The Royal Flush

​How many times should we poop a day or a week?? What should a healthy poop look like? This unfortunately can be kind of hard to study because most people don't really think about their poop much nor do they know what is considered normal. So when asked in a survey to describe their bowel frequency and texture, some people may not even really know how to answer these questions. Do you know?? 
 
Unfortunately, WE DON'T TALK ABOUT POOP ENOUGH. Granted, it’s not the best table talk (unless of course you’re out to dinner with a group of dietitians), but it is something we all need to be aware of and educated about.
 
A recent study in 2017 studied the US population via a survey asking these exact questions. How often do you poop each week and what does it look like (based on the Bristol stool chart). Here is what they found:
 
3% have < 3 poops per week
60% have 3-7 poops per week
30% have 8-14 poops per week
6% have 15-21 poops per week
1% have >21 poops per week
 
They also found that normal poops happen more often in men than women, in those with a higher education and income, in those requiring less medications (<2 per day), and in those who eat more fiber (>20g per day). 
 
Based on the above results, researchers concluded that normal for the US population is considered at least 3 poops per week up to 3 poops per day. However, this doesn't really highlight the other considerations of what is considered a healthy bowel movement such as the texture of the poop (is it firm, sticky, loose, pebble-like), the stool weight (how big is it), or the sense of complete evacuation (do you feel empty afterwards?). 

​Another study of Coastal Indians, who eat a predominately plant based diet, found that the average stool frequency was 14 poops per week, mostly resembling an easy to pass smooth banana. They also found that vegetarians and more physically active individuals tended to pass stool more frequently. Average stool weight in Asia is also much higher than that of a Western populations, with an average of 311g per 24 hours. Stool weight in many Western populations is low (80-120g per day) which is associated with an increased risk of colon cancer. Stool weights of 150g per day can help reduce this risk. 
 
So what is considered optimal?? Clinically, I do not agree with 3x per week! The Western population as a whole is not eating enough fiber. If you look at other higher fiber eating populations, they average 2 poops per day, with an average poop weight of 150g. This translates to TWO LARGE, firm but not hard, easy to pass, bowel movements per day. I also see this in my clients. When they are pooping 2x per day, they feel good, they look good, and they are happier. 
 
So just because you are pooping every day, it does not mean your poop is considered optimal. If you are concerned about your pooping habits, work with a gut health dietitian (like me!)