The Subject of Bowel Movements may seem strange and unusual to write about, but for your health and well-being nothing should be held back. Having healthy cleansing of the body is not only good for you physically but it can affect you mentally and emotionally. Who doesn't feel lighter after a nice royal throne relief session? In Chinese medicine all aspects of our bodily functions are questioned and recorded to assess the health of the patient and any imbalances the patient might be experiencing.
The movement of the bowels and whether the patient has an issue of constipation or diarrhea is important in assessing patients. Many patients are not well educated on how many times they should go to the bathroom a day. Some patients have a bowel movement one time a day and assume that they have no issues of constipation. Some patients have a bowel movement one time a week and assume that they are not constipated. Many patients are surprised when an Acupuncturist wants to treat them for constipation based on their bowel frequencies. Modern western research and literature on the subject is also at a loss as to what is deemed a normal frequency. Only in the ancient texts are we given a guideline to measure the basic frequency.
In Dorland’s Illustrated Medical Dictionary it states: Defecation- 1. The removal of impurities, 2. The evacuation of fecal material from the rectum. But it does not clarify how many times it should occur in a human or animal species. There is no mention of frequency or amount of fecal material to be expelled; it only states that it is necessary to remove the impurities.
In Merck’s Manual in the section under Diarrhea and Constipation: it states: No body function is more variable and subject to extraneous influences than is defecation. Normal bowel habits very considerably from person to person, being modified by age, individual physiologic factors, and dietary, social, and cultural patterns. In an urban civilization, normal bowel frequency ranges from 2 to 3 per day to 2 to 3 per week. Changes in stool frequency, consistency, or volume, or blood, mucus, pus, or excess fatty material (e.g. oil, grease, film) in the stool may indicatedisease. Merck’s again has no set amount or frequency only an outcome of what to expect if a disease pattern has manifested. But, to avoid disease it is necessary to avoid the pattern or be aware of the pattern that would result in disease in the first place. One interesting aspect of it that is mentioned is “In an urban civilization” i.e. a reference to urbanization and the change in our dietary habits.
In the LingShu, 32. The Balanced Man and Starvation it states: The full stomach causes the intestines to empty. The full intestines cause the qi to move up and down, which settles and pacifies the five viscera. The blood, veins, and arteries will be harmonized and smooth. The seminal essence and spirit will be the water and grains. Consequently, the center of the intestines and stomach can at that point hold from these grains two dou, and of water, one dou five shen. Thus, the balanced man twice a day can eliminate two shen and one-half. For one entire day, five shen. In seven days, five times seven, or three dou and five shen, which means the amount detained from water and grains is completely drained. The LingShu states both volume and a basic frequency of defecation. If a patient is having at least two bowel movements a day it is safe to say they are at the minimal amount expected.
In the Nanjing the 43 Difficult Issue; Huang Ti asks: When someone does not eat or drink, that person will die after seven days. Why is that so? (2) It is like this. Under regular circumstances, one’s stomach contains two pecks of grains and one pec and five pints of water. Hence a normal person will go to the latrine twice a day, each time passing two and a half pints. In the course of one day he passes five pints. In Seven days—five times seven—[this adds up to] three pecks and five pints, [leading to] complete exhaustion of water and grains. The measurements in; Paul Unschuld’s Nan Ching, are given in modern terms and gives a more accurate volume according to modern standards.
In the research about defecation and bowel movements, there is no definite number of times a day that is specified, nor is there a specific frequency. Although one of the side affects of some medication can be constipation and one of the symptoms of depression is constipation. In fact constipation has many etiologies from dietary and emotional causes to physical, as stated in Merck‘s Manual. One of the reasons it is possibly difficult for modern medicine to give an accurate frequency and rate is the changes in modern society’s diet. Originally, in the time that the Ling Shu and Nanjing were comprised the Asian diet was different. It consisted mostly of lean meat, vegetables and fruits. The present Asian diet consists of a large amount of complex carbohydrates, and the Western diet is one of the worst in the modern world filled with fats, sugars, salt and triglycerides from mostly processed and fast foods.
As Acupuncturist it is important to advise patients on lifestyle modifications such as diet and exercise and how to mix foods together. I stress the importance of eating fresh organic vegetables, fruits and meats with a minimal amount of grains. Dr. Robert Chu L.A.c. QME author of Master Tung’s Acupuncture for Allergies, Autoimmune Disorders, and Cancer Treatment A quick clinical reference for Acupuncturist lecture Notes, recommends as part of his acupuncture protocols to include points on the stomach channel ST34, 36, 37 with Stomach 37’s principle action being to move the bowels. As Dr. Chu stated in his literature “Everyone feels better after a bowel movement.” When a patient comes in for depression and constipation, I concentrate their treatment on the constipation, with acupuncture, massage and herbs. The result is they time and time again state how much better they feel. My patients many times ask me what is normal and I advise them that they should have as many bowel movements as times they eat food. After finishing my research on the subject matter, I am confident I am on the right path in line with the ancients. I make sure that my patients are having at least two bowel movements a day and prefer they have as many bowel movements as they eat.
1) Dorland’s Illustrated Medical Dictionary 24th Edition W.B. Saunders Company Philadelphia and London copyright 1900-1968 page 390
2) Berkow, Robert M.D.,: Merck’s Manual, 16th Edition, Merck’s Research Laboratories, Division of Merck & Co., Inc. Rahway, N.J. 1992 pg. 809 section 54.
3) Wu Jing-Nuan: Ling Shu or The Spiritual Pivot Asian Spirituality, Taoist Studies Series, The Taoist Center, Washington D.C. copyright 1993 University of Hawaii Press, Honolulu, Hawaii pgs. 130-131
4) Unschuld,Paul: Nan-Ching, The Classic Of Difficult Issues University of California Press Berkeley, Los Angeles, London 1986 pg. 425
5) Chu, Robert PhD. L.A.c. QME: Master Tung’s Acupuncture for Allergies, Autoimmune Disorders, and Cancer Treatment, A Quick Clinical Reference for Acupuncturists Lecture Notes Revision 3.0 Medicine Dharma Healing Center July 2013