Your Complete Guide to Going No. 2

Because understanding the ins and, yes, the outs of your body is essential for good health.

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As the famous children's book puts it, Every one Poops, but for many of us, that's not the end of the story. Nearly 15% of Americans now have irritable bowel syndrome (mostly undiagnosed), and about one in five of us deals with chronic constipation. Women are about twice as likely to suffer from either of these conditions as men are. We all poop, but not always easily, or healthily.

"We're a society whose diet is getting worse," says Gerard Mullin, M.D., a gastroenterologist and director of Integrative GI Nutrition Services at the Johns Hopkins University School of Medicine. Between that and today's off-the-charts stress levels, a factor that also affects your gut, many people are either backed up or rushing for the restroom.

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So let's not dissolve into giggles or run away from the subject. Instead, recognize that food needs to move through you to deliver the nutrients that keep your body humming along. And consult our all-purpose, highly informative guide to pooping (with surprisingly attractive visuals!).

Admit it, you've always wondered…

Q: Why is it so hard to go when you're on vacation?

A: "The day and night cycle is super-important to our bodies. The colon is dormant most of the night, then within minutes of your waking up in the morning, activity there spikes," says Anish Sheth, M.D., a gastroenterologist in Princeton, NJ. "If you're vacationing in a different time zone, your regular sleep cycle changes and you can lose your normal reflex to go." There may also be some level of "poop shyness," says Nick Haslam, Ph.D., a social psychologist and professor at the University of Melbourne. "When you're in an unfamiliar environment, there's less comfort and more anxiety about it."

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Q: Is fiber really that important?

A: Yes. The reason it comes up in every conversation about your gut is that it's absolutely crucial to a smoothly functioning digestive process, say experts. Fiber absorbs water into the stool, helping to move it through your system easily; it also feeds healthy bacteria in your gut, says Mullin, author of the book The Gut Balance Revolution. But chances are you don't get enough of the nutrient; the average American woman eats only about 15 of the 25 grams of fiber she needs each day.

Q: Does poop size matter?

A: Yes, but not as much as shape and consistency. If you're regularly clogging the toilet, it could be what you're eating. Loading up on fiber (as we've said, generally a good thing) can lead to larger, bulky, but soft poop, says Felice Schnoll-Sussman, M.D., director of the Jay Monahan Center for Gastrointestinal Health in New York City. If you don't drink enough water, your stool may be hard and dry and more difficult to flush.

Q: Does stress make you poop more or less?

A: Both. Your body's fight-or-flight response that gets activated in stressful moments slows digestion, meaning food takes longer to move through your gut, increasing the risk of constipation. At the same time, stress can rev up the contractions in the colon that will likely induce diarrhea. So at different tense times in your life, you may experience one or the other.

Q: Are all the "flushable" wet wipes people use clogging up the country's pipes?

A: Oh, yes. According to experiments by Consumer Reports laboratories, some brands of "flushable" wipes can break down in water—but it takes hours longer than toilet paper, which dissolves almost instantly. Other wipes don't fall apart at all. In fact, waste water treatment officials from New York, Oregon, Minnesota, and other states have reported that huge blobs of clothlike fiber now regularly have to be pulled from the pumps and pipes of their sewage systems, at a taxpayer cost of millions. Can't live without that "clean" feeling? Put wipes in the trash, not the toilet.

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Q: Are some people just "better" poopers than others?

A: Probably. One reason? There may be an inherited component to some gut issues. Irritable bowel syndrome, for example, may run in families, says Elena Nascimbeni Ferran, M.D., a gastroenterologist at NYU Langone Medical Center in New York City, but researchers don't yet know if that's because of genetics or diet and lifestyle habits we pick up from our parents.

Q: Let me guess, there's a poop app, right?

A: Yep, the Bristol Stool Scale iPhone app, complete with helpful (if icky) little drawings to help you classify the quality of your poop.

Q: Why do antibiotics sometimes cause diarrhea?

A:"Bad bacteria is in everybody's stool, but it's usually hanging out behaving itself, because other, healthy bacteria is keeping it at bay," says Sheth. When your healthy gut germs get depleted by antibiotics, and the particularly nasty germs that are resistant to the meds proliferate, diarrhea can happen. Taking probiotics may help balance things out again, although more research is needed about their effectiveness.

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Rules For Healthier BMs

1. Eat more fiber, for goodness' sake. To make your quota of 25 grams a day, follow the half-your-plate rule: Always pile half your dish with fruits or vegetables and you'll get two or more ½-cup servings of fiber-rich produce at every meal. The fiber all-stars: beans and lentils; whole grains, like oatmeal; raspberries; artichokes; broccoli; pears; and apples.

2. Drink water—enough so that your urine is a very pale yellow. Staying hydrated keeps poop soft, easing the way out. And if you bump up your fiber intake but don't drink enough water, things won't move through your system as quickly or smoothly, says Schnoll-Sussman.

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3. Eat more naturally probiotic foods, which have live colonies of healthy gut bugs like bifidobacteria. The easiest source is yogurt with the words "live" or "active cultures" on the label. Kefir, kimchi, and miso also contain probiotics.

4. Exercise regularly. Whether it's jogging or yoga, physical activity spurs motion in the colon and also relieves stress, which can majorly mess with your regularity.

50 Shades Of Poop?

Poop should be—no shock here—brownish. If there's frequently some other hue in that bowl, you could have an issue worth looking into. Just know that eating lots of dark green veggies or beets or taking Pepto-Bismol can make stool appear yellow, green, reddish, or black. (Yes, Pepto can turn poo black.) Oddly colored poop, without these diet quirks, may mean there's too much fat or blood in your stool and could indicate intestinal, pancreatic, or other problems—call your doc. If you see actual blood, get checked out right away. Don't put it off.

If You're Constipated…

…these short-term fixes can help get things going. Not working? See a doctor to rule out IBS or other issues.

Eat some wheat bran, nuts, or seeds.

Again, everyone needs to get plenty of fiber, but when you're stopped up, focus on foods that have a specific kind: insoluble fiber, which bulks up stool and helps move it along. Chow down on wheat bran, artichokes, seeds, nuts, and broccoli. And, it bears repeating, be sure you're drinking enough water. All that fiber could cause gas and bloating if you're not sipping enough fluids, says Mullin.

Try a supplement.

While it's best to get your fiber from food, a supplement like Metamucil or Benefiber can help regulate you in a pinch, says Sheth.

Have an extra cup of coffee.

Caffeine stimulates movement in the colon. There's no exact dosage to follow; caffeine truly works differently for everyone. So add a small cup to your routine and see how that goes.

Take magnesium.

"It's known as a natural laxative, it's safe if used sparingly, and it works," says Sheth. Just note: Relying on it long-term isn't a good idea since too much magnesium can lead to kidney issues and other problems. A typical dose for adults with constipation is 500 milligrams, twice a day.


Good for everyone, as we said, but can be particularly helpful if you have what Mullin calls "slow transit."

If all else fails, go for the right kind of laxative.

Choose a brand like Miralax that's clearly labeled as an "osmotic laxative," says Sheth. These draw water into the intestines to speed things up, as opposed to stimulant laxatives, which can cause cramping or weaken the body's natural ability to move the bowels if overused.

If You're Having Diarrhea…

Get the right fiber.

"If someone is leaning toward diarrhea a lot, they may benefit from more soluble fiber, which helps feed good gut bacteria," says Mullin. And soluble fiber can soak up water from the digestive tract, making stool firmer. Some foods high in the stuff? Apples, bananas, and oatmeal.

Try a probiotic supplement.

Probiotics like lactobacillus can reduce diarrhea that's caused by taking antibiotics; other studies suggest they may also improve symptoms of IBS.

Sip some Metamucil.

It works for constipation, but it can also help regulate loose stools, says Mullin.

Cut back on caffeine.

Remember how it stimulates the colon? Yeah, not what you want now.

Common Meds That Mess You Up

These may cause constipation: Narcotic painkillers like Percocet or codeine; general anesthetics; some antidepressants like Elavil; antacids that contain aluminum.

These may cause diarrhea: Antibiotics; NSAID pain relievers like ibuprofen; heartburn meds like Nexium and Tagamet; Zantac.

This story originally appeared in the April 2015 issue of Dr. Oz The Good Life.

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