Bowel patterns are highly variable


Prof Goh: The colon is meant to hold faeces. There is nothing toxic about that.

Although some worry when they do not pass motion daily, University Malaya Specialist Centre consultant gastroenterologist and hepatologist Prof Datuk Dr Goh Khean Lee (pic) affirmed that it is not necessary for people to defaecate every day.

“There is no fixed bowel pattern. Passing motion is totally variable, although it usually happens once per day.

“Normally, we pass motion upon waking up because the migrating motor complex of our intestines is quiet when we sleep but is activated when we wake up,” said Prof Goh.

According to the John Hopkins Medicine website, stool elimination is considered normal if it occurs three times a day or three times a week, depending on the person.

Prof Goh said that bowel patterns are highly variable and this variability does not necessarily mean anything medically.

“Oftentimes, it’s related to a person’s intrinsic motility of the colon and rectum, which is inborn,” he said.



“In other cases, it may be related to the type of diet we take. A person who takes a diet with lots of fruits and vegetables will often have looser bowel motions.”

Even if bowel movements are not regular, this does not necessarily indicate serious health risks, according to Prof Goh.

“When stools are not emptied regularly, water is absorbed continuously from the colon, making them harder on subsequent days,” he said.

“However, bowel irregularities usually do not signify cancer. Bleeding may signify cancer, but if it does, it is often a late sign.

“Cancer of the colon is a fast-emerging cancer in Malaysia and is often silent in the early stages and is best screened with a colonoscopy.

“Early colon cancer can be cured. Colonic polyps, which usually precedes colon cancer and which does not give rise to symptoms, can be dealt with at the time of colonoscopy.”

What is considered a healthy or “ideal” bowel movement pattern depends on what is normal for that person.

As such, there is no need to immediately panic if one does not take a dump once a day.

Prof Goh cautions those who resort to detoxification because they are anxious about irregular bowel movement patterns.

“The colon is meant to hold faeces. There is nothing toxic about that.

“However, there are people who continue to subscribe to this erroneous notion that they need to detoxify and are willing to pay about RM2,000 to RM5,000 for ‘therapists’ to cleanse their colon,” he said.

This treatment could include having patients consume laxatives and inserting solutions or liquids into their rectum via a tube to cleanse their colon.

“This practice should be stopped and instead patients should be encouraged to go for colon cancer screening if they are above 45 years old.

“A high-fibre diet helps with better movement of bowel, and is also good for blood sugar levels, cholesterol and heart disease,” advised Prof Goh. – By Clarissa Chung

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