According to the dominant medical advice, moving your bowels as little as once every three days is considered normal, while, in fact, a frequency this low indicates severe fecal impaction, stool transit disorders, and chronic constipation — the conditions that commonly precede enlarged hemorrhoids, diverticular disease, polyposis, and colorectal cancer.
According to the medical doctors, once every three days is
okay, but on the fourth day you are considered constipated.
This is, obviously, incorrect, because according to
every single primer on human physiology and functional digestive
disorders, ideally you should move bowels after each major meal, but not
less than once a day.
If you fail to do so, you are affected by a condition
called “latent” constipation. Because it is invisible, it predisposes
you to all major colorectal disorders, from enlarged hemorrhoids to
How do you determine if you are affected by “latent”
constipation instead of mere “irregularity”:
— You do not move bowels at least every day;
— Your stools don‘t match type 5 or 6 on the Bristol
Stool Form scale;
— Your stool weight per bowel movement exceeds 150
— You have to strain, even very slightly, to complete
a bowel movement;
— You already have enlarged hemorrhoids, or any other
— You are affected by bloating, flatulence, or
— You are experiencing cramping related to
— You are taking fiber supplements or laxatives, or
rely on laxogenic food, such as Activia yogurt, fiber-fortified cereals,
oatmeal, or juices from prunes, beets, and aloe.
Any of the above symptoms point to latent constipation
that may eventually turn into inflammatory bowel disease and colorectal
To learn more about the normal physiology of bowel
movements and how to restore regularity, please visit this page. It also
addresses stool frequency in infants, toddlers, grown children, adults,
To give you a better perspective on my brief overview
of bowel movements in the video, let me briefly explain how a bowel
movement works, so you‘ll understand my answer in the proper context
rather than just take my word for it:
● The natural,
un-stimulated bowel movement is always preceded by an involuntary urge
sensation. Although the sensation itself is unconscious, by the time we
have grown out of ‘pampers,‘ we have learnt well to suppress it
● The sequence of
events preceding the urge to move the bowels begins with the gastrocolic
reflex — a complex serious of unconscious events, usually in response to
eating solid food or drinking fluids, particularly on an empty stomach.
● The gastrocolic
reflex stimulates a mass peristaltic movement inside the large
intestine, which propulses formed stools toward the rectum.
● Once stools enter
the rectum, it contracts to propel them toward the anal nerve plexus,
and that stimuli is what sends you flying to the bathroom to actually
move your bowels by consciously relaxing the anal canal.
In healthy children and adults, moving the bowels is
supposed to be a completely unnoticeable, effort-free and pain-free act.
Ideally, moving the bowels is just as effortless as urination, and it
should never leave a sensation of incomplete emptying.
Anything other than what I have just described indicates
some problem related to stool morphology, colorectal disorders, or both.
In people with colorectal disorders moving the bowels
may be compromised by weak peristalsis, anorectal nerve damage, a
stretched out colon and rectum, and/or some other problem that slows
down motility — the term for propulsion of stools through the colon.
Poor stool morphology means that the stools are either
too large, or too hard, or both. Hard stools are often small though, and
are just as difficult to eliminate. This kind of stool requires
straining, from moderate to intense, and invariably damages the anal
So, my answer to this question — how often should you
move bowels — applies to healthy people with no or minimal anorectal,
nerve damage and normal stools, who reliably sense the urge to move
their bowels, and complete the act without straining or any noticeable
If this describes you, technically you should move your
bowels after each major meal, particularly the meals that contain plenty
of dietary fat, because the act of eating fat stimulates intestinal
motility more than any other factor. Here is how this not so well-known fact of human
physiology is described in a major textbook for medical students:
“Motility is influenced by the energy content and
composition of the meal, but not by its volume or pH. Energy-rich meals
with a high fat content increase motility; carbohydrates and proteins
have no effect. (R.F. Schmidt, G. Thews. Colonic Motility. Human
Physiology, 2nd edition. 29.7:730.)
Thus, ideally, teens, young adults, and middle-aged
healthy people should move their bowels at least twice a day, usually
after breakfast or lunch, and after dinner. Meals that contain dietary
fat benefit the process.
But, again, any food intake, even drinking a glass of
water slowly, stimulates the gastrocolic reflex and initiates the
complex choreography of a bowel movement. It may not, however, be strong
enough to interrupt your daily routine.
As people get older, this frequency may decrease
because of adverse changes in stool composition, loss of muscle tone,
medication, stretching out of the colon and rectum, diminished nerve
sensitivity, and/or other age, diet, habit, and health-related factors.
Is a lesser frequency okay? Yes, it is acceptable, as
long as stools remain small, soft, and light, type 4 or 5 on the Bristol
Stool Form scale that I described while answering the question What
exactly are normal stools?
But this is rarely what happens to anyone who moves
their bowels less than daily, because the stool left in the colon for
longer stretches of time tend to dry out, impact, and harden up very
Thus, if you don‘t move your bowels at least once
daily, and your stools are larger and denser than type 4 or 5 on the
Bristol Stool Form scale, you need to normalize them, increase the
frequency of your bowel movements, and keep it up to prevent further
problems following my recommendations here: No Downsize, Just Upside-down. It will guide you to all other
relevant sources of information about constipation treatment and