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Figuring out the root problem of annoying digestive woes can feel like an endless, frustrating game of detective. Seeing a specialist can be pricey, and for those who live in rural areas there may not even be one nearby. And of course this being a pandemic and all, there’s an added obstacle to booking an appointment.
While not everyone can have one-on-one access to the country’s best gut experts, Harvard University is giving anyone who wants to the chance to hear from them virtually. This week, they announced a new Harvard Health gut course, The Sensitive Gut, for a flat fee of $30. The course is aimed at educating folks on some of the most common forms of digestive probs: irritable bowel syndrome (IBS), dyspepsia (indigestion), gastroesophageal reflux disease (GERD), acid reflux, constipation, and more.
The Harvard Health gut course is divided into seven sections and can be completed at your own pace. The lectures are pre-recorded so you can watch them on your own time and there are no deadlines. The sections address all of the aforementioned digestive problems, and this is Harvard we’re talking about, so you know the doctors teaching the lectures are legit. The two doctors instructing the course are Lawrence S. Friedman, MD, a professor at Harvard Medical School and the assistant chief of medicine at Massachusetts General Hospital, and Mallika Marshall, MD, an Emmy-award winning journalist and physician.
At the end of the course, you can expect to have a better understanding of the causes and symptoms of a wide range of gut problems and what treatment plans for each often look like. With this knowledge, you’ll be able to make the most of your time with your doctor to get to the bottom of what’s going on with you. Applying what you learn to your life (in consultation with your doctor, of course) will have benefits that go beyond digestion, too. Gut health is linked to better immunity, mood, and brain function so optimal gut health is important in more ways than many may realize. It just may be the most productive thing you do all pandemic.
Want to learn more about gut health? Here’s your 101 guide from a top dietitian:
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How often should you poop? It’s one of those questions that doesn’t come up in polite conversation, but everyone secretly wonders about it. From once a day to a few times a week, everyone’s pooping habits can be different. While some of us are regular “clockwork” poopers, others might skip a day or two. But how often should you actually go? Ahead, we break down the healthy range and what different pooping patterns can mean for your gut health (including when your bathroom rhythms might warrant a trip to your healthcare provider).
board-certified gastroenterologist at the Gastroenterology Institute of Southern California
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How many bowel movements are considered ‘normal’?
Well, it depends on what’s normal for you. In fact, there’s quite a spectrum when it comes to poop frequency. “A normal number of bowel movements can range from one to three times per day to three to four times per week,” says Peyton Berookim, MD, FACG, a board-certified gastroenterologist at the Gastroenterology Institute of Southern California. Wherever you fall into this spectrum, whether it’s three times a day or three times a week, is how often you should be pooping. But pooping more or less than this range may be a sign of an underlying health concern (more on this below).
However, the number of poops you take every day (or week) isn’t the only indicator of gut health. Comfort (i.e. how easy it is to push out your poop) is too. “What really matters is that people have complete, spontaneous bowel movements,” Dr. Berookim says. “This means having soft stool, evacuating completely without straining.”
Why is everyone’s pooping schedule so different?
“Numerous factors can influence an individual’s pooping schedule,” Dr. Berookim says. Here are just a few things that can affect your daily number of bowel movements, per Dr. Berookim:
Underlying health conditions such as thyroid problems, inflammatory bowel disease (IBD) such as Crohn’s disease and ulcerative colitis, a gut infection, or a colon tumor
What to do if you’re worried about your pooping frequency
Again, there’s no exact quota of bowel movements that you need to be hit. Some people go a few times a day, while others are good with a few times a week. What really counts is what’s normal for you. However, if you think you poop too much or too little, or if your pooping schedule has changed suddenly, it may be a good idea to reach out to your healthcare provider for guidance.
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“It’s important to pay attention to changes in your bowel habits, as they can indicate underlying health issues,” Dr. Berookim explains. Your provider can run several tests (e.g., bloodwork to check your thyroid levels) to see if something is affecting your stool frequency, he adds.
You can also try a few simple home remedies to get your poops back on track. Often, it’s just a matter of tweaking your daily habits. Here are Dr. Berookim’s gut-friendly tips:
Increase your fiber intake: “Fiber can help with both diarrhea and constipation by bulking up stool,” Dr. Berookim says. Just make sure to start slowly. Adding too many fiber-rich foods to your diet too fast can lead to uncomfortable bloating and gas.
Add more movement to your routine: “Physical activity is also important as it stimulates intestinal function,” Dr. Berookim says. When you don’t move enough, your gut can get sluggish. “This is why many hospitalized patients who are bedridden become constipated,” he adds.
Stay hydrated: Drinking enough water is crucial for combatting constipation. “Individuals should drink approximately 1 ounce of water per kilogram of weight,” Dr. Berookim says. So, say you weigh 68 kilograms (that’s approximately 150 pounds), aim to sip 68 ounces (about eight and a half glasses) of H20 each day to keep things flowing smoothly in the bathroom.
Manage stress: “Stress typically increases gastric secretions, leading to diarrhea,” Dr. Berookim says. He recommends stress-busting practices like meditation and yoga to help regulate your stress levels and your bowels.
Try a probiotic: “Probiotics can help balance gut bacteria, which can help both diarrhea and constipation,” Dr. Berookim says. Before you take a probiotic (or any new supplement), though, it’s always a good idea to check in with your provider to make sure it’s okay.
Use a footstool when you poop: If you’re struggling to poop, the Squatty Potty ($21) is a great tool to rely on. “Placing the foot on a stool … straightens the rectum and relaxes the puborectalis muscle, making it easier for stool to pass through,” Dr. Berookim says.
When to see a healthcare provider about your poop schedule
We’re all unique, and our pooping habits are no exception. What may be normal for you, may not be healthy for someone else. As long as your poops are consistent, soft, and seamless (i.e., you don’t pop a blood vessel trying to push them out), the number of bowel movements you have per day or week isn’t all that important.
On the other hand, if you’re dealing with chronic diarrhea or constipation, or your poop frequency has changed out of the blue, your body might be telling you that something’s up, and it’s time to see your provider. Digestive diseases (or, conditions that affect your GI tract) can often cause changes in your pooping habits. The following symptoms are generally the first signs of digestive problems, so it’s a good idea to be on the lookout for them:
If you have any of these symptoms, your healthcare provider may choose to perform blood tests, stool tests, or a colonoscopy (a procedure that involves checking the inside of your large intestine using a long, flexible tube with a light and a tiny camera on one end), among other diagnostic exams. These types of tests will help them rule out any underlying health conditions that may be affecting your poop, such as irritable bowel syndrome, inflammatory bowel disease, colon cancer, or gastroesophageal reflux disease (GERD).
It’s not always comfortable talking about poop—we get it. But, if you’re noticing changes in your bowel habits or have concerning symptoms, it’s important to tell your provider about them so they can offer treatment options to ensure that going number two isn’t your number one problem.
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Not everyone has an appetite for a hearty breakfast right when they wake up. But a steaming hot cup of coffee? Hand it over ASAP, please. We all have that delicious food or beverage vice that gets us through the day, and for most coffee lovers, that starts as soon as they open their eyes and head to the kitchen or their fave local coffee shop. But…is it bad to drink coffee on an empty stomach?
quadruple board-certified physician in internal medicine, gastroenterology, obesity medicine, and lifestyle medicine
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Sure, that jolt of caffeine wakes you up fairly quickly, but the problem is that coffee is also pretty acidic. Out of a pH scale of zero to 14—with anything below a seven being considered highly acidic—coffee lands somewhere around the 4.8 to 51 spot. This means if you already deal with gastrointestinal issues like acid reflux, drinking a cup of joe on an empty stomach might make things a little worse.
Below, we’ll learn whether drinking coffee on an empty stomach is truly bad for you long term. Plus, tips to make your morning cup a little easier on your gut—if you’re not quite sold on ditching this daily ritual.
Is it bad to drink coffee on an empty stomach?
Spoiler alert: Downing a cup of coffee before breakfast isn’t necessarily bad for your stomach. A recent review about coffee’s gastrointestinal effects found that its acidity isn’t likely to mess with your stomach lining2 or increase your risk for gastrointestinal problems. (But it can still cause temporary irritation if you have acid reflux.)
Supriya Rao, MD, a gastroenterologist with Tufts Medical Center in Boston, Massachusetts, agrees with this finding. However, she’s not personally a fan of drinking coffee without also eating a bit of food, which can help serve as a buffer to prevent an upset stomach or flare-up of symptoms from gut health conditions (like diarrhea with irritable bowel syndrome, for example).
Side effects of drinking coffee on an empty stomach
For many people, drinking coffee first thing in the morning helps them poop…fast. But for others, there might be some lesser-known (potentially negative) consequences to drinking the bean juice right when they wake up. Here’s a breakdown of those effects:
It may increase stomach acid. Because coffee is acidic, it’s possible that it can trigger or worsen symptoms of acid reflux or GERD (where stomach acid flows up into your esophagus, causing burning and pain) if you already have it, Dr. Rao notes. Also, if you have an ulcer (an open sore on the inner lining of your stomach), you might find drinking coffee on an empty stomach—or drinking it at all—makes your stomach uncomfortable.
It could cause bloating or pain, especially if you have irritable bowel syndrome (IBS). Caffeine contains stimulant properties that can jumpstart your bowels and make you poop. But this effect can cause your stomach to cramp, especially if you have a condition like IBS, which often leads to diarrhea, constipation, or a mix of both. “I generally advise patients who have bloating, abdominal pain, or changes in bowel habits from coffee to reduce their consumption overall,” Dr. Rao says.
It might make you more jittery. When you have coffee on an empty stomach, caffeine can enter your bloodstream faster, potentially making you more sensitive to its stimulant effects. This can leave you feeling jittery, restless, and anxious, and even cause your heart to race.
It may spike your blood sugar. For some people (especially those with diabetes or high blood sugar) coffee can slightly raise your blood sugar—even if you drink it black. According to recent studies, this effect is about 50 percent stronger when coffee is consumed on an empty stomach compared to when it’s consumed with breakfast.
The best way to drink coffee to protect your gut
Long-term, it’s unlikely that coffee is going to do serious damage to your gut. So drinking it on an empty stomach (if it doesn’t bother you) is just fine. That said if you do notice an uptick in symptoms like reflux, pain, bloating, or jitteriness, and you still want your morning caffeine ritual, there are some things you can do to dampen the unpleasant effects.
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Here are some tips to try:
Add some low-fat milk to your coffee. Some people have found that adding low-fat milk to their coffee helps to reduce its acidity and prevents reflux symptoms. There’s not much scientific evidence to back this claim, but as long as you’re not lactose intolerant or allergic to dairy, it is worth a try. Just remember to avoid whole or full-fat milk as it can worsen symptoms like bloating and gas. Dr. Rao is also a fan of nondairy options like almond or oat milk because dairy can trigger symptoms3 for some people with IBS.
Try a darker roast. Research has found that dark roast coffee is slightly less acidic than lighter roasts, so it might be worth giving them a try next time you’re at the store.
Have a small bite to eat. Try a little nibble of food if you can’t stomach the idea of eating a full breakfast first thing, Dr. Rao suggests. A slice of whole wheat toast, a banana, or a few spoonfuls of yogurt will help coat your stomach and potentially reduce pain, cramping, or diarrhea.
When to see a healthcare provider for acid reflux
Because coffee and many other foods (like citrus, spicy, or fried foods) can cause acid reflux to flare up, let your healthcare provider know if you’re having these symptoms on the regular. The Mayo Clinic notes these symptoms will often include the following:
Burning in your chest
Food or sour liquid washing up into the back of your throat
Upper belly or chest pain
Trouble swallowing
Feeling like there’s a lump in your throat
These could be signs that you have gastroesophageal reflux disease or GERD—a chronic form of acid reflux that should be treated. Your healthcare provider may prescribe prescription antacids or request tests like an MRI or endoscopy to figure out the underlying cause of your symptoms.
The final takeaway
Drinking coffee before breakfast isn’t likely to damage your stomach, but it might make you a little uncomfortable if you’re prone to gut health problems. If your pre-meal caffeine fix causes symptoms, you can keep them in check by adding some low-fat or nondairy milk to your coffee, switching to a dark roast, or having a bite-sized snack with your morning beverage. (No need to say goodbye to your beloved wake-up ritual!)
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Rune, Christina J Birke et al. “Acids in brewed coffees: Chemical composition and sensory threshold.” Current research in food science vol. 6 100485. 22 Mar. 2023, doi:10.1016/j.crfs.2023.100485
Nehlig, Astrid. “Effects of Coffee on the Gastro-Intestinal Tract: A Narrative Review and Literature Update.” Nutrients vol. 14,2 399. 17 Jan. 2022, doi:10.3390/nu14020399
Cancarevic, Ivan et al. “Is There a Correlation Between Irritable Bowel Syndrome and Lactose Intolerance?.” Cureus vol. 12,1 e6710. 20 Jan. 2020, doi:10.7759/cureus.6710
