Proper Number of Daily Bowel Movements?

Well, I actually think that is one of those questions that are sort of nonsensical, sort of like, "how many pancakes does it take to shingle a dog house?" Well, not really nonsense same as that, because it is a reasonable thing to wonder, but one without an answer just the same.

The reason is that there is no PROPER number. It all depends on your personal circumstances. The main thing is how YOU feel. If you feel constipated, then it is not enough. If you feel like a slave to the toilet, it is too much. The number will vary from person to person. http://www.mayoclinic.com/heal...el-movements/my00786

Of course, you cannot use dialog from a comedy as any sort of resource, but I didn't think you were. I don't think I ever saw any medical recommendation that was anything close to 6 BMs a day for a person with a colon.

But, just to give folks something to gauge their own function by, the docs generally say somewhere between 4-6 times a day is typical and expected long term function after j-pouch surgery. But, your actual results may be different and you feel perfectly well. I doubt you want a lower frequency because that could promote bacterial overgrowth. We all know what higher frequency is like, but if there is no urgency or anal irritation, even that is not so much of a bad thing.

So, it all boils down to "whatever makes you feel well."

Jan

Whenever I see my surgeon he asks how many B.M.s I have a day. I don't count but I know the 4-6 times as being typical for us so that is what I tell him. This last time I saw him I told him I actually have 2-3 B.M.s first thing in the morning. I attribute this pattern to gravity. After being horizontal during the night, just getting vertical and moving around in the a.m. allows the stool to move on down! After one visit to the toilet the next phase moves on down. Two to three times does it and then I'm good to go almost the rest of the day before needing to visit the toilet again. This is just my pattern and it seems normal to me!

Jan-

I don't know if you saw this movie but the conversation I mentioned is a little deeper and more serious than you might think. First, having watched this movie, I am convinced that one of Seth Rogen or Evan Goldberg either have IBD or have someone in their families who does. There is another scene in the movie in which a young girl and her father go into a convenience store and ask the owner (who is depicted as a "Soup Nazi" type character) to use the store bathroom. The young girl appears to be in some distress. The owner then points at a sign that says "Restrooms for Customers Only" and starts yelling at them. The owner later in the movie gets killed, very horribly.

In addition to this, the debate over the proper number of daily bowel movements between Rogen and Baruchel is in the context of a conversation over whether they should get some food from Carl's Jr. I actually never heard of this restaurant, because I live on the east coast, but evidently it is a chain burger & fast food type restaurant in California.

My understanding of the debate is it has nothing to do with constipation but rather an ideal number of daily bowel movements to keep the cancer out of a normal healthy colon. Remember that Rogen, who is playing himself in the movie (as are all the other actors) is doing a cleanse on his colon and trying to resist the temptation of going to Carl's Jr. for a burger. Ultimately Seth Rogen relents, goes to Carl's Jr and eats a big messy burger.

So my question has nothing to do with constipation or comfort level. It has to do with the proper number of daily bowel movements, in a coloned person, to theoretically prevent the development of cancer, or in a J Pouch person, to prevent bacterial overgrowth or pooling of feces that in some cases (like my own) that is being shown to cause bacterial overgrowth. In other words the rate at which we should keep the stool moving through our intestinal tracts to keep these serious issues from developing. I really think that was the question in Rogen's mind when he wrote the movie. I don't think it was a cheap joke. By the ways, there is no answer provided in the movie.

Yes, I did see the movie a couple of weeks ago. I've seen pretty much all of Seth Rogan's movies, and they often go off on detailed riffs of current topics. Not sure you can make any conclusions about the actors based on the dialog.

But, basically, from all that I've learned and read in journal articles, proper bowel habits are based on comfort and feelings of well-being. J-pouchers who strive to have 1-3 bowel movements a day don't do it for health or well-being. They do it for convenience.

Personally, I feel better when things stay loose and evacuate easily. I don't count the number.

So again, no real proper number, just a range considered normal. The only articles I've read that recommended a minimum of 3-4 bowel movements daily were from complementary health providers, most of which were selling "cleanse" products.

Jan

I found the topic interesting and there are a variety of things in the movie which are based on reality, such as Rogen's fondness of marijuana and Franco's fondness for collecting art. The list goes on. People who simplistically say movies are fiction do not get it. So was the movie Alien but the writer had Crohn's Disease and that led to the creation of one of the greatest scenes in film history and directly due to his experience with IBD. If you interviewed Rogen I bet you find the same thing led to the writing of the scenes I mentioned. I would bet money on it.

I doubt it matters here whether fictional movie dialog reflects an actor's real life thoughts. So, I'm not interested in placing bets on that or discussing it further.

I thought the real question was about what the actual recommendations from the medical community were for bowel frequency. That is what is relevant for us. On that, my response is the same.

Jan

I wish I was down to 4 to 6 bowel movements a day. That would be like heaven to me. I can't remember doing that since I have had my J-Pouch back in 1994. As it is, I am chained to that toilet and am very frustrated.

Regardless, Having a pouch is better than dealing with UC that I had for 8 years until 1994.

Right now, the doctor thinks I may have Bacterial Overgrowth but will not prescribe me meds until I have the Hydrogen Test next week and he receives the report of my stool sample.

Rocket

Sounds good Rocco. If you actually have C. diff, the wrong antibiotics could just make things worse. Of course, it is possible to have both bacterial overgrowth AND C. diff! And let's not forget IPS, which is just another "fly in the ointment." Your ongoing stress doesn't help either...

I hope you get on the right path soon. Sometimes even if the treatment isn't particularly effective, if you know what is going on, THAT in itself, is useful because it can help you accept things and take them in stride more. Doesn't make them go away, but sometimes being able to cope better is a huge step.

But, I agree, having a treatable illness is always preferable to "I must be going crazy!" That is, of course, the treatable illness IS "going crazy" (I am joking, naturally- even though it is no laughing matter).

Take care,

Jan

That is why I am hoping they actually find something wrong to start treating it.

Yes, this illness, right now, is not be treated and that does drive me crazy.

Rocket,

Actually, one of the questions going through my mind when I started this thread was whether increasing transit time (and hence BMs) could help a bacterial overgrowth situation. I mentioned this earlier. I am being prescribed Lactulose and I know that Lactulose increases my daily BMs, however, I had thought that the reasoning behind it was that it is a prebiotic which creates a better bacterial balance. But then I also wondered whether the prebiotic effect created more BMs and hence are more BMs better for someone like me (and maybe you) that has BO. I still do not know the answer.

In any event good luck with the hydrogen and stool tests and post the results in that thread you started when you get them.

I will. thanks CT

Lactulose increases frequency because it is a synthetic sugar that is not digested, not because it is a prebiotic. That is why it is used as a laxative.

The prebiotic angle of it does promote increased growth of probiotic bacteria, which in turn should reduce trouble-maker bacteria, through competition. Of course, for this purpose, you take smaller doses than for a laxative.

But, yes, your thinking is correct that higher frequency reduces bacterial growth and lower frequency increases it. Basically, the longer the stool sits in the pouch, the more likely there will be fecal stasis promoting bacterial overgrowth. However, this is reservoir related because it is less common with an end ileostomy. If you have bacterial overgrowth that goes way beyond the pouch, that isn't so much frequency related. But, I imagine that overall gut slowing could contribute.

The ileal reservoir is not exactly like a colon or rectum, even disregarding the cellular differences. There also is no "one way valve" that prevents back flow from the reservoir into the rest of the small bowel. With the colon, there is the ileocecal valve.

Jan

quote:

There also is no "one way valve" that prevents back flow from the reservoir into the rest of the small bowel.

This is exactly what is causing the bacterial overgrowth in my case. My GI calls it "backwash stool."

So how does one know if a prebiotic only promotes the growth of desirable bacteria and not undesirable bacteria too?

When I had a colon I went 3 times a day. When I had cancer and got constipated from it I hardly went, maybe weekly. Then I got a scoped. When something isn't right, get checked...

I was always told 3 is a pretty normal, healthy schedule if you eat right and work out, etc.

Now if I ate like crap and shoved greasy fried foods and sugar down into my gut I would go 6 times. I ate pretty clean before I got diagnosed with FAP though so 3 was the average.


With a BCIR, I go when it bothers me since I don't poop like a jpoucher does.