If you’ve ever wondered whether you’re pooping often enough, taking too long, or trying too hard, a new book called You’ve Been Pooping All Wrong aims to relieve you of some misconceptions and point the way toward healthy habits.
The author is the gastroenterologist Trisha Pasricha, MD, MPH, a physician-scientist at Boston’s Beth Israel Deaconess Medical Center, an assistant professor at Harvard Medical School, and the Washington Post’s Ask a Doctor columnist.
Here are seven of the most persistent myths about bowel habits, according to Dr. Pasricha, plus useful ways to rethink what “normal” really means.
1. You’re Focused on Pooping Every Day
Is a daily bowel movement the gold standard? It’s not. Contrary to what you may have heard, healthy bowel habits are not defined by how many times per day you poop, nor is a daily bowel movement the ultimate goal, writes Pasricha.
The healthy range is much broader than many people realize — anywhere from three times a day to once every three days.
That doesn’t mean frequency is meaningless; it just means it’s not the whole story. Someone can go every other day or so and be perfectly fine if it’s easy and comfortable, notes Julia Barten, DPT, a physical therapist at the Stanford Pelvic Health Center in California.
A better benchmark is whether pooping feels easy and fits into your life and not whether it happens on a perfect 24-hour schedule.
2. You’re Sitting on the Toilet Too Long
A bowel movement should not feel like an endurance event. If you’re straining, sweating, and lingering on the toilet hoping something finally happens, that’s a sign to stop, according to Pasricha.
“Get up after five minutes, walk around, and try again later,” she writes, warning that prolonged straining can raise the risk of hemorrhoids (enlarged or swollen veins around the outside of the anus or in the lower rectum).
Barten tells her clients that a healthy bowel movement should happen passively with a healthy and relaxed pelvic floor and without active forcing. In ideal circumstances, it should be done in less than five minutes.
That said, not all stools are perfectly formed, and some require more patience or effort to fully evacuate. “But it’s counterproductive to make a habit of sitting longer than 15 to 20 minutes to complete a bowel movement,” says Barten.
3. You Assume Pain Is Normal
“No pain, no gain,” isn’t a good motto for toilet habits. A healthy bowel movement should be comfortable and reasonably easy to manage in everyday life. If it regularly hurts, feels wildly urgent, or derails your day, that could signal an issue, writes Pasricha.
Pain on the way out is not something to brush off, she notes, because it can point to a problem near the anal area, such as a hemorrhoid or fissure (crack or tear in the thin tissue lining the anus).
Common culprits for pain during pooping include poorly formed stool and pelvic floor muscle issues, says Barten.
Sometimes the fix is basic: more fluids, more fiber, more movement. In other cases, especially if pelvic floor muscles are too tight or not coordinating well, pelvic health physical therapy can make a real difference, Barten says.
4. You Think Constipation Is 1 Thing With 1 Cause
Constipation is a term that encompasses many different biological processes and symptoms, Pasricha writes. For example, two people may both spend an hour straining for very different reasons. One may have a pelvic floor disorder where the stool gets to the end of the digestive system, but the body isn’t letting it out easily, while the other has a lack of propulsion — the colon isn’t pushing effectively enough to move waste forward.
The reasons behind the symptoms are important because they can change what kind of help is most likely to work and determine whether the problem is really constipation at all, says Barten.
5. You’re Trying to Poop in the Morning Even if Your Body Isn’t Ready
For many people morning is prime pooping time. The body often gets a boost after waking up and eating, thanks in part to the gastrocolic reflex — a normal response that helps stimulate the colon after food enters the stomach, according to Pasricha.
But there’s no one perfect hour to poop. A consistent morning toilet routine can work for some people, especially if sleep, meals, stress, and exercise are on a fairly regular schedule, says Barten. But the bigger goal is an easy bowel movement when your body is ready for one, whenever that is.
That said, pooping is mainly a daytime activity and shouldn’t routinely wake you up from sleep, writes Pasricha.
6. You Worry That Using a Laxative Is Bad
A lot of people hear “laxative” and immediately think of dependence or personal failure. Pasricha pushes back on that. “There’s no great horror in ‘needing’ a laxative if it will help you live your best life,” she writes, especially if lifestyle changes are not enough to promote healthy bowel movements.
At the same time, taking multiple laxatives a day or using laxatives frequently should prompt you to check in with a doctor about what is driving the problem and whether something other than laxatives might work better, she says.
7. You Think Your Colon Needs a Cleanse
Detox culture has done a number on people’s understanding of gut health, says Pasricha.
You don’t need to cleanse your gut of toxins because you already have very sophisticated organs that do that job.
And those juice cleanses that promise to clear “pounds of poop” that are hanging out in your body? Pasricha says that’s a myth — for most people, the poop you have in your body is perennially in transit and expelled within a couple of days without a detox.
On top of that, juicing strips away most of the beneficial fiber from fruits and vegetables, she says.