We all have them, but we rarely discuss them.
Unless you’re in the naturopathic/functional/integrative medicine space.
In which case, you most definitely discuss bowel movements. BMs, for short.
How often should you be having a BM?
- Standard GI criteria define constipation as a combination of: fewer than three BMs per week, straining, difficulty passing stool, hard stool, feeling like you haven’t fully passed stool, over a period of 3-6 months.
- Meanwhile, naturopathic medicine would say BMs should be happening daily.
The reason this matters is that care and treatment are often delayed until there’s a diagnosis.
But if we identify and address a concern ahead of a diagnosis, it allows for better health, improved outcomes and more efficient resolution.
So, you want to be pooping daily.
- At least once, but not more than two or three times.
- Ideally, your daily BMs should be easy to pass and formed like a log.
- We discuss this in way more detail during appointments, but I’ll spare you the details here.
Think of BMs like taking out the trash.
- The trash contains what your body wants to excrete, including toxic metabolites, excess hormones, cellular waste and more.
If that trash sits in your GI tract for an extended amount of time, it can make you feel unwell.
- It can worsen bloating and gas, affect your appetite and reduce your energy levels.
- It impacts your gut microbiome, an important player in metabolism, neurotransmitters and immune function.
- Delayed defecation can also lead to waste getting reabsorbed.
There are so many reasons to take out that trash daily.
Additional tidbits:
- A 2020 review published in the Lancet noted that functional GI disorders “affect up to 40% of people at any one point in time, and two-thirds of these people will have chronic, fluctuating symptoms.”
- A 2020 review published in Clinics in Geriatric Medicine stated, “Chronic constipation affects one-third of the US population and occurs disproportionately in the elderly and female individuals, increasing in older individuals who are institutionalized. This condition has a significant impact on health care costs and quality of life.”
- A 2024 review published in the World Journal of Clinical Cases noted that chronic constipation “is multifactorial and involves factors such as decreased interstitial cells of Cajal [which affect GI muscle contraction], altered colonic motility, enteric nervous system dysfunction, intestinal flora disturbances, and psychological influences.”
There are myriad factors that can contribute to and cause constipation, and there are also different types of constipation that can impact quality of life and health status, especially as we age.
If you are experiencing constipation, know that better BMs are possible.
- It’s important to get a good workup so that treatment can be tailored to your individual situation.
- Treatment can include therapies like dietary and lifestyle changes, supplements, herbal medicine, medication, counseling, mind/body work and more.
- There are many natural therapies that can be supportive.
Talk to your doctor if you need support. If you’d like integrative support, please reach out.
May you be well.
Resources include:
DOI: 10.1016/S0140-6736(20)32115-2
DOI: 10.1016/j.cger.2020.08.007
DOI: 10.12998/wjcc.v12.i24.5476
American College of Gastroenterology
Diaz S, Bittar K, Hashmi MF, et al. Constipation. [Updated 2023 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513291/
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