The experts weigh in on the dos and don’ts of number twos.
Some days you might find yourself in and out of the toilet, and some days might go by without a single visit for a number two. Should this be a cause for concern?
Five experts weighed in on if we have to poo every day, and five out of five experts said no. Here are their responses in detail:
Christopher Hair, Gastroenterologist
“The human body is complex, which helps to explain why so many “normal” functions differ between people, including sleep, urination and defecation. What is perceived as normal for many, is out of normal for others. Pooing is one such example of this range. What is normal is well defined yet broad. In many studies into normal ‘healthy’ defecation, normal pooing ranges from three times per day to three times per week. Less than 40% of healthy people poo once a day.
“Pooing out of the normal for an individual might signify illness such as infection (pooing more) or cancer (pooing blood). Sometimes not pooing at all might indicate illness, such as a metabolic condition.”
“Opening your bowels every day is not essential for the proper functioning of your digestive system. However, long periods without bowel movements (fewer than three three stools per week) can cause a number of complications such as haemorrhoids, anal fissures or faecal impaction. Constipation can be caused by many factors, including a range of medical conditions, some medications (such as opioids, some antacids), nutritional supplements (such as iron) and of course, a diet low in fibre.
Dan Worthley, Gastroenterologist
In a recent large study of 4,775 people reporting “normal” bowel patterns, it was found that about 95% of people move their bowels between three and 21 times weekly. So between three times a day and three times a week is what I like to call the “Goldilocks zone for pooing”.
But just as important as frequency, is form. To describe our stool consistency, we use the Bristol Stool Form Scale which uses a seven-point scale ranging from Type 1 “separate hard lumps, like nuts” to Type 7 “watery no solid pieces”. Type 4 (“Like a sausage or snake, smooth and soft”) is the Nirvana of all bowel actions, but 50% of normal patients report some variation from this.
Jakob Begun, Gastroenterologist
Stool is the end product of our gut metabolising our food, and it consists of non-absorbed material, microbes and water. Each week the average person produces between 500 and 1,100 grams of stool. The frequency of defecation is governed by many factors including diet, the intrinsic motor activity of the gut, the rectal capacity, behavioural factors, as well as the gut microbiome. Studies have generally confirmed the “three and three” rule – that normal bowel frequency varies between three times a day, and once every three days.
When assessing whether people have constipation there’s an emphasis on symptoms in addition to stool frequency. So a person who moves their bowels less often than once a day, but does not have any discomfort, straining, or other symptoms, is normal.
Vincent Ho, Gastroenterologist
Studies in the UK and Sweden found almost all patients had a frequency of bowel motions between three times per week and three times per day. So this is thought to be the normal range for how often you should go to the toilet. Experiencing temporary changes in bowel frequency or consistency is normal. Many non-disease factors are known to affect the frequency of bowel motions including fluid intake, physical activity, diet, age and social factors such as embarrassment in going to the toilet at work.