Regular gal: How often should you 'go'?

Remember Carly Simon's song, "Anticipation"? I never heard of the song until Heinz Ketchup used it in a commercial. (In the commercial, the anticipation of eating the food slathered in ketchup was worth the wait.)

When it comes to a bowel movement, for most people, constipation is not a fun way to experience anticipation. In fact, one of the biggest issues in the primary care office is constipation. Women are affected by constipation more than men, but we aren't really sure why.

When I was a medical resident in Los Angeles, I lived in a noisy apartment for one year. I would occasionally see my landlords, who seemed nice enough, but I never really had a conversation with them. One night, as I was returning home, the landlord asked me if I could help his pregnant wife. (I thought she was pregnant, but I learned a long time ago never to ask, "Are you pregnant?" I once asked a woman this question to learn she was in fact not pregnant. I think this is defined as a faux pas.)

Anyway, I told my landlord that I was not an OB/GYN, and he understood this. They had just paged their OB and were waiting for a call back. Because of the extreme nature of the situation, he thought perhaps I could bring her some relief.

I agreed to help and entered his apartment for the first time. I don't remember what his apartment looked like because I only remember hearing a woman's violent screams. I looked at my landlord and said, "Is that your wife screaming?" He nodded.

He took me to the bathroom where I found his mother and his wife. With all due respect to my landlord's wife, I suddenly felt like I was in the movie The Exorcist. My landlord's wife was contorted on the commode, holding her pregnant belly, and screaming very loudly.

First thing I did was ask her if she was in pain. She said she wasn't, but she couldn't force out a bowel movement. I asked her to relax and take some deep breaths. When she was calmer, I asked how long it was since her last bowel movement. "Five days," she replied.

I learned in medical school that having a bowel movement every day is not considered normal. The range was between one and five days. A Hollywood executive at my gym in LA told me that was wrong, and three times a day was normal.

So what is normal? I learned at UVA medical school that the laxative industry has convinced Americans that one bowel movement a day is healthy and necessary.

Frankly, I don't think it really matters how "regular" a person is as long as there isn't any discomfort and it is within five days. If you don't have a bowel movement for a few days and there are no associated cramps or gas, then that is fine. However, after five days with no BM, medical complications can develop.

My landlord's wife wanted to have a bowel movement because she thought it was a bad sign not to have had one in five days. She was right. However, as hard as she was struggling, I was afraid she was going to push the baby out into the toilet.

She was tormented and angry that she was constipated, and I had to reassure her there were ways to get thing rolling. Thankfully, her OB called at that moment and relieved me of my duties. When I saw her the next day, she said, with a sheepish smile on her face, "mission accomplished."