Good Bowel Health

Good bowel health is an important part of our lives, yet rarely talked about. When discussing this with clients many are surprised at what is considered ‘normal’ for how often you should use your bowels, what can impact our gut health, and that we can optimise our emptying technique. Below we will discuss what’s best for a healthy gut. 

What is considered normal for our bowels?

• Normal bowel movement frequency ranges from emptying 3 times per week, up to 3 times per day. 
• Bowel movements should be well-formed, soft and easily passed.
• You should not need to strain or push to pass a bowel motion.
• You should feel that you have emptied your bowel completely.
• It should not be painful to pass a bowel motion.
• A normal bowel movement time is spending 5-10 minutes on the toilet. You don’t want to rush, but if you’ve not had success after 10 minutes, then you shouldn’t wait longer. Try again the next time you have an urge or 20-30 minutes after your next meal.

The range of what is considered ‘normal’ for how often we open our bowels is quite wide. A sign of good bowel health is a regular pattern. If it’s within the above timeframes and working well for you, then you don’t need to change it. If you are noticing that your bowel habits are changing then it may be worth investigating or speaking to your doctor, particularly if you notice any blood in your stool or other symptoms you are concerned about.

What can impact our bowel health?

• A few of the most common things to impact our bowels include (²⁾
• Dehydration – this can make our stools firmer
• Diet – a lack of fibre, more fatty foods or certain other foods can impact stool consistency and formation
• Medical conditions such as IBS, or certain medications such as iron supplements
• Stress/anxiety
• Changes in routine/travel
• Pregnancy
• Ageing
• Regular exercise can help stimulate your digestive tract to process food and signal the need to empty the bowels (³⁾

For good gut health and general hydration, an ideal fluid intake is approximately 1.5 – 2.0L per day. This is all fluids including tea, coffee, water, juice etc. If someone does not have enough fluid, or their bowels are influenced by other factors and need a higher fluid intake, then they may experience firmer stools which are harder to pass. Too much caffeine or alcohol can impact negatively on our bowel health. (¹⁾

To help with good bowel consistency, a diet with a good intake of soluble fibre such as fruits, vegetables, and whole grains is beneficial for most people3. If stools are too soft and need ‘bulking up’, insoluble fibre such as pasta or rice, nuts, and fruit with the skin on, can help form better bowel movements (2). Depending on what has been eaten, food can take 12 – 48 hours to travel through the gut (1). 

Optimising emptying technique:

Some tips to facilitate bowel emptying include optimal positioning, not straining and establishing a good bowel routine.

Positioning (4):

The best position is sitting on the toilet with your knees slightly higher and wider than your hips, a long straight spine, feet on a footstool (unless you have issues with flexing your hips past 90 degrees) and resting your elbows on your knees. 

Technique (4):

To help pass a bowel motion, you don’t want to strain or hold your breath. Ideally widening your waist or bulging your lower stomach instead. Sometimes making a cow’s “moo” sound can help create gentle pressure without the downward strain or pushing action we want to avoid.

Bowel routine:

Establishing a routine, whatever your frequency, can help your body get into the rhythm of opening its bowels. Bowel movement tips for a good routine include having a hot drink on waking, moving around for 20-30 mins whilst keeping the abdomen and pelvic floor muscles relaxed, and then sitting on the toilet for 5-10 minutes. Try to not rush – allow your body the time to develop the urge to pass a bowel motion. If you have not been successful after 5-10 minutes, do not wait any longer. Try again after your next meal or if you have the urge to go. Sometimes it takes the body a while to get into the routine, so stick with the routine for a while. 

What can you do if you are having issues?

You can speak to your GP, or seek out a Pelvic Floor Physio. They take a history of your issues, assess them appropriately and help you address any concerns.

You can also call the National Continence Helpline on 1800 33 00 66 from 8am–8pm Monday to Friday (AEST) to get advice, information or local services that may be available from a trained advisor.

Who can help me at Malvern Physiotherapy Clinic?

Hayley Runting is our post-graduate trained Pelvic Floor Physiotherapist. To book an appointment with Hayley, click BOOK NOW below.

References:

1 Bowel Health, (2014) Jean Hailes Foundation, accessed at https://www.jeanhailes.org.au/health-a-z/bladder-bowel/bowel-health#tips-for-good-bowel-health, accessed on 22nd November 2022

2 Milosavljevic T, Popovic D, D, Mijac D, D, Milovanovic T, Krstic S, Krstic M, N: Chronic Constipation: Gastroenterohepatologist’s Approach. Dig Dis 2022;40:175-180 

3 Włodarczyk J, Waśniewska A, Fichna J, Dziki A, Dziki Ł, Włodarczyk M. Current Overview on Clinical Management of Chronic Constipation. J Clin Med. 2021 Apr 16;10(8):1738

4 ‘Poor Bowel Control’ (2021) Continence Foundation of Australia, accessed at: https://www.continence.org.au/information-incontinence-english/poor-bowel-control?id=533, accessed on 22nd November 2022

Published December 9, 2022