Regular emptying of the colon is a basic human need and contributes to maintaining good health. Irregular bowl movement causes health complications. Everyone has a different frequency of regular bowel movement, some 1 x day, others 1 x in 2 - 3 days.
Bowel movement (defecation) is influenced by many factors, e.g. by a diet rich in fibre, vegetables, fruit, cereals, or by exercise and change of position, psychological comfort or by practicing emptying reflex.
The emptying reflex can be rehearsed by regular daily repetition of several
steps which follow in the same order: A patient drinks a glass of mineral water or a glass of cold water with juice, followed by breakfast and tries to defecate. If is successful, the same process is repeated in the coming days, which may lead to developing a conditional discharge reflex.
Defecation is a reflective process that begins with the contraction of circular muscles at the interface of the transverse and descending colon. The contraction of the longitudinal muscle causes a shift of the intestinal contents further into the rectum. The pressure on the rectal mucosa causes weakening of the internal and external sphincter of the anus, followed by defecation.
The frequency of defecation is individual. The amount and appearance of faeces mainly depends on the amount and type of ingested food, fluids and the digestion process.
The most common defecation disorders include constipation, diarrhoea and stool incontinence, which occurs most frequently with sphincter damage, neurological diseases or it can occur in the overall weakening of the body, such as in the elderly.
When assessing a stool, the following is analysed:
- The quantity of one excreted stool ranges from 60 – 250 g.
The following stool forms are recognized:
- Sausage or snake like shape due to narrowing at the end of the colon,
- separate hard lumps such as in spastic constipation and water,
- no solid pieces in increased intestinal peristalsis.
The stool can have the following colour:
- A light colour when eating dairy products,
- dark colour when eating leafy vegetables, beetroots, paprika or caused by medication,
- light grey (acholic) which means the stool exhibits a lack of bile pigments,
- melena, which is a tarry stool that contains digested blood of the upper digestive tract with a source of an intestinal bleeding
- enterorrhagia, which is characterized by the presence of fresh blood in the stool.
In terms of smell
- sour (occurring in diarrhoea)
- sweet (occurring in melena) smells are distinguished.