Bowel Hygiene- A Novel Exploration of a Daily Habit

Written by Dr Shobhitha Tantry B

💩Bowel Hygiene:

Gut health is increasingly explored, as it is the cornerstone of the overall health with its multi-organ network connections- neurological, microbial, metabolic, hepatic, immune to name a few.

Gut ecosystem is to be as much protected as your external environment.

Bowel hygiene, thus, is a concept that encases your daily, modifiable lifestyle behaviours, just like your any other hygiene protocols.

🧐Let’s explore into the core!

There are five pillars of bowel hygiene:

Dietary regulation and hydration
Adhering to routine timing
Physical activity
Mind–body practices and
Behavioural toileting habits

📄So, what’s in the basics? And why they need to be strong?

Dietary regulation and hydration:

Max your fibre intake- 25-30g per day- soluble fibre (oats, beans, lentils, apples, citrus fruits, etc) – for happy microbes and insoluble (whole grains, seeds, vegetables and fruits with skin- take care that it’s organically grown) to give bulk to your stools.
Replenish your body’s 60%- drink adequate water as per your body needs and excretes! Do not ignore your signs of dehydration- dry skin, mouth, eyes, feeling of giddiness, frequent rise in temperatures with no underlying cause or other significant history.
The happy microbes- these are your warrior microbes that safeguard your gut barrier from the harmful ones. So, what are they? They are yogurt, curd, idly, dosa, pickles, kimchi, kanji, dhokla.
Do not process processed ones- Choose unprocessed foods! Say no to the whites, the fried, and the unnatural.

Behavioural Toileting Habits

Adhering to routine timing- schedule your bowel movements- especially after the breakfast – as it helps in supporting your gastrocolic reflex.
Respect your urges- when they come, attend to it! No Vegha dharana (suppression of natural urges). If you supress or delay, the urge reflex may weaken over time.
Posture- squatting is the most optimal posture so that your rectum is relaxed, with angle maintained at 35⁰ than your regular western toilets that is at 90⁰. You can also use footstools for the western toilets.

Physical Activity and Mind- body practices

Exercise- Regularmoderate exercise strengthens your core muscles- that is of your abdomen and pelvis, hence supports your digestive organs. Exercises like walking aids by increasing blood flow and reflexively acting on the motility itself. Avoid intense physical activity which may cause hypoperfusion to your gut.
Manage your stress- SMET (self-management of excessive tension)/ cyclic meditation/ mindfulness anything that helps you get rooted. Happy mind = happy tummy.

Sanitation and Environmental Hygiene

Cleaning Methods: Use water for cleaning after defecation, not tissues!
Restroom Hygiene: ensure adequate ventilation to control mal-odours and indoor air quality.
Handwashing: Proper handwashing with soap after contact with excreta can reduce diarrheal disease risk by up to 40%.

Assessing Normalcy

Frequency: Normal range is typically 3 times/week to 3 times/day.
Stool Form: Ideal stool is a smooth sausage shape (Type 4 on the Bristol Stool Scale) that is passed effortlessly without pain or straining.