A Common Problem
Did you ever have one of those older relatives in your life that emphatically asked you whether or not you had your daily bowel movement (BM) yet? The ones that would swear the key to staying healthy is simply having a BM every day. This was the mentality not too long ago. Before we had all of our fancy testing and research revealing the importance of gut health, our ancestors knew that to stay mentally and physically fit, you needed to stay regular. Unfortunately, these words of wisdom that have been passed down from generation to generation have all of a sudden lost their meaning, leaving a significant portion of our population struggling with accomplishing one of the most basic tasks; having a regular BM. In today’s blog, I will explore a common problem many of you may suffer from, gastrointestinal dysfunction. I will highlight why it is important to have a healthy digestive tract while giving tips on how to get to the root of your symptoms.
A common diagnosis many of you are probably familiar with is Irritable Bowel Syndrome (IBS), a problem affecting an estimated 20% of the U.S. population1. For those of you who are not familiar with IBS, this is the diagnosis the majority of people will receive from their doctor or gastroenterologist when they complain of bowel related issues. The table below lists the criteria needed to receive an IBS diagnosis.
The problem with an IBS diagnosis is the fact that it doesn’t help resolve much of anything. Sure it allows your practitioner to place a new diagnosis code into your chart and prescribe a few prescriptions like Miralax or Imodium to cover up the symptoms, but it does almost nothing for answering the question why. Why am I having abdominal pain, gas, bloating, and change in stool frequency and appearance? This is the piece that all too often gets left out of an IBS diagnosis leaving people with a name to blame but no real resolution.
How Should I Poop?
So let’s talk about how your bowel movement should be. What is normal? The majority of medical professional’s normal is any scenario that sits outside the criteria for abnormal, which would be constipation or diarrhea. Constipation is described in the medical community as having fewer than three bowel movements a week with diarrhea occurring when a person has frequent loose or watery bowel movements2, 3. Anything outside these definitions is typically considered “normal” and gains little attention from many health care practitioners. I don’t know about you, but if I am having any watery bowel movements or only having three BM’s a week, my life is miserable! At the beginning of each appointment, my patients all fill out a symptom tracker form which asks them to rate their symptoms for multiple body systems on a scale of zero to four. This allows me to see what symptoms and problems people are having. It amazes me how many people come into the appointment claiming they have regular bowel movements on their symptoms tracker, then proceeds to tell me they have three bowel movements a week, or better yet, four bowel movements a day! Let me be the first to say, despite what you have been previously told or brought up to know; THIS IS NOT NORMAL! Ideally, you should be having one to two soft bowel movements a day that are smooth and snake like in appearance. There should be no pushing, straining, bleeding or discomfort; and if there is, something needs to change. One of my favorite pictures to show people is the Bristol Stool Chart. As you can see in the chart below, there are several ways your poop can present itself, but the one you want to shoot for is Type 4. If you vary too far in either direction, something is off.
The Importance of a Healthy Gut
The reality of bowel habits is the fact that they are a relatively good indicator of your overall digestive tract (gut) health. As research continues to develop and technology becomes more advanced, we are learning just how important the gut is to orchestrating general health. In fact, some are now calling the gut “the second brain” because of the enteric nervous system; a complex network of over 100 million nerves located in the lining of the gut that play pivotal roles with immune, neurological, and endocrine functions throughout the body. The gut is home to at least 70% of the immune system and is a significant player in detoxification which allows the body rid itself of problematic chemicals, toxins, and cellular by-products. Digestion and absorption of proteins, healthy fats, carbohydrates, minerals, and vitamins all depend on the health of the digestive tract. The gut is also the manufacturing site for over 90% of the body's serotonin, the happy neurotransmitter that plays a crucial role in mood, memory processing, sleep, and cognition. One of the most rewarding aspects of my profession is to see people reverse depression, anxiety, insomnia, and a host of complications that many people have battled for years simply by addressing the gut.
What Could Be Causing My Gut Problems?
There are a variety of culprits to consider when trying to identify the root cause of digestive dysfunction. The three things I find most valuable when trying to determine the source of gut problems is a person’s story and symptoms (which is why the initial appointment is 80 minutes in length), targeted testing (both conventional and functional), and a physical exam. One of the most frustrating things about gut dysfunction is the fact that multiple problems can cause similar symptoms. That is why it is so important to know what you are treating before you treat it. I have seen many people spend a substantial amount of time and money inaccurately treating infections or conditions they assumed were present based on symptoms. Testing is a big investment in the beginning but can save you a lot of misery and frustration in the long run.
The chart below lists a few of the more common sources of gut complications that I have come across when working with patients. These may be worth investigating if you are having trouble with your bowels. If time permits, is always best to start with the least invasive most cost-effective intervention first, diet.
As you can see, there are many sources of gut dysfunction, and believe it or not, this list is only a small portion of the possibilities. IBS and digestive dysfunction are common issues in our society that can take an enormous toll on both your overall health and quality of life. Band-Aid solutions like Miralax, Imodium, and Metamucil are not acceptable long term solutions and do not have to be your fate! If you or someone you know is suffering from unresolved digestive problems and want to work to identify why they are there, please call GrassRoots Functional Medicine at (888) 644-7668 and set up an appointment. We have a new location in West Lebanon, New Hampshire and a second location in San Antonio, Texas. I would love to partner with you on your journey to optimal wellness.
In good health,
Dr. Seth Osgood DNP, FNP-BC, IFM-CP
About the Author: Dr. Seth Osgood is a Doctor of Nursing Practice, Board Certified Family Nurse Practitioner and Institute of Functional Medicine (IFM) Certified Practitioner. Dr. Osgood received his post-graduate training in Functional Medicine through the IFM and from working with Dr. Amy Myers. He has helped people from around the world improve their health utilizing a Functional Medicine approach.