The 'Three and Three' Rule of Pooping Tells You If You're Normal or Not

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?

We asked five experts if we have to poop every day.

Here are their detailed responses:

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. Pooping is one such example of this range. What is normal is well-defined yet broad. In many studies into normal, "healthy" defecation, normal pooping ranges from three times per day to three times per week. Less than 40 percent of healthy people poop once a day.

Pooping out of the normal for an individual might signify illness such as infection (pooping more) or cancer (pooping blood). Sometimes not pooping 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 stools per week) can cause a number of complications such as hemorrhoids, anal fissures, or fecal impaction. Constipation can be caused by many factors, including a range of medical conditions, some medications (such as opioids and some antacids), nutritional supplements (such as iron) and, of course, a diet low in fiber.

The best way to promote optimal digestive health and regular bowel motions is to drink plenty of water and consume high-fiber foods at every meal. This can be achieved through a varied diet including whole-grain breads and cereals, legumes, nuts and seeds, vegetables, and fresh fruits.

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In a recent, large study of 4,775 people reporting “normal” bowel patterns, it was found that about 95 percent 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 pooping.”

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 percent of normal patients report some variation from this.

Stool is the end product of our gut metabolizing our food, and it consists of non-absorbed material, microbes, and water. Each week the average person produces between 500 and 1,100 grams [between 17.6 ounces and 38.8 ounces] of stool. The frequency of defecation is governed by many factors including diet, the intrinsic motor activity of the gut, the rectal capacity, behavioral 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.

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. 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.

This article was originally published on The Conversation. Read the original article.

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