Do unruly bowels affect your life? Or are you just wondering whether your bowel movements are normal?
When was the last time you experienced ‘poophoria’ – a term coined by experts to describe the feeling of elation and inner peace following an easy-to-pass and fully relieving bowel movement?
If you’re one of the 6.5 million people in the UK who have a bowel problem or the one in seven adults who have constipation at any one time, probably not recently.
In her new book, registered dietitian Tamara Duker Freuman aims to help readers reach ‘poophoria’ and achieve regular bowel movements.
That’s a pretty huge promise, so just how will she do that?
The aptly-named Regular recognises there is no one-size-fits-all approach to restoring bowel regularity. Instead, it aims to guide you in identifying the specific cause of your irregularity and then offer a tailored solution.
It also tackles specific gut health conditions, including irritable bowel syndrome and coeliac disease.
Freuman says: "I want people to understand how they can figure out their bowel problem and what remedies are potentially available to them that they aren't aware of. If something is wrong in your bowels, there's a reason why. And if there's a reason why, there's almost certainly a solution to it."
What counts as 'regular' bowel movements? In her book, Freuman explains that many factors, such as ease of passing poos and how you feel before and after, determine this. When it comes to frequency, she says, what’s considered ‘normal’ can vary – anything from four bowel movements per day to three per week.
It's important to remember that what works for one person might not work for another. Freuman explains that solutions for keeping regular are specific to you and your individual issues. She says some conditions can only be treated with medicines, but she has some general tips for us all.
That is, the length of time it takes for food to move through your whole digestive system. Once you are aware of your own bowel transit time, you can use this to inform your diet.
Freuman says: “One of the key things in terms of restoring regularity is managing the amount and type of fibre in your diet. This affects how things move through us.
"If you have a rapid transit time, you don't really want to be eating the type of fibre that makes things move through faster because you're already prone to this."
The type of fibre that tends to speed up passage through your digestion is less fermentable, insoluble fibre, like cellulose (found in all green vegetables).
Freuman adds: "However, if you're prone to things moving through slowly, make sure that you eat enough of the type of fibre that can hold on to moisture in your bowel. This is because the longer things spend moving through you, the more water gets reabsorbed back into the body and the harder and the more dried out your stool is going to be."
This type of fibre is found in oats, barley, beans and lentils, as well as fruit and vegetables including peas, carrots, tomatoes, apples and citrus fruit.
Freuman says: "Understanding your transit time can also provide insight into whether supplements, medications, fibre and/or foods are going to be best suited for your problem.”
“Consistency is really important when it comes to your bowel habits,” says Freuman.
“What I often see is people [find something], such as a magnesium supplement, that helps them stay regular. They then have a good bowel movement every day, but they don't want to feel dependent on it. So they use it for a couple of weeks, until things are regular and then they stop because they think their bowel has learnt how to behave. Then, slowly but surely, they start to veer back to [irregularity].
"Once you've invested the time and energy and unlocked your perfect bowel regimen, you have to stick with it.”
She also recommends maintaining your routine when you are away from home for lengths of time, remembering to take whatever you need to stay regular with you.
“Whether it's mealtimes or fibre intake or taking supplements, consistency with your regimen is going to yield consistency in the bathroom.”
Freuman says there can be a lot of misleading digestive health advice on the internet.
“Generalised advice that people are giving is not universal," she says. "Someone on Instagram knows nothing about you or your food tolerances. You have to be wary of people who market their gut health programme. If you've been dealing with a chronic issue for years, you know your body better than anybody else. You have all the wisdom that you need to fix your problem.
"People tend to dismiss their own experience of their body and follow a third party outside point of view that has no relevance to them. I wish more people felt empowered to listen to their bodies and trust their own experience more than the internet.”
Freuman feels strongly that we shouldn’t be embarrassed to talk about an activity that is essential to human existence.
“We all sleep, we all breathe, we all eat and we all poo. Everybody does it,” she says. As someone who has become as comfortable talking about poo as about the weather over the course of her career, she is keen to break the poo taboo and hopes her book will help with this. She does recognise that society has made progress.
“Gut health has eased us into having conversations about poo, because we now understand that the gut is essential to many areas of health."
“If this book had come out five years ago, it would not have been received as well.”
Freuman has worked in gastroenterology for the past 13 years and she has noticed that she keeps seeing the same bowel problems and hearing the same questions, concerns and gut health myths, which is why she felt the need to write Regular.
“If you put this information out there in a way that is accessible and easy to read, you can get it into the hands of the world. A lot of people who are suffering needlessly would not need to be.”
She says bowel issues also have a massive impact on people’s quality of life. “Some people shape their entire lives around pooing. Those who go too much or have diarrhoea or have unpredictable bowel habits can wake up hours before they have to be somewhere just to make sure that everything is out of them. Or sometimes people don’t eat enough because they're afraid that eating might cause stomach disruption.
“Knowledge is power. If you can really empower people with knowledge and solutions, it's a massive boost for their quality of life.”
Regular is out now.
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