10 minutes to empty, talk to a health professional.
“What should my stools look like?”
The Bristol Stool Form Scale is a great way to show what you should aim for. Ideally, you want to empty a stool that is formed like a sausage and is soft enough that it is easy to pass completely without straining. That generally means we should aim for a stool that is between a 3 and a 4 on the Bristol Stool Form Scale.
“Should I Take A Laxative To Help Me Empty?”
The answer to this question depends on your individual symptoms and problems that you might be having. We always recommend that you talk to your health professional before taking a laxative.
Laxatives are actually a broad term that is used to describe foods, products and activities that increase the movement of your bowel. Laxatives aren’t just a product you buy from the chemist and they all won’t cause you to have violent diaorrhea! Just eating breakfast, doing some exercise or having a cup of coffee can all stimulate your bowel and can have a laxative effect. Certain foods like pear, prunes and kiwifruit can all help to stimulate your bowel as well and also have a laxative effect.
Dietary fibre is a type of laxative that helps to achieve a well-formed but soft stool. Fibre is the part of plant foods, such as fruits, vegetables, nuts, seeds and legumes that our bodies can’t digest. There are two types of fibre:
- Soluble fibre: helps us to feel fuller for longer because it helps to slow the emptying process in our stomach
- Insoluble fibre: absorbs water to soften our stools and regulate our bowels
It is important to have a combination of both soluble and insoluble fibre to keep our bowels healthy and moving. It is recommended that adult men consume 30g of fibre and adult women 25g of fibre per day.
Eating a variety of fruits, vegetables, wholegrains, nuts, seeds and legumes will help to boost your fibre intake. But, let’s be honest, no one is perfect with their diet! In fact, we know that most Australian’s don’t get enough fibre from what they eat. Sometimes we need a bit of extra help to boost our fibre intake. This is where a fibre supplement comes in.
Fibre supplements essentially give bulk to stools and promote a formed but soft stool. There are lots of different fibre supplements available. The tricky thing is what is helpful for one person, might not be helpful for others. Plus, working out the amount of the fibre supplement you need can also take some time. So, there may be a bit of trial and error involved to determine what is the best fibre supplement for you.
The most commonly known fibre supplement is Metamucil. Metamucil is made from psyllium husks, which is a soluble, but sticky fibre. Some other commonly used fibre supplements are Benefiber, which is made from wheat dextrin and Normafibe, which is made from Sterculia. If you choose to take a fibre supplement, being consistent with it every day is much more effective than taking it on some days and not others.
Osmotic agents are another type of laxative that help improve your stools by drawing water through the bowel to soften the stool and help it move through your bowel. Some examples of this are Lactulose or Movicol.
Stimulant agents move muscles of the bowel to get your stool moving. Senna is a commonly known stimulant agent.
Stool softeners do exactly as their name suggests – they soften the stool by increasing the amount of water and fat your stool absorbs which helps it move easier. An example of a stool softener is Coloxyl.
Contrary to popular belief, fibre supplements, stool softeners and osmotic agents are generally safe for long term use. However, it is difficult to know which one is right for you. Please talk to your health professional before starting to take a laxative.
What Can Pelvic Health Physiotherapy Do To Help My Bowels?
A Pelvic Health Physiotherapist can help you to:
- Improve your routine or pattern of emptying your bowel
- Improve your stools so they are well formed but soft and easy to pass
- Improve the time you spend on the toilet
- Improve the way you empty so you get that feeling of relief on the toilet!