Having a bowel movement is the purest form of detoxification. You need to do everything you can to optimize that. On today’s show. We’re talking about how to poo properly so that you have a fantastic smooth move first thing in the morning – what I like to call stool nirvana.
Before I get into the nitty gritty of position and propulsion, I want to spend a minute talking about preparation. Fiber, water, and exercise are the essentials for stool nirvana so you need to make sure you’re getting enough of all three. And I’ve covered those plenty of times on the podcast but in case you missed them, or need a refresh, check out episode 2 Shy Bowel, Episode 7 Iron Man Bowel Movements, episode 13 Mamma Jama Poos, and episode 38 Stool Nirvana, for some really useful background information.
OK, so you filled your plate with fiber, you’re drinking at least half your body weight in ounces of water and you’re getting 30 to 60 minutes of regular exercise every day. You are poised for some really good bathroom action. When we come back: what else you need to do to have that smooth move.
We are back talking about how to poo properly and my number one tip is drink a big glass of water first thing in the morning. Now I’m not talking about electrolyte water or alkali water or magnesium water – just plain water. And I recommend having at least 40 oz next to you on your bedside table. First thing I want you to do when you open your eyes is to sit up or stand up and drink that big 40 ounces of water. You don’t have to chug the 40 oz all at once. You could take a few minutes to get it all down, but you want to have a large volume of water in your stomach. Why? Because that is going to trigger something called your gastrocolic reflex. The gastrocolic reflex is a physiological reflex that controls the motility of your lower GI tract. When your stomach is stretched from a large meal or a high volume of water, it triggers your gastrocolic reflex, and that increases motility in your colon, pushing the products of digestion further down in the colon to make room for more food that’s coming in.
Now, in the morning, those products of digestion have formed into actual stool and they should be sitting right at the bottom of your colon waiting to exit. When you drink that large volume of water, and again you don’t need to chug it, but you want to get it down within a minute or two, when you stretch your stomach like that from the water, it triggers your gastrocolic reflex and that means that nice pile of poo you have sitting at the bottom of your colon is going to be more likely to exit because your colon is stimulated and contracting. That’s what the gastrocolic reflex is: it’s an increase in movement in the lower colon which is exactly what we want! We want movement!
Tip #2 is when you get that urge to go, you must heed the call. You must literally drop it while it’s hot. Once you get that urge, that sensation that hmm, my poo is trying to come out, if you ignore it and decide you’re going to check your phone or you’re going to make some coffee or you’re going to read the paper, you risk something called reverse peristalsis, where the poo now starts to move back up your colon in the opposite direction. And if you want to hear more about that, check out Episode 2 Shy Bowel. So heading straight to the toilet when you first feel that sensation that you might need to have a bowel movement is absolutely essential if you are trying to have a smooth move first thing in the morning. When we come back, position, propulsion and clean up.
In order to have a smooth move there are two positional factors you need to know about. The 1st is that you want to increase intra-abdominal pressure because that is going to help push the stool out. The second is that there’s a set of muscles that make up something called the anal sling, and the angle of your anal sling needs to change in order to release the bowel movement into the toilet. Definitely go back and listen to Episode 2 Shy Bowel if you want to learn more about the mechanics of which muscle has to contract and which one has to relax. But for now, what I want you to know is that bringing your knees up accomplishes both of those goals. It increases your intra-abdominal pressure which is going to help the stool exit and it adjusts the angle of the anal sling, and that is also going to help to release the stool. There are a couple ways you can do this. Most of you have probably heard about a little step stool called the Squatty Potty. I think it was featured on one of my favorite shows, Shark Tank. But even if you don’t have an actual squatty potty, any small stool – pun intended, will work. You can turn a small rubbish bin upside down and put your feet on that. You could use a stack of old phone books or encyclopedias. Or you can do my favorite move which is to pull your feet up onto the toilet seat. Important warning here: if you are not flexible and you don’t have good balance don’t do this because you could fall off the toilet.
I was in Iceland recently and I was using a public bathroom and there was a sign with a diagram showing how to use a western toilet – the sign actually said, “How to use a western toilet”, and the diagram was instructing people to sit on the toilet rather than squatting on it with their feet on the toilet seat. And I was thinking that in parts of the world, like parts of Africa and Asia, and some parts of Europe like Turkey, where people often squat to use the bathroom, they have a lot fewer bowel problems. So Western toilet where you’re sitting versus squatting equals Western bowel habits with more constipation. But I can appreciate this was a highly visited rest stop in Iceland and I can understand why they did not want people putting their feet up on the toilet seats but I just want to point out to you that having your feet up like that and squatting over the toilet is actually a much more natural position for having a smooth move bowel movement.
OK, you had your 40 ounces of water first thing in the morning. You got that urge to go. You went immediately to the bathroom. You sat on the toilet. You bent your legs and put your feet up on a stool. You are ready for some action. Now it’s time for some gentle pushing. Notice I didn’t say straining. I said pushing. You want to try and push the stool out with firm but gentle pressure and then relax for a minute. And you can do a few cycles of that – maybe 2 or 3 times. But you want to avoid prolonged energetic straining because that can lead to hemorrhoids and something called rectal prolapse where a part of your rectum is protruding from your anus. For more on that, check out episode 35 on Hemorrhoids.
Super important point here as we’re talking about propulsion. You do not want to take your phone or a book or a magazine into the bathroom with you. Because that is going to take your attention away from propelling the stool out and you’re not going to be focused on pushing and making sure that the stool exits, you’re going to be focused on checking your e-mail or catching up on news or reading your book. So this is not the time to multitask. This is important business and it needs your full attention. The other point I want to make here is that if you’re pushing and you think the bowel movement is done and you stop pushing, that can end up pinching off the stool before it’s completely out and so instead of one nice log, you end up with small pellets – like sausages on a string. So you want to maintain that push long enough for the stool to completely exit.
The final thing I want to talk about is the clean-up. We want to successfully remove all the stool from around our anus after a bowel movement. When we finish having a bowel movement, we don’t like the idea that there’s still some stool hanging around and it may stain our underwear. But you need to keep in mind that the skin around your rectum is very delicate, and if you’re wiping a lot with dry toilet paper, that will likely irritate that area. Wetting the toilet paper will lead to soggy toilet paper, and that also makes it difficult to clean up. So what I recommend is a little bit of petroleum jelly. Keep a tube of it in the bathroom and squirt some onto the toilet paper for that final wipe. That petroleum jelly is going to help remove any final traces of stool, and it’s also going to provide some protection – it’s going to coat the skin in that area and prevent it from getting super dried out and irritated. I don’t recommend using any kind of wet wipes. And particularly nothing scented. Those products tend to have a lot of chemicals in them and they can irritate your rectal area so just a little bit of petroleum jelly on the toilet paper is what I recommend if you find that you are wiping a lot. Now, if you’re fortunate enough to have a bidet, that’s great. When we were building our house about 10 years ago, the one non-negotiable for me was a bidet in the master bathroom. My husband thought it was unnecessary but I was really insistent and I’m telling you – and this may be TMI – but I use that bidet every morning after my bowel movement. I get on it backwards because I’m washing my rear end, not the front. Highly recommend a little warm water irrigation of the anal area before the final wipe or after the final wipe also works well. For my patients with diarrheal illnesses like ulcerative colitis or Crohn’s disease, where they may be having bowel movements multiple times a day, and the stool is often loose, a bidet or a bidet attachment is essential for helping to keep that area clean without irritating it from frequent wiping. If you don’t have a bidet, not to worry, there are lots of devices you can add to your toilet that can turn a regular toilet into a bidet, and many of these are under $100. A link to a review of the top 5 bidet attachments is in the transcript for this episode, which you can find on the website at Gutbliss.com under Podcast.
I want to leave you with three takeaways about having a smooth move:
1. Pay attention to your position on the toilet – having your knees up to approximate a squatting position is going to help tremendously.
2. Heed that call when you feel the urge to go and push, but don’t strain.
3. Be gentle with the clean-up. Your rectal area will appreciate a bit of petroleum jelly on the toilet paper, or some irrigation with a bidet or bidet attachment after wiping.
So that’s it for this week’s episode of the Gutbliss Podcast on smooth moves: how to poo properly. If you have a burning question that has anything to do with your digestive tract, I would love to hear from you! You can email me through the contact form at Gutbliss.com or DM me on Instagram @Gutbliss.
