Digestion Often Goes Awry

I often read the Ask Dr. Gott column in my local paper. I generally enjoy Dr. Gott’s interesting approach to readers’ questions, as he tends to come at topics from a more lighthearted and unique perspective than most conventional docs. I have particularly enjoyed his stance on promoting more natural approaches to lowering cholesterol (cinnamon, fish oil, etc.) vs. using statins with harmful side effects. However, in spite of his somewhat progressive view on some topics, there are other areas of medicine in which he takes a hard line, conventional approach that really doesn’t make sense. Thyroid disease is one area in particular that he often misunderstands, but I don’t need to really address that since Mary Shomon, thyroid expert and patient has done so already. And, honestly, I’m not looking to bash Dr. Gott in this post. I just want to set the record straight on his explanation of digestion.

Here is the letter that was posted in the paper & Dr. Gott’s response:

DEAR DR. GOTT: I read your column daily but don’t recall seeing my question before. My wife will eat a meal and then shortly after have a running bowel movement. She will declare that something she just ate must have made it happen. I’ve repeatedly explained to her that it’s not possible to eat something and have it pass through a person that fast, that it takes many hours and possibly overnight. She insists she can eat something tainted now and within the hour it makes her run to the bathroom.

Please clarify this for me and especially for my wife. I’ve tried to tell her if she has a runny bowel movement soon after eating, it’s most likely from something she ate earlier or the day before.

DEAR READER: For most healthy adults, it takes 24 to 72 hours following a meal for it to be digested and excreted. It takes up to eight hours for it to pass through the stomach and into the small intestine. It then enters the large intestine for further digestion and absorption of fluids and nutrients. Elimination of undigested food residue begins after 24 hours, but complete elimination may take longer.

The rapid sensation your wife experiences may simply result from the new food stimulating the existing digestive process. I side with you on this one.

And, here is my follow-up:

Dear Dr. Gott,

I regularly read your column and enjoy your answers as you often point to interesting solutions. However, your recent 9/6/11 column on Urgency after Eating really missed the mark with regards to the woman in question’s problem (urgent bowel movements after eating). You note how normal digestion is supposed to take place in 24-72 hours, but the reality is that what is supposed to happen with digestion often doesn’t. It is a very individualized process, particularly if a digestive problem is occurring. I am a dietitian, so I am well-versed in what we believe the body is supposed to do with the food we eat, but there are a myriad of reasons why this process often goes awry.

On a personal level, three years ago I began having urgent bowel movements 15-30 minutes after eating. I found it hard to believe that a food could trigger such a response, but it absolutely did. For me the trigger was (is) gluten, and any food that contains that protein will cause an almost immediate response in my body. Unfortunately, it is quite common for it to happen after eating a meal at a restaurant even after telling the server that I must avoid gluten, as restaurant foods are typically laden with additives.

Rather than “siding” with the woman’s husband as you did, you really should have suggested she investigate a potential gluten intolerance or other food sensitivity. Dairy (particularly lactose intolerance) is a well-known trigger for diarrhea, as are stress, viruses, excess consumption of sugar alcohols, fat, or hypertonic solutions. I hope you will consider these factors in future responses, and more importantly acknowledge that what someone says is happening is far more important than what is supposed to be happening

Best Regards,
Michelle Traub, R.D.

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