Monday, April 4, 2011

Much ado about Bowel Movement

Want to manage your toilet metrics? There's an app for that. Actually, multiple apps - like this one recording precise GPS location of bowel events along with their shapes and odors or IBS symptom tracker and GI monitor, approved and designed by gastroenterologists.

Yet, the lists of metrics provided by these applications are not complete - no options to record color, consistency, texture, effort... And what about total time spent? According to IBS forums, it could range from seconds to ... "long enough to play a full game of Scrabble". An Israeli scientist (Sikirov, 2003) found that times "needed for sensation of satisfactory emptying" range from 50 to 130 seconds for healthy volunteers.  He plotted time and effort vs the height of toilet (41cm or 16-inch-high, 31cm or 12-inch-high toilet, and a plastic container) and found notable correlations - the shorter the better. US team (Rao et al, 2006) evaluated internal pressures of subjects with a water-filled balloon or silicone-stool in their rectum, rating their stooling sensation. As one could guess, silicone was more pleasurable and sitting was better than lying flat.  Japanese scientists (Sakakibara et al, 2010) measured hip flexon vs angularity of the  rectoanal canal and recorded abdominal pressure. Their conclusion was that squatting helps.

This is in line with observations by IBS sufferers: like this one about getting down on hands and knees and rubbing the floor with head before going to bathroom. or keeping knees elevated by placing feet on a footstool.
who wrote this well-researched article for Slate (Not a bunch of Internet quackery!) conducted his own squatting experiment - each morning for a week, following a bowl of corn flakes and a cup of coffee . As his 10-minute routine dropped to a minute, he was able to free an hour per week for more productive work.

The moral of the story is that we need not only switch to stand-up desks for work, but also to better-designed toilets - like this one from Japan, adjustable to several different squatting and sitting postures.

Perhaps one day such toilets will make a splash in other parts of the world.

Sikirov D (2003). Comparison of straining during defecation in three positions: results and implications for human health. Digestive diseases and sciences, 48 (7), 1201-5 PMID: 12870773

Rao SS, Kavlock R, & Rao S (2006). Influence of body position and stool characteristics on defecation in humans. The American journal of gastroenterology, 101 (12), 2790-6 PMID: 17026568

Ryuji Sakakibara, Kuniko Tsunoyama, Hiroyasu Hosol, Osamu Takahashi, Megumi Sugiyama, Masahiko Kishi, Emina Ogawa, Hitoshi Terada, Tomoyuki Uchiyama, & Tomonori Yamanishi (2010). Influence of Body Position on Defecation in Humans. LUTS: Lower Urinary Tract Symptoms, 2 (1), 16-21

PS. Aurametrix analyzes bowel movement and finds the best amounts and combinations of soluble and insoluble fiber, water, starch, probiotic strains,  and many other ingredients. 


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