A team led by researchers from the Institute for Systems Biology (ISB) examined the clinical, lifestyle, and multi-omic data from over 1,400 healthy adults. Those with certain health conditions or medication use were excluded from this study to focus on generally healthy participants.
Participant bowel movement frequency was categorized into four groups to look for associations between frequency and factors such as demographics, genetics, gut microbiome, blood metabolites, and plasma chemistries. The categories were: constipation (one or two bowel movements per week), low-normal (between three and six bowel movements per week), high-normal (between one and three bowel movements per day), and diarrhea.
How often you poop influences physiology and health
The team found that how often people poop can have a large influence on their physiology and health. The findings showed that age, gender, and BMI were associated with bowel movement frequency. This was specifically true for younger people, women, and those with a lower BMI, who tended to have less frequent bowel movements.
“Prior research has shown how bowel movement frequency can have a big impact on gut ecosystem function,” said Johannes Johnson-Martinez, the lead author of the study. “Specifically, if stool sticks around too long in the gut, microbes use up all of the available dietary fiber, which they ferment into beneficial short-chain fatty acids. After that, the ecosystem switches to fermentation of proteins, which produces several toxins that can make their way into the bloodstream.”
Unsurprisingly, participants who reported eating a fiber-rich diet, with better hydration, and maintaining regular exercise habits tended to find themselves in the optimal bowel movement zone.
Microbial composition of the gut microbiome, constipation and diarrhea
Microbial composition of the gut microbiome was found to be a sign of bowel movement frequency, and fiber-fermenting gut bacteria (associated with good health) appeared to thrive in a zone of frequency where movements occur 1-2 times per day. However, bacteria associated with protein fermentation tended to be greater in those with constipation and bacteria associated with the upper gastrointestinal tract tended to be greater in those with diarrhea.
Several blood metabolites and plasma chemistries also showed significant associations with bowel movement frequency, suggesting links between bowel health and chronic disease. Specifically for microbially derived protein fermentation byproducts that are known to cause kidney damage such as p-cresol-sulfate and indoxyl-sulfate, which were greater in the blood of participants reporting constipation, while chemistries associated with liver damage were greater in participants reporting diarrhea.
According to the researchers, blood levels of indoxyl-sulfate, in particular, were significantly associated with reduced kidney function, providing preliminary support for a causal link between bowel movement frequency, gut microbial metabolism, and organ damage in this healthy cohort. Additionally, the researchers also examined associations between frequency and anxiety and depression, indicating that mental health history is also connected to how often people poop.
Final thoughts
“Chronic constipation has been associated with neurodegenerative disorders and with chronic kidney disease progression in patients with active disease,” said Dr. Sean Gibbons, ISB associate professor and corresponding author of the paper. “However, it has been unclear whether or not bowel movement abnormalities are early drivers of chronic disease and organ damage, or whether these retrospective associations in sick patients are merely a coincidence.
“Here, in a generally healthy population, we show that constipation, in particular, is associated with blood levels of microbially derived toxins known to cause organ damage, prior to any disease diagnosis,” Gibbons said.
“Overall, this study shows how bowel movement frequency can influence all body systems, and how aberrant bowel movement frequency may be an important risk factor in the development of chronic diseases,” Gibbons said. “These insights could inform strategies for managing bowel movement frequency, even in healthy populations, to optimize health and wellness.”
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