Dr Sarah Brewer June 27, 2017

Healthy bowels are important for overall wellbeing. Dr Sarah Brewer looks at what you can do to keep yours working well.

When your bowels are working properly, it's easy to take them for granted, but if they start to play up, bowel function – or lack of it - has a major impact on your quality of life.

Some of us are tempted to ignore our bowels but as the nature and consistency of our motions indicates how rapidly food passes through the gut, they can reveal a lot about our digestive health.

The stool scale

A team of gastroenterologists from Bristol invented a stool classification scale in 1997, which defines seven different types of bowel motion.

This means doctors are now able to diagnose some bowel problems according to their symptoms, without having to refer patients for tests. Bowel problems are not something you should diagnose yourself, however, as an examination is important to rule out more serious bowel disorders. Always seek medical advice if you notice a change in bowel habit, recurrent pain, or see blood or slime in your motions.

The Bristol Stool Scale

TYPE 1 Separate hard lumps, like nuts

TYPE 2 Sausage shaped but lumpy

TYPE 3 Like a sausage or snake but with cracks on the surface

TYPE 4 Like a sausage or snake, smooth and soft

TYPE 5 Soft blobs with clear cut edges

TYPE 6 Fluffy pieces with ragged edges, a mushy stool

TYPE 7 Watery, no solid pieces

What's your type?

TYPES 1 & 2 are abnormally hard (ie constipation) and result from a slow bowel transit time.

TYPES 3 & 4 are described as "perfectly normal bowel motions."

TYPES 5 is poorly formed, soft and verging on abnormal.

TYPES 6 & 7 are abnormally loose (ie diarrhoea).

TYPES 1, 6 & 7 are considered abnormal and suggest a current bowel problem or increased risk of developing one in the future.

The role of probiotics

What you may not realise is that your bowels contain around 11 trillion bacteria – more than the total number of human cells in your body. Together, these bacteria weigh around 1.5kg and play an important role in intestinal health. In fact, every 1g in dietary fibre you consume increases the weight of your motions by around 5g – mostly due to increased weight of bacteria.

Ideally, at least 70 per cent of bowel bacteria should be 'probiotic' which includes bacteria types such as Lactobacilli and Bifidobacterium. Only 30 per cent should be other types of bacteria, such as E.coli, which tend to produce gas and in some circumstances harmful toxins.

Cooling help

Peppermint, a traditional remedy for indigestion and bowel spasm, is among the most effective treatments for treating symptoms of irritable bowel syndrome such as abdominal cramps.

Research exploring the effectiveness of fibre, antispasmodics and peppermint oil found that peppermint oil was the best therapy of the three for irritable bowel syndrome.

First line of defence

Our gut is an important first line of defence against infection, and contains a large amount of immune cells.

Your probiotic bacteria play an important role in this defence, helping to boost immunity and also protecting against common conditions such as eczema and asthma.

Keeping a balance

Because our bowel empties regularly, probiotic bacteria are lost from the body along with their less friendly relatives.

If you are stressed, eating badly or taking antibiotics, the number of probiotic bacteria gets smaller, which can lead to an imbalance known as dysbiosis. Lack of probiotic bacteria increases the risk of a number of digestive problems, including:

• Bloating;

• Diarrhoea;

• Constipation.

To maintain a healthy balance of probiotic bacteria in your intestines, aim to top them up regularly – ideally on a daily basis – in the form of a probiotic supplement. Prebiotics also help to promote the growth and survival of probiotic bacteria.

Fantastic fibre

Many of us don't eat the recommended minimum of 18g fibre per day, and a fibre supplement can help to maintain bowel orderliness. Psyllium seed and husks is a highly effective, natural and gentle fibre source.

In the intestines, psyllium forms a bulk that acts rather like a sponge, gently scrubbing the bowel clean as well as absorbing toxins and excess fats. It is particularly helpful for people who cannot stomach other forms of fibre such as bran. Always consume with plenty of water.

And finally…

Don't take your bowels for granted. Spend a bit more time gazing at what you produce, eat more fibre (fruit, veg, wholegrains). If necessary, introduce a fibre supplement and consume probiotic products regularly. If you do develop persistent symptoms don't be embarrassed to seek medical advice.

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