Everyone poops, but not everyone does it daily.
New research by the Institute for Systems Biology (ISB) suggests that how often you have bowel movements is linked to long-term health.
The ISB-led research team examined data from over 1,400 healthy adults to understand how bowel movement frequency affects health.
Their findings, published in Cell Reports Medicine, highlight that the frequency of bowel movements can significantly influence one’s overall health.
The study used data from participants of the wellness company Arivale, focusing on generally healthy adults and excluding those with certain health conditions or medication use.
Researchers categorized participants into four groups based on self-reported bowel movement frequency: constipation (one or two times per week), low-normal (three to six times per week), high-normal (one to three times per day), and diarrhea.
The team then looked for associations between bowel movement frequency and various factors, including demographics, genetics, gut microbiome, blood metabolites, and plasma chemistries. They found that age, sex, and body mass index (BMI) were significantly associated with bowel movement frequency. Younger people, women, and those with a lower BMI tended to have less frequent bowel movements.
“Prior research has shown how bowel movement frequency can impact gut ecosystem function,” said Johannes Johnson-Martinez, the study’s lead author. “If stool stays in the gut too long, microbes use up all the dietary fiber and switch to fermenting proteins, which produces toxins that can enter the bloodstream.”
The researchers found that the gut microbiome’s composition was a clear indicator of bowel movement frequency. Healthy, fiber-fermenting gut bacteria thrived when bowel movements occurred one to two times per day. In contrast, bacteria associated with protein fermentation or those from the upper gastrointestinal tract were more common in people with constipation or diarrhea.
Several blood metabolites and plasma chemistries were also linked to bowel movement frequency, indicating potential connections between bowel health and chronic disease risk. For instance, harmful byproducts of protein fermentation, like p-cresol-sulfate and indoxyl-sulfate, were found in higher levels in people with constipation. These byproducts are known to damage the kidneys. Similarly, indicators of liver damage were elevated in individuals with diarrhea.
Blood levels of indoxyl-sulfate were particularly associated with reduced kidney function, suggesting a possible link between bowel movement frequency, gut microbial metabolism, and organ damage even in healthy individuals.
Not surprisingly, those who reported eating a fiber-rich diet, staying hydrated, and exercising regularly were more likely to have bowel movements in the healthy range of one to two times per day.
“Chronic constipation has been linked to neurodegenerative disorders and chronic kidney disease progression in patients with active disease,” said Dr. Sean Gibbons, ISB associate professor and corresponding author of the study. “However, it was unclear whether abnormal bowel movements are early drivers of chronic disease or just coincidental in sick patients.”
“In this generally healthy population, we show that constipation is associated with blood levels of microbially derived toxins known to cause organ damage, even before any disease diagnosis,” Gibbons added.
The study also found connections between bowel movement frequency and mental health, indicating that anxiety and depression history is related to how often one poops.
“Overall, this study shows how bowel movement frequency can influence all body systems and how abnormal bowel movements may be an important risk factor for chronic diseases,” Gibbons said. “These insights could help develop strategies for managing bowel movement frequency to optimize health and wellness, even in healthy populations.”
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