Wednesday, 30 April 2014

Poo Taboo…Constipation

In order to assess nutritional health, I often ask patients about their bowel movements and inevitably, they are a little embarrassed to talk about it.  Everyone poops.  No big deal.  At least not to a dietitian, it’s not a big deal because after all, “what goes in, must come out.” 

With the limited vegetables and fruits we consume and increased intake of refined and processed foods, constipation is not an uncommon occurrence in our modern society. That’s why food manufacturers are always touting “high fibre” and “with added fibre” products. But the constipation picture is not just as simple as “more fibre equals better poop.”  Good poop (also called “stool”) are not just about regularity or frequency, it’s also about texture.  Here’s a quick explanation of what makes good poop. 

*If you have Inflammatory Bowel Disease or other health conditions that affect your gut and therefore your stool, then you’ll need to speak with your dietitian or your family doctor in a one-on-one appointment.
If you don’t already have one, click these links to find a dietitian and family doctor

What is “regularity”?

Regularity or frequency can vary for different people.  Some people may have bowel movements three times a day and some people have them three times a week.  Anything in between this range is “normal” – generally speaking, according to Dr. Anish Sheth and Josh Richman – authors of “What’s Your Poo Telling You”. 

What about textures?

Stool texture is on spectrum.  Constipation is at one end of the spectrum and diarrhea is at the other.   
Constipation is when stool is hard, or pebbly – like rabbit droppings/deer droppings.  Diarrhea is when the stool is watery, or “fluffy.”  It’s not formed.

Look at the Bristol Stool Scale below for reference.  Ideal poop is #4 on the scale.

How to make good poop?

In order to prevent or relieve constipation, remember the analogy of “The 3 ‘legged’ stool”: fibre, fluids, and physical activity.


Men should consume at least 38g of fibre per day while women should consume 28g. Check out this Alberta Health Services handout on fibre content called “Fibre Facts” on sources of fibre and how can you get more fibre in your diet. 


Most adults need about 2.5L-3L of fluid per day.  The fluids can come from water, coffee, tea, soups, and milk.  Other fluids such as soft drinks and juices are not encouraged because of the high calorie content of these drinks. 

Physical Activity:

The Canadian Physical Activity Guidelines recommends a minimum of 150 minutes of moderate physical activity per week for adults for overall good health.  Even if you just start moving more than you usually would, such as going for an extra walk around the block, this could help to improve your bowel health.  

If you need help becoming more active, please talk to your PCN family physician or PCN healthcare professional about the Prescription to Get Active program.  

So if you’re finding your poo is not similar to a #4 on the Bristol Stool Scale, perhaps the “3 legged stool” that makes up your #2 need a bit more support to achieve balance – balanced nutrition and lifestyle for a #1 healthier you. :)

Sally Ho is a Registered Dietitian at the Leduc Beaumont Devon Primary Care Network.