The Poop Episode

This is Good inside. I'm Dr. Becky. Today on the podcast, we're going to take the shame out of a thing that absolutely everyone does.

And so I take him into the bathroom, he sits down on the toilet, and I always say, do you need privacy or are you fine? And sometimes he'll want privacy, and sometimes he won't. And then he'll say, do you need to go poop, too? And I have to remind myself when other, you know, women are in the bathroom that it's okay for me to say, loud and proud, yes, I do have to poop right now.

So everybody poops. And most of us probably feel some shame or embarrassment about that, me included. And don't get me started on how poop discussions change. Once you have kids, what color is their poop? How big is it? How often are they going? When are they going? Where will they poop? Where will they not poop? I want to invite you to come on this poop journey with me as we all do our best to reduce poop shame and feel more at home in our bodies. I'm Dr. Becky, and this is good Inside. I'm a clinical psychologist, I'm a mom of three, and I'm on a mission to rethink the way we raise our children. So while everybody poops, we don't always like talking about it unless it's somebody else's poop, like your kids. Well, my guest today is going to help us change all of that. Abby Myers is a physician assistant at the Mayo Clinic in the gastroenterology and hepatology department. I'll let her introduce herself.

My name is Abby Myers, and I am a wife and a mother of twin boys who are almost five years old. They are the love of my life, and after a long bout with infertility, I'm so happy that they are here. I am a physician assistant, and I have been in the medical field, combined gastroenterology, but also colorectal surgery, for the past 11 years. And that was spurred by an interest. As a young child, I was sick with ulcerative colitis and needed to undergo some pretty significant surgery by the eighth grade. And I kind of noticed that healthcare professionals were telling me, oh, I know how you feel. I know how you feel. And then when I would ask them, oh, you have an ileostomy? They would say, oh, no, no, no, I don't have that, but I know how you feel. So I told my mother, I don't wanna be a teacher anymore. I wanna go into healthcare. And I promise I Will never say that to anybody unless I actually know how they feel. And so that's kind of what spurred my interest in GI and colorectal surgery. And from there, it's just kind of. That's been my passion, and I've kind of stuck in that area for the past 11 years. Wow.

Thank you for sharing that. It is so amazing to find a career that is, like, in line with your experience and passion. It's amazing when it's all so aligned. So there's so many different things we could talk about. And I feel like I was about to say the thing we're gonna start with, but maybe it will just be the thing we talk about for the whole time. Is poop.

My favorite topic?

Okay, so you go first, then, like, talk to me about poop. Just you start. You're the expert.

Sure. Well, I am a mom and a physician assistant in the area of poop, but I'm not a pediatrician, and I'm not a potty training expert by any means. But I have seen in my career healthy poops and unhealthy poops and healthy ways of evacuating our poop and unhealthy ways of evacuating our poop and how significantly incomplete, even evacuation or learned behaviors over many years have then perpetuated evacuation disorders and how that disrupts one's life completely. And so I. I knew early on, even before we had children, that I was going to come at this potty training thing with open curiosity about poop and open dialogue in our home and sharing body mechanics and why we do it and how we do it and what makes poop. The moment that my kids could move, I started saying to them, oh, mommy's got that poopy feeling or pee pee feeling. I gotta go to the potty. And so we would say, drop everything, and they would crawl and follow me to the bathroom, and they would sit by the bathroom. And, you know, even to this day, I really don't have, you know, my own privacy in the bathroom. But that's okay. I get all worked out that, you know, we're just normalizing, that this is a bodily function that everybody has. There's nothing special about it there. You know, there's no pressure about it. Everybody does it. And so that's kind of where I started with the children. As we've got that potty feeling. We've got to go now.

You know, when you were talking about that, Abby, one of the things I think a lot about is shame in general and how the antidote to shame in my mind is connection. Right. So anything that we've stored with shame, we've stored in a state of aloneness. Right. And as humans who are oriented by attachment, things that we learned we had to be alone with were almost learned as, oh, well, this is inherently non conducive with attachment, so it must be bad. And it's interesting. I haven't really thought about this extension until you were talking about it, but as you were modeling that pee pee feeling, that poopy feeling, and then your kids learn that, oh, like, I can be connected to my mom while she's pooping. What you're doing is something so much more than saying, I want my kids to be in the bathroom while I poop. What you're saying really is you're laying the groundwork for poop isn't shameful. Poop isn't bad. Poop is part of the normal human experience. The same way you would be with me when, I don't know, happy and excited or when I'm in a moment of sadness. Like, we can be together in this. And. And I think a lot of us fast forward, right? Like. Like, I'm pretty sure when your twins are 28, you're not gonna be like, mommy has that poopy feeling. And they'll be like, oh, I'm gonna follow mommy to the bathroom. Like, I have a feeling that's not the way it's gonna go. But you've set this whole foundation for a total absence of shame.

Absolutely. And we saw this actually the other weekend we went out to dinner. And in the middle, there's not a lot of people at the restaurant. I have four year olds. We have to go early. Right. So when we're sitting at the restaurant, there are some other people there, and all of a sudden, one of my twins says really loudly, of course I need to poop so bad. And I said, all right, let's go. And so we just stand up. And that's the other thing. You know, when our kids say that they have the poopy feeling or have a pee feel feeling, we just believe them. Yeah. Do we have to go to the bathroom a thousand times? Do we know that they want to just look at what this bathroom looks like in this new place? Yes. Is it disgusting when it's a porta potty in a park that we've never been in? Probably. But we believe them every time. And so I take him into the bathroom, he sits down on the toilet, and I always say, do you need privacy or are you Fine. And sometimes he'll want privacy, and sometimes he won't. And then he'll say, do you need to go poop, too? And I have to remind myself when other, you know, women are in the bathroom that it's okay for me to say loud. Loud and proud. Yes, I do have to poop right now. But I think that's still hard. And that's, you know, when we talk about the shame and, you know, having a bowel illness as a child, you know, I was embarrassed to go to the bathroom. I was embarrassed what that meant. And I think I want to make sure that my children are not embarrassed, and they're actually teaching me to become more comfortable with pooping in public or talking about pooping in public. It's so obvious.

But such a big shift. And I think about my own early years and even now, right. As someone who I consider myself a pretty confident person, but, yeah, like poops and farts, it's like, oh, no, no, that was me. Nope. Right? Like, it. It is literally a part of being a healthy human being. Everyone poops, everyone farts, everyone has diarrhea. Like, everyone has been constipated. Right. And you're right. The things we can learn from our kids. Right? It's almost like when your kid says, in a restaurant, I have to poop. It's almost like we should look around the restaurant and just know internally instead of that, oh, so embarrassing. Say to yourself, I just did all of these human beings a favor. I just de shamed their poop for them. You're welcome. You're welcome. You could pay me $5. You could pay me $5 for that. Right? Like, it is such a gift to other adults.

Yes. So when you talk about, you know, everybody having poops, we live on two acres, so we often go outside and we look at, you know, the poop in the yard and animals poop, and we talk about, like, the different shapes of poop and the different types of poop that we see. And then, you know, they talk about their own poop as well. And now that I don't have control over, you know, seeing what's in their diaper and things like that. Oh, do they need more hydration? Do they need, you know, more movement? Those things I do talk to them about, you know, take a look at your poop. Your poop tells us a story. Your poop tells us what we have been eating. Your poop tells us how your body is feeling. Your poop tells us if you're sick or if you need more Water. And so there are times that my kids will even. Last night, one of them came out to me and said, you know, mom, I had little poop that looks like deer poop, and I think I probably need to drink a little more water. You're exactly right. You do need to drink a little bit more water. And let's move our bodies. So, you know, first thing you woke up this morning. I gotta drink water, mom. Yep, you do. And so we, we really talk about why does poop happen? Why is it different per animals based upon what we're eating? And then I translate that into human beings, that we all eat different things, we all have different practices of hydration and movement, and that all leads to different types of bowel movements.

Okay, so now, now I feel like I need to learn a lot of things from you. So can you go over some of the things you just named and help me learn? Help all of us here learn? Like, what could I be seeing in a poop that's a sign of, you know, not just naming it unhealthy poop, but as a sign of some of the things you named. More movement is needed, or maybe I'm sick, or maybe I need more of a certain nutrient. Can you, can you teach us about, you know, what to notice and what it might mean?

Sure. So I think first we clear out the red flags that, you know, we talk. I talk to my kids, especially as a child with ulcerative colitis. I didn't tell my mom that I was seeing blood in my poop. I didn't understand. And so I tell my children, if you see blood in your poop, we can't flush that down. Mom or dad need to see that. Then also safety here. We also tell them that nobody else should really be looking at their poop or watching them poop. That only mom and dad can be there for that. Or a doctor, if mom and dad say it's okay. So, okay, now that we got those two big ones out of there, what we want or what we strive for is one to two kind of soft formed stools. That's called a Bristol type 4 kind of snake like stools. Maybe once a day up to, you know, every, even every three days, depending upon people's diet and, you know, how much they're moving, whether they are taking different medicines or, you know, maybe they have underlying medical conditions that cause them to be a little, a little bit more constipated.

I, I like to know the names of things. Bristol four.

Yeah. Bristol is the stool scale. And it Goes one to seven and one are going to be those, like hard pebble stools, kind of like a rabbit or a deer poop. Seven is going to be pure liquid. Maybe some like sandy sediment in the bottom.

So this is not a higher is better.

No situation.

This is like you want to be perfectly average.

This is like a Goldilocks. Not too hard, not too soft. Some are just right.

Got it.

But knowing that we can all exist within that spectrum and it can just be a part of. Maybe we had an entire, you know, carton of blueberries. Yeah, you're gonna have some diarrhea from that. Maybe that's gonna be a looser stool. So we strive for kind of right in that middle there and easy to pass. And so if somebody is having harder to pass stools, maybe those little pebbles, they look kind of Dr. 2 on the Bristol scale is like a dry sausage looking. They always equate it to food. My kids get that. So we do kind of talk about that in our home. But when it's a little bit more dry or a little bit harder. Balls of stool. We encourage my. In my home and in my patients, I encourage them to increase their fiber. Now, kids aren't going to know what fiber is, so we do that as parents. We increase maybe some of the fruits and vegetables that they're drinking, but fiber is no good if we're not pairing that with some water too. So making sure. Oh, has my kid been outside running a lot and sweating, playing sports? Maybe they need more water.

So I don't know that. So fiber. If I'm just giving my kids a lot of fiber, but I'm not watching their hydration. Like, I'm not getting the most from my intervention.

You're not? No. Making sure that hydration is helping. So the fiber helps to bulk, but the. The water helps us to not make it hard.

Okay, great.

Now if we're swinging the other direction in liquidity, we have to see is my kid's sick. Are we able to maintain hydration here? You know, those are going to be the worrisome. Are they urinating enough? Do their lips look chapped? Especially in our younger babies and potty training, that they might not be able to tell us they're thirsty. So that could tell us that they might be sick. Or did they just eat an entire carton of blueberries? Did they have a bunch of juice? So sugar promotes more liquid type stools because the water kind of follows with the sugar.

Huh. Okay, this is all so helpful. A couple other questions. Color. Color. Tell me about that.

Okay, so everyone wants to talk about colors of their poop. I don't get too excited as a medical professional about the color so much red is an important color. You know, blood, if it's kind of pale, I might think about, you know, hydration component of it. If it's a little bit more like dark black, green kind of looking, that makes me think a little bit more about bile. And maybe they're having like a rapid transit. Maybe they're not feeling very good. You can imagine those times when you've been diarrhea sick and you are having lots of stool, but then coming after that might be that yellowy b, greenish, dark green looking stools. That can usually be more of an indicator that you're having like a sickness and illness there.

Okay, what about those floaters?

Yeah, that's normal too. That's just depending upon what we're eating and what we're drinking, the fat content of the stool. And so you're going to notice that it changes. And usually what I kind of counsel with my patients and when I look at with my children and even myself is, you know, is this a sustained change that's lasted more than like three, four days? And it if so maybe it is something that I should bring up to somebody if it doesn't seem quite right. So we always talk about our kids, you know, trusting, like intuitive eating and you know, do you got that poopy pee pee feeling? But also, if as a parent we're worried about something and it's prolonged more than just a couple of days, I think it's still worth bringing it up. And maybe you're told normal, let's just watch it. Okay, great. But you spoke up for yourself, so we have to trust ourselves too, as parents.

Okay, I want to bring in a voicemail I got that I would love to listen to together because I feel like together we could brainstorm some helpful ideas. So let's play it.

Hi. So I have a question that I really have not been able to get an answer about. My son just turned three and he potty trained at the end of April. He hardly has any accidents. He hasn't had accidents for months and he only had a couple of pee accidents at the beginning. He has refused to poop in the potty and demands to have a diaper. At first we would, you know, encourage him to go in the potty and he did a couple of times when he was first learning and then after that he started holding his poop in and he just will not go Unless we put a diaper on him. We were worried about his health and his digestive system, and he was clearly in a lot of pain. So we let him go in the diaper, but he still will not go in the potty. And I'm just wondering, is there something else we should try to do, or will he come along to this, come around to it on his own? Is there a timeline we should be sticking to? He is going to preschool. He just started preschool, and they don't do any diapers. So we've told him that if he has to poop when he goes there, he needs to go in the potty or wait until he gets home. And I just don't know what to do. So. Thanks.

What does this bring up for you, Abby?

Everybody likes to poop at home.

Wait, just say that again.

Everybody likes to poop at home. We all just like to poop where we're comfortable.

I really mean this. I feel like there's something in my body that's tearing up as you're saying that. Like, just so normalizing. Like, wait. We all like to poop where we're comfortable. And even more generally, we're all more comfortable feeling vulnerable and exposed when we're, you know, in a place that feels really safe and known to us. And pooping is like, you're naked. You're, like, sitting down. You're, you know, you're working through something, maybe.

Right?

So I love that framework. Okay, so let's normalize that. Like, yes, it's really normal to want to poop in a way that is most comfortable and known to you. And I think as parents, we're often like, okay, well, what's after that? And there is after that. But sometimes it's okay to just pause and be like, wait, that shifted my body. That shifts how I feel. That shifts my urgency. That shifts the question of what timeline. It also makes me just align with my kid instead of being against them. Right. Okay, so what else? So I think that's a great way to start.

So I think as adults and as parents, we understand that there are these, like, societal pressures that are in place. There is control here. We have to have our kid potty trained before they go to preschool. They can't be in this classroom if they aren't potty trained. So we are taking on that pressure, and then we're placing it on our children, whether we feel like we are or we aren't. And so this was something that I really worried about, putting my own kids into preschool, too. Like, there Are going to be accidents. There are going to be things that happen, whether it's poop holding or peeing. It's a new environment. We all prefer going to the bathroom at home. So I think first is sitting with that, that we feel that pressure and it's not right. Schools, you know, I understand they can't be doing that for a lot of children of helping them through diapers and things like that. It's a rite of passage. But this isn't going to last forever. When you use the example of my kids being 28 coming in the bathroom with me, no, that's not going to happen. And her son is not going to be 28 years old and only pooping in a diaper either.

I just, I just wanna name that because we all do this as parents so much that I've called it the fast forward error. Right? My kids hitting, and I see them in jail, my kids not pooping. And like, for some reason I have an image of them at like age 30 in a diaper. And we fast forward our struggle today to the same struggle, but with our kid older in higher stakes. And then we take all of that anxiety of all those years in the future and we bring it back to today. And then we intervene today based on that anxiety, based on that fear, as opposed to based on. Whoa, whoa, whoa, whoa, whoa. Okay, what is today's date? How old is my kid right now? What's going on for my kid and what do they need today? Because the best thing I can do, even for my kid in the future is helping them with what they need today and like saying hi to that fear and that fascination. Forward thought. Ooh, let me come back. And even saying out loud what day it is is like a good reminder for your body. It is not 2049. No, no, no. Okay, let me come back and remind my body I'm going to figure this out. I have faith in myself and my kid.

It's.

It's hugely anxiety relieving.

I think the other piece of this too is that, you know, with that control, like I mentioned, I even struggle with that, not having control over watching my kids. You know, how much pee did they have? Did they really empty their bladder? Did they really empty their bowels Fully and completely. I have friends who have this poop, we call it, and we're not in control of this. And our kids are. This can be triggering, it can be stressful, and we don't know, do we just give them a diaper because we know that they're not going to feel comfortable if they don't get their poop out, or are we perpetuating the problem? So one of the things that I had done and what I had encouraged some of my friends to do is first of all, make sure there's no underlying medical issues, that there's like an outlet problem in the anus or, you know, that the stools are too hard and maybe they hurt them coming out, and so they feel more comfortable in their diaper. Also, think about what kids. Their body position is when they are hiding behind the couch or in the curtains, kind of squatting down, going in their diaper. That body position is entirely different than sitting on a potty. And so when we talk to our children about, you know, sitting on the potty, what makes you comfortable? You know, what's comfortable with the diaper here? Also, maybe, is it because kids, a lot of time will go hide when they're pooping in their diaper. Is it that they want privacy in the bathroom? Is it kind of scary? Everybody's staring at them to go poop, and maybe that's not what they want either. So kind of having a conversation, does it hurt when it's coming out? What is the. You know, at this age, when we're potty training, there's. There is some conversation that our kids can tell us, you know, why they prefer a diaper versus the potty. And maybe the size of the potty, it might be the body positioning, it might be that it hurts. And so we can. We can intervene in different ways based upon what our kid is telling us there.

I really mean this. So, so helpful. And, you know, I think kids have very few opportunities to really say, I am in full control, full control, and that's okay. We don't want them to be in full control of deciding if they go to school. Right. They don't do those things. But what they can fully be in control of is what goes into their body for food and what goes out of their body with pee and poop. And they are then very kind of understandably resistant to anybody impinging on those few areas that they actually feel really independent. And then it becomes almost an identity battle that the more I my. The more I feel my parents anxiety about my poop or control or you have to poop before I do this. I know you're able to do it. Why are you being so difficult? Right. When they add control and shame, my body, literally, from a psychological point of view, tenses up. It's the opposite of the movement and release. We need but also, it's almost like a kid would have to resist more as a way of saying, now, this is the only way I can define being my own person is. Is actually by keeping all of this in right? And we can't win that identity battle when it becomes this, like, existential crisis of independence. So I'm wondering how we end this conversation, Abby, because I really, like. I feel like we could talk forever. And, like, I am gonna follow up with you. I have so many other things I want to say. Anything. Anything you want to share with parents, anything you want to get off your chest about poop. Any poop songs you, you know, I don't know, have in your repertoire to sing. Anything we. Anything that you think would be a good. A good pause for now.

I don't have any poop songs.

I wish I did.

I do sing a lot of songs to my children, but I never made up a poop one. You've sparked my creativity. Now I might have to come up with one. One thing I do want to mention is if your kid is sitting on the potty and they have that poopy feeling, but no poop is coming out. I this a lot for my kids, Mom.

No poop is coming out of my.

Body, but I have that feeling. I really encourage them. Take three big breaths, and I show them how we fill up our belly with it. And adults can do this too. Three big breaths where we fill up our abdomen. And if nothing comes, it's time to get off the toilet until we have that poopy feeling again. And a lot of times, my kids will start yelling from the bathroom. It's working. And of course it is, because we need to fill up that abdominal cavity with some pressure to help our muscles kind of relax and evacuate from below. It's not actually bearing down and pushing. It's this filling of our abdominal cavity. And so that's a big thing, is deep breaths and just allowing. Honoring our urge to defecate. That's important. And then allowing it to happen. So no more than three to five minutes on the toilet, maximum.

This. This is another great way to end it, like, does so many things. It really helps the process, the evacuation process, and it kind of is a signal to your body, like, I'm so safe. I will be trying that later today, so. And I will be thinking of you, you know, in that moment. I will. This has been so helpful, so deshaming, so immediately usable. And I want to thank you for not only, you know, talking about a topic that feels almost still taboo in so many homes and talking about it in a way that really makes sense and is so actionable. So, so thank you so much.

Thank you for having me talk about something that I'm so passionate about. And I love to talk about poop. And just a reminder, everybody does it and we're all on the same playing field. There's nothing exciting about it. Everybody does it.

So let's end today with one simple action item that we can all do in our homes with our kids. Talk about poop with your child today. Not in the context of of do they need to poop or I know you have to go poop, but just in the context of de shaming the poop process. It can be simple and short. Just saying to your kid, hey, you know what? Everyone poops. You know what? We talk a lot sometimes about your poop that's going on in your body and I trust you to figure that out. You should know that I poop too. I poop, you poop, everyone poops. Poops. Let's d shame poop together in these small ways. Thanks for listening. To share a story or ask me a question, go to goodinside.com podcast. You could also write me@podcastoodinside.com parenting is the hardest and most important job in the world and parents deserve resources and support so they feel empowered, confident and connected. I'm so excited to share Good Inside Membership, the first platform that brings together content and experts you trust with a global community of like valued parents. It's totally game changing. Good inside with Dr. Becky is produced by Jesse Baker and Eric Newsom at Magnificent Noise. Our production staff includes Sabrina Farhi, Julia Natt and Kristen Muller. I would also like to thank Eric Kobelsky, Mary Panico, Jill Cromwell Wang, Ashley Valenzuela and the rest of the Good Inside team. And one last thing before I let you go, let's end by placing our hands on our hearts and reminding ourselves, even as I struggle and even as I have a hard time on the outside, I remain Good inside.