Many people can lay claim to their bowels being as regular as ‘clockwork’. This simply means that a person will get the urge to pass stool around the same time every day without any additional bowel movements outside of these time periods. Similarly a bowel movement is not missed at the designated time. However, ths ‘clockwork’ bowel habit can sometimes become disturbed.
Not every person has such bowel regularity. Many people suffer with disorders of bowel habit, namely constipation or diarrhea. Sometimes this is acute, meaning that it is short-lived. At other times it can be chronic, meaning that it is ongoing for months, years or even for a lifetime. It is estimated that approximately 15% of Americans suffer with chronic constipation. Diarrhea is rarely chronic and the exact incidence is difficult to estimate.
Normal bowel habit varies from one person to another but if it is less than 3 times a day and more than 3 days a week then it is accepted as being normal. In addition the stool quantity should be less than 200 grams daily although weight is not usually considered in bowel regularity. The reasons for these definitions are discussed in further detail.
The quantity of stool passed out in a day varies from one person to another. It is largely dependent on the amount of food that is ingested and the portion that remains after digestion and absorption of nutrients. The maority of the stool weight is made up of water and the bulk is determined by the fiber that absorbs water.
However, diarrhea is defined as passing stool of more than 200 grams per day or about 200mL of liquid stool per day. Therefore normal stool quantity should be less than 200 grams daily. The weight may not correlate with the volume as some stool may be bulkier than others.
Although the frequency of stool varies among people, normal frequency can be ascertained by the two extremes of abnormal bowel habit. One one hand there is constipation which is defined by less than three bowel movements ina week. Therefore normal bowel movements would be more than three movements in a week.
On the other hand diarrhea is defined by more than three bowel movements in a day. Therefore normal bowel frequency would be less than three bowels movements in a 24 hour period. Sometimes frequent bowel movement may be present like in some cases of IBS (irritable bowel syndrome) although it is not considered to be diarrhea as such.
What are irregular bowel movements?
The term irregular bowel movements are usually used to describe constipation. In constipation a person cannot ‘predict’ when a bowel movement will or should occur. When the constipation is severe a person may go for a week or more without a movement. Even when a movement occurs it often arises without sufficient warning and a person may suddenly experience urging, sometime at the most inopportune times.
Irregular bowel movements can be frustrating in that there is no predictability or allowance for convenience of a bowel movement. Constipation can also be uncomfortable where a person feels bloated and constant urging to pass stool but are unable to do so. Irrespective of the unpredictability of a bowel movement, it eventually does occur and often the stool is hard with significant straining required to pass out the stool.
- Read more on chronic constipation.
- Read more on changes in bowel habit.
- Read more on chronic diarrhea.
The causes of both extremes of irregular bowel movement, constipation and diarrhea, are discussed above. It is important to note that a large number of chronic constipation cases are due to unknown causes. This is believed to be due to abnormalities in physiology rather than a disease and is referred to as functional constipation. Similarly functional diarrhea could be due for irregular bowel movements.
Reasons for No Bowel Movements
At the extreme end of constipation is a complete lack of bowel movement. This is known as obstipation. Technically it refers to obstructive constipation because even in severe constipation there is some stool passed eventually. However, when an obstruction occurs there there is a failure for stool to be expelled. As the name suggests, obstipation occurs when there is blockage in the bowel. This may occur with:
- Fecal impaction
- Foreign body in the bowel
- Volvulus (twisted bowels)
- Intestinal polyps
- Colorectal cancer
Remedies for Irregular Bowel Movements
Laxatives work to trigger a bowel movement in most people. It is a convenient and effective short term measure for constipation but should not be used for maintaining bowel regularity in the long term. There are a number of non-drug measures touted for making the bowels more regular. While most of these remedies can be effective, many people find that its effects are short-lived and the bowel habit never becomes permanently regular.
Water and Fiber
A combination of increased water and fiber intake is often the main remedy advised for bowel regularity. It works for most people and requires a permanent change in diet, although fiber supplements are available. Fiber cannot be digested in the gut and mixes with wastes and undigested food to form stool. Water adds to the mix and is absorbed by fiber which then swells the stool.
Physical activity can also help with bowel habit. The effects of gravity and movement expedites the passage of stool through the bowels. It is essential that exercise is done regularly in order to ensure regular bowel habit. A combination of cardiovascular activities and weight training exercises are recommended. Moderate activity about an hour after eating will help with digestion and possibly stimulating a bowel movement.
Fruit and Vegetables
The benefits of fresh fruit and raw vegetables are an effective dietary remedy for maintaining regular bowel movements. It is largely due to the fiber content within fruit and vegetables but these foods also have a host of other substances that can be beneficial to health, although not specifically for the bowel. Filling up with fruits and vegetables also reduces the intake of low-fiber foods that may contribute to constipation.