Everyone poops sometimes, but does the frequency really matter?
A new study published on July 16, 2024 in the journal Cell Reports Medicine revealed that bowel frequency significantly affects physiology and long-term health, with the best outcomes associated with bowel movements once or twice a day.
Previous research has suggested a link between constipation and a higher risk of infection, and diarrhea with a higher risk of neurodegenerative conditions.
However, because these findings were observed in sick patients, it remains unclear whether irregular toilet visits are the cause or the result of their condition.
“I hope this study can open the minds of clinicians to the risks of not managing bowel frequency,” said senior author of the study and associate professor at the Institute of Systems Biology in the United States, Dr. Sean Gibbons.
Microbiome researchers explain that doctors often see irregular bowel movements as just a ‘nuisance’.
Associate Prof. Gibbons and his team collected clinical, lifestyle, and biological data – including blood chemistry, gut microbiome, genetics, etc. – from more than 1,400 healthy adult volunteers with no signs of active disease.
Participants’ self-reported bowel movement frequency was categorized into four groups:
• Constipation (once or twice a week)
• Low-normal (three to six times a week)
• High-normal (one to three times a day)
• Diarrhea
When faeces sit in the gut for too long, microbes deplete the available fiber – which they ferment into beneficial short-chain fatty acids – and instead ferment proteins, producing toxins such as p-cresol sulfate and indoxyl sulfate.
“What we found is that even among people who are healthy but suffer from constipation, there is an increase of this toxin in the bloodstream,” said Associate Prof Gibbons, emphasizing that this toxin is very taxing on the kidneys.
In the case of diarrhoea, the team found clinical indicators indicating inflammation and liver damage.
Associate Prof Gibbons explained that during diarrhoea, the body releases excess bile acids, which would otherwise be recycled by the liver to dissolve and absorb dietary fat.
Intestinal bacteria that ferment fiber, known as strict anaerobeswhich is associated with good health, thrives in the Goldilocks Zone of one or two bowel movements a day.
However, Associate Prof Gibbons points out that more research is needed to determine this optimum range more precisely.
Demographically, young people, women, and those with a lower body mass index (BMI) tend to have less frequent bowel movements.
Hormonal and neurological differences between men and women may explain these differences, he said, in addition to the fact that men generally consume more food.
Finally, by pairing biological data with lifestyle questionnaires, the team painted a clear picture of those who typically fall into the Goldilocks Zone.
“It’s eating more fruit and vegetables – that’s the biggest signal we’ve seen,” said Associate Prof Gibbons, along with drinking plenty of water, regular physical activity and eating a more plant-dominant diet.
The next step in the research could involve designing a clinical trial to manage the bowel movements of a large group of people, followed over a long period of time to assess its potential in disease prevention. – AFP
