Sean Gibbons
Appearances
The Excerpt
SPECIAL | How bowel frequency impacts your health
So this was a large cohort of individuals from a scientific wellness company called Aravale. And we had approximately three to four thousand people in this cohort. We filtered down the number of people who were a part of this particular study by looking at those who were the healthiest among them. So we got down to maybe two thousand or so people who had no reported diseases.
The Excerpt
SPECIAL | How bowel frequency impacts your health
whose clinical chemistries like their LDL cholesterol and their insulin resistance were all in the sort of healthy range. So these were as healthy as we could find.
The Excerpt
SPECIAL | How bowel frequency impacts your health
Those who had a high bowel movement frequency, which is maybe four or more bowel movements a day, which is classified as diarrhea, they showed signatures of stress on their liver. Their liver enzymes were out of range. They also saw higher levels of inflammation. This isn't perhaps that surprising because we know that we produce bile. That's excreted into our bowel.
The Excerpt
SPECIAL | How bowel frequency impacts your health
And if we are experiencing diarrhea, we actually lose a lot of our bile through defecation. And our body has to work hard to produce more of it. And that puts strain on the liver. And inflammation has long been known to be associated with diarrhea as well.
The Excerpt
SPECIAL | How bowel frequency impacts your health
So those who are on the low end, which is, you know, three or fewer times per week, kind of constipated individuals, they showed a rise in microbially derived metabolites in the bloodstream from the fermentation of proteins. So microbes fermenting proteins into these molecules like p-creosol or endoxyl or phenylacetate.
The Excerpt
SPECIAL | How bowel frequency impacts your health
And many of these molecules are toxins to the kidneys, the liver, and even to the brain. So these are not necessarily that good for us, and they've been linked to chronic diseases.
The Excerpt
SPECIAL | How bowel frequency impacts your health
One of the main reasons we embarked on this study is that there are all of these associations out there between several different chronic diseases and bowel movement frequency. So for example, those who have neurological conditions like Parkinson's disease or Alzheimer's disease, Oftentimes before they get diagnosed with these diseases, they have had maybe decades of chronic constipation.
The Excerpt
SPECIAL | How bowel frequency impacts your health
So constipation tends to precede these things. Similar for chronic kidney disease, we see that constipation often precedes the disease condition, but no one really knew whether that was correlation or causation.
The Excerpt
SPECIAL | How bowel frequency impacts your health
is it just a side effect of the disease or is the constipation perhaps a driver of disease ideology and so that's why we focused on these healthy individuals because these folks were not sick this is before any disease has manifested itself and yet we're still seeing the sort of metabolites and risk factors associated with these diseases elevated in the bodies of these people who are experiencing aberrant bowel movement frequency
The Excerpt
SPECIAL | How bowel frequency impacts your health
It's a way of kind of measuring frequency by eye. So it's a scale between one and seven, where on one end you have watery stools, diarrhea, and on the other end you have dry, hard pellet kind of stools, which is on the constipated end. And in the middle, you have the nice, smooth kind of sausage texture to the stool, which is where you want to be, essentially.
The Excerpt
SPECIAL | How bowel frequency impacts your health
It's a way to kind of measure water content and transit time just by visually inspecting your stool.
The Excerpt
SPECIAL | How bowel frequency impacts your health
Yeah, it's very important, and it's a bidirectional communication between our bodies and our microbes. So first of all, the amount of dietary fiber we consume affects transit time. It keeps the water content of stool high, it adds more bulk, and it promotes the production of short chain fatty acids.
The Excerpt
SPECIAL | How bowel frequency impacts your health
So microbes in our gut prefer to ferment dietary fibers into these organic acids, which are healthful for us. And these acids actually promote the smooth muscle contraction of our bowel and promote faster transit through the gut. But if stool remains around for too long in the gut, microbes start to exhaust those fibers and they switch to the next best thing, which is protein fermentation.
The Excerpt
SPECIAL | How bowel frequency impacts your health
and protein fermentation gives rise to these molecules i talked about earlier that were associated with constipation like phenyl acetate or endoxyl or p creosol and so we know that microbes when they switch to this fermentation process they're producing these molecules and you know in our in our study we find that these molecules are elevated in the blood when you are constipated and that's where they're coming from
The Excerpt
SPECIAL | How bowel frequency impacts your health
I guess finally, I'd say that microbes are capable of producing human neurotransmitters, and these neurotransmitters can interact with our gut nervous system. The gut is one of the most densely innervated organs of the body, and these interactions with these neurotransmitters can also affect motility and contraction in the gut.
The Excerpt
SPECIAL | How bowel frequency impacts your health
There's a lot of work, I think, that needs to be done still in this area, but it is known that travel, long distance travel on airplanes, for example, can give rise to transient constipation. So that's a well-known factor. There's also traveler's diarrhea. People can often catch a bug when they're traveling somewhere, and that can induce differences in their transit time.
The Excerpt
SPECIAL | How bowel frequency impacts your health
And then shift workers, people who have disrupted sleep patterns or abnormal sleep patterns, The schedule of their dietary intake, their eating, can be somewhat different from the normal mealtimes that most of us experience. And this can affect these processes we're talking about, organic acid production, protein fermentation, constipation, diarrhea.
The Excerpt
SPECIAL | How bowel frequency impacts your health
So we know it does affect things, but I think more work needs to be done to understand it better.
The Excerpt
SPECIAL | How bowel frequency impacts your health
So in this population of people we were studying, we had questionnaire data about their lifestyle. We found some perhaps unsurprising things. So for example, those people who were in this Goldilocks zone of pooping, they tended to eat more vegetables and fruits. So eat your fresh fruits and vegetables. They also tended to be more hydrated. So be sure to drink plenty of water.
The Excerpt
SPECIAL | How bowel frequency impacts your health
That helps with motility. And they had higher levels of activity. They were wearing Fitbit trackers. So we could track how many steps they were taking. So between diet, exercise and hydration, these simple factors can help improve your bowel health.
The Excerpt
SPECIAL | How bowel frequency impacts your health
Well, if you're experiencing chronic bouts of constipation or diarrhea, you should talk to your clinician because these could be underlying conditions of other problems in your body. But bowel movement frequency itself isn't often monitored that closely by clinicians. However, our study, I think, points to the fact that maybe that's the future, right?
The Excerpt
SPECIAL | How bowel frequency impacts your health
Maybe the future of medicine should include this as a parameter that we pay closer attention to. Because even though we haven't causally proven that the rise of these metabolites in the blood due to constipation will eventually lead to something like a neurodegenerative disease, it seems likely that that could be the case.
The Excerpt
SPECIAL | How bowel frequency impacts your health
And that by having long-term levels of constipation or diarrhea, we might be increasing our risk for chronic diseases. So it might be very important to pay attention to it and to keep in that Goldilocks zone.
The Excerpt
SPECIAL | How bowel frequency impacts your health
I don't have a strong take on it. Again, I'm not a clinician. I'm a PhD, so I can't give medical advice. I don't have a lot of data on colonics, so I don't know a ton there, other than it is the case that people who are getting a colonoscopy get the functional equivalent of a colonic right there. They get cleaned out before the procedure.
The Excerpt
SPECIAL | How bowel frequency impacts your health
What we find is in people who take Miralax or have themselves cleaned out, It's a window of opportunity for opportunistic pathogens. So we'll sometimes see that people are colonized by organisms like Clostridioides difficile. Even if they don't get sick, they're sort of benignly colonized by these things in these windows of opportunity when their commensal microbiome biomass is depleted.
The Excerpt
SPECIAL | How bowel frequency impacts your health
And then it can lay in wait to a future date when maybe you take antibiotics and your microbes are again disrupted and this pathogen can look around and say, oh, now there's an opportunity to cause disease. But long story short, I think colonics, I don't know exactly what the health implications are other than they might be windows of opportunity for these pathogens to invade.
The Excerpt
SPECIAL | How bowel frequency impacts your health
There's no hard and fast ideal frequency, I would say. Currently, clinically, there's a wide range that's considered healthy. Everything from three times a week to three times a day is considered fairly normal. And that's very wide. But based on what we'll talk about here soon, I would say maybe once every other day or a couple times a day is probably where you want to be.
The Excerpt
SPECIAL | How bowel frequency impacts your health
I guess I want people to think about their microbes. The microbiome, it's a fairly emergent field. It's about 20 years old now. We're just beginning to understand how to manipulate our microbiota to optimize our health. While the microbiome doesn't have a super, super strong effect on human health and disease in the short term, it seems to be critical for our long-term health and longevity.
The Excerpt
SPECIAL | How bowel frequency impacts your health
disruptions to the composition and the functionality of our microbiota are associated with many chronic diseases like we were discussing earlier and you know if you're not paying attention to your microbes if you're not feeding your microbes with the kinds of things they like to eat like dietary polysaccharides from plants they'll start eating you.
The Excerpt
SPECIAL | How bowel frequency impacts your health
They'll eat your mucus layer, which will thin and cause inflammation. You'll get constipation. And all of these factors can potentially increase your risk for things like diabetes or chronic kidney disease or neurodegenerative disorders. So to stay healthy throughout your lifespan, feed your microbes.
The Excerpt
SPECIAL | How bowel frequency impacts your health
One of the reasons we embarked upon this study is the student working on it, Johannes Johnson Martinez, he had family members who had suffered from neurodegenerative disorders, in particular Parkinson's disease. And I myself actually have an aunt who passed away a few years ago and suffered for many years with Parkinson's disease.
The Excerpt
SPECIAL | How bowel frequency impacts your health
And so we were we were interested in understanding what factors could give rise in the long term to these types of conditions. And for both of our family members, these individuals had suffered from chronic constipation for decades prior to the disease diagnosis. And this was a clue to us as to what might be driving disease in the long run and why we wanted to look in a cohort of healthy people
The Excerpt
SPECIAL | How bowel frequency impacts your health
to understand, you know, is this just correlation or causation, right? Is bound movement frequency actually a risk factor in the long run for these types of conditions?