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How to Have Healthy Bowel Movements

Originally published in March of 2008. Please note that portions of this article have been plagiarized online. All of the thoughts in this article are my own. - Ben Kim

To have healthy bowel movements, it's essential that you support colon and rectal health with all of your daily choices. Keeping these areas clean and healthy provides the following benefits:

  1. A lowered risk of developing colorectal cancer, one of the most common types of cancer in industrialized countries.

  2. A lowered risk of experiencing irritable bowel syndrome, chronic constipation, and chronic diarrhea.

  3. A lowered risk of developing hemorrhoids.

  4. Less gas production.

  5. More efficient absorption of water and minerals.

  6. A feeling of lightness, comfort, and well-being in your abdominal region.

Before we discuss specific choices that you can make to keep your colorectal region healthy and to have comfortable bowel movements, let's review some basic anatomy and physiology of this area.

Your colon and rectum are collectively referred to as your large intestine, which is the last part of your digestive tract.

A Journey Through Your Large Intestine

After food passes through your stomach and small intestine, the remaining material, mostly waste products in liquid form, move on to the your colon, which is the first part of your large intestine.

Your colon is approximately six feet long and serves primarily to dehydrate liquid waste material.

Your colon begins at the lower right hand corner of your abdomen, where it's called your cecum. Attached to your cecum is a twisted, worm-shaped tube called your appendix.

From your cecum, your colon travels up the right side of your abdomen, where it's called your ascending colon. When it reaches your lower right ribs (just below your liver), it turns to travel across your abdomen to just below your lower left ribs; here, it's called your transverse colon.

Just below your lower left ribs, it makes another turn and travels down the left side of your abdomen - this portion is called your descending colon.

Your colon then makes one last turn toward the middle of your lower abdomen, forming an "S" shaped segment that's called your sigmoid colon.

Your sigmoid colon empties waste materials into your rectum, which is like a storage pouch that retains your feces until contractions in your large intestine stimulate a bowel movement.

To understand how to keep your colorectal region clean and healthy, let's go over a few key details on how your large intestine works.

Large Intestine Physiology

Movement of Waste Material

After you eat a substantial meal, your stomach expands enough to trigger a reflex that causes a contractile wave (called a peristaltic wave) to travel through your small intestine and push any liquid waste material (chyme) that is sitting in the last part of your small intestine into your large intestine.

Once enough liquid waste material accumulates in your cecum (the first part of your large intestine), the waste material begins to move up your ascending colon.

Movement of waste material through your colon is facilitated by something called "haustral churning." Your colon is divided along its length into small pouches called haustra. When a haustrum is filled with substantial waste material, its muscular walls contract and push the waste material into the next haustrum. The contractile reflex that allows haustral churning is regulated by your enteric nervous system, which is a division of your autonomic nervous system.

Your autonomic nervous system is regulated involuntarily (without regular conscious input on your part), and is intertwined with your emotional health. This is why bowel movements and colon health are intricately tied to emotional states like feeling calm or anxious.

On average, your colon experiences anywhere from three to twelve moderate waves of contractions every minute. After every substantial meal, your colon experiences a much larger contractile wave, called "mass peristalsis." Mass peristalsis serves to push waste materials from your transverse colon all the way to your rectum. In most people, mass peristalsis occurs about three times a day.

Water and Nutrient Absorption

The mucosal lining of your large intestine is lined with tiny pits that open into long, tube-like intestinal glands; these glands are lined with specialized cells that absorb water, and other specialized cells (goblet cells) that release mucous into your large intestine to lubricate your stools and to protect the lining of your large intestine against acidic substances and potentially harmful gases.

The specialized cells that absorb water from your waste materials are responsible for about 10 percent of the water that you absorb from the foods and beverages that you ingest; the remaining 90 percent is absorbed by cells that line your small intestine.

This 10 percent of water absorption in your large intestine amounts to anywhere between a pint and a quart of water, and represents a significant portion of your body's daily intake of water. As water is absorbed from the waste material in your colon, so are some nutrients, mainly minerals like sodium and chloride.

It takes anywhere between three to ten hours for your large intestine to absorb enough water from waste material to turn it into solid or partially solid stools. Your stools consist mainly of water, mucous, fiber, old cells from your intestinal lining, millions of microorganisms, and small amounts of inorganic salts.

When your rectal pouch is distended with enough feces to trigger a contractile reflex, your feces are pushed out through your anus. When you consciously contract your abdominal wall, your diaphragm moves downward and helps open up muscles that line your anal sphincter.

Your rectum is lined with three horizontal folds, called your rectal valves; these valves are what prevent stools from passing through your anal sphincter when you pass gas.

If you choose not to release stools when you experience the urge to do so, your reflex contractions may stop, in which case you likely won't have a significant bowel movement until the next mass peristalsis occurs.

Diarrhea and Constipation Explained

When waste material travels through your digestive tract too quickly for sufficient water absorption to occur, your stools will be runny and more frequent than normal.

Three main causes of diarrhea are:

  • Undesirable microorganisms

  • Food intolerances (like lactose intolerance)

  • Stress

In the first two cases listed above, it makes sense that your body would want things to move quickly through your system; your body doesn't want to spend time digesting foods that it can't properly extract nutrients from or that are laced with disease-causing microbes.

Stress can cause transit time to shorten by messing with your enteric nervous system; please recall that your enteric nervous system controls the reflex contractions that mark "haustral churning." Your enteric nervous system is a part of your autonomic nervous system, and your autonomic nervous system regulates your physiological responses to emotional and physical stress.

When waste material travels through your colon more slowly than it should, enough water is extracted from your waste material to cause your stools to become uncomfortably hard.

Five main causes of constipation are:

  • Eating sporadically, or eating meals that are too small to elicit mass peristalsis.

  • Not going when you feel an urge to go.

  • Lack of a healthy intestinal lining that is capable of producing enough mucous to properly lubricate your stools (vitamin A deficiency is a potential cause of this situation).

  • Insufficient intake of water, water-rich foods, and/or fiber-rich foods.

  • Stress.

Steps You Can Take To Have Healthy Bowel Movements

Eat substantial meals; don't nibble on small amounts throughout the day.

Each time you eat a substantial meal, you stimulate stretch receptors in your stomach that are responsible for triggering normal and mass peristaltic waves throughout your small and large intestines. These natural contractile waves promote regular movement of waste material through your colon and rectum.

Also, eating substantial meals allows significant boluses (roundish masses) of waste materials to travel together through your colon, turn into well formed stools, and get eliminated from your body in an efficient manner.

Don't suppress the desire to go.

If you regularly suppress the urge to have a bowel movement, waste materials spend more time than is optimal in your colon, causing excessive dehydration of these materials and formation of hard stools.

Avoid anal intercourse if possible.

Your anus is designed to be an exit, and your anal sphincter is not naturally inclined to comfortably allow external objects to enter your rectal pouch. Your anal sphincter is designed to stretch to allow passing of stools when your rectal pouch accumulates enough waste materials to illicit contraction of its walls.

Repeated anal intercourse can lead to a loss in anal sphincter tone, which may lead to incontinence issues, if not now, then in the future.

Repeated anal intercourse can also lead to regular injury of the mucosal lining in your rectal pouch, anal canal, and in some cases, the distal region of your sigmoid colon. Repeated injury and healing of these areas may increase your risk of developing polyps, which can increase your risk of developing colorectal cancer.

Ensure adequate intake of water and/or water-rich foods.

Water helps to move waste materials along, and is absorbed throughout the entire length of your colon. Insufficient water intake can cause stools to form far before waste materials reach your rectal pouch, which can cause constipation.

This doesn't necessarily mean that you need to drink several glasses of water per day. If you eat plenty of water-rich plant foods, then you can rely on your sense of thirst to dictate how much water to drink. For more guidance on this issue, please view:

Why Drinking Too Much Water Is Dangerous

Eat fiber-rich foods regularly.

Fiber adds bulk to the boluses of waste material that travel through your large intestine, and this bulk is essential to your colon's ability to turn waste materials into well formed stools.

A diet that is rich in vegetables, fruits, legumes, and whole grains ensures high fiber intake.

Ensure optimal vitamin D status.

Optimal vitamin D status significantly lowers your risk of developing all types of cancer, including colorectal cancer.

To learn more about how to make sure your body is getting enough vitamin D, have a look at the following:

How to Make Sure that You Are Getting Enough Vitamin D for Your Best Health

Ensure adequate vitamin A status.

As mentioned earlier, glands that line the mucosal lining of your colon are responsible for releasing mucous that is needed to lubricate your feces; vitamin A is needed to maintain the health of these specialized cells that release mucous.

It's best to ensure adequate vitamin A status by eating healthy foods that contain vitamin A.

Ensure adequate intake of healthy fats.

All of your cells, including those of your large intestine and nervous system, require a constant influx of undamaged fatty acids and cholesterol to remain fully functional. If you don't ensure adequate intake of healthy fats, your nervous system and the smooth muscles that surround your digestive passageway - both of which are responsible for creating peristaltic waves throughout your digestive tract - may deteriorate in function.

Also, intake of healthy fats is necessary for optimal absorption of fat-soluble vitamin A, which, as mentioned above, is critical to building and maintaining the mucosal lining of your colon.

Healthy foods that are rich in healthy fats include: avocados, organic eggs, olives, extra-virgin olive oil, coconut oil, coconuts, raw nuts, raw seeds, and cold-water fish.

Build and maintain a population of friendly bacteria in your digestive tract.

Large populations of friendly bacteria can keep your digestive tract clean and healthy by:

  • Promoting optimal digestion, thereby preventing build-up of toxic waste materials.

  • Taking up space and resources, thereby helping to prevent infection by harmful bacteria, fungi, and parasites.

Work at feeling emotionally balanced.

Stress can interfere with your ability to clean your colon through its effect on your enteric nervous system. I can state with certainty that the majority of people who have come to me over the years with a chronic colon-related health issue have had significant anxiety in their lives.

If you have a challenge with colon and rectal health, I encourage you to take a careful look at ways that you can minimize the amount of stress and anxiety you experience.

Closing Thoughts On Having Healthy Bowel Movements

Please remember that healthy bowel movements are generated by good overall health. Chronic constipation is the single greatest cause of having an unclean and unhealthy colorectal region because over time, constipation causes your bowel walls to face excessive pressure. This pressure is created by you straining to go and by your colon walls creating stronger contractions to help eliminate hard stools.

Excessive pressure on your colon walls can cause little pouches called diverticuli to form. Sometimes, small bits of waste material can get lodged in diverticuli, which can lead to diverticulitis and other potentially serious health challenges.

Please also note that nowhere in this article have I mentioned how many bowel movements you should have daily. How many you have isn't important compared to the quality of each movement. If you focus on making food and lifestyle choices that produce comfortable bowel movements, you can have peace of mind in knowing that your colon and rectum are in likely in good health.

 
 

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Comments

Thank you Dr. Kim for starting to put your articles on mp3. I listen to a variety of topics on my mp3 player everyday when I go for my walk. I love combining listening to great information and walking in fresh air and often sunshine. My ability to listen and retain is heightened and I tend to walk longer than I would normally. When the Universe beckons for a "stop and smell the roses moment", I simply push pause and enjoy the moment.

Regards,
Sharon

I had trouble opening/listening with Firefox and had to switch back to IE before I could listen.

Also, the volume of your voice was very low. We could hear the intro music fine, but even with the volume turned all the way up, we couldn't hear it well enough to sit and lsiten. Perhaps you need to get your mouth closer to the microphone? I am not an expert on why or what makes it work, but jsut wanted to let you know the difficulty we had.

I think the idea of the audio files is great...then we can listen while we are making dinner, etc.

Keep trying!

Theresa

Great job on the audio..taped it and plan on listening to it again while driving...also will print article for "health" file...thanks

Very important information, especially for people living with IBS.

I really appreciate your addressing this seldom-explained subject and correctly anticipating many questions. I thought I knew a lot about it, having taken medical course work, but your presentation was much more complete and easy to understand and apply personally and holistically. Thank you for making it available on audiotape for those who learn more easily by hearing than by reading. This knowledge will help me change many eating habits that are destructive to my health in this specific area.

Keep up the good medicine!

Great idea! I really enjoy your site and am committed to eating better and living better at the ripe ole age of 54. Never too late.
The article was very helpful and the recording will be great for the walking time!
Thanks

54 is not a ripe old age, friend. You're just middle aged. Middle age begins at about 35 to about 80 then its old age up to 120 then its very old age. If you think you're old already you're in bad shape and you need to detoxify to keep up with the rest of us!
From a 58 year old middle aged woman.

I agree that 58 is still young, but don't agree that middle age starts at 35 !!! I had my babies after 36. I don't consider that middle age.

80 is middle aged? How so? That is a very ripe old age O_O

In addition--58 is pretty old, too. Just because you feel great, that doesn't mean you're a middle aged woman. You're pretty much a senior citizen already. There isn't anything wrong with that, either. I look forward to being in my 50's, 60's and so on.

Embrace being an elderly gal, lol :P

The age is just a number Its not important "how old you are"
Important is "how you feel"

I generally nibble most of the day and tend to usually only one substantial meal each day, occasionally two, never breakfast until several hours after arrising. I eat mostly raw organic fruits, nuts, veggies, sprouted whole grain breads, raw cacao, goji's, Bernard Jensen drink every morning about an hour after waking, an H2O2 diluted solution immediately upon rising, cod liver oil and calphonite before retiring and have mostly healthy BM's 3x/day. I take plant based supplements and porcine pancreatin, bee pollen (local). Cooked meat 1 - 3x week, generally small portions [always raw cider vinegar before meat meals]. What I mean by healthy BM's are mostly 18" stool. I believe an apple a day [organic only] is paramount to good health and clean colon and if traveling, eat apples enroute and have readily available at destination.

When we looking to keep a healthy colon. I would like to suggest you few healthy tips for your healthy colon.

Fiber: is an amazing rich food it is a Great choice for healthy colon.

Vitamin D you can get it by various sources if you stand in the 15-20 mins of daily exposure is an sufficient for healthy Colon

Don’t Hold it if you feel that your bowel movement coming go head for a bathroom. If you try to hold it in, its built up a fecal matter can release toxins into your body.

Water if you are thinking to keep your colon healthy drink as much you can drink water don’t count it how much your drinking.

Exercise is an important part out of 5tips. This helps you ward off colon cancer and other diseases.

Having normal bowel moments are always recommended for healthy life and make your colon free from unwanted wastage. To avoid colon problems, need to have proper diet and change life style. Irregular bowel moments lead to many health problems like constipation, abdominal pain, fatigue etc. For colon cleansing there are many artificial therapies. Colon Irrigation or Colon Hydro Therapy is the best and effective for colon detoxification. It is the process of passing humid purified water into rectum by using a special device called speculum which has one outlet and one inlet. When water is injecting through inlet of speculum into colon mean while feces coming out of colon through outlet of the device. It takes 40 -50 minutes and make sure this procedure will be done by experts. It is one of the alternative processes for cleansing and my suggestion is always go for natural remedies which are safe and give long lasting results.

Hi Ryan… Is there any chance to get side effects with this colon irrigation process? Please let me know what kind of diet precautions we need to follow after and before this process and also give me any natural diet tips for colon cleansing. While giving the answer please consider this, I am in diet for weight loss.
Thank You.

Chronic constipation. This word has been troubling my niece from past 2 years. She is always constipated and the days it’s too worse than ever. We have taken her to the doctor and she has been on medication and the diet and lifestyle changes that were suggested even now no change has been observed. One friend of mine suggested for colon hydrotherapy and after the process she’s doing well. Issues associated with the chronic constipation have been declined and the bowel movement has been normal now. Ever since having the <a href="http://www.colonhealthmagazine.com/colon-health/colon-hydrotherapy-treat... hydrotherapy</a> and changes suggested by the therapist for diet and lifestyle patterns she is normal.

I heard that these colon cleanses are a very controversial topic

VERY INFORMATIVE

the article was excellent
the only issue was understanding the process, so if u can add pictures also to the whole explanation at various points, it would do a great learning to somebody like me who is from a non-science background

Keep up the good work
thanks

Everywhere now the current trend is to advise people to 'graze ' throughout the day rather than to eat a substantial meal. I prefer substantial meals and usually skip breakfast so I'll be hungry for lunch to have the appetite to eat a substantial meal. Yes, this does stimulate bowel movement providing the food consumed doesn't include milk-cheese or apple or guava seeds which constipate me. At last an article that says that what I do is acceptable! Then again, I probably would eat less if I grazed but then I'd have a big stomach and weigh more for being full of feces.

Kudos to a really extensive explanation of the colon's function and colon health! I just want to highlight the importance of having good bacteria in one's digetsive tract, especially since a lot of people seem to think that all bacteria are bad. In the same way, I would also like to point out that while on a cleanse, one has to ensure that he or she removes toxins and just BAD bacteria from one's system. While on a colon cleanse program, one should try to take probiotics in order to balance the body's good bacteria.

Explained to brother to include more fiber/water in diet. He is diabetic and doesn't eat regularly. He relies on stoll softener, which I told him slows down his metabolism and makes his body have a hard time eliminating. He has been using stoll softener for over 10 years. I'm sure he is backed up and then with the IBS he also has diarrhea every 3 days. He still does not feel light when he finally does eliminate which means he still has fecal matter in his intestines. He has headaches, can't sleep lying down and of course extremely tired. I told him about the 'leaky gut syndrom' and how to change the diet entirely. His new wife is not listening and continues to serve him white bread, cookies, etc. His diet is absolutely awful. He's only 51 and has the body of an 80 year old man. His diabetes has left him without feeling in his feet and legs and he thinks it's funny. It's sad to see a person not take steps to remedy his sad condition. I'm in obtimum health and exercise, eat right (I threw out anything white in my kitchen, I don't touch sugar at all and feel great, lost weight and elmininate up to 2 times a day and always have energy). Thank you for your wonderful article. I'll try to reasure him again to think about changing his diet. I also found a website that said Aloe vera helps to in elimination and cleanses the colon. Hope I can get through to him. Thanks again and have a nice day.
Mrs. S

Hi,
connect onto this page thinking that there were going to be suggestions of a herb or vitamin to take and a colon cleanse regrime/enema or diet
BUT surprise surprise
very good "basic" info 'that is comforting to see and confirm how oneself is going
thank you

ps have you heard of pranic herb that is used for menopause?
thanks again

Dr. Kim, this is absolutely the best information I have ever ever read on this subject. Because of having a problem in this area like many others, I have researched this subject quite a bit, but nothing was as informative and any more helpful than that which you shared. My 91 year old mother-in-law, who has been around awhile, also declared this is the best informative article she has ever read about our bowels, how and what makes them move. Thank you. Thank you!

The majority of search based web content is a joke, aimed at serving the website owner so I rarely find what I'm looking for, much less feel like my time was well spent. Not so this time. Thank you Dr Ben Kim! I am blown away by the quality of this article. The voice is intelligent,informative and its easy to understand without being too plainspoken. The organization of info is ideal for reading and reviewing and the advice is exaclty what I'd hoped to find. I am a busy woman so I don't take time to comment on what I read on the internet, but this is by far the most well written and informative web-based health content I have EVER read!!!! Your site will have a permanent home in my favorites bar at the top of my internet window. Keep writing. We need you!

Mostly a good post, with the exception of advocating for whole grains, raw vegetables, and more fiber. Larger stools are not better. The body is not designed to eliminate large stools. Whole grains are not more nutritious than meat, and are also acid-producing and difficult for many to digest, especially for those who are already experiencing problems. They are constipating and irritating, and consuming more water to eliminate them is not the answer. This only serves to wash out essential minerals. I refer you to two books, Wheat Belly by Dr. William Davis, and Fiber Menace by Konstantin Monastyrsky. For me, protecting the mucosal lining does not include the scraping that's inherent in consuming fiber-rich foods.

I agree, I significantly reduced my whole grain intake and removed wheat from my diet completely. The only whole grains I eat now are oatmeal. I feel so much better.

Another thing I do is drink a glass of warm lemon water every morning as soon as I wake up. This seems to make me "go" about 20 minutes later.

No mention of magnesium, deficiency of which is rather common and can cause constipation. Getting plenty of vitamin C also helps. (Over-supplementation of either one results in diarrhea).

This was an excellent article, very thorough. I have auto-immune hypothyroidism. One of the symptoms is constipation. Can you say how colon function is affected by hypothyroidism and what, if anything, should be done to minimize it?

Thanks for the informative article, Dr. Kim. The only part that I'm not sure makes sense is the advice to avoid anal intercourse. The vagina is designed to be an exit as well, but it can also be an entrance (in the case of women who enjoy vaginal penetration).

If this advice is sound, then there would be a positive correlation between a receptive anal sex and incontinence. There would also be a positive correlation between receptive anal sex and colorectal cancer. I am not aware of such correlations; are you?

Two other major factors that cause constipation are the "food" we eat in this day & age, it's actually foreign to our bodies so our bodies don't know how to break it down properly & digest it as quickly. Also certain meds,especially pain medicine & especially opioid based,such as your oxycodone's, methadone, fentanyl etc..(Even Neurontin <nerve med>).Dexedrine,Adderall,(most ADD meds)make you extremely dehydrated leading to constipation.A few things that have helped me in general are raw apple cider vinegar,castor oil,aloe Vera juice,fish oil, & ORGANIC colon cleanses or even full body cleanses.(you have to be consistent with these though, you can't just do it once & expect to be regular forever).It's a lifestyle to be maintained due to all the toxins, chemicals, hormone injections,artificial flavoring etc. present in the "food" we consume everyday.I recommend the co-op for quality cleanses.Water w/ lemon is also good for keeping your insides clean(& for your complexion:). Hope this helps.

Repeated anal intercourse does not lead to issues of incontinence when done correctly. Correct meaning: there is no painful sensation, the sphincter is properly relaxed beforehand, and plenty of water or silicone based lubricant is used. Anal intercourse also increases local circulation and studies say it's a positive factor in preventing prostate cancer.

Thank you, Dr Kim for educating and teaching people how to live to their optimum capacity and well-being.
You are truly an honorable and virtuous man of the highest order.
Blessings to you.
I appreciate and applaud you for your efforts and contributions.

Re: Fear & Emotion.....What an excellent article! As stated in the article visualization is a valuable management tool. It works well to "relieve and comfort", and may direct the mind to improved mindfulness and confidence. Beyond visualization....the source of the emotion may permanently be
removed (still remains in computer server memory) by allowing the emotion to come to the surface
and then being repeatedly "erased" until it no longer presents itself. Yes, this is a lot of work, but becomes nearly automatic and very freeing if one is sincere about mindfulness and living in the moment. This is not for those who choose to hold onto memories or "live in the past". It involves a true "letting go", moving "with the flow"......into a state of natural consciousness and awareness. This process provides health, energy, and balance. Like stretching exercises to maintain spinal health, "as needed" mind maintenance provides the desired results. Thanks agsin, for being you.

hard to believe I've gone 52 years knowing almost none of the things that were in this article and I'm an educated woman. This was brilliant well-balanced article on time and I also really enjoyed learning about anatomy and how everything functions this was wonderful concise and comprehensive in a nice short format

I thought the article by Dr.Kim was very interesting. I have downloaded it to study it further. I thought there should be diagrams along with the article to actually see what I'm reading(I'm not familiar with all the parts of the body that he was referring to.)
I'm in my 80's & rather active still. However some things(rectum,et all) seem to have slowed down. I'm now wondering if this is made up on my part? Does age play a part?Thank you,(I would hope someone would answer)

This article about the bowel , amazing I have I b s , gone through rough times , and had to force to get things going , I am very gratefull for this . Thanks much ....

Drinking fresh pure celery juice works wonders for constipation and more, from
Anthony William, the Medical Medium.