You KNOW you've wondered this :). 

Hi, it's me, Dr. Kelly, Pelvic Floor Expert, and Double Board Certified Pelvic PT to the stars, here to teach you EVERYTHING you every wanted to know (and a few things you never even knew you wanted to know) about how your AMAZING body turns food into poop.  

The gist of this post is that Poop is supposed to happen EVERY DAY, painfree, in less than a minute, with NO STRAINING, and preferably not in our pants.  Are you ready to learn more about this?  I sure am!  Let's GO!

How Your Body Makes Poop

1 Your Poop Starts BEFORE You EAT!!!

Say what?!?!  It's true.  You Poop BEGINS with the food that you choose to put into your grocery cart, and the drinks you choose to put into your glasses, my friends.  

In the most simple sense, food comes in one end of a tube, and poop comes out the other.  But you literally can't have poop come out the back end, if you don't have enough "stuff to make the poop" coming in the front end.  And for some reason, many people don't think about this rationally.  And of ALL THE STUFF, three things matter THE MOST!!!

a. You Need Enough FLUID to Make GREAT POOPS!!

You've heard this a million times in this blog, and on my socials, and you'll hear it a million more, but you need to take your body weight in pounds, and divide this by two.  That gives you your BASE NUMBER of fluid ounces to shoot for each day.  So I weight 160#, so I need to shoot for 80 oz of fluid every day!  75% of which should be non-caffeinated and non-alcoholic.  Non-negotiable.  (more base-fluid if I am active, breast-feeding, or live in a high-dry climate)

b. You NEED Enough FIBER to Make Great Poops!!

YES!  25-30grams, or 10 grams of fiber PER MEAL should be your foundational goal for ever after.  But here's the thing, chicken-wing.....if you are eating "all the fiber"...without enough water...you're going to be constipated!!!!  

Deets on constipation later, but did you know that fiber isn't just "the stuff that forms the poop" but it's actually the food that feeds our gut bacteria, so that THEY can digest our food for us, and make the nutrients available to our body?  

Isn't that amazing, and a little creepy?!?!  

c. You NEED Enough Protein (& just STUFF) to Make Great Poops!!

Bare Arse Minimum of 20 grams of protein per meal, but honestly closer to 80 grams a day is great, and if you are actually trying to build muscle, which ALL of my perimenopausal and menopausal women should be, then I NEED YOU to work with a nutritionist AND personal trainer (and primary care provider, if needed) to get your protein intake up to nearly a gram per pound of body weight, ladies.  YES, I said it.  And I mean it.  You can do it.  

If you don't have enough STUFF going in the tubes, you won't make GREAT POOPS. 

d. You also Need "The RIGHT STUFF" to Make Great Poops!!

Mike drop...did you know that everyone has an "enterotype", which is a primary bacteria in our intestines that help us digest our food for us?  And remember that the fiber we are eating is mostly to feed the bacteria in our guts...so the food that we eat, is honestly to feed the bacteria to keep them happy, so they can break down the rest of our food to nourish us properly....

...but if I eat a bunch of sugar...then all sorts of "bad bacteria" can flourish in my guts, and I might feel crappy.  I might know that I feel crappy, or I might not know this.  I might also be depressed, or have blood sugar issues, or pain issues, or period issues.  And they might be as related to my diet as they are to my posture or muscle balance.  WOW.  

...and when I switch to a CLEAN DIET, these "bad bacteria" can no longer thrive, because we starve them off, and they no longer have extra sugar to live off of....and now we're left with good bacteria, and we are happier, less painful, less bloated....possibly having better poops (as long as we're drinking enough water and have a relaxed buttonhole)....so fascinating, and worth a blog post of it's own right.  So that's why great poops start with food choices....on to step 2...THE MOUTH!!!

2. The Mouth

Physical digestion starts in the mouth, where you (hopefully) chew your food :). I mean, I guess technically it might have started when you saw the food, or smelled it, as your salivary glands would have started to secrete digestive juices, to get ready for the delicious food.  But once the food hits your mouth, your teeth will mash it up, your tongue will pull it to the back of your throat where it is pulled down into your stomach, where digestion starts to get crazy. 

3. The Stomach

Digestion in the stomach is truly incredible.  There's acid strong enough to burn a hole through your car's bumper, yet your stomach (generally) doesn't eat itself.  The stomach is offset to the left of our belly a bit, and shaped like a jelly bean, so that liquid can kind of "bypass" the main digestive parts, and move right down to the small intestine, but "solid food" needs to spend some time churning in acid, to be broken down into a mush....picture creamed corn (technically called chyme, and I DARE you to use that in your social media TODAY, and PLEASE TAG ME IN IT!!), before it's sent on to the small intestine, through a special valve called the pyloric sphincter.  

The pyloric sphincter is like a miniature butthole, which rests closed, and opens in small bits, automatically, to allow small portions of digested food (the chyme, remember) into the small intestine, where the MAGICAL small intestine can work on absorbing the nutrients for us!!

4. The Mystical, Magical, Small Intestine!

Cue the Benson Boone music.  The Small Intestine might be my favorite organ, and that is saying something.  It is divided into 3 parts, the duodenum, jejunum and ileum, and is where our body absorbs most of the nutrients from our food.  

Super Cool fact about the absorption in the small intestine: In the villi of the small intestine, where the actual absorption of nutrients is taking place---the barrier between the intestines and the blood stream is only one-cell thick!!!. So remember in the opening section when I said how important our food choices were?  If we choose a food that our body does not like---what that means scientifically is that our body would recognize that food as an enemy, or antigen, and treat it as a "bad-guy cell", and have an immune reaction to it.  

If the immune reaction is bad enough, it is a full-blown food allergy....but if it is mild, we just get bloaty or irritable...but if the barrier is only 1-cell thick and we get bloaty...that one-cell might inflame, and suddenly digestive juices are in the bloodstream....and now they can get anywhere in the body...and that's not good.  So it's imperative to all humans, but again, especially my perimenopausal and menopausal sisters, that we occasionally do Anti-Inflammatory Protocols to check in with our digestive tracts to see "what foods our bodies are tolerating well NOW, at this point in our lives", so that we can minimize systemic inflammation.

At the end of the small intestine is another important door, the cecum, which is another internal butthole, that controls the flow of chyme from the small intestine into the large intestine.  When the small intestine is "done absorbing nutrients", the body signals the cecum to open. While it's amazing how often this happens perfectly, lots of things can cause this to go wrong.  That's for another post. 

5. The Large Intestine. 

Okay, The food has been lusted over by the eyes and nose; smashed by the teeth; mushed by the stomach; pillaged of nutrients by the small intestines...now the mush passes perfectly through the cecum and finds itself in the ascending colon, which travels from low in our right hip up to under our right ribcage....then the transverse colon which goes from under our right ribcage, to under our left ribcage....then finally down our descending colon, which goes from under our left ribcage to our lower left hip.  This whole time, water is being resorbed into the body, and some final salt balance stuff is being taken care of (so if you aren't drinking enough water, and your chyme was too dry to begin with, you are going to have rabbit pellets, friend). 

Finally, the poop ends up in the storage tank, the Sigmoid Colon.  

6. The Sigmoid Colon, Anal Canal & Rectum

This is where the REAL magic happens, seriously.  The sigmoid colon makes 3, 90 degree turns in it's final descent to the rectum, which is ridiculous, but is likely how we rarely poop our pants in real life, considering how soft (most of our) poops are.  

The Rectum is the holding zone where our poops rest before they are ready to come out.  

The internal and external pelvic sphincters rest here, as do the pelvic floor muscles, and herein lay the magical nerves that help your brain and body decide the ever-so-important question "Is it poop? Is it gas? or is it diarrhea?"  

There are super-special cells that are constantly testing, or sampling  the stuff inside the rectum to see if it is poop, gas, or diarrhea.  If it is "some poop and some gas", there is a cool reflex that lets us fart without pooping ourself (again, for another post, because this one is getting long).  And if we have to poop, these special cells will give us an urge, which should be a medium one, NOT an emergency, which we should listen to....we should walk to a bathroom, sit down, put our feet up on a stool, so our knees are higher than our hips.  We relax our pelvic floor muscles, which is the signal for the colon to push the poop out, and Voila! our colon should push our poop out within 15-25 seconds, we should wipe 1-2x, and then not have to poop again for another day or so (technically some people do poop 2-3x/day, some people 3/wk...but as long as it is soft-formed sausages and easy to pass, it's considered "normal"...however I've never met anyone who pooped 3x/wk who met that criteria).  

So that's how your body turns food into poop.  Your body should make poop daily, painfree, hopefully not in your pants.  If that doesn't happen, you know who to call, I think ;). 

XOXO

Dr. Kelly 💋

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