The inside story

When it comes to bowel behaviour, there’s a big range in what’s normal and how often you should have a bowel motion (poo). 

Many people believe that going once a day, at around the same time, is the standard. However, research has found that just one in three adults has a consistent 24-hour poo-pattern. 

As a general rule of thumb, anywhere from three times a day to three times a week is considered normal.

So rather than trying to fit into a non-existent normal, it’s better to learn what’s normal for you. That way you’ll be aware if anything changes.

If you experience a sudden change in your pattern for more than two weeks, speak to your doctor.  

No matter if you go once a day or twice a week, a UK study of toilet timings found that most poos (60%) were done in the morning. For men, the most popular time to poo was between 7-8am, while for women, poo-time peaked in the hour later, between 8-9am. 

Another (yet smaller) peak poo-time occurred in the early evening, lining up with dinner time. The researchers found a post-meal poo was common, and largely due the increased activity in the gut and bowel.

Jean Hailes physiotherapist Amy Steventon says that a natural reflex to poo can be stimulated most efficiently in the morning, with breakfast, a warm drink and physical activity or movement.

If there was such a thing as a picture-perfect poo, it would be soft, sausage-shaped, brown and easy to pass. Doing a poo should feel like you’re relaxing or ‘letting go’. Needing to strain, push or tense up on the toilet is a sign you might be constipated and/or that your pelvic floor muscles are not relaxing and ‘letting go’ in the way they should.

Constipation affects women more than men, and can have health effects beyond just a feeling of discomfort.

Chronic straining can weaken your pelvic floor muscles (the sling of muscles that keep your lower organs in place), stretch the tissues that support your pelvic organs putting you at risk of prolapse and anal fissures (small tears in the anal tissue) and it can also cause hemorrhoids (swollen veins in your anus).

But onto the good news! Most cases of constipation are successfully treated by eating a diet high in fibre, drinking more fluids and exercising daily. If it does not improve, see your doctor.

Surprising but true, poo is typically 75% water – the remaining material is made up of protein, sugars, undigested fats and food residues, as well as bacteria (both live and dead).

The exact water content in poo can differ significantly from person to person – and even from poo to poo! And it mainly comes down to how much fibre you eat. 

People with a higher fibre intake, such as vegetarians, typically have more water in their poo – around 79%, whereas those who eat less fibre and more protein have poos that are about 73% water.

In particular, the fibre type known as insoluble fibre – found in wheat bran, rice bran, fruit and vegetable skins, nuts, seeds, legumes and wholegrains – is known to increase the water content, creating softer poos that are easier to pass.

While mainly known for its role in the reproductive system, the female hormone progesterone has an effect on the gut too.  Progesterone can slow down the natural muscle contractions in the gut, having a slight constipating effect. 

Progesterone levels commonly peak in the second half of your cycle, explaining why pre-menstrual constipation is common in some women – diarrhoea/looser bowels are also common before your period, but this is thought to be due to the increase in other substances called prostaglandins. 

Progesterone is also dramatically increased in pregnancy, and is thought to be one reason why pregnant women experience constipation at a higher rate than the general population.

Just like your bowel, there’s a lot of variation in bladder habits. However, on average, a normal bladder can hold about 250-500ml of urine (that’s around 1½-2 cups) and needs emptying between 4-8 times a day, plus up to once overnight. 

How often you need to go depends a lot on how much fluid you’re drinking, as well as other factors such physical activity levels and even the weather.

Needing to wee during the night is common, particularly as we get older, but it’s worth noting that a healthy bladder wakes you up when it’s full and gives you enough time to get to the loo.

Your bladder is a reservoir. Its job is to store urine until you have a suitable time and place to empty it.

Going 'just in case' may train the bladder to hold smaller amounts of urine. Then, when you really need to hold on, it can be harder to do so.

For better bladder health, listen to your body’s internal messages and go when your bladder tells you to – rather than the other way around.

There are several times in a woman’s life when she is at more at risk of bladder leakage, such as during pregnancy and post-partum. During menopause is another time.

The hormone oestrogen promotes the health of the urinary system in many ways. It helps with bladder control and in keeping our pelvic floor muscles elastic.  

When levels of this hormone naturally drop at midlife, problems with bladder leakage can occur. Topical oestrogen can help to treat this; so too can maintaining your pelvic floor fitness.