The Real Reason You’re Constipated and What to Do about It
Struggling with constipation? You're not alone. Dr. Kerry Winge reveals the surprising truth about why common solutions aren't working and what you can do about it. In this eye-opening episode, discover why fiber isn't always the answer and learn the science-backed solutions for better gut health. From the gut-brain connection to practical morning routines, we're breaking down everything you need to know about maintaining healthy digestion.
Get expert insights on natural remedies, understand the Bristol Stool Scale, and learn why stress might be the hidden culprit behind your digestive issues. Plus, discover the truth about probiotics and common gut health myths. Subscribe to the Bottoms Up podcast for more insights on digestive health and wellness.
Transcript
Dr. Kerry Winge: [0:00] Welcome to the Bottoms Up Podcast. I'm Dr. Kerry Winge, and today we're talking about something we all deal with, but no one wants to admit.
Dr. Kerry Winge: [0:10] Constipation. Yeah, that bloated, sluggish, why haven't I gone in three days kind of constipation. You're uncomfortable. Your jeans feel too tight, and suddenly you're on Google at 2 a.m. typing, can I die from not pooping? Hey, we've all been there. Here's the thing. Nearly 20% of adults suffer in silence. But not today, friends. We're breaking the stigma and getting real about why your gut might be ghosting you. Today, we're diving deep into the science of why constipation happens, what your gut is trying to tell you, and most importantly, how to get things moving again. Because trust me, fiber alone is not the magic cure that everyone thinks it is. We're covering everything from the fiber fails, the sneaky foods making things worse, whether coffee's your best friend or your worst enemy, and some science-backed hacks to help you poop like a pro. So if you're feeling backed up, bloated, or just plain frustrated, go ahead and grab a glass of water, take a deep breath, and let's get into it. A quick reminder, this content is for educational purposes only, and always consult your healthcare provider before making your health decisions.
Nathaniel DeSantis: [1:35] And quick introduction to myself, I'm Nathaniel DeSantis, the producer of the podcast and the unofficial co-host. For those of you wondering, getting a lot of feedback in the light. So thank you for the comments. And let's get into it. Let's dive right into it. Why are so many of us backed up, Kerry? Let's go over it.
Dr. Kerry Winge: [1:53] All right, let's talk about the five most common causes of constipation. Low fiber diets, dehydration, stress and anxiety, sitting, and ignoring your urge to go. So with low fiber diets, most of us actually are only getting half of the fiber that we need. So that's like trying to drive a car with barely any gas. And dehydration. If you're not drinking enough water, your poop is going to turn into a dry, stubborn brick that just sits in your gut. A lot of people don't understand that stress and anxiety also contribute to constipation. In fact, sometimes it's the top contributor because your gut and your brain are basically in a toxic relationship. So when you stress, your gut stresses out too, and it tenses all up. Combine the stress and anxiety with too much sitting and you're not going to be able to do it. Your poop is just sitting in your gut.
Nathaniel DeSantis: [3:00] Okay. So if it's sitting in your gut for too long, what happens?
Dr. Kerry Winge: [3:05] You really want to know this answer?
Nathaniel DeSantis: [3:06] I don't know if I want to, but I think the audience wants to know. So for the sake of the audience, we'll answer for that.
Dr. Kerry Winge: [3:13] All right. Wah, wah, wah. It actually reabsorbs into your body, into your bloodstream, and it's toxic. And what happens is when it reabsorbs, the water goes first. So it makes your stool even drier. and it's really hard to pass. That's when you get those big poops that don't want to come out and you can end up with hemorrhoids. It's just not good. You know, if you ignore your urge and if you hold it in too often, your body actually stops sending you the I have to go signal. And your gut actually has a reflex with your brain. It's called the gastrocolic reflex. And it happens 20 minutes after a meal where if you listen to your body, you'll kind of feel that urge like, hey, I have to go. So 20 minutes after a meal is actually a good time to go poop.
Nathaniel DeSantis: [4:03] A topic that I think is really important to this and something you mentioned about one of the five most common causes is fiber, right? I remember in college, I had to take a health science class, one of the best classes I took. My grade wasn't that great, but I learned a lot. But I do remember that I learned not all fiber is created equal. So let's kind of unpack what that means, not all fiber is created equally. What is that?
Dr. Kerry Winge: [4:35] Okay, so there's two types. There's soluble fiber and there's insoluble fiber. The easiest way to explain it is think of fiber like a kitchen sponge and a broom, the two different types. So the soluble fiber is your sponge and it is absorbing the water and it creates a gel in your system so that it makes your poop softer and easier to pass. So you can find that type of fiber in oats and chia seeds, apples with the skin on, and beans and avocados.
Dr. Kerry Winge: [5:15] You definitely need more soluble fiber if your poop is hard or dry or difficult to pass. And so the insoluble fiber, that's where the broom comes into place. It adds the bulk and it sweeps the waste through your intestines a little bit faster. You can find that in whole grains, nuts, seeds, leafy greens, and carrots. So you're going to need more insoluble fiber to help push things along if your poop is slow, sluggish, or stuck. But the best strategy overall is you need both. You absolutely have to have both types of fiber to get everything moving. So you're giving fuel for the train to get going, and then you're giving it a little bit gas so that it moves faster.
Dr. Kerry Winge: [6:08] However adding too much fiber too fast like if you went from 10 grams to 30 overnight you are going to be absolutely miserable because you're going to bloat. The gut does not like you to do anything fast so just add a little bit at a time. Allow your body to adjust maybe three, four, five days and then increase your fiber intake from there. The other thing is, is you have to make sure that you have enough water because fiber without water is like cement in your gut and nothing is going to move.
Nathaniel DeSantis: [6:46] So sometimes I remember when I was growing up, I'd walk in my kitchen and my mom would have this fiber, I don't know, almost like supplement where it was like a powder. It's like extra fiber, right? Are those good? Do those work well? Is that something people should be using and supplementing with or is it just better to like reach for the oatmeal instead that morning whole.
Dr. Kerry Winge: [7:06] Foods are better, hands down. If you have a problem, then you can add a fiber supplement for a shorter period of time. But you don't want your gut to be, you know, relying on something that you're taking as a supplement on a daily basis. Plus, you're getting more nutrients from whole foods than you are from that fiber supplement.
Nathaniel DeSantis: [7:26] How much fiber do we need? And does it is there differentiation if you're a man or a woman?
Dr. Kerry Winge: [7:31] Well, actually, men just need a little bit more than women. On the average, men need about 38 grams of fiber a day, and women need 25. So it's not always easy, but it is achievable. And I thought and so we didn't have to spend a lot of time on fiber itself like the actual foods that you can eat because there's so many different combinations that you could do and it's based on your preference and your gut and allergies there are just way too many variables so we thought the best way to show this was that we were going to attach some recipes to the end of the podcast remember we discussed that so the chia berry power bowl is a really good one for breakfast. Plus, we're attaching a recipe for a fiber-filled lunch, a snack, and dinner. And if it's not anything that you like, at least it will get your brain thinking and you can figure out what works best for you. But there are options.
Nathaniel DeSantis: [8:32] We'll make sure to put the link in the show notes for you guys to go press on that and get the link to all these recipes that we're talking about. It'll be really easy to find on Kerry's website. So check the show notes if you're interested in those. But because we're talking about fiber, that made me think about things like breakfast and oatmeal and things like that. And then that has me wondering, morning gut routine, right? Morning should be a great way to start the day and set the tone, set the mood, including for our poops. So what about an easy morning gut routine to get the pipes moving?
Dr. Kerry Winge: [9:05] Yeah, let's hydrate first. I, every morning, I do room temperature water, warm lemon water, and it hydrates and also kickstarts your digestion. I usually add black chia seeds, about one tablespoon, to my warm lemon water, about 20 to 30 ounces, and then I wait 10 minutes so that those chia seeds can gel a little bit, and then I'll add a half a fresh lemon. The other thing I do in the morning is I move my body. Movement equals digestion as well, and a 10-minute walk is going to give you instant gut activation. Then you're also increasing your breath, you're breathing a little bit, you're moving your lymph system because we discussed before is that your lymph system doesn't have its own pump. So your body has to move for your lymph system to move and that gets rid of all of your toxins. It also decreases your anxieties.
Dr. Kerry Winge: [10:01] Then for your belly, you can massage it. Rub your tummy a little bit in the circular motion and usually go clockwise because with the gut, we have the ascending colon, the transverse and the descending colon. So up on the right, cross to the center, down on the left. So you do want to go in that clockwise motion. And if you wanted to, you can add a little bit of castor oil, which is very anti-inflammatory and that will help too. I know on TikTok, they always say put castor oil in your belly button. Have you heard of that, Nathaniel, before?
Nathaniel DeSantis: [10:35] I believe I do remember that being a trend for a while. I thought it was a little bit weird, but yeah, I remember.
Dr. Kerry Winge: [10:42] So it is true. It is a good hack. It's a fact, not a myth. But you want to do your whole gut with the castor oil. So you don't have to worry about using too much. Slather it on. The only thing you have to be careful of is it isn't oil. So it stains everything. So make sure that you put like an older t-shirt on so that you can protect your clothes or anything you might come in contact with. And then in addition, when you do start your morning poop, you want to use a squatty potty or a stool, a poop stool for proper poop posture. And what that means is you want to sit down on the toilet and make sure that your knees are higher than your hips because your body was actually designed to squat and not sit. So we talk about the anal rectal angle. The anal rectal angle is the poop chute and it's like this. But when you sit down and you have a stool under your feet, when your knees come up, it changes the anal rectal angle to more erect so that gravity can help you not only eliminate, but eliminate more poop.
Dr. Kerry Winge: [12:00] So think about it this way. Every animal and mammal that you know, they all instinctively squat to poop. And now I'm gonna talk directly to the moms and you might get a kick out of this, but it's very common when kids reach about two years old that they wanna like completely strip naked and poop without any clothes on. And the other thing that they do, because they want to be free, and then they put their feet on the toilet.
Dr. Kerry Winge: [12:29] And you turn around and there's your kid, naked, putting their feet on the toilet, just sitting there. And nobody told them to do that. Nobody told them to get a squatty potty. Instinctively, they put their feet up there because it is natural. So what do we do in the U.S.? We buy higher toilets. And that's awful because that's really changing that angle bad. And it's hard for us to eliminate. And it's more difficult sometimes, too, to get up and off the toilet. Often, you know, older adults have to have bars there. So all of a sudden, you know, you can't get up and you can't poop and it's not a good idea. So here's my PSA. Everyone needs to have a poop stool. Poop every single time with a stool in every bathroom of your house. And if you have one, great. Buy one for a friend.
Nathaniel DeSantis: [13:24] All of this stuff is really good to start the process of getting the pipes moving. But I don't know. Let's say you're a busy individual and you just want to kind of get it to fix fast. You just want a quick fix. Are there any like foods we can eat? I mean, obviously there are medications we can take and I think we'll kind of discuss later why that's not always the best idea in the long term. But, you know, what about like a natural food? Can I eat something? I'm like all of a sudden like, oh, it's time to go. You know, what can I do for that?
Dr. Kerry Winge: [13:59] So the OG constipation cure that everybody's heard about for years are prunes. They actually do work. Kiwis are great. They're really high in fiber and high in vitamin C. They are clinically proven to help. And then there's magnesium-rich foods because magnesium naturally relaxes the gut. And magnesium is found in almonds, spinach, and dark chocolate. And then the buzzword, too, is fermented foods. Fermented foods like kimchi, sauerkraut, kefir, and pickles. But pickles actually have to be fermented in salt, not in vinegar. Because pickles can be fermented in either. You're really going to have to read the labels. But when they are fermented with salt, which is a brine fermentation, then you have your probiotics. The reason why you don't want to use the pickles that are fermented in the vinegar is because vinegar is acidic and it prevents the growth of bacteria, both the harmful bacteria, but also the beneficial probiotics. So the vinegar pickles don't have the live cultures that support your gut health.
Nathaniel DeSantis: [15:12] Got it. I will be sure to stock up on all those things in case I get constipated. But I think we have some Q&A, both ones that we thought of but also I think we're going to start with a listener question, yes, which we have a couple.
Dr. Kerry Winge: [15:30] Listener questions today, it's great.
Nathaniel DeSantis: [15:31] We do and I think at the end we'll be answering a listener question from the last episode on cortisol so be sure to stick around with that but this question is a two-in-one, this first one's a two-in-one involving vacation and pooping. The listener asked, why do I always poop on vacation but not at home? And then on the flip side, why is it that some other people feel more constipated on vacation than they do when they're at home?
Dr. Kerry Winge: [16:01] Wow. Usually on vacation, you are stressing less. And so when you stress less on vacation, you have more movement, you have better hydration. And so it's like a gut vacation too. But on the flip side, if you're feeling more constipated on vacation, a lot of it has to do with the stress that you're feeling when you're traveling. I mean, what stresses you out when you travel, Nathaniel?
Nathaniel DeSantis: [16:28] Well, unfortunately I'm pretty easygoing, but I do know I have some type A family members. The stresses that they get are things like crowds, right? Like big crowds they don't do well with. Sometimes when you travel, you unfortunately get sick, right? It does a cold going around, something like that. I'm thinking long lines. I recently did a trip with my sister overseas and there were some very long, stressful lines. And if you get there late, you're thinking, oh my God, I'm going to miss everything. And it just kind of causes this overall stress and, you know, freaking out about making deadlines. Like we have tickets that we have to show up on time and being like, so on rigid with everything that sometimes stresses people out. So I think that's kind of the stress associated with travel.
Dr. Kerry Winge: [17:12] Yeah, yeah. Or if you're sitting in the plane next to the person who is coughing incessantly and you can't go anywhere, that stresses me out. But if you remember from the cortisol episode, we talked about our system, our fight and flight system versus rest and digest. So when you're stressing out, the stress actually slows your digestion because your body in fight or flight is prioritizing your survival system. And when the gut is responsible for the rest and digest, everything is going to back up. And that's a reason for your constipation. Also, flying itself dehydrates you. And, you know, water is super expensive in the airport. People will still get it, but you have to, first of all, you can't bring your water through TSA, which is annoying, but you can't. And then when you get there, if you don't have your water bottle, you got to pay seven bucks for water. So a lot of times people don't drink a lot of water when they're traveling, not only because of the expense, but because they don't want to use the public bathrooms and people don't want to pee on the plane. It's disgusting.
Dr. Kerry Winge: [18:21] Unfortunately, that will lead to dehydration. So when you're flying, the rule of thumb is you should have eight ounces of water for every hour that you fly. And, you know, also when you're on vacation, you have food that you usually don't have. So you're having an excess of everything like, hey, I'm on vacation. I'm going to eat and drink what I want. And, well, your system gets backed up because your system gets pissed off. So it happens. It does.
Nathaniel DeSantis: [18:52] This ties back into what you're saying earlier though. If you're on vacation then not every place, if you're at a resort this might be a little bit different, but let's say you go to Europe or you go to New York, you go to like a city you can walk around and yes you've been eating a lot but choose to walk instead of taking the Uber if it's a short walk if you can do that and that will help kind of loosen things up and get things moving for you. The worst thing, I've had this happen, being constipated on vacation, it can ruin a trip. It really can. Conversely, I have had a stomach bug on vacation that can also, yeah, that's a way to ruin a trip too. That was no, that was no fun.
Dr. Kerry Winge: [19:35] That in Mexico when you weren't supposed to drink the water.
Nathaniel DeSantis: [19:38] Believe it or not it was Spain actually. Yeah, it's we actually, it's this is funny I'll say for the audience. We refer to it as what my illness, we called it the Spanish poo, like the Spanish flu, the Spanish poo. My sister, Courtney, I got to give her credit. It was very funny. So be careful. Don't get the Spanish poo, which reminds me, can you actually be full of shit? Is that a thing?
Dr. Kerry Winge: [20:08] So do you mean me or like people in general?
Nathaniel DeSantis: [20:11] People in general. I'd say the constipated people. Are they full of shit?
Dr. Kerry Winge: [20:16] Actually at any given time everyone can be walking around with between five to ten pounds of poop in your belly. That's a baby. That's a baby. It is. It is. It's funny because people say, you know, hey, you've heard the term like I have a food baby. People eat and they bloat. Well, you imagine if they already have that five to ten pounds of poop in there.
Nathaniel DeSantis: [20:37] Speaking of babies, that actually makes me think. This is something that my girlfriend Emily has a problem with. Anytime she's on her period or on her menstrual cycle, she says she gets constipated. What's the connection between that and why? Why is it the case? And is it, is this isolated to her? Is this like a thing?
Dr. Kerry Winge: [20:57] No, it is usually with every woman. They have some level of constipation based on their hormones and the changes that are happening right before their period. So hormones actually control more than just your mood, right? They play a huge role in your gut health and they play a big role in your digestion. So if you ever have felt that you're backed up before your period, you're not imagining it at all. The week before your period is called the luteal phase and I call it the constipation zone. I see a lot of patients that are in my clinic, and we help them with releasing some of their constipation points using acupressure and a lot of other techniques that we have. If you guys have any problems, come see me.
Dr. Kerry Winge: [21:47] But overall, your hormones, when they're changing, before your period starts, your progesterone rises. And progesterone is one of the major hormones that slows your digestive down like a traffic jam actually in your intestines. In fact, when women are pregnant, their progesterone and estrogen actually, you know, they go through the roof because they're trying to grow a beautiful human in their belly. But one of the things that happens in the first three months of pregnancy when that progesterone shoots up as well is everything slows down and they have constipation problems. So at that point in time, when your gut starts to slow down, that we talked about the traffic jam, your gut is absorbing more water and it's making your stool harder and drier. Because your body is what's called a, in a conserve energy mode. So your metabolism slows down and slow does your, and so does your digestion. This is what is causing the bloating, the constipation, and also feeling full even after small meals.
Dr. Kerry Winge: [22:58] So in order to fix this, I mean, if you have a monthly cycle, it's happening every month. You want to increase your fiber and your hydration. So I would suggest eating some flax seeds and chia and some leafy greens, as well as what we mentioned before, those magnesium-rich foods, almonds, dark chocolate to relax the intestines, and the warm lemon water that we talked about for the kickstart in the morning. That's going to help your digestion. The other thing that you can do is focus on gentle movement, walking and yoga to help your digestion, and eat some probiotic-rich foods like yogurt and kimchi to balance your gut bacteria. But I'd like you to avoid dairy, red meat, and processed foods because all of those can worsen your cramps and your bloating. In order to manage some hormonal constipation, you can also track your cycle. So I want you to notice when your constipation happens to you and so that you can try to prepare for that.
Nathaniel DeSantis: [24:02] If you have an iPhone, the health app has really good period tracking built in. And if you have a newer Apple Watch within the past year or two, it actually will use your body temperature to help you track your cycle as well. I know that that is something that my sister has a dedicated device just for tracking her temperature, her basal temperature is I believe what it's called and it's really good at figuring out when these things are going to happen and if you can track it and see the correlation I think that's really powerful to have that data point so you can know and if you know, oh like my Apple Health app is telling me in a week I'm gonna have my period then you can be more cognizant about those things and maybe go to an extra yoga class like you're talking about. But let's move on now though to the to myth or fact. Let's talk about some myths that people hear and some facts that people hear. So let's talk about this first one and you tell me if it's a myth or a fact.
Dr. Kerry Winge: [25:04] Okay.
Nathaniel DeSantis: [25:05] Do some people say you need to have a bowel movement every day? Myth or fact?
Dr. Kerry Winge: [25:11] Fact, because that would be good. Everyone's normal is different, though. So some people go one to three times a day where others go every other day. Constipation is actually defined more by difficulty passing the stool or infrequent, hard or painful bowel movements rather than the exact frequency, which is going to be individualistic to every person.
Nathaniel DeSantis: [25:35] So next one, and this one would apply to me really well. Something I think the listeners will learn is that I have a bit of a coffee addiction. I have like half a pot to a pot. It's bad. That's probably the worst thing I do to my body, though. So that's the worst thing. A little bit too much coffee. I'll take that. But sometimes, and I think this is a fact. So correct me if I'm wrong, though. But myth or fact, drinking coffee is one of the best ways to relieve constipation.
Dr. Kerry Winge: [26:03] Fact. That is true. and I'm not going to harp on your coffee habit either because coffee is really high in polyphenols and if you are drinking a high quality coffee, then that's a game changer. And coffee can actually stimulate bowel movements. For some, it's due to the caffeine's effect on the gut, but you have to be careful because coffee can dehydrate you. So, and if it does, then it can potentially worsen your constipation in the long run. So hydration and fiber are actually more reliable for the regularity. You can drink the coffee just because you enjoy it.
Nathaniel DeSantis: [26:41] Well, the great news is I drink a gallon of water a day, so I I don't think my coffee's impacting me. Until I take a cortisol test, my coffee's causing no problems. Let's go on to the next student though. Myth or fact, laxatives are a safe long-term solution. True, false?
Dr. Kerry Winge: [27:00] No, no. Overuse of stimulant laxatives like Ex-Lax can make your body dependent on them. So then that weakens your natural bowel function. just like when I was telling you that there was a connection between your bowel and your brain. So if you're giving your body something in order to go all the time, then your body's not going to do its job. So I really want you to focus on the natural methods that we went over first, diet, hydration, and movement.
Nathaniel DeSantis: [27:33] What about holding in a bowel movement? Some people say holding in a bowel movement isn't a big deal. True, false, meant, fact.
Dr. Kerry Winge: [27:41] No, you do not want to ignore the urge to go because that can lead to your stool building up and it will be harder and drier. It's going to make your constipation worse over a period of time. So the chronic suppression of not going can also lead to issues like hemorrhoids and it can lead to pelvic floor dysfunction, which is what I treat every single day. It's called pelvic floor dyssynergia. It is a coordination disorder. So what that is, is when you try to poop, your body needs to relax in order to allow everything to exit. But your brain wants to tighten up your pelvic floor when something's trying to come out. So basically, everything gets jammed up. And if you have a problem with this, come and see me at the clinic. We have a ton of different treatments that we can offer in order to solve your constipation problem.
Nathaniel DeSantis: [28:42] I don't know. If you are like this, Kerry, I'm sure someone listening is like this. but I, maybe TMI for the audience, but I sometimes get anxiety poops. Like if I know, for example, I get, I know I have to be on a stage and give a presentation. I love giving presentations. I love public speaking, but sometimes all of a sudden it's like, because I'm like, oh, I don't want to have to poop during this. The anxiety of that makes me have to go to the bathroom. But what I'm hearing is that stress is a constipator. Why is stress in this situation not a constipator.
Dr. Kerry Winge: [29:19] Well, it can go either way. It definitely can. You also feel that, you know, or you've heard about when people get nervous, they vomit.
Nathaniel DeSantis: [29:25] Yeah.
Dr. Kerry Winge: [29:26] So yours is just coming out the other end. It is just your nerves. And that is the brain-gut connection, right? Your gut's not nervous. Your brain is telling you that you're nervous. And as a result, your body is responding and kind of eliminating everything that you have.
Nathaniel DeSantis: [29:43] Yeah. Well, I had one bad experience with, I learned the hard way that running and movement can be a diuretic.
Dr. Kerry Winge: [29:50] Oh no.
Nathaniel DeSantis: [29:51] I think that's scarred me.
Dr. Kerry Winge: [29:53] Yeah.
Nathaniel DeSantis: [29:54] There was a short-lived one-day period where I was like, maybe I want to be a Navy SEAL one day. And I read that running is like the number one thing to do. And I was like in middle school. And so I went for a run and I quickly learned, Maybe I don't want to be a Navy SEAL. Maybe running's not for me. Maybe I should stick to lifting. That's what I did. But it's funny because anytime I go on a road trip, like in my car, in my trunk, I keep two rolls of toilet paper. And then when I go on a road trip, I never have that poop anxiety. So if anyone is like that and has that problem, put that in your trunk, not a problem because I would always be like, what if that's- Literally, put it in your trunk. Because I'd always have like this anxiety like well what if I'm on the road and I get stuck and something happens like I'm in a traffic jam for eight hours which has happened to me before you know not that I'm stuck and I have to go to the bathroom but the eight hour traffic jam and just having that in there helped with my anxiety of that.
Dr. Kerry Winge: [30:53] It gives you it gives you a little bit of reassurance just in case I have what I need I think that's smart.
Nathaniel DeSantis: [31:00] Thank you. Let's go back to our myth or fact, I think something that we should answer is what about this idea that only older adults get constipated?
Dr. Kerry Winge: [31:12] Definitely not. I mean, it's true that as you age, that can slow down your digestion, but constipation affects all ages. I treat kids in the clinic as well. I think my youngest was four. Actually, that could talk. No, that's not correct because I've had some infants as well. So, you know, babies that have colic, they also have some slow motility issues. But especially stress, poor diet, dehydration, sedentary lifestyles, young, healthy individuals can experience constipation. We already talked about it due to travel, hormonal changes, gut imbalances. So that encompasses everyone. It's not age specific.
Nathaniel DeSantis: [31:54] What about the, what about probiotics? People say, take a probiotic, you'll be good to go. Is it an instant fix? Yes? No?
Dr. Kerry Winge: [32:05] No, they're not quick fixes. Probiotics support your gut health, but over a period of time. So if you start to take them and you take them regularly using probiotic foods, as well as some supplementation, they're going to help regulate your bowel movements. But it's best when combined with fiber, hydration, and a balanced diet. And also, not all probiotic strains work the same way, and some are better for bloating rather than constipation. And you really have to be careful which ones you choose based on your individual chemistry.
Nathaniel DeSantis: [32:39] Okay, and then what about, I've heard that if you're constipated, you should just wait it out.
Dr. Kerry Winge: [32:48] Well, chronic constipation that's lasting weeks or months, that can lead to hemorrhoids and anal fissures and fecal impaction. So that if that's left untreated, that's something that you'll end up in the ER for. We don't want that to happen. You really have to address the root cause, whether it's diet or hydration, stress, or even if you would have an underlying medical condition. It's pretty rare, but it absolutely can happen. So no, don't wait it out. If it's been more than five days, then I think it's important to address that.
Nathaniel DeSantis: [33:23] Last myth or fact, I've heard this. I tend to think this is not true. Maybe it is. Maybe it's not. We'll see. But eating greasy or fatty foods will help lubricate the intestines. Is that true or no?
Dr. Kerry Winge: [33:39] No, not at all. It can make you sick. And if you don't have a gallbladder, you can end up going to the toilet very quickly. But the true fact is that unhealthy fats that are in fried foods and processed oils, they're going to actually slow down your digestion, causing bloating rather than promoting your bowel movements. However, eating healthy fats like avocados, olive oil, flaxseed oil, they can support a smooth digestive process.
Nathaniel DeSantis: [34:11] Love that we quickly did that rapid fire because I'm sure a lot of people have heard those myths, have heard those truths, whatever it might be. And it's good to have definitive answers on those. So I think we're coming to the end of the episode, though. And I thank you, everyone who's listened this much, but stick around to the very end because we're going to answer a listener question. But before we do that, Kerry, could you just do a quick recap, key takeaways, simple action steps that people can do from what we've learned today?
Dr. Kerry Winge: [34:40] Absolutely. Okay. Recap. I want you to increase your fiber, 25 grams for women, 38 grams for men, and two to three liters of water a day. Make sure that you're working and moving, not just sitting all day. Try to integrate your movement. If you have a sedentary job, try to get up two to three minutes every hour, have short walks, including your workouts. You want to support your gut with the prebiotic and the probiotic foods. Remember, we have a recipe right at the end of the podcast that are in the links.
Dr. Kerry Winge: [35:22] Work on finding tools to manage your stress, observe your thought patterns because of of the gut-brain connection, we all know it's a real thing. And I want you to listen to your body signals. So when you feel that you have to poop, you need to go. But most importantly, actually two things. Number one, if you're having some constipation problems, you can always contact your local pelvic floor physical therapist. They will help you. And buy yourself a poop stool if you don't have one and buy one for everyone you know. So now you have everything that you know to keep things moving, literally. Try these tips. Let us know what works best for you.
Dr. Kerry Winge: [36:12] And if you love this episode, hit subscribe, share it with a friend who needs to hear this, and send us your gut health questions for next time.
Nathaniel DeSantis: [36:21] All right. So we're here at the end of the episode, and now is the time to answer two listener questions that we got. We're going to start with the first one that relates to poop. And then in a second, we're going to talk about cortisol and tie it into the last episode. The first question, though, Jen from Colorado asks, how do I know if my poop is normal? I've heard something called the Bristol scale, but I'm not sure what's actually healthy.
Dr. Kerry Winge: [36:48] You know what? I love this question because it's so important. And yet people often feel embarrassed to ask about it. You know, everybody's looking at their poops. So let's dive in and demystify what is actually happening in that bathroom. So what's normal and what's not normal? Here's the thing. Normal can vary quite a bit from person to person. So some people poop three times a day, other three times a week, but both can be perfectly healthy. What matters is more the consistency and the comfort and your normal and was actually regular for you. So she asked about the Bristol, the Bristol stool scale or the Bristol stool chart.
Dr. Kerry Winge: [37:39] Other one. You can Google it. It's very, very easy to find. So think of it as more of like a, it's like a poop personality test, and it helps us categorize the different types of bowel movements. There are seven types.
Dr. Kerry Winge: [37:56] I'm trying to describe them in a way that's not going to actually gross everybody out. Hopefully, if you're eating your breakfast, you might want to put it down for right now while you're listening to this podcast. So type one, it's like hard separate lumps, like little rabbit pellets. And type two is lumpy, but it's held together, kind of like a bumpy sausage. These two types usually mean that you're constipated and that you might need more of that soluble and insoluble fiber that we had talked about, as well as more water in your diet. Type three and four, this is where you want to be. These are our Goldilocks poops and they're just right. So type three is like a sausage, has a little bit of cracking in the surface and four is smooth, snake-like, we kind of call it the ultimate banana poop. So if you're hitting these types of poops most of the time, high five, good job. But then we're moving on to more of like a little bit of a looser stool, that's five through seven. And type five is kind of like a soft blob, clear edges. Six is mushy with some ragged edges, and seven is when you have that kind of like explosive diarrhea that you can't hold in. These might mean that you're actually dealing with some inflammatory problems or that something is moving through your system a little bit too quickly.
Nathaniel DeSantis: [39:20] Great, great info on the Bristol chart or scale. Again, Google it. you can you can see the visual representation of what one through seven look like. So take a look at that not when you're eating breakfast as Kerry said, but it is worth paying attention to. So the second listener question comes from Kim, and this is the one that ties in with last week's episode on cortisol. And as a reminder, we talked about fasting, but Kim asked, well, Kim actually said, love the podcast. Thank you, Kim. How does intermittent fasting affect cortisol? So we talked about fasting and how it affected it, but intermittent fasting just as a primer for the audience is a little bit different from fasting. Fasting is when you go generally a day or more without food. Intermittent fasting is when you have fasting windows. So it might be like a 16 hour window. That's the most common or 18 hour, the second most common without food. And then you have a time that you can eat every day. So how can we answer that question for Kim?
Dr. Kerry Winge: [40:26] Okay, Kim, here's an answer to your question. And thanks for asking it. Because I'm sure that there's other listeners that want to know the same information. So let me break this down in a way that will hopefully make sense to everyone. First, we need to understand that cortisol is our body's primary stress hormone and think of it as part of your body's natural alarm system. So it works on a daily rhythm with the highest levels in the morning to help you wake up and the lowest at night when you're winding down. So now when we talk about intermittent fasting, or IF, as many people call it.
Dr. Kerry Winge: [41:05] We're essentially introducing a new pattern to our body's routine. And yes, so this absolutely affects our cortisol levels, but in some really interesting ways. So in the short term, when you first start intermittent fasting, your body sees this change in your system as a mild stressor. So it's like, hey, where's my breakfast? And it responds by bumping up those cortisol levels just a little bit. But this isn't necessarily bad because it's actually helping you by mobilizing those energy stores and keeping your blood sugar stable when you're not eating. But here's where it gets really fascinating. And I love sharing this with my patients. So your body is incredibly adaptive. and after you've been practicing it for a while, the intermittent fasting that is, something remarkable starts to happen. That initial cortisol spike, it often becomes less pronounced. So I've seen patients whose cortisol rhythms actually improve with their intermittent consistent fasting and this is really important for all of our listeners, timing does matter a lot.
Dr. Kerry Winge: [42:20] So if you're doing it, try to align your eating window with daylight hours because it works better with your natural cortisol pattern. It's like rowing with the current instead of against it. And now I do need to add a note of caution because if you push your fasting too far, we're talking like long periods of time, or if you are severely restricting your calories, you may end up with chronically elevated cortisol. And that's not what we want. We don't wanna work against ourselves. And remember, everyone's different. So what works beautifully for your friend might not work for you. But for anyone trying, here's my doctor's tip. Start gradually and pay attention to how you feel. Are you more irritable? Are you having trouble sleeping? Do you feel a little anxious? These might be signs that your cortisol response actually needs some attention. So if you try these tips and actually have that hallelujah poop, we want to hear about it. Well, maybe not all the details, but let us know what works for you. DM us, tag us, and send us in your gut health questions for our next episode. We will see you soon. Happy pooping.