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.