Doctor's Note

I know people are suckers for poop videos—I’m so excited to finally be getting these up! There was actually a recent one though--Diet and Hiatal Hernia--that talks about the consequences of straining on stool. Hernias are better than Bedpan Death Syndrome, though—that’s what I talk about in in my next video: Should You Sit, Squat, or Lean During a Bowel Movement?

I do have some older videos on bowel health:

For more on this concept of having “normal” health parameters in a society where it’s normal to drop dead of heart attacks and other such preventable fates, see my video When Low Risk Means High Risk.

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  • UCBAlum

    One BM every few months? Forget “normal”…on what planet is that even possible?

    • Joseph Gonzales R.D.

      In the Marshall Islands when diabetic participants joined our lifestyle intervention program, that induced a nutrition component, were embarrassed and confused when they started to have daily BMs. Some participants only went once weekly, so yes, this is very normal (or abnormal I suppose) for some populations (even on this planet) ;-) Cannot underestimate nutrition education for more fiber in the diet!

      • George

        OFF-TOPIC QUESTION: Joseph, on the left side of the homepage, I see Dr. Greger’s speaking schedule. From what I see, he gives a lot of speeches. Are the videos of his past speeches available anywhere on this site for the visitors to watch? Thanks Joseph.

        • Joseph Gonzales R.D.

          Yes they are! You’ll see his most prominent videos and links at the bottom of each NutritionFacts page. Scroll to the bottom of the page and on the right hand side there are 3 videos “Food for Disabling Diseases” “Foods for Common Diseases” and “Foods for Killer Diseases” – Talk about 3 whole hours of all-you-can-handle FUN! ;-) Let me know if you cannot find them I’ll link separately. Thanks, George.

          Nutrition Videos
          Browse Topics
          Latest Videos
          Foods for Disabling Diseases
          Foods for Common Diseases
          Foods for Killer Diseases

          • george

            Hi Joseph: I found them. Thank you so much for your help.

      • Lawrence

        Hi Joseph. There was an article recently in The Guardian about the Runit Dome and it got me thinking about the Marshall Islands again and a talk by Brenda Davis I heard a while back. Long story short, far be it to toot your own horn so I’ll do it for you. Folks can have a look at these pictures and wonder along with me what a wonderful and unique experience it was living and working in the MI on such a humanitarian mission.

    • The Detonator


      **Slow Clap**

    • ricklomar

      I see what you did there. I squat before you.

  • Slim055 .

    Interesting thing about seeing these videos on youtube is the “like-themed” videos suggested by the AI when this one ends. Have a happy day.

    • Wade Patton

      Those “like themed” suggestions are the bane of my Youtube existence. They have too much “skew” built in to them. The ADHD like me, do not need assistance going off in the wrong direction. When i find a good source, I go to their section and look through everything they have uploaded. Found some great things that way. Rarely through the AI suggestions, way too much “popularity” and “trending” action there for me. Cheers

      • Slim055 .

        Hmmm … the collection of recommendations I received for this video could have been politely characterized as “quack scat” and did not tempt me too much. ;)

  • Followup1

    I am a vegan, very occasional cheese, and I only ‘go’ once every two days. : ( But, that is better than pre-vegan days when I went once per week. Three times per day would be a dream come true that I know ain’t never gonna happen.

    • Joseph Gonzales R.D.

      I know people someone who eat tons of fiber, but only goes once per day or every other day when traveling (or sometimes just away from home). I am not sure and need to see some research but perhaps there is a “stress” (psychological) component to successfully achieving a healthy bowel movement? Not saying this is your case, but your comment reminded me of my friend. I would agree once every other day is much better than once a week! I commend you!

      Best wishes,

      • guest

        Actually, stress is likely a bigger cause of constipation then is lack of fiber. IBS, to my knowledge, with constipation is related to the mind body gut axis. You can feed all the fiber you want, but if there is something screwy with the mind body gut axis, things are going to get clogged up until stress is relieved. Countless GI doctors know this, and is the reason they often prescribe psych meds to relieve constipation. Sure, lots of fiber helps someone who does not have these mind body gut issues, but for those that do, it is just a part (and sometimes small part) of the solution.

        • Tasos Papapetrou

          To my experience these people need to add just magnesium and maybe b complex.Nothing more,

      • Lola

        I use to go once a day and now that I am in menopause (I do take topical estrogen) I become constipated no matter what I eat if I do not have enough estrogen for bowel peristolis. I was a total vegan falling Dr. fuhrman’s diet for two years and I was still constipated. I truly believe it is a case of hormones or lack thereof, not how much fiber I get since I was on a WFPB diet. I am about 80 % WFPB diet now and I do find when I eat fattier foods or have alcohol I have an. Easier time going to the bathroom! Very frustrating!

        • Did you ever try taking Epsom salt baths? The magnesium–which can be lacking in WFPDs– may help. You have to make the water quite hot to activate the salts, I’ve been told.

      • ricklomar

        Totally agree. My sister eats well but is often stressed out running her business. In her words, she has ‘no time to poop’.

      • Any thoughts on whether magnesium -rich Epsom salt baths could stimulate bms?

      • Venla

        I also have anecdotal evidence to back the stress claim up. When I spend all day at home, I have a bowel movement about 30 minutes after each meal. When I go to work, though, even if I eat right before, I do not. Same story for shopping, seeing a movie, etc. All I can figure is that my body “knows” I’m away from home and decides it is not the best place.

    • charles grashow

      I’m NOT a vegan – eat meat, cheese, eggs, milk BUT also a lot of natural fiber. Average for me is 3x/day.

    • Jocelyn

      I find dehydration has a big part to play also – eating a lot of fiber also requires a lot of fluids – make sure you are drinking plenty of water!!
      Also, why not just drop the cheese entirely? I think any ex-smoker would agree that its harder to quit smoking if you, well, keep smoking…And Dr. G gives us PLENTY of good reasons to eliminate such a dangerous food, and bowel health is one.
      Go vegan, its better for the animals and its better for you!

      • Followup1

        I am a vegan, except when my wife slips some cheese in her fixin’s. I don’t think that under those rare times is done harm. Additionally, I am an animal rights activists I do my share to stop cruelty to animals, and cannot wait for the day when there is no slaughter of the innocent.

        • Kim Churchman

          Yeah! When we and the animals can live in peace, together roaming, grazing, enjoying. I had goats once, on enough acreage, so that I could pull down a low tree branch, and they would eagerly defoliate it. I enjoyed the zest in their eyes, and then I would let the branch spring back up out of their reach, and on to the next branch further along. Time seemed to stand still. I long for the day, same as you.

          • Followup1

            You should be a writer! Nice.

    • Person

      You are not vegan then.

    • Tallmark

      Use Dr. Richard Schulze’s “Intestinal Formula #1”. Nothing that I have ever tried worked like this. BTW, I’m a vegan as well.Check out “Eliminate” on the main page. Also, I don’t make a dime whether you buy products from him or not. Good luck!

  • guest

    Please explore role of stress and anxiety issues and bowel movement, reflex. Not in regards to the
    stress of going to the bathroom, just the stresses of everyday life, and certain peoples’ depression
    and anxiety issues.
    Quite often this alone is the cause of constipation, and much less so the diet.

    Serotonin and dopamine synergy in the gut. There is a reason some people benefit from low-dose
    anti-depressents in regards to constipation. But no thanks, I don’t want the side-effects of these drugs.

    • Joseph Gonzales R.D.

      Great point I literally just wrote about this, but I thought I may be looney because I have yet to see the research. Obviously certain medications can cause constipation but I too wonder about the research on anxiety and stress and contraption. 10 gold stars for anyone who can jump in here and find some research on this topic! Thanks for your post.

      • dar

        well, as many of us know,’medications’ are magnesiun depletors,& mg is, among 800 other things, a muscle relaxant & stress buster, so easy pooping ain’t gonna happen…

      • Matthew Smith

        Dr. Greger writes about probiotics and mood here, suggesting the brain and intestines are a neural highway that mirror each other.

        How does Dr. Greger recommend taking probiotics?

        Thank you.

        • 2tsaybow

          Hi Mathew,
          I believe that Dr. Greger says that if you eat a whole food plant based diet you will grow the correct probiotics naturally. Whole plant foods promote the growth of good microbes.
          They are in the plants naturally. You don’t need to take any pills if your diet is plant based. Except for B12 of course.
          Hope this helps!

          • Matthew Smith

            Thank you. I should take his advice and stop using unnatural sweetener. Maybe that is what is killing my intestinal microflora. Dr. Greger still writes that deficiencies abound, for instance, with Potassium. He talks about how many nutrients are first made at the very end of the colon and how their is limited means to adsorb some important nutrients.

          • 2tsaybow

            Thank you for your response. I’m sorry that you’re having problems with your microflora. I know I like to add a little sweetness to my strawberry coca concoctions and I use artificial sweeteners as well. And of course Dr. Greger has a recommendation for artificial sweeteners as well: He even says that Erythritol can have antioxident benefits in this video:

            Erythritol has been hard for me to find in my area so I am going to try to puchase it on ebay. Xylitol is the sweetener I have right now, but if I put too much into my treats it loosens up my bowels a bit too much..

          • Matthew Smith

            Dr. Greger has a recipe for vegan dark chocolate ice cream:

            2 and a half tablespoons of cocoa powder.
            frozen cherries or strawberries,
            a little nondairy milk,
            vanilla extract
            and some erythritol or some dates and you have instant, decadent chocolate ice cream

            I would like to try this, is this similar to what you are making?

            It has a lot of heart benefits, I am glad you are eating cocoa. Are you staying away from dark chocolate because of the LDL raising saturated fat? Dark Chocolate was still shown to reduce all cause mortality by half in moderate consumption, (like a hundred grams!), in many studies, making it a true super food. Please let me know how Erythritol works for you.

          • 2tsaybow

            Oh thanks, I think I’ll use this as an excuse to buy some frozen cherries!

          • Kim Churchman

            Big difference between cocoa powder and dark chocolate. Cocoa is my choice because it’s essentially fat free.

          • Matthew Smith

            Congratulations on your health conscious decision. Where do you get your cocoa? Do you believe it has a large number of health benefits?

          • Kim Churchman

            It’s in the baking aisle, either in a dark brown Hershey can or a yellow Nestle one. It’s antioxidant, ’bout all I know. And fat free.

          • Kim Churchman

            I’m enjoying a stevia-erythritol product that I get from WalMart, in the sugar section, brand name Skinny Girl. I know, dumb name. But it really nails the sweetening I want. I’s a liquid in tiny squeeze bottle. I’m writing to that company now to ask for bigger bottles, because I buy them six at a time.

        • Joseph Gonzales R.D.

          Good question! He always says “get them from foods first,” and I tend to agree. Check out this video about boosting good bacteria without probiotics. Perhaps if someone is taking probiotics for a specific reason then these videos and blogs can help: How Should I Take Probiotics? and Should Probiotics Be Taken Before, During, or After Meals?

    • Karl Young

      Well here’s an anecdotal data point (I’m a vegan that eats a lot of fiber). When I’m working at home in pretty relaxed situations I typically go 5 or 6 time/day. But if I’m out dealing with the normal stresses of negotiating and interacting with the world I usually only go a couple of times a day and don’t feel any reflex pressure to go when I’m out and about, Though I guess in my case the stress I experience when I’m out wouldn’t be considered abnormal or to be causing any problems re. bowel or colon issues…

    • Panchito

      The gut has its own brain called the enteric nervous system. Therefore, if it has its own computer, it may not be as simple as adding more fiber.

      • badgut

        It isn’t as simple as adding more fiber and staying hydrated. That gut brain has a mind of its own and I’d sure like to straighten it out. Some of the time it works fine and other times not so well… But since going WFPB it at least is always soft. One thing that doesn’t help is old injuries that messed up the nerves.

        • Fred

          Say you are out doing the hunter-gatherer thing…since you are on the lookout for predators…human and otherwise…you’d need to relax to take a dump. I think some hemorrhoid cases are due to continual stress.

  • Wade Patton

    1 or 2x, maybe 3. BTW just (roughly) calculated a typical day of eating for me, the fiber = 62g.

  • Sundar Mudupalli

    Think you eat enough fiber? Think again! Do you eat 10 cups of plain cooked oatmeal a day ? – that is 40g of fiber – which is the RDA for men 50 and over. This is the simplest, most important and least known diet advice – that is – take enough fiber (40g per day) to have 2-3 bowel movements per day. It is difficult almost impossible to have a bad diet if you consume enough fiber in your food.

    • Wade Patton

      I start every day with oatmeal or grits topped with berries and flaxseed. Then the beans and potatoes and greens…so easy and tasty. 50-100g is likely my fiber total each day. Easy and tasty and healthy.

    • Darryl

      2⅓ to 2½ cups of cooked beans also have ~40 g fiber, for a third as many calories as the oats. One 14 oz can of beans (or home cooked equivalent) has about 25 g fiber, so one can be well on one’s way to that target for under 400 calories.

  • Mike Quinoa

    A classic. Uncharted territory illuminated by Dr. Greger’s characteristically dry, and sometimes ironic, humor.

  • Walter firl

    I love your work, and listen to every thing you say. I try to live as close to your recommendations as possible, but I have one idiom that I do not believe. You mentioned evolving over millions of years. The true science stands against that as far as I can tell. This may not be your field, so I’d like you to at least look into Ian Juby on Google. He has lodes of info, just like you, except that it is on a different issue.

    • Lawrence

      Thanks, Walter. I laughed so hard it stimulated another bowel movement!

  • Jeewanu

    “Howard, bring me the Post and the Times. This is gonna be an all-dayer!!!”


    I take calcium supplements and get a stool once a ta day. I think it’s the calicium

    • SeedyCharacter

      Magnesium is well known for loosening stool. A lot of calcium supplements have magnesium added. Not sure of he laxative effect of calcium alone. Or are you suggesting you’d have more BMs if you didn’t take the calcium supplement?

  • Plantstrongdoc M.D

    I had a professor of gastroenterology who said, let patients defecate on a white piece of paper from 1 meter above, and I can tell their GI ailments in 95% of cases, without colonoskopy (which can be dangerous and painfull), bloodtests, X-rays and so on….. but no fancy procedures or tests so that would never be an option…

    • Lawrence

      Rorschach missed his calling.

      • Plantstrongdoc M.D.

        Yes, because of diarrea…..

    • Fascinating! Care to share any more details from that prof? such as describing various types of stool and associated ailments?

  • Charzie

    Ahhh, this is full of sh**!

  • SeedyCharacter

    A really funny and informative small book written by a GI doc is “What’s Your Poo Telling You?” (by Josh Richman and Anish Sheth, MD). I keep a copy (along with the companion book “What’s My Pee Telling Me?” on the top of my toilet lid. When I hear people chuckling in the guest bathroom, I know they’re reading about poo or pee . . .

  • SeedyCharacter

    Since we’re sharing our bowel habits here, I am so glad to have effortless 2-3 poos per day. I recently had to take a few tylenol with codeine tablets to deal with some pain and the resulting constipation was so terrible I decided to experience the pain rather than take more pills. It made me feel so sorry for folks who have regular constipation, especially if they’re not aware of natural ways (e.g. fiber & fluids) to treat it.

    On a humorous note, most of the time when I head to my bathroom to poo, one of my cats follows me in and takes his poo in the litter box, too! It continues to make me laugh.

  • Lawrence

    I would Google ‘bowel obsession syndrome’, but I’m afraid to see what the targeted ads and Youtube recommendations would look like.

    • Dasaniyum

      try duckduckgo?

  • Noe Marcial

    How much is too much? is any study on that? i mean not diharrea, but soft consistence.. (sorry ahha).
    my grand mother after going to a hfpd is worry about that, she says that goes 4 5 times a day.. i dont know if it is an exsageration but it will be that be too much?

  • Noe Marcial

    i have saw this bristol stool chart
    so apart from how many times, the way we do it may says many things. my grand grand mother (in paraguay rural area, have look for the poop of all her children and dependig on the consistency giving them the right kind of food. i wonder if this bristool stool charl is correct, i supouse it is much more info about it.. i have notice for exsample that people that eat to much oil use to go many times to the toilet.. but it is more steaky and close to diarrea.. this moovemnts dosent seems soo healthy.
    i know my be disqusting but it wiill be good to put some light on poop .

  • Kim

    Okay, you’ve addressed pooing… what about peeing? Can it be normal to pee up to, say, 20 times a day? I think I probably urinate 15 times a day or so. I drink a lot of water, eat a lot of fruit (lots of watermelon lately), and have a small bladder. Always wonder whether or not to trust general guidelines for people about these kinds of things. Most people are chronically dehydrated. Also, is it better to not have to get up during the night to urinate, or does that mean you’re not adequately hydrated (as I’ve heard some claim). I’ve always preferred avoiding too much water before settling down to sleep so that I don’t have to get up, but I don’t mind doing so if it’s better for my health. Thanks! :)

  • mvdl123

    i personally think how much and many times a weak you need to go to your bathroom really depends on your diet, i would rather think that people should much more look at if your fecies are in a normal state cause watery poo is never right and extremey dry and thick isnt right as well, people should rather think of that instead of how many times you should go to a bathroom

  • stevchipmunk

    UNFORTUNATELY, THIS VIDEO discourages people from eating diets high in fiber… since who wants to — or has the time or the availability while working to — have bowel movements of 3 times a day? You know, as in… IS TOM IN THE BATHROOM AGAIN?! What the hell does he do in the bathroom all day?!

    • Kim

      3 times a day wouldn’t take up much of a person’s time, and remember that it becomes as quick and effortless as urinating. Gone are the days of needing reading material in the bathroom. ;)

      • Wade Patton

        Exactly. Leave the SAD diet behind and also the SAD poop (and the complications directly related: diverticulitis, hiatal hernia…). It’s such a rewarding experience on so many levels. The high-fiber BM also doesn’t have the intense urgency that I was accustomed to before (as 1x frequency somewhat SAD eater). It’s a very _manageable urgency_, if there is such a thing.

  • Alive and Laughing

    I have read many of the comments, but so far I haven’t seen anyone discuss this. I eat probably 95% PBWF, a bit less when dining out, though not frequently. I often have three or four bowel movements in the morning, sometimes only a few minutes apart. My thought is that each fiber-filled poop is too long to fit into the rectum, so the second and even third movements are really just a continuation of the first. Does anybody concur or have this experience? This is from someone who was formerly easily constipated. I take a tablespoon of chia seeds soaked in water morning and night along with supplemental magnesium, along with lots of veggies and fruits.

    • Wade Patton

      Sometimes I have two, “back to back” so to speak. Sometimes they are spaced more evenly. My flaxseed intake varies as I simply don’t eat the same thing every day. That is my sole fiber supplement and is mainly for the lignans and other flaxseed wonders. Always have two or three when nervous/anxious about an event, like a bike race–and that was before WFPB, will update if that changes.

  • ms zebra

    I’d like to hear what people here have to say about “transit time”. Today, the time from mouth to bum was only 6 hours for me. I had a bit more green tea during the day than I’d like, so that probably affected the time some, but I do seem to have fairly quick digestion. I wonder if this is a sign of bad nutrition absorption. Everywhere on the web it seems like 24-72 hours is “normal”, but I think I average about 10-12 hours.

    • I think transit time may be dependent, in part, on type of fiber. Pectin, I’ve read, goes through you quite rapidly. Anybody out there know more about transmit time and types of fiber?

  • Maree

    I have very regular bowel moments. Same time everyday but my problem is flatulence. I am a vegan and eat no processed foods. Since becoming a vegan 18 months ago I have had nothing but incredibly smelly flatulence. What is going on? I love my veggies but the more I eat the worse I smell. It is a very distressing situation for me, particularly at work. Doctors can’t find anything and I have tried to eliminate what might be the culprits but nothing is working. How can I eat my veggies without the foul burning gaseous odors that they produce?

  • Kim Churchman

    More drinking water? Traveling, for me, makes me forget to drink water.

  • Kim Churchman

    So you think you eat enough vegetables? Check out Dr. Terry Wahl’s TEDtalk on YT. Three Platefuls, she recommends – to hell with the half-cup portion we are told to use by the Fed-to-us Government! She’s paleo, I won’t eat animals, but boy am I eating vegetables now!

  • Craig

    too funny

  • marysaunders

    Middle-school re-visited, to kick the year out! Thanks, commenters. I thoroughly enjoyed the thread.

  • Peggy

    I have been following Dr. Greger’s eating recommendations for two months. My poops have become more on the diarrhea side, very liquidy. What could be causing this? What changes might I make in my diet to firm things up. (The opposite question of most folks!). Thanks!

    • There’s a lot of plant foods and herbs that help with that, I can’t remember specific ones at the moment but there are many. Another thing could be a detox happening, it can take months for your body to adjust to a new diet especially when it has a lot to “clean out” through detoxification, so what you’re experiencing is probably your body doing what it needs to do as now you’re giving it the things it needs to be able to do them.