Bowel health

Your bowel is made up of 2 main parts:

• the small intestine (small bowel), which absorbs nutrients from digested food
• the large intestine (large bowel), which absorbs water as digested food goes through it.
• Your bowel is part of your digestive system. Your digestive system turns everything you eat and drink into nutrients to fuel your body.

Your digestive system is a long, muscular tube that starts at your mouth and ends at your anus. It includes your:

• mouth
• oesophagus – a tube that connects the mouth and throat to the stomach
• stomach – an organ that breaks food down before it goes into the small intestine
• small intestine – a tube that connects the stomach to the large intestine
• large intestine – where poo is made before it leaves the body through the rectum and anus.

Depending on what you’ve eaten and other factors, it can take 23 to 37 hours for food to travel through your digestive system.

Your rectum (the last part of the large intestine) stores poo and signals you need to go to the toilet.
Your anus (the end of your large intestine) has anal sphincters that keep your large intestine closed until you’re ready to poo. They are supported by your pelvic floor muscles to help control your bowel movements.

Your pelvic floor is made up of muscles and tissues that stretch from your tailbone to pubic bone. It acts like a supportive hammock for your bowel, bladder and uterus. It’s important to keep your pelvic floor muscles strong.

Good bowel health is more than being regular. Signs of a healthy bowel include:

• doing soft, formed poos
• being able to hold on for a short time when you feel the urge to poo
• pooing without straining or feeling pain
• completely emptying your bowel when you go to the toilet.

Learn more about bowel health on the Continence Health Australia website.

It’s normal to poo from 3 times a day to 3 times a week.

Your poo should be soft, shaped like a sausage, and easy to pass. It should take you one to 2 minutes to empty your bowel. If it takes longer, you may be constipated or have a bowel-emptying problem.

The colour of your poo is almost always brown due to bile, a fluid produced by your liver to help digestion. Sometimes what you eat, for example, beetroot or liquorice, can affect the colour of your poo.

It’s also normal for your poo to smell.

Your gut includes your:

• stomach
• small intestine
• large intestine.

It has different types of bacteria (also known as the gut microbiome). Your genetics and diet influence your gut microbiome.

The more species of bacteria you have in your gut, the healthier it is. A healthy gut may have more than 1,000 species of bacteria.

Poor gut health is linked to many health problems, including:

• obesity
• diabetes
• heart disease
• anxiety
• skin conditions
• inflammation associated with autoimmune conditions (e.g. Crohn’s disease and coeliac disease).

You can improve your gut health by eating high-fibre foods. Good sources of fibre include:

• fruit
• vegetables
• legumes (e.g. beans, chickpeas, lentils)
• wholegrains (e.g. oats, brown rice, corn).

It may also help to:

• eat a variety of unprocessed foods of many different colours
• eat food with live bacteria every day (e.g. pot-set yoghurts, kefir, kimchi, sauerkraut, kombucha, fermented pickles)
• reduce artificial sweeteners and food additives.

But we need more research to understand how these impact gut health.

Bowel (colorectal) cancer is when cancerous tissue grows inside the lining of the large intestine. It’s the fourth most common type of newly diagnosed cancer in Australia.

About half of people diagnosed are women. The risk increases with age, but if the cancer is found early, you have a very good chance of survival.

It’s important to have regular bowel cancer screening as it can detect blood in your poo before you notice it, reducing your risk of illness or death from cancer.

Bowel incontinence is when you can’t control your bowel movements. It can range from an occasional leakage of poo to a complete loss of bowel control.

Many women have bowel incontinence at some time in their lives.

If you’re worried about incontinence, talk to your doctor. They will ask about your medical history and symptoms. They may also ask you to keep a diary of your bowel habits and list what you eat and drink for 7 days.

During your appointment, your doctor may do a physical examination. This might include checking your:

• belly
• anus and anal sphincters
• pelvic floor muscles
• rectum.

You can ask your doctor to explain what they will do and tell them if you don’t feel comfortable with any parts of the examination.

You might need to do some tests. For example:

• a test to check your anal reflexes and sensations
• an ultrasound to check the rectum and the anal sphincters.

You may be able to prevent and manage bowel incontinence with diet and lifestyle. For example:

• drink plenty of fluid (preferably water) each day
• reduce caffeinated and alcoholic drinks
• eat a healthy diet with a variety of foods that contain fibre
• stay active
• do regular pelvic floor muscle exercises
• learn how to use your pelvic floor muscles to hold on until you get to the toilet and relax when you sit on toilet.

Medicine or surgery may be used to treat some types of bowel incontinence.

You can:

• get help from a continence health professional, such as a pelvic floor physiotherapist or nurse continence specialist
• contact the National Continence Helpline.

Learn more about good bowel health.

Irritable bowel syndrome (IBS) is a chronic gut disorder that affects your stomach and intestines.

IBS is a group of symptoms, such as pain and bloating in your belly (abdomen) and changes in your bowel movements, for example, constipation and diarrhoea.

About 4% of the population have IBS. It’s more common in women, especially those aged 18 to 39 years.

Symptoms of IBS may include:

• recurrent belly pain, cramping or bloating that often eases after doing a poo or farting (passing wind)
• alternating constipation and diarrhoea
• changes in how your poo looks
• changes in how often you do a poo
• farting.

These bowel symptoms may not be related to IBS. It’s important to see your doctor if you’re concerned about any changes to your bowel habits.

Commonly accepted causes of IBS include:

• diet (food intolerances)
• stress
• gut infections (gastroenteritis)
• medicines
• problems with signals between the brain and gut.

There are no tests to diagnose IBS. Your doctor will usually diagnose IBS based on your symptoms and how often you experience them.