Sure, it's not glamorous, but poo is something every woman should be well-versed in (Paris included). But unlike other health issues that receive endless media coverage, bowel awareness is unlikely to attract celebrity endorsement. (We're not expecting to see a brown ribbon day any time soon.) So we pulled on some very long rubber gloves and delved into the bowel to get to the, yep, bottom of it all...
The making of poo
You know the basics: you eat food, it goes through your intestines and gets to the other end, when it's time to set the brown snake free into the porcelain jungle. But what exactly is that brown snake made of? And how did that delicious meal of pancetta linguine go from being so appetising and fragrant to being, well, poo?
When you swallow food, your stomach releases digestive acids and enzymes that break down protein. The leftovers dribble into the duodenum (the first part of the small intestine), where enzymes from the pancreas are released to break down more proteins, as well as carbs and fats. As your nosh makes its way through eight metres of small intestine, most of your food's nutrients are absorbed. By the time it reaches your large intestine, or bowel, what's left of your dinner is either waste matter, or stuff your body can't digest, like fibre.
The bowel is a bit of a one-trick pony - pretty much all it knows how to do is absorb water out of stuff. Hanging out in the bowel are around one to two kilograms of bacteria, which break down fibre and starch.
By the end of the whole process, which usually takes around 24 hours, you're left with about 200 grams of poo - about as much as a small can of baked beans. This makes its way to the rectum and, when your brain signals your sphincter muscles to relax, it exits your body and plops into the toilet.
What you eat plays a major role in how well, and how often, you poo. You need fibre because it adds bulk to your poo, making it easier to get rid of. WH nutrition expert Sharon Natoli recommends eating about 30g of fibre a day to keep things in tip-top working order. If you're not getting enough, Natoli suggests you sprinkle wheatbran or psyllium husks (from health food stores) on your brekkie cereal, or snack on dried fruit during the day.
What's normal? What's not?
"Everyone is different, so there's also an enormous amount of variability in poo," says WH health expert and GP, Dr Ginni Mansberg. A recent British study of more than 2000 men and women found there was quite a broad range of "normality" in bowel habits, not only in appearance (on a six-point scale from hard, round lumps to mushy) but also in frequency - anywhere from three times a day to three times a week. The study, conducted by researchers from the University Department of Medicine, Bristol Royal Infirmary and the University Department of Epidemiology and Public Health Medicine, Canynge Hall in Bristol, UK, also revealed that most people drop the kids off at the pool in the morning.
What you should be seeing in the bowl is a single, long banana-like shape, says Dr Anish Sheth, co-author of The Book of Poo, a Spotter's Guide. Pebbly poo indicates a lack of "stool cohesion", according to Dr Sheth. Fibre not only adds bulk to your poo, it also acts as a glue to hold everything together. "This glue is actually a fatty-acid gel that is formed when ingested fibre is fermented by bacteria residing in the [bowel]," Dr Sheth explains.
And what about floaters - are they bad? "Poo floats because it has gas in it," explains Professor Bolin, a Sydney-based gastroenterologist and President of the Gut Foundation. "Floaters aren't bad - they mean you're producing lots of gas, which is a sign you're getting enough fibre." If your poo sinks to the bottom like a stone, it's worth checking your fibre intake.
What you shouldn't be seeing: pencil-thin poo. Skinny ones can indicate you're pushing too much (which constricts the anal sphincter) or a more serious problem - rectal cancer. See you doctor if your deposits are persistently scrawny or become thinner over several weeks.
Natural gas
Another unpleasant by-product of digestion is the fart. These result from the gas produced by bacteria in your bowel breaking down fibre and starch - creating methane, hydrogen, and hydrogen sulphide (AKA rotten egg gas).
"Some people create more methane gas, which means their farts don't smell," says Professor Bolin. "Others produce more hydrogen sulphide." They're the ones you don't want to be stuck next to on a plane. The type of gas you produce depends on the type of bacteria in your bowel. According to Professor Bolin, the type of bacteria now dwelling in your nether regions is determined by what your mum ate when she was pregnant with you, and what you ate up until you were about seven. So next time someone lets a stinker rip in the lift, blame their mum.
It's more likely to be a man who's the guilty party, too. Men let Fluffy off the chain an average of 12 times a day, according to Professor Bolin, compared to seven times for women. "We don't know why," he says. "It could relate to food, but it could also be because women are more socially aware and may supress their gas." But holding it in may not be such a hot idea either, according to Professor Bolin, who points out that it may make problems with bloating worse.
As for your poo's aroma? That's another story: "It's the amines and proteins in poo which create that smell," says Professor Bolin. The smell can also be affected by what you eat. "Protein-rich foods generate more smelly poo," says Natoli. "Spices can make it worse, as can garlic and onion."
When things grind to a halt...
While poo itself is far from pleasant, the lack of it - constipation - is worse. "The bowel is a very stupid organ," says Dr Mansberg. "As long as stuff sits in the bowel, it will keep on pulling water out of it." So, the longer waste matter sits in the bowel, the drier, denser and harder it becomes.
When you become constipated, the poo in your bowel forms a block," says Dr Mansberg. "Maybe some pebbles will break off, but the bulk of it stays put." So how do you shift the bugger?
Surprisingly, eating lots of fibre now is the worst thing you can do. "This will only block you up more," Dr Mansberg explains. "What you need are low-fibre foods such as white breads and pastas, and a good dose of paraffin oil [from your chemist]." This will loosen the blockage and get it moving. "You can also ask your chemist for a laxative called Agarol. It makes everything slippery."
Once the problem has, er, passed, you should definitely up your fibre intake. "Lack of fibre may have been what caused constipation in the first place," Dr Mansberg says.
Uncool runnings
Diarrhoea is a sign that things are moving too quickly, and not spending enough time with our simple friend the bowel before rushing out the other end. "Diarrhoea is mostly caused by a viral infection," says Dr Mansberg.
Lactose intolerance can also sometimes cause runny poo. But as Professor Bolin points out, this is unlikely. "Only around six in 100 people are lactose intolerant," he says. "People will think they are, but it's more likely to be irritation from fat or caffeine that's causing the problem."
Nerves can also cause the runs. It's basically your body reacting to stress, says Professor Bolin. "The butterflies you feel are your bowels wriggling."
And if you think your period affects things, you're right: "A woman produces reproductive hormones differently during her period," explains Professor Bolin. "These hormones react with the gut, and can cause diarrhoea."
And if you're on the pill? "There is no conclusive proof that a bout of diarrhoea while you're taking oral contraceptives will leave you unprotected," Dr Mansberg. "but if you're worried, it's always better to be safe than sorry - use an additional contraceptive, such as condoms."
A final word on all things pooey: colonics. Are they a good way to detox? "Colonic irrigation was developed for patients with spinal disorders or injuries, who need help to poo," says Dr Mansberg. "At some point it was picked up by people who (incorrectly) see the bowel as toxic." And as the colonics industry is not regulated, pretty much anyone can do it, she says. "There is no code of conduct, no minimum standards, and it is so dangerous in the wrong hands." Apart from the risks involved (bowel perforation, death), colonics also flush out all the good bacteria along with the bad. "Your body does a great job on its own," Dr Mansberg says. So learn to embrace its by-products. Er, not literally, of course.
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