Bowel health in adults: Dr Joe Kosterich

If you’re eating every day, then your bowels should be moving every day. Dr Joe Kosterich talks about general bowel health, including what a healthy bowel action is, how often it happens, how to help your bowels function effectively, and when to see your doctor.

Video transcript

If you’re eating every day, then your bowels should be moving every day. Hi, I’m Doctor Joe and we’re going to be talking about the bowels. The bowels are maybe not everybody’s favorite dinner time topic, but an important one nonetheless, because what’s going on in the intestines does in fact affect most of what goes on in the body.

The term constipation is not a very good one in my opinion because it means so many different things to so many different people.  It’s generally taken to mean that the bowels aren’t working terribly well. Now for some people that might mean they’re going once a week, while for other people it might mean they’re only going once a day.

So what do we mean when we’re talking about a healthy bowel action? Essentially it means when you go to sit on the toilet, it doesn’t require a lot of effort. In other words, if you’re having to push or strain or make odd noises to get the bowels moving, that’s telling you that the bowels are not working as efficiently or effectively as they can do.

In an ideal world, if we’re eating every day, then we should be emptying our bowels every day and some people argue that it should be twice a day but I wouldn’t get too excited about that. What is important though is that there is not a lot of effort required. How do we know if we’re making effort? It will be different for different people, but you’ll know if you’re having to really push or not and this may vary from day to day according to what you’ve eaten.

Now the important point in all of this is to figure out what we can do so that our bowels function effectively. We want them working effectively because the bowels are getting rid of what the body doesn’t want. If they’re not getting rid of what the body doesn’t want – guess what – it stays within the body and if people aren’t emptying their bowels effectively they may find subtly that they get tired or nauseated. Sometimes people get headaches, and eventually they may start to get stomach cramps and pains as well.

To keep the bowels working well is not that difficult. There are two primary things that are needed: Number one is enough water and number two is enough fibre. If I had a dollar for every person who said they’re eating enough fibre and that their bowels still aren’t working that well, I’d be sitting under a palm tree in the Bahamas somewhere! How much or how little fibre your body needs is not dictated by the amount that you give it, it’s dictated by the end result. If you’re having to put out pellets every third day, the amount of fibre you’re taking in isn’t enough.

The other trap that many people fall into is that a lot of foods will say ‘added fibre’ – particularly packaged foods. There’s only one reason they’ve added fibre and it’s that it has been taken out in the first place. The best sources of fibre are in fact, fruits and vegetables, with whole grains coming in second. Everything else you can pretty much raffle.

Some people like to use fibre supplements which you can often get from chemists or health food shops.  They’re okay as supplements but not as a substitute for eating your fruits and vegetables. The other key important thing is drinking water. What we want is for the bowel motions to have bulk, so it’s a little bit like a sponge – you want to be soaking up the water. If the water is not there it can’t be soaked up.

You may be wondering – when should I be going to the doctor about my bowels? Generally, if there is a change in bowel pattern or if you’re finding you’re getting some bleeding from the bowel, you should visit with your doctor. Neither of these things automatically means cancer so it’s important not to panic but it is time to check it out.

There are particular groups of people who are a little bit more likely to have problems with bowel motions. The elderly would be one group and also in pregnancy, some women find that the bowels slow down; interestingly, some find the exact reverse. That’s where again the fibre and fluid is important. The elderly may need something to help chug the bowels along and there are a number of preparations that you can get, again generally from the chemist without a prescription.

One needs to be wary of relying on anything that artificially moves or flogs the bowel. They can be helpful short term though but shouldn’t be relied on as a long term solution. There are some other preparations that are not laxatives as such, but can also help to get the bowels a bit more regular. And again you can have a chat with your doctor or sometimes the chemist to determine what’s best.

To wrap up, as I’ve said, the bowels should be working everyday in an ideal world. To get that happening, we need to give the bowel what it actually wants and needs to be working effectively for you so it’s clearing out the bad stuff and getting rid of the toxins from your body.  You should be going to the toilet and sitting down with not a lot of effort. You don’t have time to read War and Peace and the whole thing should be pretty much over within thirty to sixty seconds, and away you go.

The most important thing is having a good fibre intake which is determined by the end result, not by what you think is the right amount of fibre, and also consuming enough water. The proof of the pudding here is not in the eating but will be in the sitting!