Normal bowel movement: what frequency of stool is considered optimal?

• Irregular bowel movements
• Constipation
• Treatment and prevention
• Preparations for normalizing stool and treating constipation
• Benefits of Duphalac®

The intestines play an important role in the well-being of every person.
If going to the toilet is irregular, accompanied by difficulty and does not bring relief, the usual rhythm of life may be disrupted. The mood deteriorates, internal discomfort and a feeling of heaviness cause unpleasant sensations. Many people begin to take action on their own to get rid of the problem, resorting to remedies such as herbal tea, enema, etc. For some, these remedies allow them to completely cope with the problem, for some they bring only temporary relief, and for others they do not help at all . And then it is necessary to look for another solution. However, before looking for a solution to the problem, it is necessary to distinguish between two fairly similar concepts - irregular bowel movements and constipation.

Irregular bowel movements

It all starts with irregular bowel movements. To understand what irregular stool is, let’s go backwards and define what regular stool is. It is considered normal when bowel movement occurs at least once a day1. According to modern physiology, only 8% of healthy people have stool less than once a day. Thus, 92% of practically healthy people have stool at least once a day1.

The frequency of bowel movements is influenced by the amount of fluid consumed and the type of food. The use of refined, purified, ready-made factory products provides the digestive system with only easy-to-digest substances and little fiber. As a result, bowel movements may become less frequent than usual.

Separately, it is necessary to highlight the problem of irregular bowel movements during pregnancy. Less frequent trips to the toilet may be associated with physiological changes in the body. Hormones that promote a relaxed state of the uterine muscles and maintain pregnancy can cause a decrease in intestinal muscle tone4. In late pregnancy, mechanical compression of the intestine may occur4. Irregular bowel movements may persist after childbirth. Since the work of a woman’s entire body is aimed at bearing and giving birth to a healthy child, other body functions may suffer for the sake of this goal.

Causes

The most common cause of constipation is a nutritional factor - dietary habits. This problem concerns many adults in the modern world: the frantic pace of life and irregular food intake, the predominance of refined, soft, ready-to-eat foods in the menu - all this leads to a delay in bowel movements and changes in bowel activity.

Researcher Rykova in her work points out that “improper nutrition can provoke the development of constipation, which develops as a result of a decrease in the volume of food and water consumed, a decrease in dietary fiber in the diet, excessive consumption of animal proteins, as a result of increased extraintestinal fluid loss (polyuria) "(Rykova S. M., 2022, p. 28).

Other common reasons include the following:

• irritable bowel syndrome (IBS);
• structural and other disorders of the intestinal structure: lengthening or shortening, strictures (narrowing), etc.;
• anorectal disorders: anal fissure, hemorrhoids, etc.;
• gallbladder disease;
• metabolic disorders, endocrine and neurological diseases;
• systemic pathologies;
• chronic intoxication, etc.

An unhealthy lifestyle is a serious risk factor for developing constipation. This may include consciously suppressing the urge to defecate when a person does not have enough time or is not able to calmly visit the toilet.

Lack of movement also leads to delayed bowel movements - sedentary work or prolonged bed rest due to illness, injury, etc.

Doctors emphasize that constipation can be a side effect of taking certain medications.

This also means that constipation may occur due to the small amount of water consumed daily.

For example, researchers Ismailov and Skvortsov provide the following data in their work: “This is most characteristic of atropine, narcotic drugs, some anticonvulsants (difenin), calcium bicarbonate (baking soda). Psychotropic drugs (tranquilizers, antidepressants), some diuretics, iron preparations, aluminum hydroxide (Almagel) can cause constipation" (Ismailov I. Ya., Skvortsov V. V., Fedotova I. V., Kalinchenko E. E., 2016, p. 16).

Constipation

Being sensitive to your health can often help prevent irregular bowel movements from turning into constipation. There is a very fine line between constipation and irregular bowel movements. Many people focus only on stool frequency, overlooking other important symptoms. If nothing is done, constipation may develop.

The following symptoms are typical for constipation2:

• prolonged and fruitless straining,
• lumpy or hard stools
• feeling of incomplete emptying of the intestines,
• bowel movements less than three times a week,
• soreness.

Those who exhibit several symptoms at once should be especially careful. If constipation continues to bother you over the past three months, and the first symptoms appeared at least 6 months ago, we can say that the problem has become chronic3.

The leading symptoms of the problem are not the frequency of stool, but unproductive urges, incomplete release and excessive effort, as well as increased time for this process. However, stool frequency may remain normal. For this reason, many may underestimate their condition and not start treatment on time. Just look at the statistics. Constipation affects up to 40% of the population in developed countries4. During pregnancy and the postpartum period, up to 50% of women encounter this problem4.

I didn't have a bowel movement for two days. It is very dangerous?

People come to our clinic with this question very often. But we have an answer for you that will help you save time and money: there is most likely no health risk. Details are in the article.

In fact, the need to visit the toilet varies from person to person. Most people go to the toilet 0-4 times a week, but the frequency can vary from three times a day to three times a week.

As a rule, bowel retention for two days is normal. The biggest threat to your health in this situation is a feeling of slight discomfort. Most likely, you will soon be able to go to the toilet without additional treatment.

However, if you are used to visiting the toilet at least three times a day, you should listen to your feelings - perhaps you are constipated.

Most doctors consider constipation to be a situation in which:

• the person defecated less than three times a week
• feces are dry and hard
• bowel movements are painful or require effort
• after visiting the toilet there was a feeling of incomplete bowel movement.

There can be many reasons for constipation - from lifestyle and nutritional habits to medications and hormonal changes in the body. For example, pregnant women often suffer from constipation - hormones that relax the intestinal muscles are to blame for this, and the pressure of an enlarged uterus on the intestines also contributes to constipation.

However, for most people, the causes of constipation are much more commonplace:

• lack of fiber in food - this is typical for people who eat few vegetables and fruits
• consumption of dairy products - milk and cheese in large quantities can lead to constipation.
• dehydration - this happens if a person has lost the habit of paying attention to thirst and does not drink enough water, so that the stool turns out to be too hard.
• sedentary lifestyle - people who work in an office spend most of the day at the computer. But our body is not very adapted to this: the abdominal muscles also take part in the movement of food through the intestines (doctors call it “peristalsis”). People who move frequently and a lot are less likely to suffer from constipation than those who are sedentary.
• changes in lifestyle - such as travel, unfamiliar foods, or other short-term stress.
• regular abstinence - if you often have to “wait” before going to the toilet, the urge becomes weaker and the likelihood of constipation increases.

Sometimes constipation is associated with medications. These can range from relatively harmless antihistamines and over-the-counter painkillers like ibuprofen to “serious” drugs like strong painkillers and antidepressants. If, after starting treatment, “pill” constipation begins to occur regularly, tell your doctor about it so that he can adjust the dosage or replace the drug.

If stool retention lasts only two days, the problem, as a rule, can be solved without the help of a doctor. For this it is usually enough:

Listen to yourself. It is important to understand in time that you want to drink or go to the toilet. To do this, it is sometimes useful to take a break from work. During a break, you can drink tea or coffee - these drinks also improve bowel movements.

Increase the amount of fiber in your diet. The recommended amount of dietary fiber is 20 to 35 grams of fiber per day. For most people, a couple of apples, a serving of vegetables and a bowl of whole grain pasta will be enough. For constipation, citrus fruits and prunes, wheat bran, oat or flax porridge are especially useful.

It is better to increase the fiber content gradually - if you overeat on vegetables and fruits, you may get a stomach ache out of habit.

Move. Warm-ups and a daily hour-long walk are enough.

But you shouldn’t take laxatives on your own, even if they are sold without a prescription. There are 4 types of laxatives, they are designed to solve different problems, so choosing the right drug is difficult. In addition, drugs have contraindications, and there is a chance that the dosage will be incorrect, causing another problem - diarrhea.

If you have not had problems with bowel movements before, you should consult your doctor before buying a laxative. The doctor will explain which medicine to choose, in what dosage and how long it should be taken.

Schedule a visit to your doctor if lifestyle changes don't help and constipation lasts longer than three weeks.

There are situations when you cannot wait three weeks. Make an appointment immediately or call your doctor if you experience the following symptoms in addition to constipation:

• blood on toilet paper or in the toilet
• weight loss
• fever or weakness.

Treatment and prevention

It is important to prevent irregular bowel movements from becoming constipated, but to take control of the situation in time and help the intestines restore normal functioning. Don't wait for the problem to get worse. We need to act.

The main goal is to get rid of the disturbing discomfort, restore the normal rate of bowel movements and return stool without difficulty.

The result can be achieved by changing your lifestyle and eating habits. It is necessary to include foods rich in fiber in your daily diet. It is also important to monitor your water balance and consume at least 1.5 - 2.5 liters of fluid per day. It is recommended to eat more vegetables, fruits, berries, food bran, dried apricots, prunes and apples5.

However, in practice it has been observed that the diet may not have a lasting effect5. It is perceived not as a new lifestyle, but as a temporary limitation for relieving symptoms, which later leads to their return and the problem becoming more serious, chronic.

Normalization of stool is facilitated by increased motor activity, strengthening of the pelvic floor and abdominal muscles. It is also important to create comfortable psychological conditions for going to the toilet7. Calm, measured morning hours are the most optimal for the formation of stable urges in accordance with biological rhythms. However, sometimes the above measures are not enough to cope with the problem. Then laxatives come to the rescue.

Chair color

Norm

Normal baby's stool may be yellow, orange, green or brown!

Peculiarities

• The first 2-3 days of life, the color of the original stool, or meconium, is black-green (due to the large amount of bilirubin, also in meconium, intestinal epithelial cells, amniotic fluid, mucus).
• On the 3rd day, the stool is called transitional, it contains the remains of meconium, but it is already larger in volume and lighter.
• Then the color of the stool of breastfed children becomes yellow-orange, and of bottle-fed children yellow-green.
• At 4-6 months, various changes in stool color when vegetables and then fruits are introduced into the baby’s diet

Mothers are very often concerned about the sudden appearance of green stool in both breastfed and bottle-fed babies. With such sudden changes, you need to understand whether the child’s condition has changed, whether there are any complaints or whether he is calm, has a good appetite and is gaining weight well. After all, weight is a very sensitive indicator of the health of such a small child!

Our baby is calm, his appetite is preserved, and he is gaining weight.

Any change in diet changes the color of the stool. This happens if you:

• Changed the formula (refrain from changing the formula frequently, this is a big blow to digestion) - if your child tolerates this formula well and grows, just “grow” with it.
• Enter anyone! complementary foods, although the brightest colors come from fruits and vegetables in your baby’s diet. The color of the stool in this case depends on the color of the complementary foods - green stool when taking green vegetables (broccoli, peas and green beans), red when taking carotene-rich fruits and vegetables (carrots, pumpkin, peach, apricot), beets give a pink-burgundy tint stool, do not introduce it into the diet too early (before 10 months). There is a relationship between the color of the stool and the diet of a nursing mother, which is maximum when there is a large amount of fruits and vegetables. Therefore, do not panic when you see the green or red contents of the diaper, if there is no mucus or blood, but remember what new has appeared in your baby’s diet over the past day or what culinary experiment you embarked on yesterday.
• You give your child medicine (or the mother breastfeeds and takes medicine herself)
• Taking some medications changes the color of the stool: black color is associated with taking iron supplements and carbon sorbents; taking antibiotics (even by a nursing mother) often changes both the color of the stool (more green) and its consistency (more liquid).

If there are no other abnormalities besides the greenish color, then you have nothing to worry about.

The child's condition has changed: there is vomiting, no appetite, the stool is loose, contains mucus or even blood, the baby is quickly losing weight.

These are signs of an intestinal infection, its course is dangerous at this age, you should immediately consult a doctor!

Alarming symptoms, you should immediately contact your pediatrician!

• The stool of a child in the first month of life is white or very light (the color of “white clay”) - this color of stool, especially in combination with increasing jaundice and dark urine, may indicate a narrowing or underdevelopment of the bile ducts inside the liver, most often of a congenital nature. In this case, urgent consultation with a pediatrician, surgeon and additional examination are necessary. If an apparently healthy, previously older child develops similar symptoms, liver disease is likely, which is also a reason to immediately consult a doctor.

Preparations for normalizing stool and treating constipation

According to their action, laxatives can be divided into several groups:

• Irritating laxatives – tablets, suppositories, drops. They irritate intestinal receptors and cause increased peristalsis.
• Increasing the volume of intestinal contents are ballast substances (bran, flax seed).
• Helping to soften the contents - liquid paraffin, petroleum jelly.
• Osmotic agents increase the fluid content in the intestinal lumen (lactulose, lactitol, macrogol/polyethylene glycol).

All of the above groups of drugs have strengths and weaknesses (You can read more about the types of laxatives, their advantages and disadvantages in the article “How to choose the right laxative?”). However, to solve the problem, an integrated approach to treatment will give the best result. A combination of physical activity, proper diet, drinking enough water and the use of laxatives allows you to restore regular bowel movements and restore the joy of life3. To normalize stool and treat constipation, the optimal choice would be osmotic agents8, in particular the drug Duphalac®.

Benefits of Duphalac®

Duphalac® has a dual effect: it gently and comfortably cleanses the intestines, providing a laxative effect, and due to its prebiotic effect, the drug allows you to restore the balance of intestinal microflora and has a long-term effect in normalizing stool6,10.

Duphalac® has a favorable safety profile and is suitable for people of any age, as well as children from the first days of life, pregnant and lactating women2,10.

Duphalac® is the optimal remedy for chronic constipation and irregular bowel movements, since when it is taken, the intestines do not stop working on their own, and it can be used for as long as necessary9,10.

RUS2132194 from 07/21/2020

Co-author of articles, editor - Shimbaretsky Georgy Alekseevich.

Symptoms and manifestations

Constipation is accompanied by various symptoms depending on the reason for which it occurs. In rare cases, stool retention is the only worrying sign.

The rhythm of bowel movements varies from person to person. Therefore, it is difficult to call constipation a bowel movement that occurs once every 2 days, if such a rhythm is natural for a person and persists throughout adult life, and there are no alarming symptoms.

Constipation is defined as having a bowel movement less than once every 2-3 days. Other symptoms include abdominal discomfort and the need to strain.

It is worth noting that defecation during constipation can be daily, but at the same time a very small amount of feces is separated (less than 100 g), and the feces themselves are dense, dry, fragmented (the so-called sheep or bean-shaped feces). When the intestinal lumen is narrowed, the contents may have a ribbon-like shape.

In some cases, a symptom of constipation is stool with mucus. With a long delay in emptying, diarrhea develops, and the feces will be heterogeneous: the first portion is dense and compressed, the second is liquid with mucus.

With constipation, abdominal pain of various localizations, a feeling of discomfort, pressure, irritation, and heaviness most often occur.

In irritable bowel syndrome, constipation is accompanied by pain, especially before bowel movements. The pain subsides after natural bowel movements or emptying as a result of taking laxatives. Stool retention is often accompanied by flatulence - increased gas production, rumbling in the stomach, frequent passage of gas, and bloating.

It should be understood that a large amount of gases aggravates the problem and slows down the movement of feces through the intestines.

With chronic constipation, symptoms of general intoxication sometimes develop, which is associated with constant poisoning of the body by the decomposition products of feces. Many patients note decreased appetite, fatigue, headaches and dizziness, unhealthy complexion, dry skin, decreased mood, nausea, lack of appetite, deterioration in performance and concentration.

With a special character, sleep disorders, neurasthenic disorders, suspiciousness and anxiety often develop.