You, The Loo and Your Number 2’s

This is sure to be a ‘crappy’ entry! – Poo – what a ‘shitty’ topic! – The sentiment of this post really ‘stinks’.

There we go! Now the potty humour is out of the way, we can have a serious discussion on what is so often a topic brushed off as the ‘butt’ of a joke (ok, sorry, that’s all). Digestive health is one of those taboo topics that people know about but don’t really like to talk about openly. I find this veil of secrecy and embarrassment so ridiculous given that everyone farts and everyone poos. The aim of this post is simply to shed light on a topic that has for too long been banished to a quiet place.   

How Does The Digestive System Work?  

This incredibly, intricate system starts at the mouth and ends at the anus. It is essentially a muscular tube of around 10 metres in length and has the critical role of breaking down the food and fluids we eat, extracting all the good stuff (and bad) and ridding of the waste. When it’s put that simply, it’s hard to view poo (‘faeces’ for political correctness) as anything else but wonderful.

Human poop, containing dead bacteria, indigestible food matter like fibre, cell debris shed from the gut wall, cholesterol and other chemicals, is the necessary vehicle for removing that waste. Perhaps now, you have a science-based reason to be proud of yourself for that morning ‘effort’.

The system basically works as such:

• In the upper digestive system – the food is mechanically and chemically pulverised into it’s simplest form. For example, carbohydrates are reduced to sugars, proteins to amino acids and fats down to fatty acids and glycerol. This is a basic explanation.
• In the lower digestive system – those broken down products are absorbed across the lining of the gut and enter the blood stream to be delivered to the cells. What’s left is excreted.

 So How It All Does It Happen?

Step 1 – when we rip into that chicken salad (or jam donut?), the teeth work by shredding and crushing the food. Saliva is added to moisten the food ball making it easier to swallow. Can you imagine digestion without saliva? For some experiential learning, go and eat a box of dry Weet-Bix. Importantly, saliva also contains an enzyme which begins the chemical degradation of the food.

Step 2 – The oesophagus massages the ball of food toward the gut passing through both the upper oesophageal and lower oesophageal sphincters. That’s correct, you’ve got sphincters like the one in your bum that lie between your mouth and your stomach. In the same way as the one you are more familiar with prevents (usually) faeces from exiting your body when it is not yet appropriate to do so, the oesophageal sphincters prevent food and liquid from entering the windpipe or back flowing into the the oesophagus once they made it to the stomach.

Step 3 – The stomach works like a mini washing machine but with the strongest ever washing powder – hydrochloric acid. This washing machine churns the food with the acid solublising it and killing any bacteria which are present. Given the acidic nature of the stomach acid, it’s easy to understand why reflux causes such pain and discomfort in suffers. This acid washes back into, irritates and stings the lining of the lower oesophagus.

Step 4 – Another day, another sphincter, this time allowing food to pass from the stomach into the small intestine. The small intestine has three sections – the duodenum, the jejunum and the ileum.

• The first part, the duodenum’s primary role is to complete the chemical breakdown of the food. Through a duct know as the common bile duct, the secretions of the pancreas and bile from the liver are squirted into the duodenum to further assist the chemical breakdown of the food matter.
• The jejunum and ileum’s major job is to absorb nutrients out of the intestine and into the bloodstream. It achieves this by virtue of its huge surface area for absorption estimated to be equivalent to the size of a tennis court. The wrinkled and folded surface of the jejunum and ileum contains finger-like projections called villi that absorb the nutrients.

Step 5 – By the endpoint of the ileum, the majority of nutrient absorption has occurred and what remains enters the large intestine, a thick muscular tube of around 1.5 metres length. Mucus and bacteria that live on the surface of the large intestinal wall begin to mix with the remaining intestinal contents forming faeces. As the newly formed poop moves along, some water and vitamins get reabsorbed into the blood through the wall of the large intestine and the remainder is held in the end part known as the rectum to await defecation.  

Not Worried About Your Bowel Habits?

I think you should be! The regularity, colour and texture of your poo can provide us some info about the health of your digestive system. But how important’s that you ask? Well digestive complications can range from acutely mild such as a little constipation or diarrhoea to very worrying such as in the case of Crohn’s disease or bowel cancer. SHIT – I hear you say!

Consider the following stats regarding Australians and this is similar to that of other western countries:

• 1 in 12 will be diagnosed with bowel cancer by 85 years of age.
• Bowel cancer is more common in men – around 3 men for every 2 women are diagnosed with the condition.
• Rates have in fact climbed amongst men from 66.5 in 100,000 men being diagnosed with bowel cancer in 1982 to 73.7 in 100,000 men in 2010. Rates are stable amongst women over the same period.
• Of the 286 new cases of bowel cancer each week, 77 of those will die from the disease.
• Bowel cancer is the second largest causes of cancer death in Australia after lung cancer yet if caught in time, 90% of bowel cancer can be successful treated.

What Your Number 2’s Say About You: What is Normal? What is Not?

Here’s a directive men – you need to start looking at your poo as doing so can provide a load of info about you!

Healthy poo is brown or golden brown in colour and generally the size and shape of a sausage. They should be relatively easy to pass without stressing or straining. One or two-visit variances from this are not necessarily a cause for alarm and may be to do with something you have eaten the night before and may be an isolated incident. However colour or texture changes which persist more than a day are worth checking out. Here are some examples:

• Small amount of fresh blood stained on the paper – small blood stains on the toilet paper are common and usually the result of abrasion from poo against your sphincter, particularly if you have been more frequent than normal. Now there’s a great reason to choose a nice, soft toilet paper. Importantly though, if it comes with pain and discomfort, you may need to visit a GP to check whether haemorrhoids have developed. These are very common and can be treated effectively.
• Bright red blood IN the poo – this is a more immediate cause for concern and can indicate some internal bleeding for which bowel cancer may be the cause.
• Black faeces – could be caused by bleeding further up in the digestive tract and often, from an ulcer. Take note that iron supplements will often lead to this colouration.
• Very light or cream-coloured poo – could be related to a range of conditions associated with the liver, gall bladder or pancreas. Given that the normal brown colour of poo is due to the presence of bile salts and another by-product of metabolism called bilirubin, the absence of this could colour may be indicative of something being wrong with those organs.
• Diarrhoea – can be caused by a host of problems both worrying and not. It could be last night’s hot curry that’s acting upon the gut and that will resolve itself. However chronic diarrhoea could indicate something more sinister such as coeliac disease, Crohn’s disease or cancer.
• Dry, hard poo – often a side-effect of some medications, it can be a worrisome experience if it persists long term. The straining required to pass can lead to haemorrhoids and there are links between constipation and bowel cancer.
• Greasy poo – tends to indicate that an abnormal amount of fat is present in the large intestine. For this to be the case, you could be experiencing issues with fat absorption from the gut that warrants further investigation.

And What’s Normal Frequency?

There is disagreement amongst the experts on what constitutes normal with anywhere from ‘once per week’ to ‘several times per day’ being cited. I personally am a lot more toward the latter (in case you wanted to know) and believe that frequently going less than once per day cannot be good for you. But then again, they may say that I am ‘full of shit’… ok, that’s the only other joke!

More seriously, the true wide-spread prevalence of constipation is evidenced by the fact that treating it has become a billion-dollar a year industry. You know the feeling of being ‘bunged up’ and bloated? Well for most of us, this is due  to poor lifestyle factors which if addressed, could relieve the discomfort.

How to Poo Proficiently – What Should I Do?

• Try to establish a routine – regularity is key and getting this connection with your body is important. Create a habit of going to the bathroom and mindfully passing WITHOUT your phone!
• Increase your intake of fibre-rich foods – because fibre acts like a sponge in the digestive tract, it also helps to bulk the stools keeping them ‘fluffier’ rather than dry and hard. The easiest way to increase fibre intake is through adequate consumption of fruit and veggies with every meal. And if you choose to eat breakfast cereals, breads and other carbohydrates like rice and pasta, ALWAYS go for the brownest option. These will contain more fibre. Make sure to increase your fibre intake gradually otherwise you may experience tummy upsets. Your mates will know about it too because you’ll suddenly become a trumpet-bum! Just 5-6 prunes or dates can make all the difference!
• Increase your hydration – along with the magnitude of other benefits, consuming around 3 litres of water a day will help with relieving constipation. If you increase your fibre intake without increasing your water intake, you will likely feel a fair amount of discomfort in your guts. This is especially true after you have had a big night on the grog.
• Get moving – exercising generally gets things moving by increasing blood flow and movement to and through the gut.

A Final Thought  

Given the very serious complications that can occur by not addressing your digestive health, I must plead with you fellas to be proactive. Start paying attention to what you’re passing because your early identification of any issues is critical to the treatment success.

‘Pooing’ remains one of those taboo topics that we need to get a little more comfortable with discussing. If you see anything worrying, please immediately consult your GP. And don’t get worried, whatever you are presenting with, he has seen many times before and much, much worse! JS