tag:theconversation.com,2011:/us/topics/faeces-27777/articlesFaeces – The Conversation2024-02-15T03:31:18Ztag:theconversation.com,2011:article/2235412024-02-15T03:31:18Z2024-02-15T03:31:18ZHow worried should I be about cryptosporidiosis? Am I safe at the pool?<figure><img src="https://images.theconversation.com/files/575532/original/file-20240214-30-7bq8q2.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C998%2C559&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/bright-aqua-blue-swimming-pool-students-2124280826">LBeddoe/Shutterstock</a></span></figcaption></figure><p>You might have heard of something called “<a href="https://www.abc.net.au/news/2024-02-13/nsw-health-alert-cryptosporidiosis-cases/103460468">cryptosporidiosis</a>” recently, closely followed by warnings to stay away from your local swimming pool if you’ve had diarrhoea.</p>
<p>More than 700 cases of this gastrointestinal disease were reported <a href="https://www.health.qld.gov.au/newsroom/doh-media-releases/rapid-increase-in-cryptosporidiosis-cases-hits-queensland">in Queensland</a> in January, which is <a href="https://www.theguardian.com/australia-news/2024/feb/13/avoid-swimming-pools-if-youre-part-of-australias-surge-in-diarrhoea-cases-say-authorities">13 times more</a> than in January last year. Just under 500 cases have been recorded in <a href="https://www.health.nsw.gov.au/news/Pages/20240213_00.aspx">New South Wales</a> this year to-date, while <a href="https://www.health.vic.gov.au/health-advisories/increase-in-cryptosporidiosis-cases-across-victoria">other states</a> have similarly reported an increase in the number of cryptosporidiosis infections in recent months.</p>
<p>Cryptosporidiosis has been listed as a <a href="https://pubmed.ncbi.nlm.nih.gov/12725505/">national notifiable disease</a> in Australia since 2001.
But what exactly is it, and should we be worried?</p>
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Read more:
<a href="https://theconversation.com/what-lies-beneath-the-bugs-lurking-in-your-swimming-pool-51028">What lies beneath: the bugs lurking in your swimming pool</a>
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<h2>What causes cryptosporidiosis, and who is affected?</h2>
<p>Cryptosporidiosis is the disease caused by the parasite <em>Cryptosporidium</em>, of which there are two types that can make us sick. <em>Cryptosporidum hominis</em> only affects humans and is the major cause of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133686/">recent outbreaks in Australia</a>, while <em>Cryptosporidium parvum</em> can also affect animals. </p>
<p>The infection is spread by spores called oocysts in the stools of humans and animals. When ingested, these oocysts migrate and mature in the small bowel. They damage the small bowel lining and <a href="https://www.cdc.gov/parasites/crypto/general-info.html">can lead to diarrhoea</a>, nausea, vomiting, fever and abdominal discomfort. </p>
<p>Most people develop symptoms anywhere from <a href="https://www.health.vic.gov.au/health-advisories/increase-in-cryptosporidiosis-cases-across-victoria">one to 12 days</a> after becoming infected. Usually these symptoms resolve within two weeks, but the illness may last longer and can be severe in those with a weakened immune system. </p>
<p>Children and the elderly tend to be the most commonly affected. Cryptosporidiosis is more prevalent in young children, particularly those <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30283-3/fulltext">under five</a>, but the disease can affect people of any age. </p>
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<img alt="A 'pool closed' sign in front of a swimming pool." src="https://images.theconversation.com/files/575739/original/file-20240214-18-g0i5b2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/575739/original/file-20240214-18-g0i5b2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/575739/original/file-20240214-18-g0i5b2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/575739/original/file-20240214-18-g0i5b2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/575739/original/file-20240214-18-g0i5b2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/575739/original/file-20240214-18-g0i5b2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/575739/original/file-20240214-18-g0i5b2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A number of public pools have been closed lately due to cryptosporidiosis outbreaks.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/bright-white-sign-local-outdoor-pool-2124260702">LBeddoe/Shutterstock</a></span>
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<h2>So how do we catch it?</h2>
<p>Most major outbreaks of cryptosporidiosis have been due to people drinking contaminated water. The largest recorded outbreak occurred in <a href="https://pubmed.ncbi.nlm.nih.gov/7818640/">Milwaukee in 1993</a> where 403,000 people were believed to have been infected. </p>
<p><em>Cryptosporidium</em> oocysts are very small in size and in Milwaukee they passed through the filtration system of one of the water treatment plants undetected, infecting the city’s water supply. As few as <a href="https://www.sciencedirect.com/science/article/pii/S1286457902016301#BIB26">ten oocysts</a> can cause infection, making it possible for contaminated drinking water to affect a very large number of people.</p>
<p>Four days after infection a person with cryptosporidiosis can shed <a href="https://www.safewater.org/fact-sheets-1/2017/1/23/detailed-cryptosporidium">up to ten billion oocysts</a> into their stool a day, with the shedding persisting for about two weeks. This is why one infected person in a swimming pool can infect the entire pool in a single visit. </p>
<p><em>Cryptosporidium</em> oocysts excreted in the faeces of infected humans and animals can also reach <a href="https://www.safewater.org/fact-sheets-1/2017/1/23/detailed-cryptosporidium">natural bodies of water</a> such as beaches, rivers and lakes directly through sewer pipes or indirectly such as in manure transported with surface runoff after heavy rain. </p>
<p><a href="https://www.sciencedirect.com/science/article/pii/S0043135418308728">One study</a> which modelled <em>Cryptosporidium</em> concentrations in rivers around the world estimated there are anywhere from 100 to one million oocysts in a litre of river water.</p>
<p>In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133686/">Australia</a>, cryptosporidiosis outbreaks tend to occur during the late spring and early summer periods when there’s an increase in recreational water activities such as swimming in natural water holes, water catchments and public pools. We don’t know exactly why cases have seen such a surge this summer compared to other years, but we know <em>Cryptosporidium</em> is very infectious. </p>
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Read more:
<a href="https://theconversation.com/explainer-what-is-gastroenteritis-and-why-cant-i-get-rid-of-it-34351">Explainer: what is gastroenteritis and why can't I get rid of it?</a>
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<p>Oocysts have been found in foods such as <a href="https://www.sciencedirect.com/science/article/pii/S0362028X22052693">fresh vegetables</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/10958471/">seafood</a> but these are not common sources of infection in Australia. </p>
<h2>What about chlorine?</h2>
<p>Contrary to popular belief, chlorine doesn’t kill off all infectious microbes in a swimming pool. <em>Cryptosporidium</em> <a href="https://www.sciencedirect.com/science/article/pii/S1286457902016301#BIB26">oocysts are hardy</a>, thick-walled and resistant to chlorine and acid. They are not destroyed by chlorine at the normal concentrations found in swimming pools. </p>
<p>We also know oocysts can be <a href="https://wwwnc.cdc.gov/eid/article/5/4/99-0425_article">significantly protected</a> from the effects of chlorine in swimming pools by faecal material, so the presence of even small amounts of faecal matter contaminated with <em>Cryptosporidium</em> in a swimming pool would necessitate closure and a thorough decontamination. </p>
<p>Young children and in particular children in nappies are known to increase the potential for disease transmission in recreational water. Proper nappy changing, frequent bathroom breaks and showering before swimming to remove faecal residue are helpful ways to reduce the risk. </p>
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<img alt="Two children playing in a body of water." src="https://images.theconversation.com/files/575749/original/file-20240214-26-4wbfib.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/575749/original/file-20240214-26-4wbfib.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/575749/original/file-20240214-26-4wbfib.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/575749/original/file-20240214-26-4wbfib.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/575749/original/file-20240214-26-4wbfib.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/575749/original/file-20240214-26-4wbfib.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/575749/original/file-20240214-26-4wbfib.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Cryptosporidium can spread in other bodies of water, not just swimming pools.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/happy-summertime-healthy-childhood-concept-two-460928809">Yulia Simonova/Shutterstock</a></span>
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<h2>Some sensible precautions</h2>
<p>Other measures you can take to reduce yours and others’ risk of cryptosporidiosis include: </p>
<ul>
<li><p>avoid swimming in natural waters such as rivers and creeks during and for at least three days after heavy rain</p></li>
<li><p>avoid swimming in beaches for at least one day after heavy rain</p></li>
<li><p>avoid drinking untreated water such as water from rivers or springs. If you need to drink untreated water, boiling it first will kill the <em>Cryptosporidium</em></p></li>
<li><p>avoid swallowing water when swimming if you can</p></li>
<li><p>if you’ve had diarrhoea, avoid swimming for at least two weeks after it has resolved</p></li>
<li><p>avoid sharing towels or linen for at least two weeks after diarrhoea has resolved</p></li>
<li><p>avoid sharing, touching or preparing food that other people may eat for at least 48 hours after diarrhoea has resolved</p></li>
<li><p>wash your hands with soap and water after going to the bathroom or before preparing food (<em>Cryptosporidium</em> is <a href="https://www.cdc.gov/parasites/crypto/resources/childcare_outbreak.pdf">not killed</a> by alcohol gels and sanitisers).</p></li>
</ul>
<p>Not all cases of diarrhoea are due to cryptosporidiosis. There are many other <a href="https://theconversation.com/explainer-what-is-gastroenteritis-and-why-cant-i-get-rid-of-it-34351">causes of infectious gastroenteritis</a> and because the vast majority of the time recovery is uneventful you don’t need to see a doctor unless very unwell. If you do suspect you may have cryptosporidiosis you can ask your doctor to refer you for a stool test.</p><img src="https://counter.theconversation.com/content/223541/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Vincent Ho does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The infection is spread by spores called oocysts in the stools of humans and animals.Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2039882023-04-24T16:14:01Z2023-04-24T16:14:01ZThe dirty truth about your phone – and why you need to stop scrolling in the bathroom<figure><img src="https://images.theconversation.com/files/522188/original/file-20230420-1700-nz53nk.png?ixlib=rb-1.1.0&rect=14%2C26%2C1970%2C1461&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Using your phone when you're on the toilet is a horrid habit. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cropped-image-beautiful-young-woman-using-488716744">Canva/Shutterstock</a></span></figcaption></figure><p>We carry them everywhere, take them to bed, to the bathroom and for many people they’re the first thing they see in the morning – more than 90% of the world owns or uses a <a href="https://doi.org/10.3390/microorganisms11020523">mobile phone</a> and many of us couldn’t manage without one.</p>
<p>But while health concerns about phones use usually focus on the <a href="https://theconversation.com/why-using-a-mobile-phone-while-driving-is-so-dangerous-even-when-youre-hands-free-71833">distraction they can cause</a> while driving, the possible effects of <a href="https://theconversation.com/theres-no-evidence-5g-is-going-to-harm-our-health-so-lets-stop-worrying-about-it-120501">radiofrequency exposure</a>, or just how <a href="https://theconversation.com/seven-tips-for-a-healthier-relationship-with-your-phone-202215">addictive they can be</a>. The microbial infection risk of your phone is much less appreciated – <a href="https://www.nature.com/articles/s41598-021-93622-w">but it’s very real</a>.</p>
<p><a href="https://yougov.co.uk/topics/society/articles-reports/2019/02/28/most-britons-use-their-phone-toilet">A 2019 survey</a> found that most people in the UK use their phones on the toilet. So it’s not surprising to discover studies have found our mobile phones to be <a href="https://cals.arizona.edu/news/why-your-cellphone-has-more-germs-toilet">dirtier that toilet seats</a>. </p>
<p>We give our phones to children to play with (who aren’t exactly well known for their hygiene). We also eat while using our phones and put them down on all sorts of (dirty) surfaces. All of which can transfer microbes onto your phone along with food deposits for those microbes to eat. </p>
<p>It’s been estimated that people touch their phone <a href="https://www.dailymail.co.uk/news/article-2276752/Mobile-users-leave-phone-minutes-check-150-times-day.html">hundreds</a> if not <a href="https://dscout.com/people-nerds/mobile-touches">thousands</a> of times a day. And while many of us wash our hands regularly after say, going to the bathroom, cooking, cleaning, or gardening, we are much less likely to consider washing our hands after <a href="https://www2.deloitte.com/content/dam/insights/articles/us175371_tmt_connectivity-and-mobile-trends-interactive-landing-page/DI_Connectivity-mobile-trends-2022.pdf">touching our phones</a>. But given how disgusting and germ-infested phones can be, maybe it’s time to think more about <a href="https://pubmed.ncbi.nlm.nih.gov/19267892/">mobile phone hygiene</a>.</p>
<h2>Germs, bacteria, viruses</h2>
<p>Hands pick up bacteria and viruses all the time and are <a href="https://www.cdc.gov/handwashing/when-how-handwashing.html">recognised as a route</a> for <a href="https://www.ncbi.nlm.nih.gov/books/NBK144014/#parti_ch7.s3">acquiring infection</a>. So too are the phones we touch. <a href="https://www.nature.com/articles/s41598-022-14118-9">A number</a> of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196688/">studies</a> conducted on the microbiological colonisation of mobile phones show that they can be contaminated with many different kinds of potentially pathogenic bacteria.</p>
<p>These include the diarrhoea-inducing <em>E. coli</em> (which, by the way, comes from human poo) and the skin-infecting <em>Staphylococcus</em>, as well as <em>Actinobacteria</em>, which can cause tuberculosis and diphtheria, <em>Citrobacter</em>, which can lead to painful urinary tract infections, and <em>Enterococcus</em>, which is known to cause meningitis. <em>Klebsiella</em>, <em>Micrococcus</em>, <em>Proteus</em>, <em>Pseudomonas</em> and <em>Streptococcus</em> have also been found on phones and all can have equally nasty effects on humans.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130244/">Research</a> has found that many pathogens on phones are often antibiotic resistant, meaning they can’t be treated with conventional drugs. This is worrying as these bacteria can cause skin, gut and respiratory infections that can be life-threatening. </p>
<p>Research has also found that even if you clean your phone with antibacterial wipes or alcohol it can still be recolonised by microorganisms, indicating that <a href="https://www.mdpi.com/2076-2607/11/2/523">sanitisation</a> must be a <a href="https://www.nature.com/articles/s41598-022-14118-9">regular process</a>. </p>
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<img alt="Woman wearing yellow jumper cleaning phone screen with a wipe." src="https://images.theconversation.com/files/522184/original/file-20230420-23-ne9bdl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/522184/original/file-20230420-23-ne9bdl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/522184/original/file-20230420-23-ne9bdl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/522184/original/file-20230420-23-ne9bdl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/522184/original/file-20230420-23-ne9bdl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/522184/original/file-20230420-23-ne9bdl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/522184/original/file-20230420-23-ne9bdl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The importance of cleaning your phone and how to do it safely.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/coronavirus-global-epidemic-woman-disinfecting-phone-1677416521">Volurol/Shutterstock</a></span>
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<p>Phones contain plastic which can harbour and <a href="https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(15)01034-4/fulltext">transmit viruses</a> some of which (the common cold virus) can live on hard plastic surfaces for up to a week. Other viruses such as COVID-19, rotavirus (a highly infectious stomach bug that typically affects babies and young children), influenza and norovirus – which can cause serious respiratory and gut infections – can persist in an infectable form for several days. </p>
<p>Indeed, since the beginning of the COVID pandemic, the US Centers for Disease Control and Prevention has introduced <a href="https://www.cdc.gov/hygiene/cleaning/cleaning-your-home.html">guidelines for cleaning and disinfecting mobile phones</a> – which, along with door handles, cash machines and <a href="https://theconversation.com/from-the-bed-sheets-to-the-tv-remote-a-microbiologist-reveals-the-shocking-truth-about-dirt-and-germs-in-hotel-rooms-202195">lift buttons</a>, are considered <a href="https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(15)01034-4/fulltext">reservoirs of infection</a>. </p>
<p>In particular, concern has been raised about the role mobile phones can play in the spread of infectious microbes in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196688/">hospital and healthcare settings</a>, as well as in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466825/">schools</a>. </p>
<h2>Clean your phone</h2>
<p>So it’s clear that you need to start cleaning your phone regularly. The US Federal Communications Commission actually recommends <a href="https://www.fcc.gov/consumers/guides/how-sanitize-your-phone-and-other-devices">daily sanitation</a> of your phone and other devices – not least because we are still within an active COVID-19 pandemic and the virus can survive for several days on hard plastic surfaces. </p>
<p>Use <a href="https://www.fcc.gov/consumers/guides/how-sanitize-your-phone-and-other-devices">alcohol-based wipes or sprays</a>. They need to contain at least 70% alcohol to disinfect phone casings and touch screens, and it needs to be done every day if possible. </p>
<p>Do not spray sanitisers directly onto the phone and keep liquids away from connection points or other phone openings. Absolutely avoid using bleach or abrasive cleaners. And wash your hands thoroughly after you’ve finished cleaning.</p>
<p>Thinking about how you handle your phone will also help to avoid it becoming colonised with germs. When not at home, keep your phone in your pocket, or bag and use a disposable paper list of to-do items, rather than constantly consulting your phone. Touch your phone with clean hands – washed with soap and water or disinfected with alcohol-based hand sanitiser. </p>
<p>There are other things you can do to avoid your phone becoming a source of viruses. Do not share your phone with others if you have any infection, or have not first sanitised it. If children are allowed to play with your phone, sanitise it as soon as possible afterwards. </p>
<p>And get in the habit of putting your phone away when not in use, then sanitising or washing your hands. You might also want to occasionally sanitise your phone charger when you are cleaning your phone.</p><img src="https://counter.theconversation.com/content/203988/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Primrose Freestone does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Your mobile phone is 10 times dirtier than a toilet seat. Here’s what to do about it.Primrose Freestone, Senior Lecturer in Clinical Microbiology, University of LeicesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1991662023-02-27T12:05:07Z2023-02-27T12:05:07ZSwimming pools v wild swimming – a germs expert on which is worse<figure><img src="https://images.theconversation.com/files/511428/original/file-20230221-18-axh3j6.jpg?ixlib=rb-1.1.0&rect=0%2C40%2C5464%2C3432&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.alamy.com/wild-or-open-water-women-swimmers-wearing-wetsuits-with-buoyancy-floats-enter-the-firth-of-forth-sea-north-berwick-east-lothian-scotland-uk-image416629506.html?imageid=FCA7E8A4-6ACE-4DCC-94AB-64CDB9B6F5C2&p=373051&pn=1&searchId=bf5dfdc822516e443cf4c25d554e4dd2&searchtype=0"> Sally Anderson/Alamy Stock Photo</a></span></figcaption></figure><p><a href="https://www.bbc.com/travel/article/20210603-why-wild-swimming-is-britains-new-craze">Wild swimming</a> has grown massively in popularity in recent times. Not only is swimming outdoors a pleasant way to enjoy the sunshine, fresh air and green leafy surroundings, it can also <a href="https://www.swimnow.co.uk/the-psychology-of-swimming/why-do-humans-like-to-swim/">help to</a> relieve stress and elevate our endorphins. This creates a sense of wellbeing as well as burning calories and exercising muscles. </p>
<p>But along with the joys of outdoor swimming come some dangers. Not only are wild swimmers more at risk from tides, currents and swells, there can also be nasty bugs and bacteria lurking in the water. And with <a href="https://www.gov.uk/government/news/sewage-in-water-a-growing-public-health-problem">untreated sewage</a> regularly flowing into seas, rivers and lakes across the country, it can be hard to find a safe spot for a paddle.</p>
<p>Of course, swimming in a pool comes with its <a href="https://www.cdc.gov/dotw/rwis/index.html">own set of risks</a>. Urinary tract infections, ear infections and tummy bugs are the most common illnesses caught here. <a href="https://www.iflscience.com/a-grim-amount-of-people-pee-in-the-pool-heres-why-you-shouldnt-63515#:%7E:text=In%20one%20survey%2C%20at%20least,as%20high%20as%2040%20percent.">Dirty pools</a> can also cause your eyes to sting and harbour all sorts of bacteria and germs – including urine, faeces and sweat. In many ways, swimming pools are like a <a href="https://theconversation.com/faeces-urine-and-sweat-just-how-gross-are-hot-tubs-a-microbiologist-explains-198367">big bath</a> filled with lots of strangers.</p>
<p>But while it’s clear that swimming in outdoor waters carries different risks from swimming in a pool, the question of where’s safest to swim may not seem immediately obvious. So where’s cleanest for a dip: swimming pools, or rivers, lakes, canals and the sea? Let’s look at the evidence.</p>
<h2>Toxic waters</h2>
<p>Unlike swimming pools where waters are carefully monitored, outdoor waters are constantly changing in composition. This means that chemicals can leach into wild waters from nearby farms or industrial areas, animals can defecate in water, and in certain areas human sewage may be legally or otherwise dumped into the water (if you can see pipes, do not get in). </p>
<p>There may not be signposts warning of local dangers, and the presence of toxic agents might not be obvious. When in doubt about the <a href="https://www.gov.uk/government/publications/swim-healthy-leaflet/swim-healthy#:%7E:text=designated%20bathing%20waters.-,Health%20risks,are%20more%20susceptible%20to%20infection">chemical safety of outdoor waters</a>, it’s better to not enter them. If the water <a href="https://outdoorswimmer.com/featured/wild-swimming-how-to-spot-a-clean-river/">doesn’t look or smell right</a>, trust your instinct.</p>
<p>There are also natural hazards to outdoor waters compared with pools, especially in the summer. <a href="https://consult.environment-agency.gov.uk/cumbria-and-lancashire/blue-green-algae-in-cumbria-and-lancashire/user_uploads/blue-green-algae-leaflet.pdf">Blue–green algae</a> is a type of bacteria naturally found in lake ecosystems. In warm summers, the algae tends to multiply and form a <a href="https://www.theguardian.com/uk-news/2022/aug/24/it-stinks-lake-windermere-plagued-by-blue-green-algae-as-toxic-as-cobra-venom">powdery green scum</a> (known as a bloom) on the surface of the lake. This blue-green algae bloom can release toxins which are harmful to humans and occasionally <a href="https://www.bluecross.org.uk/advice/dog/blue-green-algae-and-its-dangers-to-dogs">lethal to pets</a>.<br>
Swimming in or swallowing water containing toxin-releasing algal blooms can lead to skin rashes, eye irritation, severe gastrointestinal upset, fever, and muscle and joint pain.</p>
<h2>Bacteria and viruses</h2>
<p>Diarrhoea is the most common illness linked to open-water swimming, often due to sewage contamination. You become ill if you swallow <a href="https://www.cdc.gov/healthywater/swimming/swimmers/rwi/diarrheal-illness.html">contaminated water</a>, which can contain bacteria and viruses such as E.coli and Norovirus. </p>
<p>Rats living in sewers adjacent to freshwater rivers or canals can also carry in their urine the bacterial pathogen Leptospira, which causes <a href="https://www.nhs.uk/conditions/leptospirosis/">Leptospirosis</a> (Weil’s disease). The infection occurs if soil or water from a lake, river or canal that contains urine from infected animals is swallowed, gets in a swimmer’s eyes or a cut. </p>
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Read more:
<a href="https://theconversation.com/faeces-urine-and-sweat-just-how-gross-are-hot-tubs-a-microbiologist-explains-198367">Faeces, urine and sweat – just how gross are hot tubs? A microbiologist explains</a>
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<p>Leptospirosis can cause liver and kidney damage, and may be fatal if left untreated. If you develop flu or jaundice symptoms up to two weeks after swimming in a river or canal, it may be a good idea to ask your doctor for a Leptospirosis test.</p>
<p>As for the sea, <a href="https://evidence.nihr.ac.uk/alert/swimming-in-seawater-is-linked-with-an-increased-chance-of-some-illnesses/">a 2018 study</a> found that people swimming in seawater were more likely to experience infections of the ear, nose, throat and gastrointestinal system than those who stayed on the beach. So it’s a good idea to wash after swimming in any outdoor waters, and certainly before eating food.</p>
<h2>The verdict</h2>
<p>When you add it all up, even with the possibility of people peeing and pooping in the pool, a managed swimming pool will always be a safer environment for a swim. Especially when you consider things like jellyfish stings and the additional risks that come with <a href="https://rnli.org/safety/know-the-risks/cold-water-shock">swimming in cold water</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Man swimming in pool." src="https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/511432/original/file-20230221-18-yofimv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Swimming pools are a safer bet.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fit-swimmer-training-swimming-pool-professional-516633376">Jacob Lund/Shutterstock</a></span>
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<p>Compared with a pool, wild swimmers are more likely to become unwell from swimming in outdoor water as there will always be potentially <a href="https://evidence.nihr.ac.uk/alert/swimming-in-seawater-is-linked-with-an-increased-chance-of-some-illnesses/">disease-causing microbes present</a>. </p>
<p>Swimming pool water, with adequate chlorine disinfection levels and pH maintenance, is much less likely to contain infectious microorganisms and so represents a much safer environment for recreational swimming. Injuries and drowning are also much less likely in pools where trained <a href="https://www.lifeguardtv.com/why-you-should-swim-near-a-lifeguard/">lifeguards</a> and safety equipment are present.</p>
<p>Perhaps, then, an outdoor managed swimming pool offers the best of both worlds – a swim with the sun on your back in a sanitary environment.</p><img src="https://counter.theconversation.com/content/199166/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Primrose Freestone does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As well as the joy that comes with swimming, there can also be some dirty risks.Primrose Freestone, Senior Lecturer in Clinical Microbiology, University of LeicesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1983672023-02-07T12:00:02Z2023-02-07T12:00:02ZFaeces, urine and sweat – just how gross are hot tubs? A microbiologist explains<figure><img src="https://images.theconversation.com/files/507865/original/file-20230202-2164-9vdp04.jpg?ixlib=rb-1.1.0&rect=59%2C37%2C3535%2C2360&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Communal bathing can get pretty disgusting.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/los-angelescaliforniausa-05232018-people-jacuzzi-1441434797">monic zrivoic/Shutterstock</a></span></figcaption></figure><p>For many centuries we have bathed in communal waters. Sometimes for cleanliness but more often for pleasure. Indeed, in ancient Greece, baths were taken in freshwater, or sometimes the sea – which was thought of as a sacred place dedicated to local gods and so was considered <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2557448/pdf/medhistsuppl00037-0011.pdf">an act of worship</a>. </p>
<p>But it was the Romans who created state-sponsored aqueducts to allow for <a href="https://pubmed.ncbi.nlm.nih.gov/11830439/">large-scale public baths</a>. These were mainly used for relaxation but also for more private pleasures, too. Yes, the public baths were often where Romans did the <a href="https://www.dailymail.co.uk/news/article-399017/The-steamy-truth-Roman-Bath.html">dirty deed</a> - sometimes with their bath attendant slaves.</p>
<p>Two millennia on, we’re still attracted to bathing communally, though many people now have their own hot tub – sales of which <a href="https://www.theguardian.com/news/2021/apr/12/bubble-trouble-thieves-hot-tub-craze-whirlpool-baths">went up</a> massively <a href="https://businessnewswales.com/coronavirus-lockdown-leads-to-surge-in-sales-for-hot-tub-firm/">during the pandemic</a>. </p>
<p>For those that don’t have their own, there’s always the local gym or spa. And many hospitals also feature one too. This is because hot tubs are often used therapeutically for relieving and treating joint inflammation in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1754027/">rheumatoid and osteoarthritis patients</a>. Indeed, in many ways hot tub bathing is regarded as a luxury treat experience – one that’s both relaxing and rejuvenating.</p>
<p>The warmth of the water within the hot tub naturally widens blood vessels, which helps <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049052/">our muscles to relax</a> and eases sore joints. As well as being physically comforting, a sense of psychological wellbeing may also be created by the buoyant warm water and the companionship of those who share the bathing experience. </p>
<h2>Bacteria, viruses and fungi</h2>
<p>But it’s also worth bearing in mind that when we enter the waters of a hot tub whatever we have on our skin we deposit into the warm water swirling around us. <a href="https://www.huffingtonpost.co.uk/entry/hot-tub-germs_n_5268919">This includes</a> the <a href="https://www.cuh.nhs.uk/patient-information/bowel-control/">100mg or so of faeces</a> that is usually present between our buttock cheeks. This means that while you’re relaxing in the warm water, you’ll likely breathe in or swallow your hot tub partner’s <a href="https://www.medicinenet.com/what_diseases_can_you_get_from_a_hot_tub/article.htm">body’s bacteria, viruses and fungi</a>. </p>
<p>The more people in the hot tub, the higher the levels of faeces and sweat shed into the water (and urine if anyone has peed in the water). And these bodily deposits can be used by the bacteria as direct nutrients. </p>
<figure class="align-center ">
<img alt="Women in hot tub taking a photo." src="https://images.theconversation.com/files/507856/original/file-20230202-4223-3a6cvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/507856/original/file-20230202-4223-3a6cvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/507856/original/file-20230202-4223-3a6cvg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/507856/original/file-20230202-4223-3a6cvg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/507856/original/file-20230202-4223-3a6cvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/507856/original/file-20230202-4223-3a6cvg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/507856/original/file-20230202-4223-3a6cvg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">‘I just love it when we share faecal matter together.’</span>
<span class="attribution"><a class="source" href="https://www.alamy.com/small-group-of-female-friends-enjoying-a-weekend-away-they-are-taking-a-group-selfie-while-sitting-in-a-hot-tub-image244340274.html?imageid=B3F3C810-62AA-4E14-B14A-5B0EF34D7C59&p=386705&pn=1&searchId=1766fcdba780ec00b8395ff08531181f&searchtype=0">DGLimages/Alamy Stock Photo</a></span>
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<p>As hot tub owners are advised to change the water in their baths only around every <a href="https://pages.swimuniversity.com/hot-tub-cheat-sheet-website/">three months</a>, bacteria will grow. For microbiological safety, most hot tubs that recirculate water have microbe-removing filters and water is treated with microbicides (which kill germs) such as chlorine, bromine, or other disinfectants to <a href="https://www.cdc.gov/healthywater/swimming/swimmers/hot-tub-user-information.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthywater%2Fswimming%2Fprotection%2Fhot-tub-user-tips-factsheet.html">control bacterial numbers</a>. </p>
<p>Such chemicals are toxic and cause skin and eye irritation. This is why hot tub users are advised to shower after bathing (and should also shower before, too). The temperature of the water within a hot tub (around 104°F or 40°C can also cause potentially serious health problems such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548817/">core overheating</a> which can lead to feeling faint or even loss of consciousness and potentially drowning. </p>
<p>This is especially the case for <a href="https://www.nhs.uk/common-health-questions/pregnancy/is-it-safe-to-use-a-sauna-or-jacuzzi-if-i-am-pregnant/">pregnant women</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548817/">children</a>, along with people with underlying health conditions, who should always check with their GP before using a hot tub. This is why most sessions are advised to last no more than around 15 minutes and should be supervised. </p>
<h2>Dirty or filthy?</h2>
<p>While personal hot tub may be relatively safe microbiologically, public (hotel or spa) hot tub can potentially be <a href="https://www.pmengineer.com/articles/86815-microbial-loads-in-whirlpool-baths">very high in infection-causing bacteria</a> (germs), particularly if water is recycled. </p>
<p>The root problem is poor public compliance with personal hygiene guidelines and inadequate water treatment maintenance. Improperly maintained public hot tubs can lead to outbreaks of infections by human-associated bacteria which survive well in water. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/11095998/">These include</a> <a href="https://www.cdc.gov/ecoli/index.html"><em>E.coli</em></a>, <a href="https://www.ncbi.nlm.nih.gov/books/NBK441868/#:%7E:text=Staphylococcus%20aureus%20is%20a%20gram,acquired%20and%20hospital%2Dacquired%20settings."><em>Staphylococcus aureus</em></a>, <a href="https://www.gov.uk/government/collections/pseudomonas-aeruginosa-guidance-data-and-analysis#:%7E:text=Pseudomonas%20aeruginosa%20is%20a%20Gram,it%20rarely%20affects%20healthy%20individuals."><em>Pseudomonas aeruginosa</em></a> and <a href="https://www.ncbi.nlm.nih.gov/books/NBK7619/"><em>Legionella pneumoniae</em></a>. These hot tub pathogens <a href="https://www.cdc.gov/healthywater/swimming/swimmers/rwi.html">can cause</a> gut infections, diarrhoea, septicaemia, <a href="https://www.cdc.gov/healthywater/swimming/swimmers/rwi/rashes.html">skin infections</a>, urinary tract infections and respiratory infections, including Legionnaires’ disease. </p>
<p><a href="https://www.cdc.gov/legionella/wmp/control-toolkit/hot-tubs.html#:%7E:text=Hot%20tubs%20have%20been%20associated,systems%20for%20disinfectant%20and%20pH.">Legionella bacteria</a> are particularly found in the water droplets within the hot tub steam and inhaling the contaminated steam could lead to the development of life-threatening pneumonia. </p>
<p>Indeed, the infection risk from hot tub is so significant that in the US, the Centers for Disease Control has released <a href="https://www.cdc.gov/healthywater/swimming/swimmers/hot-tub-user-information.html">official advice</a> on how to prevent this. </p>
<p>So if you do still want to enjoy a hot tub, is there a way of telling if it’s safe or not? There are some clear signs of a germ-filled hot tub. When urine and other body fluids such as sweat mixes with the chlorine used to disinfect hot tub waters it creates an irritant, a pungent chemical called chloramine, which is what causes sore eyes when <a href="https://www.cdc.gov/healthywater/swimming/aquatics-professionals/chloramines.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthywater%2Fswimming%2Fpools%2Firritants-indoor-pool-air-quality.html">swimming in public pools</a>. </p>
<p>The more bathers that deposit their bodily fluids the stronger the smell of the <a href="https://poolonomics.com/chloramines/">chloramine</a> (which smells a bit like bleach) and the greater the likelihood that the spa or hotel hot tub has low levels of disinfectant and high levels of bacteria. So if the hot tub is strong smelling, the chances are it may be unsafe to use – even if the waters look clean and clear, though it’s also worth noting that the water does become murkier the longer it goes without chemicals.</p><img src="https://counter.theconversation.com/content/198367/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Primrose Freestone does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Relaxing in filth – you may never want to use a hot tub again after reading this.Primrose Freestone, Senior Lecturer in Clinical Microbiology, University of LeicesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1972002023-01-19T14:10:44Z2023-01-19T14:10:44ZAncient poop offers unusual insight into animal behaviour<figure><img src="https://images.theconversation.com/files/503978/original/file-20230111-27936-qzs82w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">One day this fresh elephant dung could be a coprolite helping scientists understand the past.</span> <span class="attribution"><span class="source">Silarock/Shutterstock</span></span></figcaption></figure><p>Some people are annoyed when they encounter a fresh pile of dung while out on a walk in nature. Others are excited because it points to the recent visit of a particular kind of animal. But some scientists, myself included, may just be disappointed that the dung isn’t fossilised.</p>
<p>That’s because coprolites – fossilised scat – are palaeontological <a href="https://theconversation.com/my-job-is-full-of-fossilised-poop-but-theres-nothing-icky-about-ichnology-182906">treasure troves</a>. They can provide all sorts of information about the animal that deposited them, including the environment they lived in, what they ate and what the climate and vegetation were like.</p>
<p>Over the past decade, our research team has identified more than 300 vertebrate tracksites in aeolianites (cemented sand dunes) and cemented beach deposits on the Cape south coast of South Africa. They date back to the <a href="https://www.livescience.com/40311-pleistocene-epoch.html">Pleistocene epoch</a>, which started about 2.6 million years ago and ended around 11,700 years ago. But it took us a long time to realise that we shouldn’t just be looking for depressions (tracks) in the rock surfaces we study; we should also be on the lookout for raised features. These, it turns out, are often coprolites.</p>
<p>In a <a href="https://meridian.allenpress.com/jcr/article-abstract/doi/10.2112/JCOASTRES-D-22-00063.1/488606/Coprolites-in-Cemented-Pleistocene-Deposits-on-the?redirectedFrom=fulltext">recent paper</a> we describe a number of firsts. Our findings are the first of their kind from southern African aeolianites. We’ve also recorded the first known instances of coprolites belonging to a Nile crocodile, and to an African elephant. And we discovered a site where roaming elephants may have repeatedly disturbed small animals, probably mongooses or genets, that were answering the call of nature.</p>
<p>These discoveries, along with our previous research, combine to create a picture of an ancient landscape so scientists can better understand what came before. Looking back can also help us understand how and when things changed and what role factors like climate or the arrival of humans played in those changes. </p>
<h2>The new sites</h2>
<p>It took one particularly obvious example to alert us to what we had been missing by not considering coprolites as study material. On an aeolianite surface near the town of Knysna, about 500km from Cape Town, we spotted 130 dark nodules, between 2cm and 3cm in size. They formed a clear contrast to the much lighter surrounding surface, on which four tracks of a medium-sized bovid (probably an antelope called a bontebok) were evident.</p>
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Read more:
<a href="https://theconversation.com/my-job-is-full-of-fossilised-poop-but-theres-nothing-icky-about-ichnology-182906">My job is full of fossilised poop, but there's nothing icky about ichnology</a>
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<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/503615/original/file-20230109-9439-ckqb1l.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/503615/original/file-20230109-9439-ckqb1l.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/503615/original/file-20230109-9439-ckqb1l.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=444&fit=crop&dpr=1 600w, https://images.theconversation.com/files/503615/original/file-20230109-9439-ckqb1l.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=444&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/503615/original/file-20230109-9439-ckqb1l.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=444&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/503615/original/file-20230109-9439-ckqb1l.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=558&fit=crop&dpr=1 754w, https://images.theconversation.com/files/503615/original/file-20230109-9439-ckqb1l.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=558&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/503615/original/file-20230109-9439-ckqb1l.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=558&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">130 coprolites, probably made by a bontebok, in a fossilised trackway.</span>
<span class="attribution"><span class="source">Charles Helm</span></span>
</figcaption>
</figure>
<p>The nodules were evenly spread over a distance of more than a metre, and a couple of them actually lay within the tracks. They were slightly flattened, suggesting that they had been lightly compressed by overlying dune layers while they were still malleable. A sample for dating from a nearby rock revealed that the site was around 76,000 years old. </p>
<p>It was our first coprolite site and it was an unprecedented finding. Bovid coprolites are extremely rare and an open-air site even more so. In southern Africa, coprolites are usually found in caves and rock shelters, in scavenger dens or archaeological deposits.</p>
<p>Also, we had luck on our side: the site is usually covered by metres of sand, and is only occasionally exposed.</p>
<p>Remarkably, close by we found a second site, but with very different characteristics. In this case we noted about 50 small tracks on a rock surface, on which were plastered about 30 raised features, many of which were cylindrical and hollow (characteristic features of some coprolites). In the low cliffs immediately above this surface we found similar coprolites in six layers in a vertical height of 2.6cm. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/503588/original/file-20230109-7616-vqurx9.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/503588/original/file-20230109-7616-vqurx9.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=441&fit=crop&dpr=1 600w, https://images.theconversation.com/files/503588/original/file-20230109-7616-vqurx9.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=441&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/503588/original/file-20230109-7616-vqurx9.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=441&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/503588/original/file-20230109-7616-vqurx9.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=554&fit=crop&dpr=1 754w, https://images.theconversation.com/files/503588/original/file-20230109-7616-vqurx9.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=554&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/503588/original/file-20230109-7616-vqurx9.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=554&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Cylindrical, slightly hollow coprolites of a small carnivore that formed part of a latrine.</span>
<span class="attribution"><span class="source">Charles Helm</span></span>
</figcaption>
</figure>
<p>The evidence was clear: this was the site of a latrine (a place that an animal returns to repeatedly to defecate), which had been used for a substantial period of time. We could not identify the tracks to family level, as many small carnivorans leave tracks that are similar in size and shape. However, the nature of the latrine suggests that a genet or mongoose might have been responsible. </p>
<p>To add to the interest, deep elephant tracks were a common phenomenon on these same surfaces, leading us to imagine the latrine-maker having to dodge trampling by African elephants at indelicate moments. </p>
<h2>More analysis needed</h2>
<p>We found two other coprolite sites. One featured both African elephant tracks and coprolites – the first of their kind ever described. The other presented us with a crocodile coprolite right beside crocodile swim traces. This is the first ever record of a Nile crocodile coprolite; it was probably deposited underwater in a shallow lagoonal environment (crocodiles defecate either on land or in water). </p>
<p>We sent samples to university laboratories for different tests, including analysis of pollen and phytoliths (microscopic silica structures found in plants). Positive results would have aided in helping us interpret the Pleistocene environment and climate. Unfortunately, as often happens, all our coprolites were “sterile”, with no pollen or phytoliths to be found. </p>
<p>Our response is to keep trying: in 2022 we identified a number of other coprolites on the same coastline, including those of the extinct long-horned buffalo. These appear to have more internal structure, which augurs well for detecting phytoliths and pollen, and perhaps even evidence of bone fragments in the case of carnivores. </p>
<p>We hope that the samples we submit this time will deliver more positive results and will shed new light on the Pleistocene palaeoenvironment of coastal southern Africa.</p><img src="https://counter.theconversation.com/content/197200/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Charles Helm does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Studying fossil dung offers another avenue for scientists trying to recreate ancient landscapes.Charles Helm, Research Associate, African Centre for Coastal Palaeoscience, Nelson Mandela UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1777482022-03-17T01:42:27Z2022-03-17T01:42:27ZA poo dose a day may keep bipolar away. When it comes to mental health, what else could poo do?<figure><img src="https://images.theconversation.com/files/451146/original/file-20220309-793-6zoqhi.jpg?ixlib=rb-1.1.0&rect=1%2C28%2C997%2C669&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-toilet-160277366">Shutterstock</a></span></figcaption></figure><p>In a world first, two Australians with bipolar have had poo transplants, their symptoms improved, and their cases written up in <a href="https://journals.sagepub.com/doi/abs/10.1177/0004867420912834">peer-reviewed</a> <a href="https://pubmed.ncbi.nlm.nih.gov/35165993/">journals</a>.</p>
<p>One of us (Parker) treated the second of these patients with so-called faecal microbiota transplantation, and published his case study in recent weeks. The other (Green) is part of a team recruiting people with depression to a poo transplant clinical trial.</p>
<p>We’d be the first to admit it’s early days for this type of treatment for bipolar or other mental health issues. There are many hurdles before we could see poo transplants for these become commonplace.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1500188402901159937"}"></div></p>
<p>So we do not advocate people abandon their existing medication, try this at home or demand their psychiatrist offer them a “crapsule” (a poo capsule and yes, that’s a word).</p>
<p>Yet the limited results for bipolar so far are promising. Here’s what the evidence tells us about the prospect of poo transplants for mental health.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/poo-transplants-beyond-the-yuck-factor-what-works-what-doesnt-and-what-we-still-dont-know-82265">Poo transplants beyond the yuck factor: what works, what doesn't and what we still don't know</a>
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</em>
</p>
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<h2>Let’s start with bipolar</h2>
<p>There are different types of <a href="https://theconversation.com/what-is-bipolar-disorder-the-condition-kanye-west-lives-with-143198">bipolar disorder</a>. This is when people have distinct periods of <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/hypomania-and-mania/about-hypomania-and-mania/">mania (or a form known as hypomania)</a> – with, for example, elevated mood, increased activity and decreased sleep – and periods of depression.</p>
<p>People with bipolar usually take medication to manage their symptoms, generally for life. These medications are mainly mood stabilisers (such as lithium), but many also take antipsychotics. These medications come with risks and side effects, which depend on the medication. Side effects can include weight gain, sedation and <a href="https://library.neura.edu.au/bipolar-disorder/physical-features-bipolar-disorder/functional-changes-physical-features-bipolar-disorder/bodily-functions/motor-dysfunction-3/">movement disorders</a>.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1288402621837893632"}"></div></p>
<h2>What happened to the two patients?</h2>
<p>In 2020, Russell Hinton, a private psychiatrist, <a href="https://journals.sagepub.com/doi/abs/10.1177/0004867420912834">described how he treated</a> the first patient. This was a woman who had tried more than a dozen different medications for her bipolar. She had been hospitalised ten times, had gained considerable weight and judged she had no quality of life.</p>
<p>After a poo transplant from her husband, she became symptom-free over the next five years, lost 33 kilograms, required no medication and her career bloomed.</p>
<p>Gordon Parker and colleagues at the University of New South Wales <a href="https://pubmed.ncbi.nlm.nih.gov/35165993/">reported their results</a> with the second patient last month. This was a young man who developed bipolar as a teenager, had tried numerous medications and became progressively intolerant of their side effects.</p>
<p>After a poo transplant, he was able to progressively cease all medications over the next year, and had virtually no mood swings. He also noted an improvement in his anxiety and ADHD (attention deficit hyperactivity disorder).</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/adhd-looks-different-in-adults-here-are-4-signs-to-watch-for-178639">ADHD looks different in adults. Here are 4 signs to watch for</a>
</strong>
</em>
</p>
<hr>
<h2>How could this possibly work?</h2>
<p>Trillions of bacteria live in our guts. This so-called gut microbiome has a huge impact on our health in general, not just the health of our brain.</p>
<p>Differences in gut bacteria have been linked to <a href="https://www.nature.com/articles/s41367-019-0011-7">obesity</a>, <a href="https://www.thelancet.com/journals/ebiom/article/PIIS235239641930800-X/fulltext">diabetes</a> and <a href="https://www.gastrojournal.org/article/S0016-5085(19)34649-9/fulltext">irritable bowel syndrome</a>.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/YB-8JEo_0bI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">What is the human microbiome?</span></figcaption>
</figure>
<p>The idea behind poo transplants is to change the gut microbiome. You take poo, with all its micro-organisms, from a healthy person and give it to the one being treated.</p>
<p>You can do this “top down”, for example, by swallowing poo capsules (crapsules), or by delivering poo through a tube inserted into the nose, to the stomach or intestine. </p>
<p>Alternatively, you can insert the poo “bottom up”. You can do this with an enema, a simple, painless procedure in which a syringe transfers the poo into the rectum. Or you can use a colonoscopy, a procedure performed under a general anaesthetic involving inserting a tube higher up into the colon.</p>
<p>Poo transplants are already <a href="https://theconversation.com/poo-transplants-and-probiotics-does-anything-work-to-improve-the-health-of-our-gut-65480">used to treat</a> the often life-threatening gut infection caused by the bacterium <em>Clostridium difficile</em>.</p>
<p>They have also been trialled, with various degrees of success, in people with <a href="https://pubmed.ncbi.nlm.nih.gov/33345703/#:%7E:text=Preliminary%20data%20suggest%20that%20FMT,UC%20being%20the%20most%20compelling">irritable bowel syndrome, ulcerative colitis</a>, <a href="https://www.nature.com/articles/s41467-021-21472-1">HIV</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/32279172/">hepatitis</a>, among other medical conditions.</p>
<p>Side effects from poo transplants <a href="https://pubmed.ncbi.nlm.nih.gov/33345703/#:%7E:text=Preliminary%20data%20suggest%20that%20FMT,UC%20being%20the%20most%20compelling">are rare</a>, and usually relate to the way in which they are given, for example side effects of the anaesthetic from poo transplants delivered by colonoscopy.</p>
<h2>So how about mental health?</h2>
<p>Abnormal gut microbiomes <a href="https://www.nature.com/articles/s41380-022-01456-3">have been linked</a> to bipolar, depression and schizophrenia.</p>
<p>When poo from depressed humans is given to rats, they appear to develop a <a href="https://pubmed.ncbi.nlm.nih.gov/27491067/">rat version of depression</a>. Likewise, when mice are given poo from someone with schizophrenia, they <a href="https://www.science.org/doi/10.1126/sciadv.aau8317">develop a mouse version of schizophrenia</a>.</p>
<p>These are indirect findings. Yet they suggest poo transplants may have the potential to treat some mental health conditions.</p>
<p>So how exactly do bacteria in the gut impact mental health? There are many <a href="https://pubmed.ncbi.nlm.nih.gov/31460832/">different ways</a>, each complicated and interacting with each other. </p>
<p>For example, these bacteria act directly on the gut wall, sending signals to the brain via the vagus nerve. The bacteria also produce large quantities of chemicals (for example, <a href="https://pubmed.ncbi.nlm.nih.gov/31460832/">short-chain fatty acids</a>), which impact virtually all body systems including the immune system. We know brain function relies heavily on immune cells.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/stomach-and-mood-disorders-how-your-gut-may-be-playing-with-your-mind-50847">Stomach and mood disorders: how your gut may be playing with your mind</a>
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</em>
</p>
<hr>
<h2>Don’t try this at home</h2>
<p>At this stage, any evidence suggesting poo transplants may help people with depression or bipolar is, essentially, anecdotal.</p>
<p>Some people have tried their own version at home, involving poo donors who have not been screened for diseases.</p>
<p>One high-profile example is Dave Hosking from the Australian band Boy & Bear. He used a “<a href="https://www.rollingstone.com/music/music-features/boy-bear-dave-hosking-fecal-transplant-919384/">poo roadie</a>” to provide him with transplants on tour to help manage his depression and anxiety.</p>
<p>We wouldn’t recommend this. Poo transplants should only be carried out under the supervision of medical professionals, using an approved and thoroughly screened poo product.</p>
<p>Poo transplants are <a href="https://www.legislation.gov.au/Details/F2021C01065">tightly regulated in Australia</a>. Donations must be screened for harmful bacteria, fungi, parasites or viruses. Donors must also not have any health condition thought to be associated with gut bacteria, such as an autoimmune condition, cancer or obesity.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/boosting-your-gut-health-sounds-great-but-this-wellness-trend-is-vague-and-often-misunderstood-155472">Boosting your ‘gut health’ sounds great. But this wellness trend is vague and often misunderstood</a>
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</p>
<hr>
<h2>What happens next?</h2>
<p>We need larger, well-designed studies to show poo transplants have a real effect, and any improved symptoms cannot be explained by other factors. </p>
<p>We also need to look for markers in the microbiome that could predict a successful result. If we knew those markers, we could optimise treatment and better measure the results. </p>
<p>The first author’s centre is recruiting <a href="https://foodandmoodcentre.com.au/projects/movingmoods/">people with depression</a> to trial poo transplants. The study will randomise participants to have an enema or placebo enema. If successful, a larger study is planned. </p>
<p>In Canada, there are three such studies under way evaluating poo transplants. These are for <a href="https://pubmed.ncbi.nlm.nih.gov/34261526/">bipolar</a>, <a href="https://clinicaltrials.gov/ct2/show/NCT04805879">depression</a>, with or without <a href="https://clinicaltrials.gov/ct2/show/NCT05174273?cond=fmt&draw=8">irritable bowel syndrome</a>. </p>
<p>Though promising, we cannot conclude at this time whether poo transplants work for bipolar or depression.</p>
<p>Until the results of these studies are in, it’s too early to say if the early results with bipolar can be replicated on a larger scale.</p>
<hr>
<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em></p><img src="https://counter.theconversation.com/content/177748/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jessica Green is affiliated with:
1. Food & Mood Centre, IMPACT, Deakin University
2. Department of Psychiatry, Peninsula Health
3. Monash Alfred Psychiatry Research Centre, Monash University</span></em></p><p class="fine-print"><em><span>Gordon Parker is affiliated with the Discipline of Psychiatry and Mental Health
School of Clinical Medicine, University of New South Wales
</span></em></p>Two Australians with bipolar have been successfully treated with poo transplants, allowing them to come off, or reduce, their medications. Here’s where the science is up to.Jessica Green, PhD Candidate and Consultant Psychiatrist, Deakin UniversityGordon Parker, Scientia Professor, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1522332021-01-27T01:10:59Z2021-01-27T01:10:59ZDo men really take longer to poo?<figure><img src="https://images.theconversation.com/files/377953/original/file-20210111-15-ruzndd.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C667&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-man-toilet-using-phone-619346291">from www.shutterstock.com</a></span></figcaption></figure><p>There’s a common assumption men take longer than women to poo. People say so on <a href="https://twitter.com/trenduso/status/1100968885203931136">Twitter</a>, in <a href="https://www.sammichespsychmeds.com/men-bathroom-memes/">memes</a>, and <a href="https://www.youtube.com/watch?v=nLcEU6ahlOI">elsewhere</a> <a href="https://www.livescience.com/why-men-take-longer-to-poop.html">online</a>. But is that right? What could explain it? And if some people are really taking longer, is that a problem?</p>
<p>As we sift through the evidence, it’s important to remember pooing may involve time spent sitting on the toilet and the defaecation process itself.</p>
<p>And there may be differences between men and women in these separate aspects of going to the toilet. But the evidence for these differences isn’t always as strong as we’d like.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-we-have-to-poo-every-day-we-asked-five-experts-98701">Do we have to poo every day? We asked five experts</a>
</strong>
</em>
</p>
<hr>
<h2>Men may spend longer sitting on the toilet</h2>
<p>Men do appear to spend more time sitting on the toilet. An <a href="https://www.dailymail.co.uk/femail/article-2641550/Britons-favourite-loo-terature-revealed-Sports-biographies-erotic-magazines-bathroom-reading-material-poll.html">online survey</a> by a bathroom retailer suggested men spend up to 14 minutes a day compared with women, who spend almost eight minutes a day. But this survey doesn’t have the rigour of a well-designed scientific study.</p>
<p>Would there be any physiological reason to explain why men spend longer on the toilet? Well, the evidence actually suggests the opposite.</p>
<p>We know it <a href="https://www.tandfonline.com/doi/abs/10.1080/00365520310000410">takes longer</a> for food to travel through the intestines in women than in men. Women are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175559/">more likely to suffer</a> from constipation related to irritable bowel syndrome than men. So, you’d expect women to take longer to defaecate, from the start of the bowel motion to expulsion.</p>
<p>But this is <a href="https://pubmed.ncbi.nlm.nih.gov/12870773/">not the case</a> even if you take into account differences in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986479/">fibre intake</a> between men and women.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-irritable-bowel-syndrome-and-what-can-i-do-about-it-102579">Explainer: what is irritable bowel syndrome and what can I do about it?</a>
</strong>
</em>
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<hr>
<p>Instead, how long it takes someone to poo (the defaecation time) is <a href="https://pubmed.ncbi.nlm.nih.gov/28470247/">heavily influenced</a> by the mucus lining the large bowel. This mucus makes the bowel slippery and easier for the stools to be expelled. But there’s no evidence this mucus lining is different in men and women. </p>
<p>One thing we do know, however, is mammals from elephants to mice have a similar defaecation time, <a href="https://pubs.rsc.org/en/content/articlelanding/2017/sm/c6sm02795d#!divAbstract">around 12 seconds</a>. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1100968885203931136"}"></div></p>
<p>For humans, it’s slightly longer, but still quick. In <a href="https://pubmed.ncbi.nlm.nih.gov/12870773/">one study</a> it took healthy adults an average two minutes when sitting, but only 51 seconds when squatting. Again, there were no differences in defaecation time between men and women, whether sitting or squatting. </p>
<p>If there’s no strong evidence one way or the other to explain any gender differences in how long it takes to poo, what’s going on? For that, we need to look at the total time spent on the toilet.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/whats-the-best-way-to-go-to-the-toilet-squatting-or-sitting-63991">What's the best way to go to the toilet – squatting or sitting?</a>
</strong>
</em>
</p>
<hr>
<h2>Why do people spend so long on the toilet?</h2>
<p>What I call the “toilet sitting time” is the time of defaecation itself and the time allocated to other activities sitting on the toilet. For most people, the time spent just sitting, aside from defaecating, accounts for most of their time there.</p>
<p>So what are people doing? Mainly reading. And it seems men are <a href="http://news.bbc.co.uk/2/hi/health/1230115.stm">more likely</a> to read on the toilet than women.</p>
<p>For instance, a <a href="https://pubmed.ncbi.nlm.nih.gov/19019015/">study</a> of almost 500 adults in Israel found almost two-thirds (64%) of men regularly read on the toilet compared with 41% of women. The longer people spent on the toilet, the more likely they were to be reading. However, in the decade or more since this study was conducted, you’d expect adults would be more likely to be reading or playing games on their mobile phones rather than reading paper books.</p>
<p>People might also be sitting longer on the toilet for some temporary relief from the stresses of life.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Meme about men avoiding parenting responsibilities by sitting on the toilet for longer" src="https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=417&fit=crop&dpr=1 600w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=417&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=417&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=524&fit=crop&dpr=1 754w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=524&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=524&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sometimes, people just need time to themselves.</span>
<span class="attribution"><a class="source" href="https://www.sammichespsychmeds.com/men-bathroom-memes/">Ramblin Mama</a></span>
</figcaption>
</figure>
<p>One <a href="https://www.dailymail.co.uk/femail/article-2641550/Britons-favourite-loo-terature-revealed-Sports-biographies-erotic-magazines-bathroom-reading-material-poll.html">poll</a> found 56% of people find sitting on the toilet relaxing, and 39% a good opportunity to have “some time alone”. Another <a href="https://www.independent.co.uk/life-style/bathrooms-shower-washing-habits-poll-a8988626.html">online survey</a> revealed one in six people reported going to the toilet for “peace and quiet”. Although these are not scientific studies, they offer useful insights into a social phenomenon.</p>
<p>Then there can be medical reasons for a prolonged defaecation time, and consequently a lengthier time sitting on the toilet. </p>
<p>An anal fissure (a tear or crack in the lining of the anus) can make defaecation a painful and lengthy process. These fissures are <a href="http://eknygos.lsmuni.lt/springer/526/178-191.pdf">just as common</a> in men as in women. </p>
<p>And <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306148/">obstructive defaecation</a>, where people cannot empty the rectum properly, is a common cause of chronic constipation. This is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3030249/">more common</a> in middle-aged women. </p>
<h2>Are there any harms from spending too long on the loo?</h2>
<p>In a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236649/">Turkish study</a>, spending more than five minutes on the toilet was associated with haemorrhoids and anal fissures. Another study from <a href="https://pubmed.ncbi.nlm.nih.gov/31996480/">Italy</a> noted the longer the time people spent on the toilet, the more severe their haemorrhoids.</p>
<p><a href="http://www.annalsgastro.gr/files/journals/1/earlyview/2019/ev-01-2019-19-AG4360-0355.pdf">One theory</a> behind this is prolonged sitting increases pressure inside the abdomen. This leads to less blood flow into the veins of the rectum when passing a bowel motion, and ultimately to blood pooling in the vascular cushions of the anus. This makes haemorrhoids more likely to develop. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-why-do-people-get-haemorrhoids-and-how-do-you-get-rid-of-them-94820">Explainer: why do people get haemorrhoids and how do you get rid of them?</a>
</strong>
</em>
</p>
<hr>
<h2>What can we do about this?</h2>
<p>In addition to the usual advice about increasing the amount of fibre in your diet and ensuring you drink enough water, it would be sensible to limit the amount of time spent on the toilet.</p>
<p>Different researchers recommend a <a href="https://pubmed.ncbi.nlm.nih.gov/28150480/">different</a> <a href="https://pubmed.ncbi.nlm.nih.gov/27723447/">upper limit</a>. But I <a href="https://pubmed.ncbi.nlm.nih.gov/30346317/">and others</a> recommend the SEN approach:</p>
<ul>
<li><p><strong>S</strong>ix minute toilet sitting time maximum</p></li>
<li><p><strong>E</strong>nough fibre (eating more fruit and vegetables, and eating wholegrains)</p></li>
<li><p><strong>N</strong>o straining during defaecation. </p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-causes-constipation-114290">Health Check: what causes constipation?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/152233/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Vincent Ho does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>If you believe the memes, men spend ages in the toilet. But they’re not always pooing. Here’s what they’re really doing.Vincent Ho, Senior Lecturer and clinical academic gastroenterologist, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1233642020-01-29T03:01:15Z2020-01-29T03:01:15ZHad constipation? Here are 4 things to help treat it<figure><img src="https://images.theconversation.com/files/312186/original/file-20200128-81395-ge8ymf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Medications, being out of your routine and not getting enough exercise can all cause constipation.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/mans-hand-he-holds-roll-toilet-1435142270">Seasontime/Shutterstock</a></span></figcaption></figure><p>Chronic constipation is incredibly common. Around <a href="https://www.ncbi.nlm.nih.gov/pubmed/30364088">one in four people</a> worldwide report symptoms, while in Australia and New Zealand, it’s around <a href="https://www.ncbi.nlm.nih.gov/pubmed/18269746">one in seven</a>. </p>
<p>Lots of things can trigger <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation">constipation</a>: being out of your usual routine (think holidays, illness or injury), <a href="https://www.ncbi.nlm.nih.gov/pubmed/31292358">having a low fibre intake, not drinking enough water</a> and <a href="https://www.health.harvard.edu/diseases-and-conditions/common-causes-of-constipation">inactivity</a>.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/29382180">Certain medications</a> can also cause constipation including iron supplements, painkillers, diuretics (to help you get rid of sodium and water), and other drugs to treat heart disease, mental health conditions and allergies. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-causes-constipation-114290">Health Check: what causes constipation?</a>
</strong>
</em>
</p>
<hr>
<p>Constipation is more common in <a href="https://www.ncbi.nlm.nih.gov/pubmed/16342852">older adults</a> and in <a href="https://www.ncbi.nlm.nih.gov/pubmed/10805262">women</a>, due to hormonal changes that slow bowel motility – the time it takes for your body to digest food and expel the waste products (stools or bowel motions). <a href="https://www.ncbi.nlm.nih.gov/pubmed/25803402">Pregnant</a> women are particularly prone to constipation. </p>
<h2>How do you know you’re constipated?</h2>
<p>Symptoms include:</p>
<ol>
<li><a href="https://www.continence.org.au/pages/bristol-stool-chart.html">lumpy or hard stools</a><br></li>
<li>feeling that your bowels haven’t emptied completely or your <a href="https://www.webmd.com/digestive-disorders/picture-of-the-anus#1">anus</a> is blocked </li>
<li>straining to pass a bowel motion</li>
<li>manipulating your body position to try and pass a bowel motion</li>
<li>having fewer than three bowel motions per week.</li>
</ol>
<p>If over a three-month period you answer yes to <a href="https://www.ncbi.nlm.nih.gov/pubmed/30364088">two or more of these symptoms</a> most weeks, then you have “constipation”. </p>
<p>The good news is it can be treated and then prevented. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/312377/original/file-20200129-93007-1k732ap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/312377/original/file-20200129-93007-1k732ap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/312377/original/file-20200129-93007-1k732ap.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/312377/original/file-20200129-93007-1k732ap.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/312377/original/file-20200129-93007-1k732ap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/312377/original/file-20200129-93007-1k732ap.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/312377/original/file-20200129-93007-1k732ap.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Women are more likely to become constipated than men because they experience more horomonal changes.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sign-toilet-wc-175899578">Kongsak/Shutterstock</a></span>
</figcaption>
</figure>
<p>If your bowels are so packed you can’t pass any bowel motions at all, see your GP. You may need treatment with specific laxatives to clear your bowels before you can start on a prevention plan. </p>
<p>Here are four things that research shows improve bowel function, which refers to the time it takes for food to move through your digestive system and be expelled as a bowel motion (called gut transit time), the frequency and volume of bowel motions, and stool consistency.</p>
<h2>1. High-fibre foods</h2>
<p>Dietary fibres are <a href="https://www.ncbi.nlm.nih.gov/pubmed/28676135">complex carbohydrates that aren’t digested or absorbed</a> in the gut. </p>
<p>Different types of dietary fibres improve bowel function through the following processes:</p>
<ul>
<li><p>the fermentation of fibre in the colon produces water and other molecules. These make stools <a href="https://www.ncbi.nlm.nih.gov/pubmed/27170558">softer and easier to pass</a></p></li>
<li><p>absorption of water into stools stimulates the gut to contract and makes bowel motions softer</p></li>
<li><p>a higher fibre intake creates bigger stools, which pass more quickly, resulting in more regular bowel motions.</p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-are-you-eating-the-right-sorts-of-fibre-20089">Health Check: are you eating the right sorts of fibre?</a>
</strong>
</em>
</p>
<hr>
<p>A good source of fibre is psyllium. It forms a viscous gel, which gets fermented in the colon, leading to softer bowel motions. Psyllium is the main ingredient in Metamucil, which is commonly used to treat constipation. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/312188/original/file-20200128-81336-9yh27q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/312188/original/file-20200128-81336-9yh27q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/312188/original/file-20200128-81336-9yh27q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/312188/original/file-20200128-81336-9yh27q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/312188/original/file-20200128-81336-9yh27q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/312188/original/file-20200128-81336-9yh27q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/312188/original/file-20200128-81336-9yh27q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Psyllium is a type of fibre that helps soften bowel motions.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/heap-psyllium-husk-wooden-spoon-bowl-1303334332">Shawn Hempel/Shutterstock</a></span>
</figcaption>
</figure>
<p>A review <a href="https://www.ncbi.nlm.nih.gov/pubmed/31764399">comparing the effect of psyllium to wheat bran</a> in people with chronic constipation found psyllium was 3.4 times more effective at increasing the amount of stool passed. </p>
<p>This is important because having a bigger bowel motion waiting in the colon to be passed sends signals to your gut that it’s time to expel the stool – and it helps the gut contract to do just that.</p>
<p>The review found <a href="https://www.ncbi.nlm.nih.gov/pubmed/31764399">both psyllium and coarse wheat bran had a stool-softening effect</a>, but finely ground wheat bran had a stool-hardening effect. </p>
<p>Other foods rich in fermentable carbohydrates include dark rye bread and <a href="https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/food-and-food-products/legumes-what-are-they-and-how-can-i-use-them/">legumes</a> (chickpeas, lentils, four-bean mix, red kidney beans, baked beans); while <a href="https://nomoneynotime.com.au/hacks-myths-faqs/how-much-fibre-should-i-be-eating">wholemeal and wholegrain breads</a> and cereals are high in different types of dietary fibres.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/multigrain-wholegrain-wholemeal-whats-the-difference-and-which-bread-is-best-89538">Multigrain, wholegrain, wholemeal: what's the difference and which bread is best?</a>
</strong>
</em>
</p>
<hr>
<h2>2. Kiwi fruit</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/30706488">Kiwi fruit fibre</a> absorbs about three times its weight in water. This means it helps make stools softer and boosts volume by increasing the amount of water retained in bowel motions. This stimulates the gut to contract and moves the bowel motions along the gut to the anus. </p>
<p>In a <a href="https://www.ncbi.nlm.nih.gov/pubmed/12074185">study of 38 healthy older adults</a>, researchers found adding two to three kiwi fruit per day to their diets for three weeks resulted in participants passing bowel motions more often. It also increased the size of their stools and made them softer and easier to pass. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/312189/original/file-20200128-81341-8njfqy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/312189/original/file-20200128-81341-8njfqy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/312189/original/file-20200128-81341-8njfqy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/312189/original/file-20200128-81341-8njfqy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/312189/original/file-20200128-81341-8njfqy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/312189/original/file-20200128-81341-8njfqy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/312189/original/file-20200128-81341-8njfqy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Kiwi fruit can help you go to the loo more regularly.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fresh-kiwi-fruit-background-556378681">Nitr/Shutterstock</a></span>
</figcaption>
</figure>
<p>Kiwi fruit are also <a href="https://www.ncbi.nlm.nih.gov/pubmed/30706488">rich in the complex carbohydrate inulin</a> a type of <a href="https://en.wikipedia.org/wiki/Fructan">fructan</a>. Fructans are a <em>prebiotic</em> fibre, meaning they encourage growth of healthy bacteria in the colon.</p>
<p>But fructans can also <a href="https://www.monashfodmap.com/ibs-central/i-have-ibs/">aggravate symptoms in some people with irritable bowel syndrome</a> (IBS). If you have IBS and constipation, check in with your GP before upping your fructan intake.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-irritable-bowel-syndrome-and-what-can-i-do-about-it-102579">Explainer: what is irritable bowel syndrome and what can I do about it?</a>
</strong>
</em>
</p>
<hr>
<p>If you don’t like kiwi fruit, other <a href="https://www.ncbi.nlm.nih.gov/pubmed/17625872">vegetables and fruit high in fructans</a> include spring onion, artichoke, shallots, leek, onion (brown, white and Spanish), beetroot, Brussels sprouts, white peaches, watermelon, honeydew melon and nectarines.</p>
<h2>3. Prunes</h2>
<p><a href="https://en.wikipedia.org/wiki/Prune">Prunes</a> are dried plums. They contain a large amount of sorbitol, a complex carbohydrate that passes undigested into the colon where bacteria ferment it. This produces gas and water, which triggers an increase in bowel movements. </p>
<p>Eating prunes is even more effective than psyllium in improving stool frequency and consistency. </p>
<p>One study of adults with constipation compared <a href="https://www.ncbi.nlm.nih.gov/pubmed/25109788">eating 100 grams (about ten) prunes</a> a day for three weeks to those who ate psyllium. The prune group passed an average of 3.5 separate bowel motions per week compared to 2.8 in the psyllium group. </p>
<p>The prune group’s stools were also softer. They rated, on average, 3.2 on the <a href="https://en.wikipedia.org/wiki/Bristol_stool_scale">Bristol stool chart</a> compared to 2.8 for the psyllium group, meaning their bowel motions were more toward smooth to cracked sausage-shaped motions rather than lumpy ones. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=764&fit=crop&dpr=1 600w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=764&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=764&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=960&fit=crop&dpr=1 754w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=960&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=960&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>If you don’t like prunes, <a href="https://www.ncbi.nlm.nih.gov/pubmed/19765364">other foods that contain sorbitol</a> include apples, pears, cherries, apricots, plums and “sugar-free” chewing gum and “sugar-free” lollies.</p>
<h2>4. Water</h2>
<p>Not drinking enough water is the <a href="https://www.ncbi.nlm.nih.gov/pubmed/27933718">strongest predictor of constipation</a>. When your body is a bit dehydrated, there’s less water for the fibre in your colon to absorb, meaning your bowel motions also become dehydrated and harder to pass. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/27933718">Aim for</a> around 1.5 to two litres of fluid per day, which can include liquids such as tea, coffee, soup, juice, and even jelly and the liquid from stewed fruit. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-your-pee-and-poo-colour-says-about-your-health-59516">Health Check: what your pee and poo colour says about your health</a>
</strong>
</em>
</p>
<hr>
<h2>Putting it all together</h2>
<p>Start by increasing the amount of water or other liquids you drink. You should be drinking enough that your urine is the colour of straw. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/312190/original/file-20200128-81346-rfkj9r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/312190/original/file-20200128-81346-rfkj9r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/312190/original/file-20200128-81346-rfkj9r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/312190/original/file-20200128-81346-rfkj9r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/312190/original/file-20200128-81346-rfkj9r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/312190/original/file-20200128-81346-rfkj9r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/312190/original/file-20200128-81346-rfkj9r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Aim for two litres of water a day.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/glass-jug-fresh-water-on-wooden-1212018088">Pixel-Shot/Shutterstock</a></span>
</figcaption>
</figure>
<p>Next, add in psyllium. Start with a tablespoon once a day with breakfast cereal. </p>
<p>Psyllium forms a gel as soon as it comes into contact with liquids so to make psyllium more palatable, mix it with a small amount of stewed fruit or yoghurt and eat it straight away. If needed, increase psyllium to twice a day. </p>
<p>At least once a day, have some prunes (either dried or canned) or kiwi fruit and a variety of other foods high in fibre, fructans, sorbitol and fermentable carbohydrate. </p>
<p>If your bowel habits don’t improve, see your GP.</p><img src="https://counter.theconversation.com/content/123364/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research and Gladys M Brawn Research Fellow. She has received research grants from NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute and the ABC. She was a team member conducting systematic reviews to inform the Australian Dietary Guidelines update and the Heart Foundation evidence reviews on meat and dietary patterns.</span></em></p>One in seven Australians report symptoms of constipation, which might include hard stools, straining to poo, or having fewer than three bowel motions a week. These four things can help.Clare Collins, Professor in Nutrition and Dietetics, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1146042019-07-04T19:46:54Z2019-07-04T19:46:54ZWhat other countries can teach us about ditching disposable nappies<figure><img src="https://images.theconversation.com/files/282604/original/file-20190704-126340-13f38tz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Look familiar? Don't fret, there are better ways.</span> <span class="attribution"><span class="source">Shutterstock.com</span></span></figcaption></figure><p>This year, the small Pacific Island nation of Vanuatu announced a plan to <a href="https://www.theguardian.com/environment/2019/jun/22/vanuatu-to-ban-disposable-nappies-in-plastics-crackdown-we-had-no-choice">ban disposable nappies</a>, as well as other throwaway items such as plastic bags. While some commentators praised the move, others worried about what the alternatives might be, and how this might affect household workloads, particularly for women.</p>
<p>While Vanuatu is the first nation to take such a bold step, it is not the first nation to recognise the environmental problems disposable nappies pose. Although most <a href="https://theconversation.com/explainer-how-much-landfill-does-australia-have-78404">landfill waste in Australia</a> and <a href="https://www.mfe.govt.nz/sites/default/files/media/Waste/National%20Waste%20Disposal%20Survey%20Final%20Report.pdf">New Zealand</a> consists of building waste, disposable nappies make up a significant percentage of household waste entering landfill – Australia uses an estimated <a href="https://www.abc.net.au/news/2019-03-22/vanuatu-to-ban-disposable-nappies/10924586">3.75 million of them every day</a>. </p>
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<p>Many urban parents find that a week’s worth of nappies barely fits into their kerbside bin, especially for families with two children in nappies. I’ve certainly met these parents stalking the streets on the evening before bin day, searching for half-empty bins to dump their surplus dirty nappies. </p>
<p>But this is not the only problem: nappies are a significant source of contamination in the waste stream. Infant faeces are a source of <a href="https://www.ncbi.nlm.nih.gov/pubmed/21477676">live vaccine</a>, <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1348-0421.1984.tb00754.x">bacteria such as <em>E. coli</em></a>, and many other hazardous contaminants. The correct procedure is to scrape faeces into the toilet before disposing of the nappy. But let’s be honest – the whole attractiveness of disposable nappies is not having to do this, especially while out and about.</p>
<h2>Lessons from a bygone age</h2>
<p>So what is the alternative? Obviously, before disposable nappies, parents had to use cloth nappies. In Australia, the standard was the fluffy terry cloth folded into a triangle; in New Zealand, the flat flannelette folded differently for boys and girls. </p>
<p>Traditional cloth nappies were much less absorbent, and therefore had to be changed about 15 times per day, before being washed, dried, and folded for next time. It’s no coincidence that this practice dates to an era when households typically featured a stay-at-home mother.</p>
<p>In recent years, modern cloth nappies have emerged, with more absorbent designs that require less frequent changing. They use modern materials such as microfibre, microfleece, polyurethane laminate, and fabrics derived from bamboo. These nappies may be snug in design, pleasing to the eye, and less prone to leaks. They also require less water for laundry, because they can be put straight into a washing machine rather than being soaked as traditional nappies were. </p>
<p>Yet, <a href="https://www.abc.net.au/news/2019-03-22/vanuatu-to-ban-disposable-nappies/10924586">as Ni-Vanuatu commentators have already pointed out</a>, these designs are not necessarily suitable for tropical climates or warmer weather due to the use of non-breathable fabrics. These fabrics might also encourage nappy rash and other related problems for babies’ delicate skin.</p>
<h2>Lessening the load</h2>
<p>The search for alternatives does not need to be limited to Oceania, however. My <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/apv.12078">research</a> with families with young infants in northwestern China examined a practice known as <em>ba niao</em>, or “holding out to urinate”. This method of infant hygiene involves very limited use of nappies, meaning laundry can feasibly be done by hand. </p>
<p>Briefly, it involves learning the signals and timing of a baby’s patterns of poop and pee, then holding them out over a basin, toilet or potty for them to release, nappy-free. Caregivers <a href="https://www.sciencedirect.com/science/article/abs/pii/S1755458616300494">look for signs</a> such as squirming, pushing, fussing, stillness, and other forms of more direct communication that precede an “elimination”. As babies get older and begin to walk, they can be taught to urinate in Chinese-style squat toilets or other appropriate places, with the help of pants with a hole cut out of the crotch.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=159&fit=crop&dpr=1 600w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=159&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=159&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=200&fit=crop&dpr=1 754w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=200&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=200&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Items used for <em>ba niao</em> in northwestern China.</span>
<span class="attribution"><span class="source">Kelly Dombroski</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>In colder parts of China, this is done by using several layers of pants, each with a hole, so babies do not have to be undressed. Caregivers tuck nappy-cloths made from old sheets or other soft rags up into the waistband of the pants, to be quickly and easily removed when a baby seems ready to “go”. If the caregiver misses the signal, the small, light cloth can be easily handwashed and dried on a balcony or radiator. If the caregiver is not near a toilet, the baby may even be held out over the ground or tiles, and urine cleaned up with a mop.</p>
<p>For faeces, babies are encouraged into a regular routine through a large morning feed of milk, and patient “holding out” until the morning elimination is done. If the baby’s bowel movements are less predictable, perhaps due to illness, some families use disposable nappy pads, tucked in the same way as the traditional nappies, but more as a backup for missing a signal rather than relying on it.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=613&fit=crop&dpr=1 600w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=613&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=613&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=771&fit=crop&dpr=1 754w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=771&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=771&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">‘Holding out’ over a basin as part of traditional hygiene practices.</span>
<span class="attribution"><span class="source">Kelly Dombroski</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Households without indoor toilets also use this method, including families who live in their shop and rely on public showers and toilets for hygiene. </p>
<p>This method is used by rich and poor families alike. Research <a href="https://www.cbsnews.com/news/how-pg-brought-the-diaper-revolution-to-china/">by disposable nappy producers Proctor & Gamble</a> estimated that Chinese consumers of disposable nappies use only one per day – or more accurately, per night. Even those who can afford disposable nappies tend to eschew them in favour of <em>ba niao</em> during daylight hours. Besides a lot less laundry, the reported benefits include less nappy rash, earlier toilet independence, and less crying and fussing.</p>
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<p>Is this a realistic practice for countries seeking to quit disposable nappies? It may seem far from westernised norms, but my research has also <a href="https://www.emeraldinsight.com/doi/abs/10.1108/IJSSP-12-2015-0150">analysed the content</a> of Australian and New Zealand-based web forums and Facebook groups, with collectively around 2,000 members. These caregivers, mostly mums, are trying to work out the best way to introduce a similar practice to everyday life here, too.</p>
<p>They are inspired by the fact that this is possible in other parts of the world, and may indeed be a key to reducing the laundry load. And if they’re not quite ready to quit disposable nappies altogether, they might at least give up the weekly raid on the neighbours’ rubbish bins.</p><img src="https://counter.theconversation.com/content/114604/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kelly Dombroski does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Vanuatu has banned them outright, while many Chinese families use just one every 24 hours. So why are Australians still sending millions of dirty nappies to landfill every single day?Kelly Dombroski, Senior Lecturer in Human Geography, University of CanterburyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1028482018-10-31T18:54:57Z2018-10-31T18:54:57ZYour poo is (mostly) alive. Here’s what’s in it<figure><img src="https://images.theconversation.com/files/241977/original/file-20181024-48700-zud1kc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Human poo is a concoction made up mostly of water with a sprinkling of the solid stuff.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/667731214?src=mtZaxJEqeYHuiYW1FMqT8w-2-4&size=huge_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>If you’ve ever thought your poo is just a bunch of dead cells, think again. Most of it is alive, teeming with billions of microbes. Here’s what <a href="https://www.ncbi.nlm.nih.gov/pubmed/6089542">studies</a> in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500995/">healthy adults</a> reveal makes up our poo.</p>
<h2>Water</h2>
<p>Our faeces is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500995/">largely (75%) made up</a> of water, although this differs from person to person. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/9771336">Vegetarians</a> have a higher water content in their stools. Those who consume less fibre and more protein have a lower water content. Fibre has a <a href="https://www.ncbi.nlm.nih.gov/pubmed/1333426">high water-carrying ability</a> and makes our stools more bulky, increases the frequency of bowel movements and makes the process of passing bowel motions easier. </p>
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Read more:
<a href="https://theconversation.com/health-check-what-your-pee-and-poo-colour-says-about-your-health-59516">Health Check: what your pee and poo colour says about your health</a>
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<p>The other 25% of faeces is made up of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500995/">solids</a>, which are mainly organic (relating to living matter) materials. A small proportion of solids is made up of inorganic material such as calcium and iron phosphate as well as dried constituents of digestive juices. </p>
<p>Around <a href="https://www.ncbi.nlm.nih.gov/pubmed/7359576">25-54%</a> of the organic material is made up of microbes (dead and living), such as bacteria and viruses.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/241982/original/file-20181024-48721-1k2v3h8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/241982/original/file-20181024-48721-1k2v3h8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=478&fit=crop&dpr=1 600w, https://images.theconversation.com/files/241982/original/file-20181024-48721-1k2v3h8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=478&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/241982/original/file-20181024-48721-1k2v3h8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=478&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/241982/original/file-20181024-48721-1k2v3h8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=601&fit=crop&dpr=1 754w, https://images.theconversation.com/files/241982/original/file-20181024-48721-1k2v3h8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=601&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/241982/original/file-20181024-48721-1k2v3h8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=601&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Our poo is teeming with microbes, most of them alive.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/success?u=http%3A%2F%2Fdownload.shutterstock.com%2Fgatekeeper%2FW3siZSI6MTU0MDM4ODc3NCwiYyI6Il9waG90b19zZXNzaW9uX2lkIiwiZGMiOiJpZGxfNjc4NjUzNDU4IiwiayI6InBob3RvLzY3ODY1MzQ1OC9odWdlLmpwZyIsIm0iOjEsImQiOiJzaHV0dGVyc3RvY2stbWVkaWEifSwiZ1hXeGE3N1h6eXQ2UWx6R3FOMGh0VFBENDZjIl0%2Fshutterstock_678653458.jpg&ir=true&pi=41133566&m=678653458&src=eyGu5IT4ZKIblGXKJ53H0Q-1-10">www.shutterstock.com</a></span>
</figcaption>
</figure>
<h2>Microbes</h2>
<p>Bacteria in faeces have been <a href="https://www.cell.com/cell/fulltext/S0092-8674(16)00053-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867416000532%3Fshowall%3Dtrue">extensively studied</a>. It’s estimated there are nearly 100 billion bacteria per gram of wet stool. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1183343/">One study</a> that looked at a collection of fresh stools in oxygen-free conditions (as oxygen can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170922">damage certain types of bacteria</a>) found almost 50% of the bacteria were alive. </p>
<p>The different types of bacteria present in faeces can influence how hard or loose stool samples can be. For example, <a href="https://gut.bmj.com/content/65/1/57">Prevotella bacteria</a>, which can be found in the mouth, vagina and gut, are more commonly seen in those with soft stools. In fact, a high-fibre diet is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368382/">strongly associated</a> with these bacteria. </p>
<p><a href="https://gut.bmj.com/content/65/1/57">Ruminococcaceae</a> bacteria, which are common gut microbes that break down complex carbohydrates, favour harder stools.</p>
<p>Viruses have been less studied than bacteria as components of the gut microbiota – the population of bacteria and viruses that live in our gut. It <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208976/">is estimated</a> there are 100 million to 1 billion viruses per gram of wet faeces in most of us. </p>
<p>This number can change considerably when people become sick with viral gastroenteritis, such as in norovirus infections, where levels of <a href="https://wwwnc.cdc.gov/eid/article/14/10/08-0117_article">more than a trillion viruses per gram</a> of stool can be found. </p>
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<figcaption><span class="caption">What is the human microbiome?</span></figcaption>
</figure>
<p>Certain types of viruses that infect bacteria, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4312520/">called bacteriophages</a>, have been linked to diseases of the gut like Crohn’s disease and ulcerative colitis.</p>
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Read more:
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<p><a href="https://en.wikipedia.org/wiki/Archaea">Archaea</a> are bacteria-like microbes that can inhabit some of the most extreme environments on Earth such as hot springs, deep sea vents or extremely acidic waters. Archaea that produce methane are known to live in the human gut and account for around <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1004833">10% of non-oxygen-dependent microbes</a>. </p>
<p>Such methane-producing archaea like <em>Methanobrevibacter</em> are associated with harder stools and constipation as <a href="https://www.ncbi.nlm.nih.gov/pubmed/19830557">methane can slow down intestinal movement</a>. It is believed there are around <a href="https://www.ncbi.nlm.nih.gov/pubmed/3721294">100 million archaea</a> per gram of wet faeces. </p>
<p>Single-celled fungi (yeasts) are present in the gut of <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002503">about 70% of healthy adults</a>. They occur in estimated concentrations of up to a million microorganisms per gram of wet faeces but <a href="https://www.ncbi.nlm.nih.gov/pubmed/18584522">comprise only a small</a> proportion (0.03%) of all microbes.</p>
<h2>Other organic material</h2>
<p>Some of the organic material includes <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500995/">carbohydrates</a> or any other undigested plant matter, protein and undigested fats. Faeces does not contain large quantities of carbohydrates as the majority of what we eat is absorbed. However, undigested amounts remain as dietary fibre. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/243198/original/file-20181031-76396-1eaiiq7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/243198/original/file-20181031-76396-1eaiiq7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/243198/original/file-20181031-76396-1eaiiq7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/243198/original/file-20181031-76396-1eaiiq7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/243198/original/file-20181031-76396-1eaiiq7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/243198/original/file-20181031-76396-1eaiiq7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/243198/original/file-20181031-76396-1eaiiq7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/243198/original/file-20181031-76396-1eaiiq7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Our faeces don’t contain a large proportion of carbohydrates as most are absorbed in the body.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
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<p>Some <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002503">2-25% of organic matter</a> in faeces is due to nitrogen-containing substances such as undigested dietary protein, and protein from bacteria and cells lining the colon that have been shed. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/7211735">Fats contribute</a> <a href="https://www.ncbi.nlm.nih.gov/pubmed/9734752">2-15%</a> of the organic material in our faeces. The amount of fat excreted into our stools is highly dependent on dietary intake. Even with no fat intake, though, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500995/">we do get some excretion of fat</a> into our faeces. Fat in faeces can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500995/">come from bacteria</a> in the form of short-chain fatty acids when they ferment foods, in addition to undigested dietary fat.</p>
<h2>Plastic particles</h2>
<p>A <a href="https://www.ueg.eu/press/releases/ueg-press-release/article/ueg-week-microplastics-discovered-in-human-stools-across-the-globe-in-first-study-of-its-kind/">recent study</a> has found that microscopic plastic particles can appear in our faeces when we drink from plastic bottles or eat foods that have been wrapped in plastic. </p>
<p>This small study of eight participants who were exposed to plastics in their food and drink identified up to nine different types of plastics in their stools. But we need larger studies and additional analytical research to understand the clinical significance of this. </p>
<h2>Poo is different in disease</h2>
<p>Not everyone’s poo is going to be the same. Diseases such as inflammatory bowel disease can lead to <a href="https://www.sciencedirect.com/science/article/pii/S0016508514002200">changes in the type of bacteria in our gut</a> and result in raised <a href="https://www.nice.org.uk/guidance/dg11">inflammatory proteins</a> that can be detected in our stool. </p>
<p>The presence of blood in the stool could signal bowel cancer, though this isn’t always the case. Fortunately there is a <a href="https://www.cancer.org.au/content/pdf/HealthProfessionals/ClinicalGuidelines/ClinicalpracticeguidelinesJuly2008.pdf">good screening test</a> that can pick up the presence of trace blood in the stools and lead to further investigations such as a colonoscopy.</p>
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<img alt="" src="https://images.theconversation.com/files/238289/original/file-20180927-48634-1c0kcp4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/238289/original/file-20180927-48634-1c0kcp4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=200&fit=crop&dpr=1 600w, https://images.theconversation.com/files/238289/original/file-20180927-48634-1c0kcp4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=200&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/238289/original/file-20180927-48634-1c0kcp4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=200&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/238289/original/file-20180927-48634-1c0kcp4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=251&fit=crop&dpr=1 754w, https://images.theconversation.com/files/238289/original/file-20180927-48634-1c0kcp4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=251&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/238289/original/file-20180927-48634-1c0kcp4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=251&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p class="fine-print"><em><span>Vincent Ho does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Around 75% of our faeces is made up of water. The other 25% is the good stuff, including bacteria, viruses and undigested food.Vincent Ho, Senior Lecturer and clinical academic gastroenterologist, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/957242018-05-23T13:10:42Z2018-05-23T13:10:42ZWhat your poo says about your health<figure><img src="https://images.theconversation.com/files/219938/original/file-20180522-51091-h4qo6j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/success?u=http%3A%2F%2Fdownload.shutterstock.com%2Fgatekeeper%2FW3siZSI6MTUyNzAxMTY0MiwiYyI6Il9waG90b19zZXNzaW9uX2lkIiwiZGMiOiJpZGxfNDgzMDkzNTU2IiwiayI6InBob3RvLzQ4MzA5MzU1Ni9odWdlLmpwZyIsIm0iOjEsImQiOiJzaHV0dGVyc3RvY2stbWVkaWEifSwid09pVGlzNXFlVG1HWkU3SDBBMm5IRzZUa3NjIl0%2Fshutterstock_483093556.jpg&pi=33421636&m=483093556&src=I0E_GIQDNF6GwSWFZnexYg-1-28">Shutterstock</a></span></figcaption></figure><p>Opening your bowels is a basic function of life. But despite the fact we all do it, pooing is not often thought to be a topic suitable for polite conversation. However, recent <a href="http://www.bbc.co.uk/news/health-43674270">popular interest in gut health</a> and the composition of poo – as well as the <a href="https://www.theguardian.com/news/2018/mar/26/the-human-microbiome-why-our-microbes-could-be-key-to-our-health">bacterial populations that live within it</a> – have helped to put bodily functions more on the map. And these days, more and more people are wondering how often you should go, what happens if you don’t go enough and how you can influence the composition of what is passed.</p>
<p>In the late 1980s, Professor Ken Heaton and colleagues conducted a <a href="http://gut.bmj.com/content/gutjnl/33/6/818.full.pdf">survey of the population</a> in East Bristol, in the UK. They reported the common wisdom that “99% of people defecate between three times per week and three times per day” which was revealed in an earlier study of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1846921/">factory workers and GP patients</a>. In Bristol, they noted that although the most common bowel habit was once daily, it only occurred in 40% of men and a third of women.</p>
<p>How often we go for a number two can differ from person to person. We all have what’s known as a “<a href="https://www.gastrojournal.org/article/0016-5085(78)90864-8/abstract">gastro-colic reflex</a>” – which means that each time we eat food, our large bowel responds and we should go to the toilet. Through a range of hormones we will experience a “<a href="https://www.ncbi.nlm.nih.gov/pubmed/12870774">call to stool</a>”. Most of us, however – from the time we can walk – suppress this call, so once a day or less has become the new norm.</p>
<p>Urgency, diarrhoea, and constipation can all be features of not going to the toilet enough. And associated with this “relative” constipation are symptoms of bloating, pain and variability of bowel habit. A simple test of how your bowels are working is the “sweetcorn test”. By swallowing a handful of raw sweetcorn – which is not absorbed by the body – the brightly coloured kernels can be easily seen in your motions. This is an easy way to assess your own mouth-to-anus transit time. It should probably be about eight hours.</p>
<h2>The composition of poo</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/26246784">Poo is made up of 75% water</a>. The rest, which is the solid stuff, is up to 50% microbes plus cells that are shed from the bowel lining and food residue. The collective name for the microbes that live inside us is the microbiome and at one time, it was thought that the bugs outnumbered our cells by ten to one. </p>
<p><a href="http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002533">Recent data</a> suggests this may be closer to a ratio of 1.3 to 1 but this will obviously depend on how often you go. Bacteria, viruses, fungi and single cell microbes make up the microbiome and all <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181834/">may be critical</a> to our health and well-being.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/219983/original/file-20180522-51105-c037fl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/219983/original/file-20180522-51105-c037fl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/219983/original/file-20180522-51105-c037fl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/219983/original/file-20180522-51105-c037fl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/219983/original/file-20180522-51105-c037fl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/219983/original/file-20180522-51105-c037fl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/219983/original/file-20180522-51105-c037fl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Up to 75% of people use their phone on the toilet.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/success?u=http%3A%2F%2Fdownload.shutterstock.com%2Fgatekeeper%2FW3siZSI6MTUyNzAyNzAyNSwiYyI6Il9waG90b19zZXNzaW9uX2lkIiwiZGMiOiJpZGxfMjQ2NzEzNjQxIiwiayI6InBob3RvLzI0NjcxMzY0MS9odWdlLmpwZyIsIm0iOjEsImQiOiJzaHV0dGVyc3RvY2stbWVkaWEifSwieG9aSXpBNyt5YWlTVlRxRm9hbk8zbVRhMUlnIl0%2Fshutterstock_246713641.jpg&pi=33421636&m=246713641&src=FFiW_UE5-dA665Qzal7nUw-1-32">Shutterstock</a></span>
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<p>From a positive perspective, the bugs in our guts not only breakdown undigestible foodstuffs, but they also produce critical nutrients, prevent certain infections and contribute to the development of our <a href="https://www.sciencedirect.com/science/article/pii/S2095809917301492">immune defence systems</a>. However, <a href="https://www.nature.com/articles/nature05414">obesity</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/23023125">type two diabetes</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/25870193">high blood pressure</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/17699621">inflammatory bowel disease</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/23370376">autoimmune disorders</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/22968153">mental health problems</a> have all been linked to dysbiosis – or change of the microbiome.</p>
<h2>Gut feelings</h2>
<p>Establishment of our <a href="https://www.ncbi.nlm.nih.gov/pubmed/24503132">microbiome starts at birth</a> and is influenced by the way we are born – either vaginally or by Cesarean – and initially fed. By the time we start eating solid food, we are well on the way to establishing our adult microbiome. What we subsequently <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303825/">eat can have an impact on the composition</a>, although this effect may be modest. </p>
<p>Our diets also may influence the metabolic products of our microbiome – these are the chemicals that the individual organisms produce – which can also have an impact on us as the host. Fibre, fat, sugars, artificial sweeteners have all been shown to modulate the composition of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303825/">gastrointestinal microbiota</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/219985/original/file-20180522-51130-x2521o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/219985/original/file-20180522-51130-x2521o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/219985/original/file-20180522-51130-x2521o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/219985/original/file-20180522-51130-x2521o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/219985/original/file-20180522-51130-x2521o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/219985/original/file-20180522-51130-x2521o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/219985/original/file-20180522-51130-x2521o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">You inherited all your human DNA from your parents — but your microbiome is more complicated.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/success?u=http%3A%2F%2Fdownload.shutterstock.com%2Fgatekeeper%2FW3siZSI6MTUyNzAyNzMxNSwiYyI6Il9waG90b19zZXNzaW9uX2lkIiwiZGMiOiJpZGxfNDE0NzMzMjkxIiwiayI6InBob3RvLzQxNDczMzI5MS9odWdlLmpwZyIsIm0iOjEsImQiOiJzaHV0dGVyc3RvY2stbWVkaWEifSwiOXZBeTBXMk5uZm1JMnVtUm5hcDhCbkVSb1dFIl0%2Fshutterstock_414733291.jpg&pi=33421636&m=414733291&src=eeeOfIiGUtECdRtfEVUyfQ-1-59">Shutterstock</a></span>
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<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/21767445">Experimental data</a> suggests that prebiotic fibres change gut microbiota and increase hormones that tell us that we are full. <a href="https://www.newcastle.edu.au/profile/emma-beckett">Current ongoing research</a> has also shown that antibiotic induced microbial imbalance is associated with changes in bitter taste expression – which influences the foods we prefer to eat. All these relationships are complex, and scientists are just beginning to understand their full impact.</p>
<p>The ultimate way to alter our microbiome is a <a href="http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002503">faecal transplant</a>, where you take on board the poo from someone else. Unpleasant as this may sound, encouraging data is emerging on the use of poo in the treatment of gastrointestinal infections such as clostridium difficile, early diabetes, multiple sclerosis and inflammatory bowel disease. But it may still be a while before you can buy prized poo over the counter in your local supermarket.</p><img src="https://counter.theconversation.com/content/95724/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Martin Veysey is affiliated to Hull York Medical School and receives funding from Australian Research Council, National Health and Medical Research Council, Central Coast Local Health District. </span></em></p>An expert explains how often you should poo and what it should look like.Martin Veysey, Programme Director MBBS at Hull York Medical School, University of HullLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/912732018-02-21T12:45:14Z2018-02-21T12:45:14ZExplaining coprophagy – why do dogs eat their own poo?<figure><img src="https://images.theconversation.com/files/207262/original/file-20180221-132647-iffgz7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/dog-guilty-expression-muddy-paws-tracks-402872977?src=AuSuv9haeBs53Dn_DK9qsg-1-3">Shutterstock</a></span></figcaption></figure><p>Dogs are scavengers. As many dog owners know to their cost, dogs often have a penchant for things that we find less than palatable. If it’s not counter or table surfing, it might be raiding the kitchen rubbish bin or snacking on rich pickings from the park, street or elsewhere.</p>
<p>Occasionally, those rich pickings include poo, much to the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1680886/">disgust of many owners</a>. That poo can be from a range of species (birds, horses, rabbits, cattle, sheep, deer, and in my own dogs’ case, cat poo is a particular favourite). But sometimes, dogs have a desire to consume either their own or other dogs’ faeces. This behaviour is called coprophagy, literally translated as “faeces eating” and, unsurprisingly, <a href="http://ww.jamesoheare.com/vol2no1boze.pdf">many dog owners don’t like it</a>. </p>
<p>Ironically, dogs are often fastidious at keeping their sleeping areas clean by removing their faeces. Dogs will also actively avoid areas contaminated with poo from other dogs. This is probably an innate behaviour that has evolved to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189355/">prevent the spread of disease</a>. So given that eating poo does carry <a href="http://www.aaem.pl/Stray-dogs-and-cats-as-potential-sources-of-soil-contamination-with-zoonotic-parasites,72604,0,2.html">disease risk</a>, why do dogs do it? A <a href="http://onlinelibrary.wiley.com/doi/10.1002/vms3.92/epdf">recent study</a> has shed further light on the subject and could help us manage the behaviour.</p>
<p>First, it seems that not all dogs eat each other’s poo. <a href="http://onlinelibrary.wiley.com/doi/10.1002/vms3.92/epdf">The study</a> found that only 16% of more than 1,000 dog owners surveyed saw their dogs consume canine faeces at least six times or more (the study’s definition of coprophagy). And 77% recorded never seeing their pets eat other dogs’ poo.</p>
<p>The research showed that several key factors appear to have no effect on whether your dog is a poo-eater. These included age, gender, whether the dog has been spayed or neutered, whether it was housetrained, whether it had been weaned or removed from its mother early, and what the rest of its diet was like. Evidence also suggests that the plethora of products designed to prevent or treat coprophagy, or <a href="http://ww.jamesoheare.com/vol2no1boze.pdf">punishing your dog for eating poo</a>, have no effect on reducing the behaviour.</p>
<p>Instead, the recent study suggests the best way to predict whether a dog eats faeces is how much access to poo they have. This is particularly the case if the faeces are fresh, with over 80% of coprophagic dogs only consuming poo less than two days old. It seems that keeping your dog away from fresh poo is the most effective strategy for stopping them eating it. This is yet another reason to promote regular poo picking and <a href="https://www.thekennelclub.org.uk/our-resources/media-centre/issue-statements/dog-fouling/">responsible dog ownership</a>, both at home and out walking.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/207270/original/file-20180221-132677-131ec9y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/207270/original/file-20180221-132677-131ec9y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/207270/original/file-20180221-132677-131ec9y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/207270/original/file-20180221-132677-131ec9y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/207270/original/file-20180221-132677-131ec9y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/207270/original/file-20180221-132677-131ec9y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/207270/original/file-20180221-132677-131ec9y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Don’t give him the chance.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/owner-cleaning-after-dog-plastic-bag-429281701?src=IMsjb1k5KTaG0cp5BCo2AQ-1-19">Shutterstock</a></span>
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</figure>
<p>In the survey, dogs described as “greedy” and those in households with two or more dogs were more likely to be coprophagic. Terriers and hounds were also more likely to be coprophagic, as were Shetland sheepdogs, with 41% of those in the study recorded as eating poo. Poodles, on the other hand, appeared to defy their name and shun the practice.</p>
<p>Yet none of this explains why certain dogs will eat poo if they can. It might simply be that some dogs like it and have learned, either by accident or with intent, to consume faeces. Perhaps dogs do it if their owners or other dogs they come into contact with show a particular interest in faeces. After all, we know that dogs often <a href="https://www.sciencedirect.com/science/article/pii/S0168159117303180">synchronise their behaviour</a> with their owners (though it’s unlikely that most affected owners are coprophagic).</p>
<h2>Evolutionary leftover</h2>
<p>But the study authors suggest that coprophagy is something much more basic. It’s possible that poo eating is an evolutionary remnant from dogs’ ancestors, where faeces could be a source of disease, <a href="https://www.sciencedirect.com/science/article/pii/S0149763405800387?via%3Dihub">especially from parasites</a>. Removing faeces early by eating it might represent a way of cleaning it up to prevent infectious parasites developing in the days after it’s deposited. And dogs today may indulge in exactly the same behaviour.</p>
<p>So what should you do if the prospect of your pet eating poo fills you with horror? Aside from owning a single, non-greedy poodle, the best thing to do is simply to prevent your dog having access to poo, especially the fresh stuff. Clean up after your dog, encourage others to do the same, and try training your dog to resist the temptation to eat poo by rewarding them with an alternative tasty snack.</p><img src="https://counter.theconversation.com/content/91273/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacqueline Boyd is a lecturer in Animal Science at Nottingham Trent University, a member of The Kennel Club and Chair of the Kennel Club's Activities Health and Welfare Sub-Group.</span></em></p>New research explains that dogs may have evolved to eat faeces as a way to prevent the spread of disease.Jacqueline Boyd, Lecturer in Animal Science, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/917242018-02-20T14:37:28Z2018-02-20T14:37:28ZWhy your tourist toilet habits are bad for locals – and the environment<figure><img src="https://images.theconversation.com/files/206809/original/file-20180216-50550-1yppnws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>While many prospective holidaymakers actively seek a change in cuisine or climate when choosing their destination, standardised sanitation usually remains a must.</p>
<p>You might think that the preference for a porcelain pew is harmless, but in reality it can put a serious strain on both the local population and the environment. In fact, many of the most pervasive problems associated with tourism can be seen through the toilet bowl.</p>
<p>Research suggests that in some locations <a href="https://www.sciencedirect.com/science/article/pii/S0261517711000793">up to 40% of water is consumed by tourists</a>. Tourists tend to splash out <a href="https://www.tourismconcern.org.uk/wp-content/uploads/2014/09/Unit2-Resource-A-1.pdf">far more per day on average</a> than local residents, who are often <a href="https://www.sciencedirect.com/science/article/pii/S0160738312000047">outcompeted</a> by industry for water access. Using limited freshwater supplies to flush tourists’ toilets means less for residents’ drinking, cleaning and cooking needs.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/207106/original/file-20180220-116360-1g3sdxp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/207106/original/file-20180220-116360-1g3sdxp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/207106/original/file-20180220-116360-1g3sdxp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/207106/original/file-20180220-116360-1g3sdxp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/207106/original/file-20180220-116360-1g3sdxp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/207106/original/file-20180220-116360-1g3sdxp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/207106/original/file-20180220-116360-1g3sdxp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Don’t be scared.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/old-style-japan-toilet-415484425?src=dQP67N10AKsBsw_E8TjrIg-1-3">Heemsuhree/Shutterstock</a></span>
</figcaption>
</figure>
<p>Environmentally, the sheer volume of incoming tourists can come at a high price. Local sewage facilities often struggle to cope with the influx of human waste. Many small islands with limited infrastructure, <a href="https://www.researchgate.net/profile/Michelle_Mycoo/publication/249023794_Sustainable_Tourism_Using_Regulations_Market_Mechanisms_and_Green_Certification_A_Case_Study_of_Barbados/links/5591255108aed6ec4bf69627.pdf">such as Barbados</a>, have no choice but to pump raw sewage straight into the sea, putting vast swathes of the Caribbean’s coral reefs at risk.</p>
<p>This defecatory deluge also depletes limited water reserves. In Cape Town, hotels are having to <a href="http://www.independent.co.uk/travel/news-and-advice/cape-town-drought-water-shortage-luxury-five-star-hotels-day-zero-laundry-showers-toilet-flush-pool-a8191966.html">abruptly limit guests’ water usage</a> as the city suffers drought. In Bali, fast-growing tourism demand is linked to <a href="http://www.idepfoundation.org/en/bwp/summary">rapid depletion of the island’s water resources</a>.</p>
<h2>Sanitation solutions</h2>
<p>These economic and environmental harms often stem from a misplaced sense of cultural superiority that accompanies us to the bathroom. The internet is awash with travellers’ <a href="https://thetravelmanuel.com/why-malaysia-has-the-worst-toilets-in-the-world/">toilet horror stories</a>, written with apparently little social sensitivity or willingness to compromise.</p>
<p>Those fortunate enough to be able to travel might want to remind themselves of UN estimates for 2017, which suggest that <a href="http://www.unwater.org/new-publication-whounicef-joint-monitoring-programme-2017-report/">61% of the global population</a> – roughly 4.5 billion people – lack access to a toilet or latrine that disposes of waste safely. Westerners tend to judge other cultures harshly, when really they should be judging global inequality, poverty and politics.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/xtn21JwhPiE?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>Perhaps some judgement should be reserved for people in rich countries themselves, where bathroom norms aren’t exactly perfect. For example, <a href="https://www.theguardian.com/lifeandstyle/2015/may/18/truth-about-poo-doing-it-wrong-giulia-enders-squatting">squatting</a> rather than sitting is better for the colon. Rather than a sight to be avoided, a glance at one’s waste before flushing can in fact be a <a href="https://www.cnwl.nhs.uk/wp-content/uploads/Healthy_Bowel-_Patient_Information_leaflet.pdf">quick and easy health check</a>. Embarrassment about bodily functions is inhibiting when holidays are meant to be liberating.</p>
<p>Different sanitation solutions suit different situations. The <a href="http://www.worldbank.org/en/news/feature/2017/11/17/world-toilet-day-2017">World Bank</a> and the <a href="https://www.worldwildlife.org/magazine/issues/fall-2016/articles/sustainable-toilets-and-their-role-in-freshwater-conservation">WWF</a> have both worked to celebrate toilet innovations across the world that challenge preconceptions and improve sustainability. For instance, <a href="http://www.worldbank.org/en/news/feature/2017/11/17/world-toilet-day-2017">urine-diverting privies in Bolivia</a> are an integral link in a chain that converts waste into fertiliser for growing crops. Cranfield University is developing the <a href="http://www.nanomembranetoilet.org/">Nano Membrane Toilet</a>, which converts waste into clean water and energy, without the need for external power or water.</p>
<p>Some Western tourist locations are already rethinking their taste in toilets. Composting toilets introduced in various Scottish nature reserves have proved <a href="https://www.fvl.org.uk/files/2314/5933/7417/Eco-loo_Case_Studies.pdf">highly popular with visitors</a>. Melbourne Zoo and other attractions have implemented <a href="https://www.zoo.org.au/about-us/vision-and-mission/environmental-sustainability/saving-water">water conservation and recycling measures</a> in restrooms, including waterless urinals. The increasing use of such practices by authorities and businesses will only help to challenge harmful expectations when people travel further afield.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/jGPpXF7y9Rg?wmode=transparent&start=37" frameborder="0" allowfullscreen=""></iframe>
</figure>
<h2>Potty training</h2>
<p>There are also simple changes that tourists can make when going to the bathroom that will have a positive impact on the environment and local communities, and possibly even lead to more interesting holiday experiences.</p>
<p>Remember that different ecological settings require different bathroom styles. Always avoid flushing wipes and other non-biodegradables. In water stressed areas, be conscious of your water usage. Don’t demand what local people don’t have. The threat of extreme drought has forced Cape Town luxury hotels to ask guests to limit the length of showers, turn off the tap while brushing their teeth, and <a href="http://www.independent.co.uk/travel/news-and-advice/cape-town-drought-water-shortage-luxury-five-star-hotels-day-zero-laundry-showers-toilet-flush-pool-a8191966.html">let it mellow if its yellow</a>, but actions like these could benefit locals in tourist destinations across the developing world.</p>
<p>Support small businesses. Their toilets may not always be gleaming, but the experience might be more memorable. While luxury tourism in developing countries <a href="https://theconversation.com/is-it-ethical-to-take-a-luxury-holiday-in-a-developing-country-80984">rarely benefits those in need</a>, going local is one way to contribute. </p>
<p>Lastly, nurture your sense of adventure. If you want to live like a local, you should defecate like one. Pack your hand sanitiser and spare toilet roll, and immerse yourself in local culture. Get ready to try out new facilities, not just whatever commode is à la mode. There are <a href="http://www.traveller.com.au/traveller-10-the-worlds-top-toilets-gzs1l0">toilet attractions</a> dotted all over the globe that are well worth a visit. For example, why not try the <a href="https://www.theguardian.com/world/2012/nov/09/south-korea-toilet-theme-park">Haewoojae Museum</a> in South Korea, solely dedicated to celebrating the lavatory.</p>
<p>We shouldn’t expect all toilets to look the same. Tourism is about challenging expectations, exploring alternatives and expanding horizons. For the sake of the environment and the vulnerable, it is high time that we became more open-minded and adventurous with our toilette when travelling. After all, when in Rome, wipe as the Romans wiped (using a <a href="https://www.theatlantic.com/health/archive/2016/01/ancient-roman-toilets-gross/423072/">wet sponge on a stick</a>, apparently).</p><img src="https://counter.theconversation.com/content/91724/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Brendan Canavan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>If you want to live like a local when on holiday, you should defecate like one.Brendan Canavan, Senior Lecturer in Marketing, University of HuddersfieldLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/860802017-11-16T11:57:45Z2017-11-16T11:57:45ZWhy we need to talk about incontinence<figure><img src="https://images.theconversation.com/files/191215/original/file-20171020-13936-1jy9u2x.JPG?ixlib=rb-1.1.0&rect=30%2C1056%2C3971%2C1913&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Claire Scott/Cranfield University</span>, <span class="license">Author provided</span></span></figcaption></figure><p>We rarely hear or speak about incontinence. But the <a href="https://www.ncbi.nlm.nih.gov/pubmed/20025020">condition</a> – the involuntary loss of urine or faecal matter – is frighteningly common. </p>
<p>Incontinence does not know wealth divides. It brings profound personal and socio-economic consequences across the income spectrum and around the world. <a href="https://www.ncbi.nlm.nih.gov/pubmed/19410574">Best estimates</a> reveal that about 8% of adults experience faecal incontinence, increasing to 15% for those over 70 years. Urinary incontinence is even more prevalent, affecting approximately <a href="https://www.ncbi.nlm.nih.gov/pubmed/14499979">24% of men and 53% of women</a> (the condition is more prevalent in women due to strong causative links with childbirth). It is <a href="https://www.ncbi.nlm.nih.gov/pubmed/20617303">equally prevalent in lower income countries</a>. </p>
<p>Incontinence is a symptom which can have <a href="http://www.ics.org/public/factsheets">many underlying causes</a>. It can result from a weakened pelvic floor (often resulting from childbirth), obstetric fistula, cancer, bladder or bowel dysfunction, emotional distress and many other conditions. And it can be traumatising regardless of where you call home. Many cultures consider incontinence to be a taboo topic, not to be spoken about in polite conversation:</p>
<blockquote>
<p>For the majority of my 34 years I’ve kept my daily accidents a secret. Even as a four year old I remember hiding my dirty underwear from my parents.</p>
</blockquote>
<p>This experience, recounted by a person experiencing faecal incontinence in the UK (to our colleagues in the <a href="http://impress-network.com/">IMPRESS Network</a>) is typical, and reveals that the condition affects all ages. Equally, a recent study in <a href="http://impress-network.com/wp-content/uploads/2017/10/Claire-Scott-Thesis-Incontinence-in-Zambia-1.pdf">Zambia</a>, conducted by a Cranfield University researcher, revealed that incontinence is sometimes considered a “curse”, particularly when it is not linked to an obvious causative “trauma” or illness. This results in the condition being more stigmatised for women (as childbirth is perceived as “natural” and not traumatic or an illness).</p>
<p>A similar study in Pakistan, conducted by the London School of Tropical Hygiene and Medicine (but not yet published) asked those experiencing incontinence to take photographs of people and objects that represented their experience. A common theme was photographs portraying the isolation they feel. Often they are excluded from their community, particularly if they are unable to bathe often enough to manage odour.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=420&fit=crop&dpr=1 600w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=420&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=420&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=528&fit=crop&dpr=1 754w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=528&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/194560/original/file-20171114-27573-1qr5ny.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=528&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Incontinence can lead to ostracism and loneliness.</span>
<span class="attribution"><span class="source">De Visu/Shutterstock.com</span></span>
</figcaption>
</figure>
<h2>What is normal?</h2>
<p>In both low and high resource contexts, there is confusion around what is “normal” when it comes to continence-related conditions, particularly those caused by <a href="https://theconversation.com/pelvic-floor-training-in-pregnancy-could-help-prevent-the-need-for-barbaric-vaginal-mesh-surgery-76440">childbirth</a> and ageing. </p>
<p>People are often unaware, for example, that appropriate medical intervention could treat or better manage the condition. This can be compounded by non-specialist healthcare professionals dismissing the condition. One British patient we have worked with reported visiting several doctors over a 30-year period before undergoing surgery that has dramatically reduced her urinary incontinence symptoms. She told us: “It has really improved my quality of life.”</p>
<p>But in locations where traditional healers are common, rural Zambia for example, those who experience incontinence (and recognise it as a health issue) may choose to visit such healers, who have not undergone medical training. If these healers are unable to address their concerns, people often simply “give up” on treating the condition at all, preferring to manage it privately and not visit a trained medical practitioner.</p>
<h2>Access is important</h2>
<p>In high income countries, primary treatment of incontinence includes pharmaceutical, surgical and lifestyle modifying interventions. Where the condition cannot be fully treated, management strategies are dominated by disposable products including catheters, colostomy bags and absorbent pads. This can have a severe impact on everyday life, bringing worries about where the nearest public toilet will be and making even short outings stressful, requiring extensive planning. This is exacerbated when those experiencing incontinence are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3980491/">homeless</a>. </p>
<p>For those with internet access, Google Maps now allows users in some Indian cities to <a href="https://www.guidingtech.com/63154/google-maps-public-toilet-locator-india/">find their nearest public toilet</a>. Extending this facility worldwide would transform lives.</p>
<p>In low income contexts and in <a href="http://www.sphereproject.org/resources/sphere-essentials/">emergencies</a>, those with incontinence often cannot afford treatment or expensive management products (or appropriate infrastructure is not there to deliver it). The previously mentioned studies in <a href="http://impress-network.com/wp-content/uploads/2017/10/Claire-Scott-Thesis-Incontinence-in-Zambia-1.pdf">Zambia</a> and Pakistan both highlighted an affordability issue for those experiencing incontinence, but not necessarily of specialised incontinence aids such as catheters and colostomy bags. Rather, the primary issue was the unaffordability of the soap they required to wash themselves, their reusable pads and their surroundings. Disposable options are often not even a consideration due to their exorbitant cost.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=420&fit=crop&dpr=1 600w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=420&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=420&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=528&fit=crop&dpr=1 754w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=528&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/194561/original/file-20171114-27616-112ec0x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=528&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Not being able to afford washing powder entrenches stigma around incontinence.</span>
<span class="attribution"><span class="source">Laboko/Shutterstock.com</span></span>
</figcaption>
</figure>
<h2>A complex issue</h2>
<p><a href="http://www.un.org/sustainabledevelopment/blog/2016/01/sanitation-becomes-separate-un-human-right-in-enhanced-fight-against-infection/">Sanitation is a human right</a>. How can we ensure that it is realised for everyone, including those experiencing incontinence? </p>
<p>Incontinence is treated and managed in a variety of ways around the world. But it is never as simple as installing a technology, selling a product or delivering an intervention. Even the most basic of management measures require supply chains, infrastructure and policies. Even where these are in place, affordability and a reluctance to seek medical help can result in many suffering quietly, often tagged with a stigma of being “smelly” or “cursed”.</p>
<p>So perhaps the heart of the challenge, and the solution to better tackling incontinence, lies in raising awareness and understanding. Through <a href="http://www.bladderandboweluk.co.uk/">education</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/26555779">public discussion</a>, <a href="http://www.telegraph.co.uk/health-fitness/body/kate-winslet-has-opened-the-floodgates-literally-how-to-cope-wit/">media coverage</a>, better <a href="http://www.bradforddistrictsccg.nhs.uk/news/lets-talk-about-incontinence/">recognition in healthcare</a> and even <a href="http://www.theguardian.com/healthcare-network/2017/aug/10/why-wrote-comedy-show-incontinence-edinburgh-fringe">comedy</a>, we can tackle stigma and reduce social barriers to appropriate healthcare. Furthermore, education can help transform the current burden of postpartum urinary incontinence through better awareness of preventative measures such as <a href="http://www.cochrane.org/CD007471/INCONT_pelvic-floor-muscle-training-for-prevention-and-treatment-of-urinary-and-faecal-incontinence-in-pregnant-women-and-women-who-have-recently-given-birth">pelvic floor training during pregnancy</a>.</p>
<p>We all urinate and defecate every day. <a href="https://data.unicef.org/topic/water-and-sanitation/sanitation/">Two thirds of us</a> have some basic sanitation system that we rely on to help us manage this, and don’t often think about what would happen if we didn’t have such access. But, undoubtedly, there have been instances where you, or someone you care for, has needed to “go” and hasn’t reached these facilities in time. Remembering the inconvenience, perhaps even embarrassment, of these experiences highlights why we need to be more open to discussing incontinence and developing management methods that allow everyone to live happy, productive and healthy lives.</p><img src="https://counter.theconversation.com/content/86080/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dani J Barrington is Editor-in-Chief of Engineers Without Borders, Australia's Journal of Humanitarian Engineering. This article grew out of conversations between Dani and Pete with Zara Ansari (Masters student, London School of Hygiene and Tropical Medicine), Claire Scott (Masters student, Cranfield University) and Sarah House (independent consultant) following a side event that they facilitated together at the WEDC 2017 Conference.
</span></em></p><p class="fine-print"><em><span>Pete Culmer receives funding from UK research councils – EPSRC and the UK National Institute of Health Research (NIHR). He is a member of the iMechE Biomedical Engineering Association.</span></em></p>Incontinence is frighteningly common.Dani Barrington, Lecturer in Water, Sanitation and Health, University of LeedsPete Culmer, Associate Professor in Surgical Technologies, University of LeedsLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/819082017-08-16T06:10:37Z2017-08-16T06:10:37ZThe hidden secrets of insect poop<figure><img src="https://images.theconversation.com/files/180868/original/file-20170803-7132-1clpv0h.JPG?ixlib=rb-1.1.0&rect=0%2C0%2C4032%2C2698&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Monarch caterpillars feeding on milkweed leaves and dropping their faces (taken in the laboratory facility).</span> <span class="attribution"><span class="source">Prayan Pokharel</span>, <span class="license">Author provided</span></span></figcaption></figure><p>Insect defecation may not seem like one of the pressing scientific inquiries of our time, but in fact the faeces of these wee creatures serves an extraordinary variety of functions in bug and human life. </p>
<p>Unlike most animals, many insect species actually <a href="http://www.annualreviews.org/doi/abs/10.1146/annurev.ento.49.061802.123212">use</a> their excrement. They utilise it as their home, for feeding, in predator-prey interactions, for hygiene, habitat location, shelter construction, for reproduction and physical or chemical defence against natural enemies. (Kids: don’t try this at home.)</p>
<p>For members of our own species, insect faeces may even have important and largely unlocked medicinal properties. Let’s take a look.</p>
<h2>A home and a soulmate</h2>
<p>For some bugs, their exrement provides a home. Larvae of <em>Chelymorpha alternans</em>, commonly known as tortoise beetles, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758384/">shroud themselves</a> for protection with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC15980/">faecal coverings</a> in the form of coatings, faecal cases or <a href="http://www.springer.com/us/book/9780792321859">faecal shields</a>.</p>
<p>For others, it’s a deterrent to enemies. The pine weevil (<em>Hylobius abietis</em>) actually deposit faeces adjacent to each of its egg as <a href="https://www.ncbi.nlm.nih.gov/pubmed/16124228">anti-feedants</a>. </p>
<p>Insect waste also plays an important role in species reproduction, as it may affect mate attraction, parental care and even paternity assurance. For example, virgin boring beetles, <em>Hylotrupes bajulus</em>, use <a href="https://link.springer.com/article/10.1007/s000490050001">faecal volatiles</a> to meet their partners, increasing the opportunity to mate. </p>
<p>Cockroaches, a bug notorious for their chutzpah and for thriving in dirty environments, use the personal scent of their faeces to <a href="http://www.sciencemag.org/news/2015/12/cockroaches-communicate-bacteria-their-feces">locate and return</a> to resting sites. </p>
<p>This is actually useful news for citydwellers trying to keep their houses cockroach free: track down roach droppings (little black or brown specs that look like a pepper flake), and you’ll find out where the roaches are congregating. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/180539/original/file-20170801-21966-vs0hbg.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/180539/original/file-20170801-21966-vs0hbg.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=967&fit=crop&dpr=1 600w, https://images.theconversation.com/files/180539/original/file-20170801-21966-vs0hbg.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=967&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/180539/original/file-20170801-21966-vs0hbg.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=967&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/180539/original/file-20170801-21966-vs0hbg.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1215&fit=crop&dpr=1 754w, https://images.theconversation.com/files/180539/original/file-20170801-21966-vs0hbg.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1215&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/180539/original/file-20170801-21966-vs0hbg.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1215&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Different faecal structures of A. Cassidine beetle larva (Coleoptera: Chrysomelidae). B. <em>Hemisphaerota cyanea</em> larva (Coleoptera: Chrysomelidae. C. <em>Monoloxis flavicinctalis</em> (Lepidoptera: Pyralidae). D. <em>Callicore pitheas</em> larva (Lepidoptera: Nymphalidae). E. <em>Chrysoesthia sexgutella</em> (Lepidoptera: Gelechiidae). F. Hispine beetle (Coleoptera: Chrysomelidae)</span>
<span class="attribution"><span class="source">Weiss, 2006</span></span>
</figcaption>
</figure>
<h2>Poop is healthy and nutritious</h2>
<p>Just as farmers use cow manure as fertiliser, ants <a href="https://www.scientificamerican.com/article/fungus-makes-zombie-ants/">spread their faeces around</a> to cultivate a garden of fungi for munching on. Fungi evidently thrive on the chewed-up leaves that ants defecate. It’s the circle of life in action.</p>
<p>Insects aren’t the only ones who use bug excrement – we humans do, too. The faeces of silkworm (<em>Bombyx mori</em>) have <a href="https://www.google.com/patents/US5908628">pharmacological properties</a> that give it analgesic, anti-pyretic, and anti-inflammatory applications in herbal medicine.</p>
<p>Termites, <em>Coptotermes formosanus</em>, employ faeces to build secure homes by mixing poop into the wall of the nest. These wood-eaters harbour a diverse gut microbiome that assists in digestion of cellulose in their diet, and a 2013 <a href="http://rspb.royalsocietypublishing.org/content/280/1770/20131885.short">study</a> showed that this bacterial community provides the termites with a natural antimicrobial that averts pathogens.</p>
<p>A prior <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1550-7408.2000.tb00022.x/full">study</a>, from 2000, had previously showed that the bacteria isolated from the termites, <em>Neotermes castaneus</em> and <em>Kalotermes flavicollis</em>, produces <a href="http://www.sciencedirect.com/science/article/pii/S0960982202010199?via%3Dihub">centrin</a>, a protein linked to cell division. This protein can aid researchers in understanding its role in the runaway cell division that occurs in cancers, leading some scientists to believe the centrin could be a <a href="https://www.ncbi.nlm.nih.gov/pubmed/25300040">target</a> for anticancer drugs. </p>
<p>A number of <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0118376">studies</a> have also observed that the black garden ant, <em>Lasius niger</em>, creates unique defecation zone within their nests. The ants keep most waste – such as dead members of the colony, debris from nest material and food scraps outside – but defecate inside, usually in the corner of their chamber. </p>
<p>You may prefer a bathroom with a flush toilet, but some insects can thrive in noisome environments where the pathogen load in the surrounding is relatively high. <a href="https://www.ncbi.nlm.nih.gov/pubmed/24271031">No pathogens can harm</a> them. Indeed, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879262/">indigenous microorganisms associated with insect faeces</a> may actually <a href="https://www.ncbi.nlm.nih.gov/pubmed/25888183">defend some species against</a> potential new pathogens. </p>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500611/">recent study</a> shows that the larval faeces of the Mediterranean flour moth, <em>Ephestia kuehniella</em>, for example, exhibits antimicrobial activity against a broad spectrum of bacteria. </p>
<h2>Can poop save lives?</h2>
<p>This has potentially interesting consequences for medicine. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075146/">lack of new antibiotics</a> and <a href="http://www.who.int/mediacentre/factsheets/fs194/en/">multi-drug resistant infections</a> are making doctors and patients anxious, and there’s some fear of an <a href="https://www.ncbi.nlm.nih.gov/pubmed/21281293">antibiotic apocalypse</a>. The anti-pathogenic properties of insect faeces may prove useful to discover new antimicrobials and probiotics. </p>
<p>But don’t start adding bug-poo powder to your morning smoothie just yet. Compounds found in the faeces of some bugs – including <a href="https://www.ncbi.nlm.nih.gov/pubmed/11240940">roaches</a> like <em>Periplaneta americana</em> and <a href="https://www.karger.com/Article/Abstract/64250">silverfishes</a> like <em>Lepisma saccharina</em> – can produce allergic reactions in some people, and even cause asthma.</p>
<p>Given that bug faeces can serve as everything from a bug babysitter to a human allergen, the realm of <a href="http://www.sciencedirect.com/science/article/pii/S0966842X09002091">bacterial community of insect</a> is an important area of <a href="http://insekten-biotechnologie.de/en/start.html">study</a> by entomologists, evolutionary and molecular biologists. Their research may even lead to innovations in antimicrobial properties that can succour in the imminent fearsome post-antibiotic era. </p>
<p>Reports say <a href="https://amr-review.org/%20https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967260/">antimicrobial resistance</a> will kill 300 million people and cost the global economy of US$100 trillion by 2050. Perhaps a little defecation could help?</p><img src="https://counter.theconversation.com/content/81908/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Prayan Pokharel does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Bugs use their own defecation to defend their young, locate their homes and increase mating opportunities. For humans, insect faeces may even have untapped medicinal properties.Prayan Pokharel, Doctoral Student in Institute for Insect Biotechnology, University of GiessenLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/595162016-07-25T04:07:09Z2016-07-25T04:07:09ZHealth Check: what your pee and poo colour says about your health<figure><img src="https://images.theconversation.com/files/131703/original/image-20160725-31162-khhpsr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Normal pee should be the colour of straw.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-232121512/stock-photo-white-toilet-bowl-in-a-bathroom.html?src=7Tc2rMTwXGHUu24B9g6akA-2-78">Devin_Pavel/Shutterstock</a></span></figcaption></figure><p>Out of the blue I passed bright red pee. I freaked, thinking it was a sign of terminal disease. Then I remembered the roasted beetroot tarts served at the party the night before – so delicious I’d eaten three! </p>
<p>Beetroot, artificial colours, vitamin supplements and medications can change the colour of your urine or bowel motions. Knowing which colour changes are due to food or medicines can save you worry, or provide an early alert to get to the doctor. </p>
<h2>Beeturia</h2>
<p>Beeturia is the term for passing red urine after eating beetroot. The red colour comes from a pigment called <a href="https://en.wikipedia.org/wiki/Betalain">betalain</a>, also in some flower petals, fruit, leaves, stems and roots. Concentrated beetroot extract, called Beet Red or additive number 162 on food labels, can be added to “pink” foods, such as ice-cream. </p>
<p>Whether betalain turns your pee red or not <a href="http://dmd.aspetjournals.org/content/29/4/539.full">depends on</a> the type of beetroot, amount eaten and how it’s prepared, because betalain is destroyed by heat, light and acid. </p>
<p>How much betalain enters your digestive tract depends on stomach acid and stomach emptying rate (people taking medications to reduce stomach acid may be prone to beeturia). Once in the blood stream, <a href="https://examine.com/supplements/betalains/">betalain pigments are filtered out by the kidneys</a>. Most is eliminated two to eight hours after eating. </p>
<p><a href="http://www.mayoclinic.org/diseases-conditions/urine-color/basics/symptoms/con-20032831">Persistent red urine can be due to</a> blood loss, infection, enlarged prostate, cancer, cysts, kidney stones or after a <a href="http://www.livestrong.com/article/383806-what-causes-blood-to-be-in-urine-after-exercising/">long-distance run</a>. If you see red and have not been eating beetroot, see your doctor.</p>
<h2>What should your pee look like?</h2>
<p>Normal pee should be the colour of straw. If your pee is so colourless that it looks like water, you probably drank more than you needed. </p>
<p>Very dark yellow pee usually means you are a bit dehydrated and need to drink more water. </p>
<p>Compare your pee colour to the <a href="https://health.clevelandclinic.org/2013/10/what-the-color-of-your-urine-says-about-you-infographic/">Cleveland Clinic’s</a> scale below.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1125&fit=crop&dpr=1 600w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1125&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1125&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1414&fit=crop&dpr=1 754w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1414&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/131697/original/image-20160725-26820-2hmmq2.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1414&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Courtesy Cleveland Clinic</span></span>
</figcaption>
</figure>
<h2>Strange pee colours due to food, drugs or disease</h2>
<p>Pee the colour of syrup or molasses <a href="https://www.nlm.nih.gov/medlineplus/ency/article/003139.htm">needs medical investigation</a>. While it could be due to extreme dehydration, it can be a sign of liver diseases such as hepatitis and cirrhosis, where a build up of <a href="https://en.wikipedia.org/wiki/Bilirubin">bilirubin</a> spills into your pee. Bilirubin is a breakdown product of red blood cells; it’s also responsible for poo’s normal brown colour. </p>
<p>Pee can turn <a href="https://www.nlm.nih.gov/medlineplus/ency/article/003139.htm">bright orange or yellow</a> when taking beta-carotene or vitamin B supplements, especially <a href="https://en.wikipedia.org/wiki/Riboflavin#Toxicity">large doses of riboflavin</a> (vitamin B2). These supplements are water soluble. What your body can’t use or store gets filtered out via your kidneys and into pee. </p>
<p>Medications including phenazopyridine (for urinary tract infections), rifampin (antibiotic for treating tuberculosis and Legionnaire’s disease), warfarin (blood thinner) and some laxatives can also change pee colour.</p>
<p>If you pass blue or green pee, it’s most likely due to food colouring or <a href="https://en.wikipedia.org/wiki/Methylene_blue">methylene blue</a> used in some diagnostic test procedures and some drugs. </p>
<p>But a range of medications can also trigger blue or green urine. These include <a href="http://onlinelibrary.wiley.com/enhanced/doi/10.1111/j.1445-5994.2005.00997.x">antihistamines, anti-inflammatories, antibacterials, antidepressants</a>, some nausea drugs or those for reducing stomach acid. </p>
<p>Rare genetic conditions <a href="https://en.wikipedia.org/wiki/Hartnup_disease">Hartnup disease</a> and <a href="https://en.wikipedia.org/wiki/Blue_diaper_syndrome">Blue diaper syndrome</a> cause blue-green urine. So see your doctor if it persists or it happens in an infant. </p>
<p>You should never see purple pee, but hospital staff might. “<a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894016/">Purple urine bag” syndrome</a> happens in patients with catheters and infections or complications. The catheter or bag turns purple due to a chemical reaction between protein breakdown products in urine and the plastic.</p>
<p>Occasionally, <a href="http://www.md-health.com/Foamy-Urine.html">pee can be frothy</a>. It’s a normal reaction if protein intake is high and pee comes out fast. It is more likely if you consume protein powders or protein supplements. Excess protein can’t be stored in the body so the nitrogen component (responsible for the froth) gets removed and the kidneys excrete it as urea. </p>
<p>See your doctor if the frothiness doesn’t go away or gets worse, as protein can leak into pee if you have kidney disease. </p>
<h2>Poo colours of the rainbow</h2>
<p>Normal <a href="http://www.mayoclinic.org/stool-color/expert-answers/faq-20058080">poo colour ranges</a> from light yellow to brown to black. The colour is due to a mix of <a href="https://en.wikipedia.org/wiki/Bile">bile</a>, which starts off green in the gall bladder, and <a href="https://en.wikipedia.org/wiki/Bilirubin">bilirubin</a> a yellow breakdown product from red blood cells. </p>
<p>Poo can <a href="http://www.mayoclinic.org/stool-color/expert-answers/faq-20058080">turn green</a> after consuming food and drink containing blue or green food colouring, or if food travels too fast through the gut and some bile is still present. </p>
<p>Poo that is yellow, greasy and smells really bad signals food malabsorption. If this colour is associated with weight loss in an adult or poor growth in a child, see a doctor to rule out gut infections such as <a href="http://www.mayoclinic.org/diseases-conditions/giardia-infection/basics/definition/con-20024686">giardia</a> or medical conditions like <a href="http://www.coeliac.org.au/coeliac-disease/">coeliac disease</a>. </p>
<p>Very <a href="http://www.mayoclinic.org/stool-color/expert-answers/faq-20058080">pale or clay-coloured poo</a> can happen when taking some anti-diarrhoeal medications, or when digestive problems affect the liver, gut, pancreas or gall bladder. </p>
<p>At the other extreme of the colour spectrum, black poo could be a serious medical issue due to <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bowel-motions">bleeding in the stomach</a> or upper gut. Or it could be a harmless side-effect from <a href="https://www.nlm.nih.gov/medlineplus/ency/article/007478.htm">taking iron supplements</a>, or eating lots of licorice. </p>
<p>Red poo can also be a serious medical issue due to bleeding in the lower gut, or from haemorrhoids, or harmless after having large amounts of red food colouring.</p>
<p>If you don’t know what colour your pee or poo is, take a look. If you see a colour that’s out of the ordinary and you haven’t eaten anything unusual, take a picture and make an appointment to show your GP.</p><img src="https://counter.theconversation.com/content/59516/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is affiliated with the Priority Research Centre in Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research fellow. She created the online Healthy Eating Quiz and the Australian Eating Survey. She has received funding from a range of research grants including NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia. She has consulted to SHINE Australia and Novo Nordisk. Clare Collins is a spokesperson for the Dietitians Association of Australia on specific nutrition issues, including Australia's Healthy Weight Week. </span></em></p><p class="fine-print"><em><span>Kristine Pezdirc is affiliated with the Priority Research Centre in Physical Activity and Nutrition, the University of Newcastle, NSW. She has received funding from Hunter Medical Research Institute. She is a member of the Nutrition Society of Australia, </span></em></p><p class="fine-print"><em><span>Megan Rollo has received research funding from a number of bodies including the Hunter Medical Research Institute, the New South Wales Government (TechVoucher) and Novo Nordisk. She is affiliated with the Priority Research Centre in Physical Activity and Nutrition at the University of Newcastle and a member of professional organisations including the Dietitians Association of Australia. </span></em></p>Beetroot, artificial colours, vitamin supplements, medications and illnesses can change the colour of your urine or bowel motions.Clare Collins, Professor in Nutrition and Dietetics, University of NewcastleKristine Pezdirc, Research Associate | Post-doctoral Researcher, University of NewcastleMegan Rollo, Postdoctoral Research Fellow, Nutrition & Dietetics, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/596832016-05-27T07:23:46Z2016-05-27T07:23:46ZThe amazing things poo can tell you about an animal’s health<figure><img src="https://images.theconversation.com/files/123539/original/image-20160523-9554-1j2nv4b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Hmmm ... looks good to me.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/dl2_lim.mhtml?src=b3VvDBjme1134hI9waqURw-1-4&clicksrc=download_btn_inline&id=421690279&size=huge_jpg&submit_jpg=">Shutterstock</a></span></figcaption></figure><p>Caring for zoo animals requires the ability to deal with an awful lot of poo … or dung, excrement, animal waste, or faeces (the latter being used if you want to be more technical). Shovelling the proverbial is often how we start and end our day in the zoo. But aside from ensuring that we provide animals with clean environments, this process of collecting animal poo is also a vital part of their healthcare. </p>
<p>A quick Web of Science search for “faeces + zoo + animal” demonstrates just how reliant we are on poo in the zoo research and veterinary community – nearly 1,000 research articles contain a reference to faecal material from animals in zoos over <a href="https://webofknowledge.com">the past 60 years</a>. That means that the scientific community publishes an article on zoo animal poo at least once a month. </p>
<p>So, as a scientist, why am I so interested? Well, first, it’s often one of the easiest samples to get hold of from a zoo animal. You don’t need to touch the animal in order to obtain the sample, so it’s non-invasive (important from both a safety and ethical perspective). </p>
<p>Second, all animals produce it. It comes in <a href="https://theconversation.com/why-do-wombats-do-cube-shaped-poo-55975">all shapes and sizes</a> and some do it in vast quantities, such as the 100kg+ of dung produced daily by an <a href="http://www.sfzoo.org/announcements/the-scoop-on-poop-opening-day">elephant</a>. But most creatures produce manageable volumes that permit analytical techniques to be employed in a reliable manner. </p>
<p>Finally, poo offers a wide spectrum of opportunities for assessing animal health.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/123944/original/image-20160525-25222-15j1vu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/123944/original/image-20160525-25222-15j1vu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/123944/original/image-20160525-25222-15j1vu8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/123944/original/image-20160525-25222-15j1vu8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/123944/original/image-20160525-25222-15j1vu8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=425&fit=crop&dpr=1 754w, https://images.theconversation.com/files/123944/original/image-20160525-25222-15j1vu8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=425&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/123944/original/image-20160525-25222-15j1vu8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=425&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Elephants are prodigious producers.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/dl2_lim.mhtml?src=yqSRxsF9NLuMzwxRk0xngg-1-31&clicksrc=download_btn_inline&id=388630417&size=medium_jpg&submit_jpg=">Shutterstock</a></span>
</figcaption>
</figure>
<h2>What poo tells us</h2>
<p>So what can a poo sample reveal? Let’s start with some of the more obvious aspects of poo-ology: just the presence of fresh faecal material in an animal’s enclosure assures us that the animal’s gastrointestinal tract is moving. Constipation has serious health consequences for <a href="http://www.sciencedirect.com/science/article/pii/S1521691810001599">any animal</a>, including potential toxicities, so we need to ensure that an animal is passing faeces as often as it should be. </p>
<p>But this isn’t always as simple as it sounds. Some <a href="http://eaglemountainpublishing.s3.amazonaws.com/PDF/Biology%20of%20the%20Vipers/CH%2031_lillywhite_.pdf">snakes</a> only pass faeces once every three months, while the world’s smallest bat, <a href="http://www.livescience.com/28272-bats.html">the bumblebee bat</a> has poo that is apparently as small as a pin head, making it very hard to see. So we need to establish our “species norms” before we start using poo as an indicator in any type of health check.</p>
<p>Another common use of faeces in zoos is for disease monitoring. Samples can be analysed for <a href="http://www.sciencedirect.com/science/article/pii/S0304401704004820">internal parasites</a>, such as worms and pathogens (for example bacteria or fungi) that may indicate gastrointestinal problems or even <a href="https://www.aza.org/infectious-diseases/">zoonotic diseases</a> – those that can be spread from animals to humans. </p>
<p>Many zoos will implement a routine <a href="http://www.eaza.net/assets/Uploads/Standards-and-policies/Standards-for-the-Accommodation-and-Care-of-Animals-2014.pdf">faecal screening programme</a> for their animals and this allows zoo vets to respond quickly if symptoms of disease or parasites are found, often before clinical symptoms of ill health are shown by the animal. It is also a valuable tool for monitoring the effect of any treatments, such as de-wormers. </p>
<p>Some of the research projects that I’ve been involved in recently have investigated aspects of the use of de-wormers in cheetahs and support a <a href="http://www.zoowildlifejournal.com/doi/abs/10.1638/2012-0028R1.1">diagnosis-based approach</a>. This means that, instead of routinely de-worming the animals, we should first check to see if they have any parasites present.</p>
<h2>Appearance is important</h2>
<p>But it’s not just about what’s inside the poo – you can tell a lot about an animal’s gut health just by looking at its faeces. I used a faecal consistency (shape and texture) scoring system – similar to the <a href="http://static1.1.sqspcdn.com/static/f/1451532/22180508/1363249562587/bristol_stool_chart.pdf">Bristol Stool Scale for humans</a> – to investigate how diet influences gastrointestinal disease in captive cheetahs. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/123946/original/image-20160525-25218-1itsd06.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/123946/original/image-20160525-25218-1itsd06.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=374&fit=crop&dpr=1 600w, https://images.theconversation.com/files/123946/original/image-20160525-25218-1itsd06.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=374&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/123946/original/image-20160525-25218-1itsd06.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=374&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/123946/original/image-20160525-25218-1itsd06.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=470&fit=crop&dpr=1 754w, https://images.theconversation.com/files/123946/original/image-20160525-25218-1itsd06.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=470&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/123946/original/image-20160525-25218-1itsd06.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=470&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Can we get some privacy, please?</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&autocomplete_id=&searchterm=cheetah&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=365257373">Shutterstock</a></span>
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<p>My colleagues and I were able to identify some key dietary risk factors for gastrointestinal disease in cheetahs, <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0120903">just by asking the cats’ keepers about their animals’ poo</a>. For example, animals that were fed rib bones at least once a week were much less likely to have experienced diarrhoea.</p>
<p>A similar study was conducted with captive tapir and enabled the generation of feeding recommendations aimed at <a href="http://www.ncbi.nlm.nih.gov/pubmed/19681143">reducing obesity in this species</a>.</p>
<p>Colour and smell are also important. For example, the faeces of raptors (which is actually a combination of urine and faeces) will turn green when the bird has an empty gastrointestinal tract. This is important when attempting to regulate meal frequency since overfeeding can lead to infections and obesity. Green faeces in raptors can also indicate <a href="http://www.gwexotics.com/wccms-resources/1/c/6/a/30c4a98c-b62d-11e0-a685-0050568626ea.pdf">lead poisoning when combined with other symptoms</a>. </p>
<p>Understanding how zoo animals digest and utilise the diets we provide is an important step in improving zoo animal nutrition. We can measure the digestibility of key nutrients by analysing faecal samples, and we can also study aspects of the animals’ gastrointestinal function by using indigestible markers and recording the time it takes from ingestion to excretion of these markers. </p>
<p>We also use these types of markers to help us determine a poo’s owner when animals are pair or group housed. I’ve spent hours pulling zoo carnivore faeces apart looking for bits of glitter (yes, the same stuff you might find in your child’s art box), lentils, or corn kernels just to figure out whose poo is who’s. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/123950/original/image-20160525-25222-1ynpzpy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/123950/original/image-20160525-25222-1ynpzpy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=788&fit=crop&dpr=1 600w, https://images.theconversation.com/files/123950/original/image-20160525-25222-1ynpzpy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=788&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/123950/original/image-20160525-25222-1ynpzpy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=788&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/123950/original/image-20160525-25222-1ynpzpy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=991&fit=crop&dpr=1 754w, https://images.theconversation.com/files/123950/original/image-20160525-25222-1ynpzpy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=991&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/123950/original/image-20160525-25222-1ynpzpy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=991&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Raptor: but when did it last eat?</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/dl2_lim.mhtml?src=Jq0k5IuP-9_cOZIIeTz19g-1-28&clicksrc=download_btn_inline&id=231357505&size=medium_jpg&submit_jpg=">Shutterstock</a></span>
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<p>In another study with colleagues in Belgium, faecal samples from captive cheetahs were analysed for products of hindgut fermentation (the efforts of all those microorganisms that live inside animal guts, including our own) to determine the <a href="http://www.jzar.org/jzar/article/view/81">beneficial role</a> that animal fibre, such as cartilage, bone or fur, <a href="http://www.ncbi.nlm.nih.gov/pubmed/22074361">plays in this species</a>. </p>
<p>The microbes that live inside the cheetah have also begun to be <a href="http://bmcmicrobiol.biomedcentral.com/articles/10.1186/1471-2180-14-43">characterised</a>, all thanks to that brown smelly stuff! As with the growing interest in the human microbiome, differences due to genetics, diet and the environment are also being characterised from a zoo <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2649005/">animal faecal perspective</a>. </p>
<h2>Windows into the mind</h2>
<p>Likewise, poo is important for monitoring zoo animals’ welfare as we can measure hormones called glucocorticoids and their metabolites which provide an <a href="http://www.bioone.org/doi/abs/10.1638/05-050.1">indicator of excitement and/or stress</a>. By performing long-term studies of the concentrations and patterns of these hormones in animal poo, and combining them with behavioural data, we can learn a great deal about how a zoo animal is experiencing its captive environment. </p>
<p>By monitoring the excretion of sex steroids, we can also start to understand whether females are displaying normal reproductive cycles, such as in <a href="http://www.sciencedirect.com/science/article/pii/S0378432098001122">captive rhinos</a>, or even finding out if they are pregnant, such as in <a href="http://www.sciencedirect.com/science/article/pii/S0093691X11005267">captive felids</a>. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/123947/original/image-20160525-25209-1uhsceh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/123947/original/image-20160525-25209-1uhsceh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=550&fit=crop&dpr=1 600w, https://images.theconversation.com/files/123947/original/image-20160525-25209-1uhsceh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=550&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/123947/original/image-20160525-25209-1uhsceh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=550&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/123947/original/image-20160525-25209-1uhsceh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=691&fit=crop&dpr=1 754w, https://images.theconversation.com/files/123947/original/image-20160525-25209-1uhsceh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=691&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/123947/original/image-20160525-25209-1uhsceh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=691&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Rabbit: unusual appetites.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&autocomplete_id=&searchterm=rabbit&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=346379069">Shutterstock</a></span>
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<p>Rather less savoury is coprophagia. This is the term given to the behaviour of eating faeces, either the animal’s own, or that of others. Some species have digestive adaptations that require coprophagia to be part of their normal feeding behaviour. A well-known example is the <a href="http://jn.nutrition.org/content/55/3/375.extract">domestic rabbit</a>.</p>
<p>In a zoo setting, coprophagia is also an important element of the nutritional physiology of a range of herbivores including <a href="http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2907.2002.00105.x/abstract">capybaras, some lemurs, mara, and beavers</a>. However, in some species, coprophagia is considered an abnormal behaviour which may have <a href="http://onlinelibrary.wiley.com/doi/10.1002/zoo.1430110503/abstract">nutritional origins</a> or be indicative of <a href="http://www.ncbi.nlm.nih.gov/pubmed/3492252">compromised welfare</a>. </p>
<p>Regardless of how it is used, though, those caring for animals should never underestimate the importance of a poo.</p><img src="https://counter.theconversation.com/content/59683/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katherine Whitehouse-Tedd has previously received funding from the Sea World and Busch Gardens Conservation Fund and the WALTHAM Foundation. She is affiliated with Cheetah Outreach Trust (a not-for-profit conservation organisation in South Africa). </span></em></p>No wonder scientists love it.Katherine Whitehouse-Tedd, Visiting Fellow, Animal and Equine Science, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.