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What your bowel movement can tell you about your health?

I have been meaning to address the topic of digestion for a while, but bowel movement is not something we like to discuss in our society. Nevertheless, it is a part of our daily regimen just like sleeping, eating, drinking water and breathing air. Bowel movement is a very good tracker of health and it has been one of the main diagnostic tools in Traditional Chinese Medicine (TCM) for centuries.



What is considered normal?


Good bowel movements happen every day or every other day without any uncomfortable sensation. Stool should be brown, soft and smooth but have a shape.


Many organs are involved in the process of digestion. Digestive function in TCM is primarily performed by Spleen organ system. Spleen is in charge of transportation and transformation of food once received by the stomach. If spleen is strong enough, it functions well to separate food & water into clear essence and turbid waste. Weak Spleen Qi can be understood as small intestine malabsorption or leaky gut syndrome when nutrients fail to be absorbed properly causing loose stool or diarrhea with undigested food. Individuals with Spleen Qi deficiency suffer from chronic fatigue, brain fog and dizziness. They tend to develop food sensitivities as malabsorption of the nutrients leads to weak immune system; in turn weak immune system fails to distinguish good from bad and starts attacking its own body.

Just like the concept of metabolism in Western medicine, in TCM digestive function relies on fire in the GI tract to break down food. You cannot cook food in the refrigerator; you need a stove for it! Therefore, it is Yang or Fire aspect of the spleen that carries that function. Spleen also needs help from Kidney Yang as Kidney Yang is a source of Yang in the entire body. Some of you might have experienced being woken up by diarrhea early in the morning. That is the main symptom of Spleen and Kidney Yang mutual deficiency in TCM. All you need to do is warm and strengthen Your kidney Yang and your problem is solved. Unfortunately, iced drinks, eating food straight out of refrigerator, having smoothies and salads as a meal replacement solution as well as exposure to air conditioners and walking barefooted all extinguish digestive fire and slow down metabolism.


Another important organ responsible for proper bowel movements is Liver. Even though Spleen Yang or slow metabolism is a popular problem among my patients, I believe I see Liver patterns a lot more. Liver is the main organ for women as it regulates and balances emotions and promotes free flow of everything. If Liver Qi gets stagnant it starts attacking already weak spleen and stomach causing constipation, pebble like stools, bloating and gasses. Liver is also to blame when it comes to IBS type of alternations between constipation and diarrhea with urgent bowel movements triggered by stress.


Of course, the main organ in charge of bowel movement is large intestine. Large intestine disharmony is usually influenced by the organs mentioned above and therefore has more of a symptomatic connotation. Most of symptoms can be separated into three groups: (1) lack of lubrication to the bowels, (2) stagnation, (3) lack of force. Dryness can be caused by an actual Yin or Body Fluid deficiency but interestingly enough in TCM Blood deficiency would cause lack of moisture in the intestines too particularly in elderly population. Yin and Blood deficient type of constipation arises from chronic illnesses, profuse sweating or bleeding. Dryness can be also triggered by excessive fire drying up the fluids. Stagnation is usually a blockage that doesn’t allow feces to pass smoothly. That blockage can be formed by pathogenic phlegm, blood stasis, food stagnation or Liver Qi stagnation. Blood stagnation is a very typical case of post-surgical type of constipation. It can also happen after giving birth. Lack of force is diagnosed as Spleen Qi deficiency and required lots of straining that can eventually develop into Spleen Qi sinking and lead to internal organ prolapse or hemorrhoid. Lung and Large Intestine has an internal – external relationship via 5 viscera and meridian theory, which means there are mutually connected. The direction of lung energy is downwards which helps with the downward motion of the stool. When lungs are too weak it can bring about deficient type of constipation.

How to normalize digestion?

1. One obvious solution is eating better.


We all tend to understand this principle and it is an important one. Eating more vegetables and dark leafy greens can definitely help with bowel consistency. I recommend minimum of 9 cups of veggies a day to all my patients, the more colorful the better! Fiber found in vegetables and legumes can absorb more water like a sponge, making feces expand and move through large intestine. But even though fiber has been a go-to solution for many years, it might be an outdated one. Taking extra fiber can certainly help resolve your problems with elimination if you consume very little fiber from your diet but not if you already eat your veggies. Recent studies suggest that having extra fiber not only is not beneficial for constipation but can also make things worse. It is the case if you suffer from low peristaltic movement of the large intestine. Having sluggish peristalsis with bulkier fiber filled stool can make you feel even more bloated, nauseous and sick.

2. Drink more water


Dehydration is a very popular cause of constipation. We should all drink plenty of water whether we suffer from digestive problems or not. I advise a minimum of 70oz of water a day and it is pure water not combined with any other liquids. However, same principle applies here that if you are well hydrated already, drinking more won’t fix your infrequent bowel movement problem. In this case, you have to look for solution somewhere else, mainly by identifying the root cause of your constipation.



3. Go for a walk


Exercising is another common but yet disregarded advice when it comes to constipation. Occasional constipation without any underlying problems can be fixed by regular exercise routine as it activates all organ systems by increasing heartbeat, stimulating nervous system and promoting muscle contractions. Sedentary lifestyle makes all physiological processes in the body stagnant and slow so it is no surprise that movement can positively impact digestion as well.

4. Review your prescription medications


Your medication can be to blame for disruptions in the bowel movement frequency. Taking OTC pain medications (NSAIDs) can significantly change your bowel habits. The list also includes anticonvulsants, antidepressants, blood pressure medications, and aluminum-containing antacids. Imbalance in salts (high calcium, low potassium levels) can also dry out your feces as they push and pull the water wherever they are present.



5. Check your thyroid function.


Hypothyroidism show symptoms of slow metabolism, which includes constipation, low energy and weight gain. Hyperparathyroidism can result in the discussed above hypercalcemia and lead to constipation as well.

6. Address the cause.


TCM is very good at identifying the root problem and offers a customized approach to the treatment. Acupuncture and Chinese Herbal Medications can work wonders for digestion when combined together. Acupuncture is great at addressing the stress and turn the switch from “fight and flight” mode to “rest and digest”. If you have been treated with acupuncture you’d probably know that your stomach starts growling sometimes when you’re lying with the needles. This is an indication of activated digestion. Acupuncture can also promote blood flow to the stomach and intestines to draw nutrients (building materials) to these organs promoting faster healing of the gut. Chinese Herbs are mixed into formulas to address particular pattern to either moisturize and lubricate the intestines, clear toxic heat from the intestines, promote metabolism and strengthen digestion and absorption of the nutrients, break down food stagnation or harmonize peristaltic movements.

7. Incorporate digestive enzymes in between meals.


While Acupuncture and Herbal Medications can be very effective at working on what ails you. It can take 3 to 6 months to get you where you need to be with your digestive health. In the meantime, you need something safe quick and easy to help you cope with day-to-day symptoms. Digestive enzyme Papain derived from ripe papaya fruit can give you the much-needed relief. Papain breaks down proteins and has been used for centuries as a folk remedy to treat digestive discomforts. It is good for both short and long-term use as it is completely safe even for small children. Papain provides relief from both constipation and diarrhea and is good to take by IBS sufferers. It also works very well for bloating and heartburn. It is a supplement of choice for my pregnant patients with weak digestion as well as patients with irregular eating habits due to traveling or busy work schedules.



8. Have apple cider vinegar right before your meal.


Apple cider vinegar may just be the panacea for all digestive and metabolic issues. It facilitates the breakdown of food and therefore promote a smoother bowel movement. There is another trick you can try with apple cider vinegar if you suffer from heartburn or acid reflux. Take 2 tablespoons of vinegar before every meal and see if your reflux is better. If you have high acidity it will aggravate the symptoms and point towards the need for antacids. However, if you get a relief that would indicate that you have insufficient hydrochloric acid. In this case, lower esophageal sphincter fails to close properly allowing stomach juice to go up and cause irritation in your chest and throat.

9. Take probiotics.


Quality probiotics can be life changing. Good gut bacteria are important in breaking down of

food and unfortunately it is stripped off of our GI tract by the exaggerated cleanliness and

sterilization in the West. C-section and limited breast-feeding can be another big cause of poor

microbiome as most of it is developed within first year of life. Rounds of antibiotics kill your

good gut bacteria as well and needs to be replenished as soon as an infection is eliminated.

Taking the right probiotics can help whether you suffer from constipation or diarrhea. It is great

at harmonizing digestion and bringing it back to tick tock mode. Unfortunately supplements are

poorly regulated in the US and a lot of OTC probiotics do not contain any live bacteria in them

and therefore straight-out useless. Pay attention to guaranteed concentration at the time of

manufacturing as well as absence of any harmful ingredients that can irritate your gut even

more.



10. Enjoy your meal


Mindful eating is extremely important and is an overlooked aspect of healthy eating. When you are rushed and stressed, your body is not focused on digestion which ultimately means that nothing is being processed as it is supposed to leading to a chronic detrimental digestive problems. You also get more comfort and satisfaction from food when you are paying attention. It is also easy to overeat when you are multitasking and focused on something else.



At the end of the day remember you are not only what you eat but also what you absorb. And your bowel movement is a clear indication of the condition of your digestion and an overall health.

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