Whether your doctor or your over-involved mother is asking, we all know exactly what that question means. Of course, a high-fiber diet plays a starring role in making us feel Howdy Doody. But regularity, it turns out, isn’t a mathematical equation as much as a matter of scatalogical opinion. Of which there are many.
Well+Good asked three health experts for the quick and dirty on what constitutes constipation, and what to do about it.
Meet our poop panel:
Colonic therapist at Great Jones Spa, Paul Labrecque, and Spa 88
W+G: How often should you poo?
BK: After every meal, so three times a day optimally. Peristalsis should set in when you’re full. But for most people the colon is sluggish and they don’t go until two days later.
W+G: Why is frequency better? What’s wrong with food hanging out in your colon for a day or two?
BK: If you eat the foods we’re designed to eat—raw food and lots of roughage—then you will go after every meal. Otherwise, the food ferments in your colon and bad bacteria flourishes; your system becomes more acid than alkaline and this can lead to a host of health problems.
W+G: What can you do to increase frequency?
BK: Eat more fiber—try four slices of Manna Bread a day. Also, ingest more oils—olive oil, avocados, and flaxseed oil, sesame oil—because they’ll make your stool softer and then it’s less painful to push. Pushing hard can cause hemorrhoids.
W+G: Why do women have more issues with constipation than men?
BK: There’s a lot of truth to Erik Erikson’s work. He was a developmental psychologist who believed that women are raised with more shame than men about number two being smelly, stinky, and embarrassing. So women hold it in. For example, many women shy away from pooping in places like Grand Central Station or at their workplace. Once you get used to holding it in, you get chronically constipated. Women need to overcome their shame about this thing called “shit.” So it smells—big deal! We were born with this digestive system, we eat, and we gotta go.
Dr. Lester Gottesman, MD, FACS, FASCRS
Chief, Division of Colorectal Surgery, St. Luke’s-Roosevelt
W+G: How is constipation defined?
Dr. G: The short answer is less often than every third day. But it’s also normal to go up to three times a day.
W+G: What can you do to keep thing regular?
Dr. G: Diet plays a big role. But there are intrinsic things that happen to the colon over time, as well as some medical conditions—calcium, thyroid, and magnesium issues—that will affect how the colon functions. For the average person, fiber is the most important factor. Have at least 30 grams of fiber a day, taken with meals and drink at least ten glasses of liquid a day. Within a day or two you’ll be more regular.
W+G: Raw foodists say you should eliminate after ever meal.
Dr. G: They’re chasing something that isn’t medically important.
Jeanette Bronee, CHHC, Nourishment Counselor
Founder of Path for Life Self-Nourishment Center
W+G: Any ideas or theories on why women suffer from constipation more then men do?
JB: Women tend to be more prone to anxiety, which affects the digestive system and the stomach, and to cravings for dairy products and sweets, which can cause more constipation.
W+G: How often should a person go number two? Is a certain frequency considered optimal?
JB: A healthy digestive system empties once or twice a day. Most people naturally go in the a.m. But if all was as nature intended, we’d go number two shortly after a meal. Which in an optimal world would be three times a day.
W+G: How many grams of fiber a day should a person consume? Any recommended fiber sources (so many people just turn to Fiber One cereal and consider the case closed)?
JB: I recommend 25-35 grams of fiber per day. Not many of us get that much. One problem is that we’ve learned that carbs are bad. Well, that’s how we get fiber—from whole grains, like oatmeal and brown rice, and fruit and vegetables. So some people need to supplement their diets with fiber in a tablet or powder form.
W+G: What do you think about colonics? Are they necessary or helpful?
JB: Colonics are a Band-Aid and I worry about people abusing them. I always try to balance a client’s diet first to get things moving naturally. But a food intolerance or not chewing food slowly can mean food is not digested. This is what the colonics take care of. And, of course, if someone wants to do a cleanse–for example, they are moving from a processed to a whole foods diet– then colonics can be very helpful, and should be combined with an intestinal cleanse as well.
Know how many grams of fiber you consume a day? What are your favorite fiber sources? Tell us, here!
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