Poop - what is normal?
This is not a substitute for direct care by YOUR doctor. Confirm with your doctor before doing any of the following.
How much should I poop???
- Most people should poop anywhere from once every 3 days to 3 times a day.
- For those of you with an ostomy, you should have 0.5 to 1.0 liters of output, on average, daily.
- Your poop consistency should be a 3 or 4 on the handy Bristol stool chart. If you are having frequent bowel movements but they look like numbers 1 or 2, then you are constipated.
- If there is blood in your stool, in the toilet, or on the toilet tissue then you should see your doctor!
Thompson WG. Constipation and catharsis. Can Med Assoc J. 1976 May 22;114(10):927-31. PMID: 1268778; PMCID: PMC1957091.
Walter SA, Kjellström L, Nyhlin H, Talley NJ, Agréus L. Assessment of normal bowel habits in the general adult population: the Popcol study. Scand J Gastroenterol. 2010 May;45(5):556-66. doi: 10.3109/00365520903551332. PMID: 20205503.
Constipation
- If you are not having bowel movements (or having bowel movements less than every 3 days), your bowel movements are hard, you have to strain with bowel movements, and / or your bowel movements are small pebbles - YOU ARE CONSTIPATED.
- Sit in 8 to 10 centimeters of warm water (sitz bath) for 15 to 20 minutes 3 times a day and after bowel movements. Then pat the area dry. Do this as long as you have pain in your anal area.
- Avoid sitting on the toilet for long periods of time (greater than 5 minutes) or straining during bowel movements. After 5 minutes, get up and walk around. Wait to return to the toilet until you are absolutely ready to have a bowel movement.
- Make sure that you are drinking at least 64 ounces of non-caffeinated non-alcoholic liquids daily.
- To PREVENT Constipation use Fiber. Fiber in your diet is sometimes not enough and frequently, supplementation is needed. Fiber supplements can be part of healthy living like vitamins and exercise (see fiber guidelines).
Constipation TREATMENT
1. Start with 200 mg Colace (Docusate) twice a day. This is in addition to the fiber and hydration recommendations. Most bottles of Colace (Docusate) say to take 100 mg twice a day. This dose is not typically effective. Increasing the dose is safe.
- OR you can start with Magnesium Oxide 400 mg tablet daily and fiber (along with staying hydrated).
- OR you can start with Magnesium Oxide 400 mg tablet daily and fiber and Colace (along with staying hydrated
2. If that does not work then ADD Miralax (purple cap bottle) 1-4 times a day. You can even take 1/2 capful or 1/3 of a capful. As Miralax is a powder, you can modify the dose as needed. You can also take 1-4 doses at one time versus a dose before each meal, etc. The right option is the one that works best for you.
3. If that does not work, then ADD one dose of magnesium citrate or milk of magnesia.
- You can substitute one of the above medications with Senna or Dulcolax. Do NOT take more than the manufacturer recommendations for these medications.
You can mix and match the above recommendations to find the right option for you. Everyone has a different GI tract, microbiome, physiology, etc so the right regimen might be different for you than someone else. The right regimen is the one that helps you get soft stool, no straining, and a bowel movement somewhere between 3 times to every 3 days.