Understanding A Healthy Stool and How to Prevent Constipation

Most who have been around elderly people know that bowels are a large issue.  While I was a medical student, I was working at the VA hospital in Los Angeles and I walked into the pulmonary ward only to find that my patient was snapping at me.  I commented that he seemed unhappy.  “Mark my words, Doc,” he said. “If you see a grumpy old man, then there can be only two reasons: either he’s constipated or his woman’s giving him trouble!”  I knew he didn’t have a woman so… “You got it!” he blurted out.  “Now, what are we going to do about it?”

Constipation

Most people think constipation means not being able to have a bowel movement regularly, but really it refers primarily to the consistency of the stool.  If you go every day, but have hard stool it can still be called constipation.  There are many aspects of what goes into your mouth that affects the consistency of your bowel movements, which is very important.  Constipation can lead many health problems, like:

1. Diverticulosis – out-pouching of the lining of the colon.
2. Diverticulitis – inflammation or infection of diverticula.
3. Lazy colon – difficulty passing stool.
4. Polyps – bumps, or tumors, that form on the lining of the colon that may bleed or become cancerous.
5. Internal hemorrhoids – enlarged veins high up in the rectum that can break open and bleed.
6. External hemorrhoids – enlarged veins near the anus that are painful, itching, or burning.
7. Anal fissures – breaks in the skin of the anus that cause pain
8. Cancer – rectal or sigmoid cancers are the most common colon cancers.

So, constipation is not a small thing!  It’s so important for everyone to understand the stool and how to prevent the complications listed above.  We’ll discuss how:

BACTERIA

Your stool is as much as 70% bacteria, by weight.  The large majority of these are in the colon and will have a big effect on your stool consistency.  While there are probably over 500 species of bacteria, we look for only a few of them to see if the colon is healthy.  There are many reasons to protect your good bacteria.

For example, when people take antibiotics they kill many of the normal bacteria and allow unhealthy bacteria and yeast to grow.  Candida, from yeast, is a very common health problem causing not just local symptoms of gas, bloating, pain, cramps, diarrhea, and constipation, but systemic problems of pain, fatigue, and weakness as well.

After antibiotic treatment, the good bacteria often grow back and restore normalcy to the colon, but sometimes it can become a chronic problem.  In the worst cases of resistant C. difficile infection, for example, a hospital might do a fecal transplant by putting a tube down the throat into the intestines of the patient and running in stool from a normal person.   Mostly, we do the same thing with PROBIOTICS, but these are grown in factories instead of other people’s colons.

Probiotics have many other benefits:

1. Produce vitamins
2. Aid digestion
3. Increase absorption of nutrients
4. Stop inflammation
5. Prevent infections
6. Help you to have normal bowel movements

The rule for having good bacteria in the bowels is to feed them good food.  Remember, you’re not just eating for one, but for over a trillion!  The food they like is called PREBIOTICS, and consists primarily of fiber that we normally don’t digest.  These are soluble fibers like fructooligosaccharides, and inulin, that and are found in fruit, vegetables and whole grains.

One of the big problems with processed foods is that the fiber is taken out and fed to animals, while the humans are eating only the starches and simple sugars.  Starch and simple sugars feed bacteria that cause inflammation, infection, diarrhea, and constipation.

Artificial sweeteners are also bad for the colon.  Bacteria are killed by certain artificial sweeteners that take it up as if it were a usable form of energy, but they can’t use it.  Thus, they don’t reproduce, and they die.  This is only one good reason (out of many) to avoid artificial sweeteners.

Even your vitamin pills can cause health problems!  When studying nutrients, researchers found that one reason for poor absorption of a nutrient was the proliferation of bacteria that used the vitamins or minerals that the person was taking.  Thus, the bacteria were growing more, but the person wasn’t getting adequate levels of nutrition.  The best way to avoid this is to take nutrients on an intermittent basis, every other day, or a week on-week off basis seems to be best.

The following is a good list of how to take care of your good stool bacteria:

1. If you must take an antibiotic for an infection, take a good probiotic as well for at least 30 days after finishing the antibiotic.
2. Avoid all processed sugar and starch.
3. Avoid all artificial sweeteners.
4. Eat plenty of fruit and vegetables.
5. Don’t take your vitamins every day, take them twice a week, or alternate weeks: one on, one off.

FIBER

The single most important thing we can do for stool health is to eat fiber because it:

1. Grows good bacteria
2. Decreases inflammation
3. Prevents infection
4. Stops and reverses hemorrhoids
5. Prevents polyps and cancer
6. Keeps the bowels clean

There is no appreciable amounts of fiber in meat, poultry, chicken, eggs, or milk products such as yogurt, cheese, or milk.  Also, all “white” foods are processed, such as white rice, white flour, or white sugar, and have very little fiber left.  Thus, all these kinds of foods may contribute to constipation and poor bowel movement health.

Fiber is found in all whole plants.

• Beans, peas, and lentils are especially high in fiber.

It’s important to vary the types of fiber you eat so you can avoid over-growth of a specific type of bacteria.  It isn’t hard.

• Just eat a variety of fresh or cooked vegetables, fruit, and whole grains.
• Include nuts, seeds, beans, peas, and lentils.

There is so much available today that we don’t need to eat the same foods all the time.

Ideally, humans should be getting about 30 grams of fiber per day.  This is based on diets that don’t contain processed foods, or large amounts of meat, poultry, fish, and dairy.  If a person is serious about getting this much fiber, they often lose weight, feel better, and have more normal stools.

Over the years I have noticed that all the “grumpy old men” that have come to my office really are either constipated or had relationship problems.  I advised them to eat more fiber, take a probiotic, and drink more water.  The way to judge is to have soft stool, one to three times per day.  These changes have led to normal stool, and happier people.

 

Would you eat 30 grams of fiber per day if you could? Every bit of fiber counts! How would you add fiber to your diet?

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