By Kristen Rogers | CNN
How often do you poop can affect greater than just whether you’re feeling uncomfortably bloated. Its frequency can even affect your gut microbiome and risk of chronic disease, a brand new study has found.
Gut bacteria that digest fiber, for instance, appeared to thrive in participants who needed to poop a couple of times a day, in keeping with the study published Monday within the journal. Cell Reports MedicineHowever, bacteria related to the upper gastrointestinal tract or protein fermentation were enriched in those that had diarrhea or constipation, respectively.
The authors also found that younger people, women, and participants with a lower body mass index had less frequent bowel movements.
“Many people with chronic diseases, including Parkinson's disease and chronic kidney disease, report suffering from constipation for years before diagnosis,” said study lead creator Dr. Sean Gibbons, who has lost members of the family to Parkinson's.
“However, it is unclear whether these variations in bowel movement frequency are drivers of disease or simply a consequence of the disease,” Gibbons, an associate professor on the Institute for Systems Biology in Seattle, added by email.
This dilemma motivated researchers to research the links between bowel movement frequency and genetics, the gut microbiome, blood plasma chemistry and blood metabolites – small molecules involved in the event and Products of metabolism – to evaluate whether the pattern could have a negative impact on the body before diagnosing a disease, Gibbons said.
The authors examined health and lifestyle data from greater than 1,400 healthy adults who participated in a scientific wellness program at Arivale, a consumer health company that operated in Seattle from 2015 to 2019. Participants, nearly 83% of whom were white, answered questionnaires and consented to the gathering of blood and stool samples.
Self-reported bowel movement frequency was divided into 4 groups: constipation (one or two bowel movements per week), low-normal (three to 6 weekly), high-normal (one to 3 per day), and diarrhea.
The authors also found that several blood metabolites and blood plasma chemistries were related to various levels. Byproducts of protein fermentation equivalent to p-cresol sulfate and indoxyl sulfate, that are known to cause kidney damage, were enriched in constipated participants. Blood levels of indoxyl sulfate have also been linked to reduced kidney function. And chemicals related to liver damage were higher in individuals with diarrhea, who also had more inflammation.
The authors imagine their results provide “preliminary evidence of a causal relationship between stool frequency, gut microbiome metabolism, and organ damage,” to a press release.
“What's exciting about this study to me is that we've long known about a link between constipation and chronic kidney disease, but the potential mechanisms have never been fully understood,” said Dr. Kyle Staller, director of the Gastrointestinal Motility Laboratory at Massachusetts General Hospital and associate professor of drugs at Harvard Medical School, by email.
“This study provides a starting point for future studies to examine this association over time … to find out whether people with low stool frequency produce more potentially toxic metabolites and subsequently develop kidney disease,” added Staller, who was not involved within the study.
Understanding gut health
“There are some important limitations here that make the results less generalizable to the average person,” Staller said, including that the study doesn’t prove a cause-and-effect relationship. The data come from participants studied at a single cut-off date, so other aspects is also at play. It's also possible that an individual's gut microbiome affects the frequency of bowel movements.
The frequency of bowel movements can be not an optimal measure of bowel function, he said.
“We know that normal stool frequency is between (three) bowel movements per week and (three) bowel movements per day, but the best measure of how quickly things move through our gut is stool shape,” Staller added. “That is, if the stool is harder, it has been sitting in the colon longer — what we call a longer transit time.”
“With softer stools, the opposite is true. A more ideal indicator of bowel function would therefore be stool consistency rather than frequency.”
In addition, most of the results are based on the group with low to normal stool frequency – three to 6 times every week – and few on the group that suffered from constipation or diarrhea, experts said.
“Ideally, we would see some kind of dose-response relationship. The worse the constipation, the worse the kidney function and the higher the number of these potentially harmful metabolites in the blood as markers.”
In addition, the sorts of bacteria in participants' stool were detected using technology that only indicates whether the bacteria belong to a bigger group or genus, moderately than to specific species. Even if the bacteria belong to the identical group, they may have different effects, he added.
Participants with generally normal stool frequency also had vital lifestyle differences, equivalent to eating more vegatables and fruits, staying higher hydrated and exercising more, said Dr. Rena Yadlapati, a professor within the division of gastroenterology on the University of California, San Diego, who was not involved within the study.
Regarding the possible processes underlying the authors’ hypothesis, “Preliminary work has shown that gut microbes switch between fiber and protein fermentation depending on gut transit time,” Gibbons said via email. “During normal transit times (normal BMFs), gut microbes ferment fiber into healthy organic acids that maintain gut homeostasis.
Overall, Staller doesn't think anyone should see the outcomes as a reason to fret concerning the speed of their bowel movements, he said. “A lot of the data comes from people we doctors would consider normal, and there aren't enough truly constipated people from which we can draw firm conclusions.”
More importantly, he added, the study has once more confirmed that dietary aspects can even influence intestinal function.
Experts’ understanding of the interactions between intestinal bacteria and body functions “is growing by leaps and bounds every day,” said Staller.
“However, any attempt to simplify this knowledge and cultivate the 'ideal' gut microbiome is still a long way off,” he added. “Our knowledge in this area is simply too underdeveloped to make profound changes in our lives based on the results of a study like this.”
The-CNN-Wire
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