A Daily Bowel Movement Does Not Mean Food Isn’t Remaining In The Gut

Just because you have a daily bowel movement does not mean feces aren’t remaining in the colon.

Effect of dietary fibre on stools and transit-times, and its role in the causation of disease, The Lancet, December 1972

The fibre-deficient food residues of Western man may remain in the bowel for several days and yet be associated with a daily bowel movement. Thus there is evidence to support the truth of the old adage that a patient may be regular but five days late.

It’s not a good situation when food remains in the gut. These authors obtained information “from more than two hundred hospitals in over twenty countries” and found:

We found no community which consumed a high fibre diet in which any of these bowel diseases [appendicitis, diverticular disease of the colon, both benign and malignant tumours of the colon and rectum] was common, nor any community which had changed from a high to a low fibre diet which had not become increasingly subject to most, if not all, of these conditions within a generation.

Across 20 countries … Bowel diseases including cancer were not common in communities that consumed a high-fiber diet. And it wasn’t about genes: “… differences in the behaviour of the bowel seem due to dietary factors rather than to any characteristic of race.”

They went right ahead and included heart disease in their hypothesis:

In the West, coronary-artery disease, diverticulosis coli, appendicitis, and gallbladder disorders loom large on the clinical scene, while cancer of the colon is second only to lung cancer as a killing neoplasm.

This was not always so. Coronary-artery disease was rare in England until 1925; diverticulosis coli was a curiosity until 1900; appendicitis appeared towards the end of the 19th century; and gallbladder disease has increased fourfold in the Bristol region since 1940. All these diseases became common after the introduction of improved milling techniques.

They noted fiber’s ability to lower serum cholesterol as one mechanism for lower heart disease.

But it’s an equation, isn’t it. Low fiber may be contributing to disease but it’s not acting alone. Are there foods people in developed countries starting eating more of when they stopped eating so much fiber-y bread and cereal? Did those new foods change the make-up of their gut microflora?

” … it has been shown that the bacteria in the colon of people eating a Western diet degrade bile to form the precursors of carcinogens. These noxious compounds would remain in contact with the colonic mucosa for a longer time and in a more concentrated form if a fibre-deficient diet was eaten.

1972. We’ve known the importance of fiber for over half-a-century. Why didn’t it catch on?