Well pain has slowed me down this week, and last not to mention a massive amount of doctor appointments. Looks like I will likely be going in for a hand surgery soon for Carpel Tunnel, caused by CRPS. It has slowed me down a bit, but I will always keep on truckin’!
This is a lot of information again, could be information diarrhea, but you know how I do. *z formation snaps* So here we go!
Everybody poops, so lets just get that part out of the way. Normally, as the saying goes, “shit happens,” but what if it doesn’t happen? I have recently been asked, as discretely as possible sometimes, about these and other gut issues, so I thought it might be time to share some knowledge about a difficult to discuss subject. We must get over it though, constipation happens, it could be due to digestive issues, poor diet, not enough hydration, post-surgery, digestive disorders, or in the case of chronic pain sufferers, a side effect of most medications available, as well as lots of other disorders. How long is “too long” before not pooping is an issue? How do you remedy or, hopefully, prevent such issues? Is there such thing as a “bad” sort of poo? Are there different positions for pooping that you can use to not over strain yourself? What to do about this is usually a very private issue, alluded to in silly commercials for harsh chemical laxatives, but never really discussed? Drag it out into the light of course! So lets get started, here is a simple image to give you a general knowledge of what most poos are made of, and some general color references. This is a great image for a quick reference for the scoop on poop.
The Whens, Wheres, & Whys of Pooping
The Whens & Wheres
The history of where ancient peoples had a poo, and what social do’s and don’ts existed around them were, usually, for valid reasons. So of course, since you know I love all things historical, here is a somewhat brief history of bathrooms, which is more important than you think. Water toilets we think are a modern invention, but using water to move waste away either through using naturally occurring water resources of human built plumbing has been a way to get waste that if it sat around could bring disease, away from the areas where people lived. The first known flushing toilets were from the Indus valley region in India, and date as far back as about 2600 BCE. Greece too had water driven toilets found in the ruins of the Minoans on Crete. Romans too had toilets where waste was washed away by water, they were though much more communal and rich and poor used them…and possibly had a chat.
They used most likely a sponge attached to a stick, dipped in water (or vinegar, depends on who you ask) from the trough in front of each seat. The rich apparently carried their own, but if you were poor you made due with the communal one. Possibly the origin of the phrase “short (or shit) end of the stick,” as you would want to be very aware of which end of the stick was grabbed when it was passed to you. There has also been a recent articles about alternative wiping options. But there isn’t 100% evidence this is actually what these pessoi were used for, and they do not seem like they would be friendly to your neither regions if used. Other than sponges on sticks, leaves, sticks, even hands and possibly the aforementioned pessoi been used to clean up after a good poop. But you can all breathe a sigh of relief and thank China for inventing toilet paper. Paper has existed in China, as we would know it, since the Han Dynasty.
It was first recorded there that paper was used for toilet purposes in about 875 CE. There is even a quote from Yan Zhitui, a government official and scholar, said –
So there are limitations culturally for what can and can not be used as toilet paper, since this would be dishonorable. Finally in Europe the privy or garderobe, which was basically an outhouse or latrine, was first improved upon by Queen Elizabeth’s godson, Sir John Harrington, invented the flushing toilet. Which was used only by the Queen really after it was made, most people used toilets that were built over rivers so water again could carry waste away. They looked much like this –
Or were sometimes built like a bridge over the river. Obviously, this is not an optimum waste disposal method. This led to a lot of issues with diseases that travel in tainted drinking water. Once it was proven that clean drinking water was key to a large amount of disease prevention, you start to see more sanitary conditions improving across most countries. Oddly though sanitation in large palaces, like the infamous Versailles, had no sanitation. Puts a real different spin on the place when you realize all those fancy French nobles were having a wee and possibly a poo in the corners. Most rooms came equipped with a chamber pot, which in many fancy castles and noble houses was all you had even if you were Queen Victoria. If you were a lady things were often more difficult, with all that fabric taking it off or lifting it all up was not really an option. So the bourdaloue was invented, you lifted just enough of your skirts to place it between your legs, clasping it firmly with your thighs you could have a wee under all that fabric at a party, and no one would be the wiser. Not so great for poos though, some women were said to straddle a chamber pot.
A lot of them had seats, most were just a hole in a board over a hole, or a stool with a hole over a bucket. They were very much like the latrines you may have used while camping, or a port-a-potty type thing. Very smelly, and rather unfortunate if it is your job to manually clean it out. Interestingly, when these were covered over and left, they are sometimes found by archaeologists, who also dig out sewers (never saw Indiana Jones sifting through poo did you?). The reason being is that a lot of information can be gleaned from a civilization’s leavings. Undigested seeds, or other plant or animal matter, was passed and can tell us a lot about diet, and general health of the population. Diseases present themselves in poo, so you can get a great snapshot at diseases that occurred and sometimes the demographics of who got it (ie: only the poor or a certain area had one type of disease, while others types appear elsewhere). You can also find a lot of interesting things that people happen to drop, rings, pottery, jewelry, coins, and many other things that happen to fall in, for us to find in modern excavations.
A lot of them in early Europe and Asia didn’t have seats and then evolved into using them later. You get the term stool for poo from the position of Groom of the Stool, who had the honor of wiping the King’s rear after a poo, since he had a fancy stool to sit on while he went. Not a job I would be knocking over people to get to, but if you were wiping the King’s rear, you were also able to get his ear. And influence on the King was, well a coveted thing at most courts. Yet only Asia has brought the past into the modern day, Asian countries employ what is dreaded by most Western tourists – the squat toilet. Or as many call them squatters.
Squat toilets could actually be quite forward thinking, for your back-end. It seems that like along with the birthing canal, the muscles that allow you to poop work in concert with gravity in a squatting position, so it may allow you to more easily pass things, and could prevent injury from over straining like hemorrhoids and other issues. It may also be a good position if one is constipated. Currently some countries are a bit more open about pooping. Germany has poop “shelves” (extremely well described by the linked blog) in their toilet to allow for proper fecal inspection, since a good poop is the key to good health in a lot of ways. Which is not incorrect, noting the amount, consistency, and other aspects of what you pass can be a key to monitoring and maintaining good health (which we will go over further down). Other countries are even more relaxed about poop, in Japan the word for poop sounds very close to the word for luck and there has been a whole market formed around lucky golden poops.
But even in Japan there was a serious crisis with women using too much water during bathroom visits, due to flushing repeatedly to hide the sound of bodily functions. Which lead to the creation otohimes, or sound princesses, which has a recorded flushing noise to cover any incriminating sounds. Inspired by a princess in the nebulous past that feared sounds being overheard as well, and had a maid drop stones in water while she was “indisposed” to cover any audible evidence.
The Whys of Pooping
So now you know the wheres of pooping, so now to understand the whys of pooping. To do that we need to understand the whole process, and why its important. So you gotta start at the top, the digestive tract is one big tube that goes from the mouth (and nose if you want to be technical) down through the esophagus, which chewed food travels down. Food moves down the esophagus, made of smooth involuntary muscles, using a wave like muscle action called peristalsis, aided by saliva and mucus that lines the digestive tract. Mucus is a large part of the digestive tract, think of it like the oil in a machine. Mucus helps everything move, and protects the stomach tissue from digestive juices, and does other things in other systems in the body but we are mainly concerned with digestion. Mucus is extremely important, like I said, oil in a machine, no oil machine stops. So to make mucus, you have to be hydrated also if you remember the first image, poo is mostly water. If you aren’t drinking enough water there is not enough mucus, and if you don’t have enough water a good poo can’t be properly formed, or moved along. Lack of proper hydration can be the source of your issues when you can’t poo a lot of the time.
The food moves to the stomach, the stomach is a muscle-y sack that has gate keepers at the beginning and end. The gate keepers are sphincters that allow food in, and food out in measured amounts. Food once it enters is broken down by the digestive juices and the muscle action (it sort of squeezes things to help turn things to a soupy food slurry) then, through the next gate keeper sphincter to the U shaped duodenum. Then more peristalsis as it goes through the small intestines. There is nothing small about them though when it comes to their importance in the digestive tract. It is where a lot of absorption of nutrients happens by the velvety covering of teeny tiny little fingers, called villi, that line the intestinal walls, and increase in surface area aiding in nutrient absorption. Small intestines are the home of gut flora. Gut flora you may have heard of, since probiotics are a huge thing these days…or at least it is if you are Jamie Lee Curtis.
Gut flora is basically a symbiotic relationship, that means we both benefit living with each other. We don’t actually know what all the gut flora bacteria are, they actually differ between humans and are difficult to grow in a lab culture. But what we do know is they are vital to having proper digestion as well as your immune system. There are some theories being bandied about lately that lactose intolerance, IBS, and other digestive/immunological disorders could be increasing in the population is due to the over use of antibiotics, which can kill gut flora. You kill all bacteria, even the good guys, and sometimes the cure is almost as dangerous as the illness.
So since we have all been on some antibiotics, it is important to try to restore as much of that good gut flora as you can, one way is actually with yogurt. You have to make sure you are eating yogurt with active cultures, so that would be traditionally made yogurts or if they are added they will note so on the label. Probiotics have helped my husband with his rosacea, by keeping it from spreading and reducing the redness, and has even helped my dog who has an issue with an overgrowth of skin flora, yeast (its not bad or contagious, its only real side effect is making her smell horrible). This happens due to a lack of bacterial checks and balances, bacteria need other types of competing bacteria to keep things in balance (circle of life and all that jazz). So eating yogurt you get lactobacillus, a type of bacteria we know is in the gut, as well as in dairy and some fermented foods. Eating home made fermented foods is also another way to get this bacteria into your system, things like kimchi, pickles, and pretty much any fermented food will have this bacteria. If you are hip and now, you probably have seen or heard of kombucha, it is a drink made from tea fermented with a symbiotic culture of bacteria and yeast (SCOBY). This is an excellent way to return helpful bacteria to the gut, and it is super easy to brew at home (instructions and recipe later).
Finally after all the nutrients have been absorbed and all food matter further digested by the gut flora, food moves into the large intestines, or colon. This is where the poop happens, this is where water is absorbed back into the body, the waste has now become less a slurry and more a thick mash, and all that good bacteria starts to ferment it so any other fat-soluble vitamins (Vitamins K, B12, B1 & B2) can be absorbed, as well as any remaining and necessary salts. The large intestines are large in circumference, and not length, it is ¹/5th the length of the small intestines. After moving through the colon, the food you have eaten has become, poop. When it has become poop, it must be stored until it can be passed through the anus, and it is stored in the rectum until its ready to go. If you ignore the signal that it is time to poop, it is sometimes returned to the colon and more water is absorbed, which could cause the very bad issue of hardened poops and again, constipation. If it is listened to it will be passed into the anal canal and then out through the anus, that’s it.
What exactly is constipation, and what do I do about it?
The What of Constipation
Well, to understand this we need to whip out the ol’ Bristol Stool Chart, which is a chart from the University of Bristol. It is a tool to help clinically discuss the nature of your poo, and it is a simple classification chart to help patients, and doctors effectively communicate poo status. Remember the poo shelf? Poo really is important for health! You should always take a look, to make sure your poo is good poo because “bad” poos could indicate all sorts of issues. If you want a good break down of the when to, and when not to, freak out about your poo, check out the article here. Poo is an extremely effective way to keep an eye on the over all health of your body.
So back to that stool chart.
So as you can see it describes the entire poo rainbow, and gives an effective and less “icky” way to describe poos. Also it gives you a general outline of what is good and bad poos. I say general since type 1 and 2 are considered constipated, but if they are easy to pass and don’t fit the other criteria of constipation it may just be you aren’t drinking enough water, or didn’t go soon enough or something like that. 3 and 4 are considered ideal, the 4th being most ideal while anything after that is considered diarrhea which is a whole different kettle of fish. So what are the other symptoms with types 1 and 2 that show it is constipation?
- Straining with more than a quarter of the times you go
- Hard poo (that’s type 1)
- Feeling of a partial poo, like you may not have pooed everything.
- Sensation of a blockage, or that things aren’t able to pass
- Fewer than three poos a week
If you have these symptoms and types 2 and 3 if you are able to pass, you my friend probably have constipation. No I am not a medical doctor, so remember if you try any over the counter and natural methods and you don’t have results in a few days, you need to contact your doctor.
The Hows of Fixing Constipation
There are simple things to do to combat constipation if you have or could have it.
Drink lots of water.
Seriously, do it. Most of us don’t drink enough water with all the sugary juices and sodas around, plain old water gets boring. I carry a bottle of water everywhere with me, I’ve used metal and other types but my favorite has been my rubber jacketed reinforced glass Zulu bottle. It is glass, so non-reactive, and surprisingly durable, considering I’ve dropped it at least 3-4 feet a few times and it bounced instead of breaking. Also if you want to add essential oils to your water
Any water bottle will do, glass, metal or BPA free plastic (it is worth it just to be on the safe side). You can always jazz water up infusing it with things like fruit and herbs, mix it up go wild. Have a basil and watermelon water (you can puree a watermelon and freeze it as ice cubes and drop those and fresh basil into your glass or pitcher), lemon balm and black berries (you can do the same as watermelon juice, with any fruit really). You can also add small amounts of essential oils to water, no more than 1 drop per 8 0z of water at first, and you want to make sure that you are getting oils that are safe to ingest. Make sure to do your own research, oils are unregulated so be careful about what quality it is of the stuff you put in.
Get lots of fiber.
I probably couldn’t sound more cliche I know, but with all cliches there is a granule of truth. It is so very important to eat lots of leafy greens, and fruits and just vegetable matter in general. Fiber is basically plant celluloid that cant be digested and acts as an internal broom to sweep things out more easily. It is important to get enough of this in your diet to make sure you poop good poops, on the regular. Making sure to get your daily recommended amounts of fruit and vegetables should cover you, if you want to eat more leafy greens great! Eat raw, I rarely recommend a purely raw diet, but for few days raw veg is a great way to give the bowls a kick start.
There are all sorts of fiber supplements and other things like, Grape-Nuts, bran muffins, and Metamucil to name the most famous. You may want to find one that works best for you with some trial and error if you choose to go the supplemental route. It can be a good way to get additional fiber if you are already eating your roughage and things aren’t moving along as they should. There are a lot of natural, and chemical dietary fiber supplements, but fresh is always best in my opinion. Just make sure to do your research, and try a few different brands, everyone and every brand is different. What works for your friend, may not work for you. One size never fits all.
No fooling. Get out and take walks, swim, run if you are able to. Any work out that just gets the blood moving helps to get that gut moving. If you are post-surgery and they “put your gut to sleep” this is a good way to go, even if your movement is limited. Walking as much as you can stand can get things going. So if poo seems a no go, go talk some exercise to help you go. There is also some Yoga to do to help with constipation, this is a good quick-start, but you may want to dig deeper and do more research if this appeals to you. T’ai Chi Ch’uan and Qigong are also good exercises to do, even walking, can stimulate things enough.
Massage the Abdomen
I have seen overall 2 schools of thought on this, first one is to rub in large circular motions from right to left on the abdomen. The other is to start where the appendix is (think lower right quadrant of the abdomen), then make small circle motions working up to (the top right quadrant) just under your ribs on the right, across the top to the other corner on the left, down to the top of the pelvis (or lower left quadrant) and then across and back around again. This is supposed to help stimulate the colon’s muscles to start contracting and sending things along. There are tons of massages and things listed if you google “massage for constipation” look around try a few see what works for you. If you ever feel severe pain doing this stop, and call a doctor.
If you are eating fiber, probiotics, hydrating, and your green roughage and you still aren’t going you may need to start trying some natural laxatives. Some fruits, herbs and vegetables on their own have laxative properties that you can take advantage of that help get things going when you don’t want to use a harsh, possibly cramp-y, laxative. A lot of foods are just naturally rich in fiber, or have laxative properties I don’t fully go over but I would like to list since they are all good additions if you are looking for relief. Things like: flax seeds, raisins, beans, leafy greens, banana, bran, peaches, broccoli, raw carrots, etc. These are just a few, but of my favorite ones are:
- Apples – Apples, they are the quickest and easiest laxative around, and so so very simple. All you have to do is get an apple, any type, and cut it into slices, leave it out for a bit til it gets brown. Then eat it. That is all, gotta love simplicity! You could also opt for unfiltered apple juice, or cider, since this will also have the same effect. Although it can cause some foul wind in some digestive systems.
- Prunes – Another simple fix is prunes, I love, love, love prunes. I was very small, maybe 2 or 3 years old, and ate a whole bag of them I found in the fridge door. I soon found out about their strong laxative effect, yet this has not diminished my love for prunes. They are an underrated fruit, reserved for “old people.” But they are so good for you, and a wonderful way to help get things going. Also fantastic kolache flavor, try it if you have a Czech bakery near you. Prune juice is also a great option, a glass or two will get things moving.
- Figs – Then there is always figs, which are not only tasty but also like prunes and apples, a good natural laxative. Dried or raw figs are a natural stool softener that can help loosen things up enough go get you going. I really like grilled fresh figs, grilled until soft with just a dollop of marscapone cheese on them it makes this medicine that is actually a treat to eat. You can also make a syrup I will list a recipe for later.
- Rhubarb – Rhubarb is a natural laxative too, and great cooked up with some strawberries in jam or in a pie, or just sliced and cooked in some honey to pour over ice cream or into a drink (like some hot or iced green tea). You can even take apple or pureed strawberries and pureed rhubarb, (with a bit of water to loosen things up to drinkable level if needed) and make a drink out of it.
- Fish Oils – Fish oil and cod liver oil are both great laxatives, fish oil is generally easier to take since it comes in capsule forms, and is found in grocery stores more often than cod liver oil. Cod liver oil is found in most health food specialty stores and is extremely fast acting (do NOT take this at bed time!) and a ½ to 1 teaspoon a day should be enough to get things going, too much can actually damage your GI tract so be careful with this and don’t go overboard.
- Water – I can not say enough, drink a lot of water. Hydrate, hydrate, hydrate. It is thought that if you drink room temperature, or even just warmer that it will help with things a little more. You can also put half a lemon’s juice in water and down it, that may get things started. As well as the previously mentioned way of adding fiber to your drinks.
- Caffeine – A good old cup of coffee is also a pretty good way to get things going, or if you aren’t a coffee drinker a strong cup of black tea since caffeine is a laxative. Moderation must be cautioned, too much of this can definitely be a bad thing.
- 1 cup Whipping Cream
- 1 tablespoon Plain Yogurt (probiotic of course)
Place yogurt in cream and set in undisturbed area in 73º F, since it is getting hot I create my own cool with ice packs. Leave for 16 to 24 hours, I like to just dump it all in my stand mixer, and cover it so nothing falls in, and whip with a paddle attachment. I set it on the speed above stir, and just leave it. If you have a splash guard, use it. This can get messy if there’s splashing. When you hear a sloshing sound that means its done, you will have the buttermilk which you can strain, and save. I use to make biscuits, but you can do loads of other things with it (though nothing is better than hot buttermilk biscuits so I don’t see why you would make anything else). You will want to put the butter that is in lumps in a bowl and smush it while holding the bowl at an angle and squeeze the liquid out. Rinse it occasionally, with cold water, and keep working the butter until the liquid from it runs clear. Add a half a teaspoon of kosher salt if you want for preservation, and there you go butter! You can whip it for fluffy spreadable butter and store it in a butter bell, or a tub. Or you can put it in wax paper or plastic wrap and roll it into shapes (just make sure to poke any bubbles with a toothpick or pin) and refrigerate, or even freeze it. You can double this for a 2 cup log of butter as well. Not an extreme measure but a great additional way to get probiotics than yogurt, kombucha or pills.
Fig and Date Jam
- 1 cup Prunes (pitted)
- 1 cup Dates (pitted)
- 1 cup Boiling water
Chop dates and prunes into small pieces, smaller the better, and place in water and bring to a boil. Cook until a thick consistency and then throw it in a jar, and store in the fridge. 1 tablespoon a day should get things done, and it is super good on toast from home made bread.
Epsom Salts are another way to get relief, generally the package will have amounts for oral doses, speak with a doctor especially if you want to venture to other orifices for dosing.
If all of the other methods have failed you it is time to move on to these recipes.
Dandelion Root Tea
- 1 ounce of Dandelion root, pounded
- 6 cups water
You must be starting to get desperate to resort to this, and the other teas, dandelion root tea is pretty horrible tasting. But it does the job. This will yield 4 doses, and you will want to pound the root until it just breaks a part a bit, don’t make a mash of it. Simmer it in the 6 cups of water until it has reduced by half. Drink 3/4 of a cup warm a day.
I got this next recipe from Jimmy Wong’s Grow Your Own Drugs series. It contains senna pods, this is a relative of cassia, you can use senna leaves but use only a few as they are far more potent than the pods.
Syrup of Figs for Constipation
- 18 grams (.6 oz) dried Senna pods
- 100 milliliters (3.4 fluid ounces) Boiling water
- 8 fresh figs, quartered
- 100 grams (3.5 ounces) Sugar
- Juice of 1 lemon
“1. Place the senna pods in a glass bowl and pour over the boiling water. Leave to steep for about 30 minutes, then strain through a sieve or piece of muslin into a blender.
2. Add the figs and sugar to the senna infusion and whizz until smooth.
3. Pour into a saucepan, and heat slowly to reduce, stirring occasionally. You want to end up with a thick, glossy sugar-like syrup – this will probably take about 25 minutes. Add the lemon juice and stir in well.
4. Take off the heat and pour the syrup into a sterilized 150 ml bottle.
USE: Shake well before use. Take 2 tsp before bed when needed. Don’t use for more than a few days at a time, or if you have severe abdominal pain.
STORAGE: Keeps in the refrigerator for 3-4 weeks.”
You can also make a senna pod tea, it is pretty powerful stuff so this should really be a last resort. Senna has been used for generations in Chinese herbal medicine, but it still should be used with caution and respect. There are also pre-made preparations from teas, to suppositories that carry senna extracts as well.
Senna Pod Tea
- 100 grams (3.5 ounces) of senna pods (half as much if you use leaves)
- 16 ounces Boiling water
- 5-10 medallions of Ginger (for taste and to ease some of the cramping)
- 3-5 drops Fennel essential oil (or 3 or 4 fennel tops of about 3-5 inches)
Steep for 3-5 minutes in a covered tea pot, and drink about 8 ounces, if you need a stronger tea let steep for longer. But the longer you steep it the stronger this will be when it comes to cramping.
If you don’t want to opt for that, you can always go with cascara sagrada, sacred bark, this is another one that you will find in a lot of pre-made preparations, but if you want to make it at home make sure you purchase just the dried bark, fresh bark could cause intestinal bleeding, and can severely irritate existing digestive issues, like Chron’s or IBS. Make sure if you have an existing digestive tract issue to discuss this option with your doctor first.
Cascara Sagrada Bark Tea
- 1 teaspoon of Cascara Sagrada bark (well dried)
- 3 cups Boiling water
Steep in a covered teapot for 30 minutes, and drink a warm cup before bedtime, possibly 2 cups if you had the first the night before and nothing happened. Again, use this with caution, and all other herbal medicines.
If all of these fail, you may want to move on to chemical laxatives, which WebMD has a good breakdown of each here. You can also try enemas, which are not my favorite thing since you should pretty much be ready to feel like you are peeing out of your ass, and it may not even fix things. After a surgery or in an extreme situation though they may be necessary. If you have not had a poo in two weeks or more, you need to consult your doctor and manual removal may be required. Which is unpleasant for all involved. Make sure you always answer the “urge” when it calls, and take care to look at your poop more often. It is way more important than you realize.
Remember, I am not a medical professional, consult your doctor before embarking on any drastic treatments, especially if you have any digestive disorders. As always, if you are in any doubt about anything whatsoever, ask a professional!