Number two and you

It’s a question many of us wonder about, but few are brave enough to ask: How frequently should you be going “number two?”

Patricia Calhoun, MD, FAAFP, a family physician with Baptist Primary Care who sees patients ranging from newborns to the elderly, said that while there is no exact rule of thumb, current consensus is that going anywhere from three times per day to three times per week can be perfectly normal. All of our bodies are different, and so are our digestive cycles.

“The biggest thing to look for is change. If you shift from going a few times a week to a few times a day, you should talk with your doctor,” she said.

What affects bowel regularity?

There are many factors that influence digestive cycles. Life stages naturally affect the frequency of bowel movements. Newborns have more frequent stools because they're limited to liquids like breast milk or formula. As they progress to solid baby foods and purees, their simple and fiber-rich diets lead to more solid stools.

"As we age and eat more complex and often less healthy food sources – think junk and fast food – we can have less frequent bowel movements," Dr. Calhoun said. "Our geriatric population may also find that being unable to exercise as frequently and taking certain medications may cause them to get backed up."

She added, "With more patients using newer injectable GLP-1 medications for weight loss, which slow food transit time down through the gastrointestinal tract, we're seeing much higher rates of constipation."

Common causes of constipation

Constipation, which refers to less frequent or firmer stools, can happen at any age.

“It’s often caused by lack of fiber or fluids in the diet,” Dr. Calhoun said. “The large intestine's job is to absorb fluid as it makes stool, so less fluid intake can worsen constipation. It can also be the result of pain medication use, certain blood pressure medications, supplemental iron or thyroid disease.”

Tips to stay regular naturally

To maintain regular bowel movements, Dr. Calhoun recommended:

• Eating a healthy diet full of fruits and vegetables, which are high in fiber.
• Exercising regularly.
• Staying hydrated and drinking plenty of water.
• Monitoring your bowel movements for any changes, especially when you start a new medication or vitamin.

Watch out for red flags

Dr. Calhoun offered two additional important reminders:

"It's critical to stay up-to-date with colorectal cancer screenings, which are recommended to begin by age 45," she said. "And be sure to watch out for any 'red flag' signs such as blood in the stool, dark tarry stools, abdominal pain or unexplained weight loss. If these or other bowel changes develop, contact your doctor quickly."

Remember, a healthy outside starts on the inside!