Imake my living dealing with assholes. Usually they’re attached to nice people seeking help for a host of common issues causing them pain or embarrassment. Many of my patients are young and LGBTQ+, needing relief from injuries caused by improperly executed anal sex, or treatment for anal STIs. But I also frequently see people of all genders and sexual orientations who are seeking help for conditions caused by constipation, childbirth and even poor weightlifting techniques. I see damage from over-wiping with rough toilet paper, or rashes or fungal or bacterial irritations caused by overuse of wet wipes. I meet people suffering from hemorrhoids, who are scared when they see unexplained blood in the toilet bowl. I talk to patients who just don’t feel sexy because of unwanted hair or irregular pigmentation. Ultimately, one thing seems to be universally true: no one feels happy, healthy or beautiful if their ass isn’t happy, healthy and beautiful. So that’s what I do – give people their happiness, health and self-confidence back, one butt at a time. And since we spend a considerable amount of our life pooping, it behooves us to understand there is a correct technique for doing it. I call this lesson Pooping 101. So you’re saying it’s possible to poop … wrong? Most of us adopted incorrect pooping techniques when we were toddlers. Western parents generally plunk their children on the toilet and make them sit there for long stretches at a time, entertaining them with stories and songs day after day until finally, success! The whole house rejoices! Often, the habit of reading on the toilet stuck. Some of you probably grew up with bookshelves or magazine racks next to the toilet. You might have memories of your parents or even co-workers walking into the bathroom with a newspaper under their arm. Even before smartphones, most of us treated poop time as prime reading time. And that’s a problem, because it’s not good for you to spend so much time on the toilet. I won’t promise you a trophy if you follow my instructions, but I can tell you that if you do, you’ll waste less time on the pot and reduce the chances of developing the complications that can arise from extended sessions on the porcelain throne – namely painful hemorrhoids, swelling and tears. What’s the right way to poop? Here’s what to do: when you feel the urge to go to the bathroom, find a toilet, sit down, wait the 30 seconds to a minute it should take for the poop to come out, gently pat your butt clean and dry, and leave the loo. Don’t forget to wash your hands. It’s so simple, yet it doesn’t reflect most people’s habits. How many times should I poop a day? There’s no hard and fast rule about how frequently a healthy person should poop; the average number of times the average person defecates can range between one to two times per day and three times per week. There is, however, a general medical consensus about how much time a healthy person should spend on the toilet pooping. Once you feel the urge and sit down, it should only take you 30 seconds to a minute to defecate. If it takes you longer than that, don’t sit there and try to force it. Remember, every time you put pressure on that area, you risk injury and discomfort. Don’t spend 30 minutes on social media or checking emails waiting for the poo to descend. Stand up and walk around. Brush your teeth, drink some water or do something else. It might take you some time before you once again feel the urge, but when you do, immediately go back to the toilet and try again. If you can only get a portion out and you still feel the urge but nothing’s happening, pat – yes, pat – your hiney clean (with paper, not wet wipes, which wash away protective skin flora), stand up, and go do your thing until the urge hits you again. What common errors do people make when pooping? The stool takes time to move into the right position to come down through the anal canal, which is why you shouldn’t try to force a poop when you don’t feel the urge. Many people will try to push a poo out in the mornings before they leave for school or work. It’s also common for people to use coffee and cigarettes, which increase the production of certain hormones and neurotransmitters that trigger bowel peristalsis (involuntary muscle movement), to encourage their body to move the poop down faster. This isn’t a great idea, as your body can become dependent on these substances to shit, and they diminish the normal movement of the bowel. Frequently, when things aren’t moving as quickly as you’d like them to, it’s not that you’re constipated – it’s just that the stool hasn’t moved into the rectum yet. However, when you do feel the urge, you need to respond to your body’s message as soon as possible. Every time you hold it in, your stool inches a little way back up, and your rectum reabsorbs some of the water from the stool, drying it out and making it harder to push out when you finally allow yourself to go. Don’t hold it. For a lot of you, this will mean getting over your reluctance to use public restrooms. Coffee shops and high-end hotels often offer clean, safe refuge. What tools can help me to poop better? Some people find that resting their feet on a little stepstool raises their knees and adjusts their pelvis in such a way to make the pooping process much faster and easier. In one study, 90% of participants said they strained less when using a stool and 71% said they had faster bowel movements. Specially made toilet stools are easily found in any home goods store or online. You could also just use a stack of books under each foot. The extent this tactic will work might depend on your height, the height of the toilet, the angle of the bowl and the type of seat you’re using. It’s also possible that the stool serves as a placebo, helping you shit using less pressure and with greater speed simply because you think it will. There have been only a limited number of studies to investigate how effective toilet stools really are, but it certainly doesn’t hurt to try, and if it works for you, great! Another way to speed things up is to raise your arms over your head, elongating the torso. This helps you breathe more deeply, thus relaxing the pelvic floor musculature and allowing the stool to release. Achieving that full relaxation is key. In fact, this is one area in which practicing with anal dilators and toys can be extremely useful to someone who isn’t interested in exploring anal sex. Using dilators and toys help people get a better understanding of their pelvic floor and what it feels like when it relaxes. That relaxation also encourages deep breathing. If none of these tactics speed up the amount of time it takes for you to poop, the problem may be related to nutrition, diet, ergonomics, water intake, or psychological or neural issues. Western diets are notoriously poor and low in fiber. That’s why fiber supplementation is key. I recommend a night-time routine paired with two tall glasses of water. Just remember: not all fiber is created equal, and the most appropriate type and method – for example, pill, powder, tablet – will vary depending on your gut. Introducing a morning routine of pre- and probiotics can also help improve your gut and bowel movements. Some might need even more help to relieve constipation. In such cases, oral remedies are a good option (start with stool softeners, then try gentle laxatives like Miralax and milk of magnesia if needed). You can also supplement these with fiber-rich foods and pre- and probiotics, and follow up with anal remedies like glycerin suppositories and enemas. You can use all of these in combination too. If you feel like you need to poop and you go more than three to five days with no results, and you’ve tried all the over-the-counter remedies, call a physician. Ideally, you should use a bidet or take a post-poop shower to clean your butt after you shit, as it introduces far less friction on that delicate skin than toilet paper. Cheap and easy-to-install bidet attachments are rising in popularity – there are even portable ones! – due to more people recognizing the economic and environmental savings of ditching toilet paper (often people use towels to dry the water off), but they’re still not standard in most homes. If you must use toilet paper, buy the cushiest ply you can afford and pat your behind, don’t wipe. Excerpt adapted from Butt Seriously : The Definitive Guide to Anal Health, Pleasure, and Everything In Between by Dr Evan Goldstein. Copyright © 2024 by Dr Evan Goldstein. Reprinted with permission of Balance Publishing, an imprint of Hachette Book Group. All rights reserved.