Better Bowels

Members article

By Jane Verity ©Dementia Care International

Doing poo is something that people don’t talk about – and yet they should. There is much confusion about what is normal, and how to manage the ‘abnormal’. Whilst we generally don’t even remember most of our regular bowel openings, and they certainly aren’t part of our social small talk, many of us have a memory of an abnormal poo that we can recount, one which elicits sympathy – I drank the water in Pakistan and then spent a night on the toilet with a bucket on my lap!

What is normal? A normal motion is soft, formed, and is passed either daily, second-daily or even weekly – weekly is acceptable for people on tube feeds.

Another way to describe poos is as ‘fluffy floaties’ or ‘stinky sinkies’ – if it floats in the toilet bowl then it is ‘normal’, but if it sinks to the bottom then one is constipated.

As a student dietician in the mid eighties, I heard Professor Burkitt, respected surgeon and pioneer of high fibre diets, speak about fibre – he made the point that the bigger the poos then the smaller the hospitals.

We are advised to eat a high fibre diet, and that a high fibre diet would be more than 40 grams of fibre per day. According to Professor Burkitt, we are constipated at 40 grams per day and should be aiming for at least 5 times that amount. Most people say they couldn’t eat that much food on a daily basis, however, there are many populations that do. If we ate even a quarter of this amount, then our poos would be soft, formed and frequent! Strategies to increase fibre intake include:

  • eating more fruits and vegetables and aiming for 7 serves per day but preferably 10-12 serves per day,
  • cooking baked products such as cakes, biscuits, desserts with both wholemeal and ordinary flour (half and half),
  • cooking with parboiled rice instead of regular rice.

We all know that we need to drink more fluid; however, there is disagreement over which fluids we should be drinking and how much we should drink on a daily basis; whether caffeinated drinks have a dehydrating effect or whether the body adapts to the caffeine intake.

Whilst all non-alcoholic fluids, including caffeinated drinks, can be counted as part of our fluid intake, it is best to drink some water every day. We should aim for at least 8 cups of fluid, of which half should be water. Many people claim that if they drink this amount per day then they will be up all night – not true – fluid intake does not increase either the frequency of weeing at night, or the volume.

For better bowels, we all need more:

  • water
  • fruits and vegetables
  • movement

Most of us are chronically ‘dry’ or dehydrated – we just don’t drink enough fluid, or drink often enough, and claim it is because we are not thirsty. Thirst is a habit – if we ignore it then it is suppressed, however, if we develop the habit of drinking frequently, especially water, then our thirst signal seems to re-establish.

Physical activity is another important factor in doing poo – the more we move about the easier it is for waste to pass through the body. All activity has a beneficial effect on the gut muscles, whether it is a tremor or other involuntary body movement, or a sport or hobby such as walking or swimming.

Are your poos fluffy floaties or stinky sinkies? If they are stinky sinkies then follow the three ‘mores’:

  • more water
  • more fruits and vegetables
  • more movement