How Many Bowel Movements Should You Have Each Day?

By Rudy Silva

Did you know that constipation is one of the most common gastrointestinal complaints in the United States? More than 4 million Americans have frequent constipation, accounting for 2.5 million physician visits a year.

Most doctors don't ask you about your regularity. They may think it is not important to have a bowel movement every day. In fact, some doctors think its ok when you have 2-3 bowel movements a week.

If you have one, two or more bowel movements a day, you may still be constipated. If you are leaving fecal matter along your colon walls because you don't eat enough fiber this is considered constipation. Remember constipation is really the elimination of all fecal matter that passes through your colon from the food that you ate in the previous meals.

If you sit on the toilet and have to stay there over 5-10 minutes pushing, straining, or paining to have a bowel movement, then you are constipated. Straining to have a bowel movement, overtime, leads to hemorrhoids, varicose veins, or fissures.

If you eat three meals a day, then you should have three bowel movements each day. The first bowel movement should take place in the morning when you wake up or soon after you have had breakfast. Typical you should experience the urge for a bowel movement 20-30 minutes after you eat. The other bowel movements should be during the day and just before bedtime.
In her book, Healthy Digestion the Natural way, 2000, D. Lindsey Berkson defines constipation as,

"A healthy person should have at least one bowel movement a day. Medical textbooks state that individual variation goes from several times a day to several times a week. However, having worked with people for many years on improving their health, I would define constipation as not having one to several daily bowel movements, or having too long an intestinal-transit time."

If you eat three meals a day and only have one or two bowel movements, then the second and third meal are backing up in your colon and staying there too long.

When your fecal matter stays too long in your colon, water and toxins are pulled out of the fecal matter and absorbed through your colon wall. This makes the fecal matter stiff and hard. Your colon will now have a hard time moving this hard fecal matter through its sections and out the rectum. The result is puffing and straining in the bathroom.

Rudy Silva has a degree in Physics and is a Natural Nutritionist. He is the author of Constipation, Acne, Hemorrhoid, and Fatty Acid ebooks. He writes a newletter called natural-remedies-thatwork.com and his information on other topics can be seen at http://www.stop-constipation.com
Original Post
What Causes Constipation?

Constipation occurs when the colon absorbs too much water or if the colon's muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly. As a result, stools can become hard and dry. Common causes of constipation are

  • not enough fiber in the diet
  • lack of physical activity (especially in the elderly)
  • medications
  • milk
  • irritable bowel syndrome
  • changes in life or routine such as pregnancy,
  • aging, and travel
  • abuse of laxatives
  • ignoring the urge to have a bowel movement
  • dehydration
  • specific diseases or conditions, such as stroke (most common)
  • problems with the colon and rectum
  • problems with intestinal function (chronic idiopathic constipation)

    Not Enough Fiber in the Diet

    People who eat a high-fiber diet are less likely to become constipated. The most common causes of constipation are a diet low in fiber or a diet high in fats, such as cheese, eggs, and meats.

    Fiber"”both soluble and insoluble"”is the part of fruits, vegetables, and grains that the body cannot digest. Soluble fiber dissolves easily in water and takes on a soft, gel-like texture in the intestines. Insoluble fiber passes through the intestines almost unchanged. The bulk and soft texture of fiber help prevent hard, dry stools that are difficult to pass.

    Americans eat an average of 5 to 14 grams of fiber daily,* which is short of the 20 to 35 grams recommended by the American Dietetic Association. Both children and adults often eat too many refined and processed foods from which the natural fiber has been removed.

    A low-fiber diet also plays a key role in constipation among older adults, who may lose interest in eating and choose foods that are quick to make or buy, such as fast foods, or prepared foods, both of which are usually low in fiber. Also, difficulties with chewing or swallowing may cause older people to eat soft foods that are processed and low in fiber.

    *National Center for Health Statistics. Dietary Intake of Macronutrients, Micronutrients, and Other Dietary Constituents: United States, 1988–94. Vital and Health Statistics, Series 11, Number 245. July 2002.

    Not Enough Liquids

    Research shows that although increased fluid intake does not necessarily help relieve constipation, many people report some relief from their constipation if they drink fluids such as water and juice and avoid dehydration. Liquids add fluid to the colon and bulk to stools, making bowel movements softer and easier to pass. People who have problems with constipation should try to drink liquids every day. However, liquids that contain caffeine, such as coffee and cola drinks will worsen one's symptoms by causing dehydration. Alcohol is another beverage that causes dehydration. It is important to drink fluids that hydrate the body, especially when consuming caffeine containing drinks or alcoholic beverages.

    Lack of Physical Activity*

    A lack of physical activity can lead to constipation, although doctors do not know precisely why. For example, constipation often occurs after an accident or during an illness when one must stay in bed and cannot exercise. Lack of physical activity is thought to be one of the reasons constipation is common in older people.

    Medications

    Some medications can cause constipation, including
    pain medications (especially narcotics)
    antacids that contain aluminum and calcium
    blood pressure medications (calcium channel blockers)
    antiparkinson drugs
    antispasmodics
    antidepressants
    iron supplements
    diuretics
    anticonvulsants

    Changes in Life or Routine

    During pregnancy, women may be constipated because of hormonal changes or because the uterus compresses the intestine. Aging may also affect bowel regularity, because a slower metabolism results in less intestinal activity and muscle tone. In addition, people often become constipated when traveling, because their normal diet and daily routine are disrupted.

    Abuse of Laxatives

    The common belief that people must have a daily bowel movement has led to self-medicating with OTC laxative products. Although people may feel relief when they use laxatives, typically they must increase the dose over time because the body grows reliant on laxatives in order to have a bowel movement. As a result, laxatives may become habit-forming.

    Ignoring the Urge to Have a Bowel Movement
    People who ignore the urge to have a bowel movement may eventually stop feeling the need to have one, which can lead to constipation. Some people delay having a bowel movement because they do not want to use toilets outside the home. Others ignore the urge because of emotional stress or because they are too busy. Children may postpone having a bowel movement because of stressful toilet training or because they do not want to interrupt their play.

    Specific Dis-eases

    Diseases that cause constipation include neurological disorders, metabolic and endocrine disorders, and systemic conditions that affect organ systems. These disorders can slow the movement of stool through the colon, rectum, or anus.

    Conditions that can cause constipation are found below

    Neurological disorders
    multiple sclerosis
    Parkinson's disease
    chronic idiopathic intestinal pseudo-obstruction
    stroke
    spinal cord injuries
    Metabolic and endocrine conditions
    diabetes
    uremia
    hypercalcemia
    poor glycemic control
    hypothyroidism
    Systemic disorders
    amyloidosis
    lupus
    scleroderma
    Problems with the Colon and Rectum
    Intestinal obstruction, scar tissue"”also called adhesions"”diverticulosis, tumors, colorectal stricture, Hirschsprung's disease, or cancer can compress, squeeze, or narrow the intestine and rectum and cause constipation.

    Problems with Intestinal Function

    The two types of constipation are idiopathic constipation and functional constipation. Irritable bowel syndrome (IBS) with predominant symptoms of constipation is categorized separately.

    Idiopathic"”of unknown origin"”constipation does not respond to standard treatment.

    Functional constipation means that the bowel is healthy but not working properly. Functional constipation is often the result of poor dietary habits and lifestyle. It occurs in both children and adults and is most common in women. Colonic inertia, delayed transit, and pelvic floor dysfunction are three types of functional constipation. Colonic inertia and delayed transit are caused by a decrease in muscle activity in the colon. These syndromes may affect the entire colon or may be confined to the lower, or sigmoid, colon.

    Pelvic floor dysfunction is caused by a weakness of the muscles in the pelvis surrounding the anus and rectum. However, because this group of muscles is voluntarily controlled to some extent, biofeedback training is somewhat successful in retraining the muscles to function normally and improving the ability to have a bowel movement.

    Functional constipation that stems from problems in the structure of the anus and rectum is known as anorectal dysfunction, or anismus. These abnormalities result in an inability to relax the rectal and anal muscles that allow stool to exit.

    People with IBS having predominantly constipation also have pain and bloating as part of their symptoms.

    How is the cause of constipation identified?

    The tests the doctor performs depend on the duration and severity of the constipation, the person's age, and whether blood in stools, recent changes in bowel habits, or weight loss have occurred. Most people with constipation do not need extensive testing and can be treated with changes in diet and exercise. For example, in young people with mild symptoms, a medical history and physical exam may be all that is needed for diagnosis and treatment.
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