The Scoop on Poop!: Flush with Knowledge, Volume Two

By MD Joseph Weiss

The Scoop on Poop! Flush with Knowledge is a uniquely informative, tastefully entertaining, and well-illustrated volume that is a comprehensive and knowledgeable overview of all topics related to the remains of the digestive process. Whether you call it poop, feces, excrement, manure, dung, or by one of the more than on

• Language: English
• Publisher: SmartAsk Books
• Release date: Jun 16, 2016
• ISBN: 9781943760336

MD Joseph Weiss

Joseph Weiss, MD, FACP, FACG, AGAF is Clinical Professor of Medicine in the Division of Gastroenterology, Department of Medicine, at the University of California, San Diego. An autodidact and aspiring polymath, he was accepted to university at age fifteen and attended the University of Michigan, University of Detroit, and Wayne State University. Reflecting his broad interests, he had three separate majors in Medieval English Literature, Astrophysics, and Invertebrate Zoology. Following his graduation from the Wayne State University School of Medicine in Detroit, Michigan, he completed his internship and residency in Internal Medicine at the University of California, Irvine Medical Center in Orange, California. Dr. Weiss is a Fellow of the American College of Physicians and a Senior Fellow of the American College of Gastroenterology. Under the auspices of the World Health Organization and others he has pursued interests in Tropical Medicine and International Medicine with extended stays in Africa, the Middle East, and Latin America. Subsequently completing a clinical and research fellowship in Gastroenterology at the University of California, San Diego, he has been active on the clinical faculty. Board certified in Internal Medicine and Gastroenterology, he has over thirty years of clinical, administrative, and research experience. Dr. Weiss is a Fellow of the American College of Physicians, Fellow of the American Gastroenterological Association, and a Senior Fellow of the American College of Gastroenterology. He is the prolific author of several dozen books on health (www.smartaskbooks.com) and papers published in prestigious national and international medical journals, as well as in the lay press. Dr. Weiss is an accomplished professional speaker and humorist, having given over two thousand invited presentations nationally and internationally. He has presented at universities, medical schools, hospitals and medical centers, pharmaceutical companies, YPO/WPO, Aspen Institute, Bohemian Grove, Esalen Institute, IDEA World Convention, International Destination Spas & Resorts (Golden Door, Canyon Ranch, Rancho La Puerta), corporate events, etc. Co-hosting a popular health care radio program on a major network affiliate in Southern California showcased his skills as a communicator.

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Introduction

The subject of this book is a human necessity, but rarely discussed in an informative manner. As a physician and educator in the field of gastroenterology, the end product of the digestive process is ubiquitous. The Old English word ‘shyte’ or ‘shite’ may sound a bit politer, but the modern equivalent of ‘shit’ is a perfectly acceptable and proper word in the English language vocabulary. The word ‘shit’ appears often in this book along with its synonyms and alternates of feces, excrement, bowel movement, and others. Shit seems to be a particularly popular word in the adolescent vocabulary, and in the common day language of nearly all languages as listed in Appendix A. The alternative words and euphemisms are numerous, and a partial list is provided in Appendix B.

The word shit, a proper term for a natural and universal human and animal activity and product, has a reputation that frequently raises embarrassment and offense. This attitude leads to avoidance of discussion, with the result that most people have very limited knowledge about the material that is produced by their own body. The fact of the matter is that lack of basic information and knowledge is unfortunately the norm and contributes to avoidable health problems. One of the main purposes of this book and its companion volumes is to provide information that is interesting, understandable, valuable, and entertaining. Visual images can aid in understanding, and this volume uses them liberally. Many people find that a visual image often imparts more understanding and information than the written word alone. This is particularly true when dealing with human health and physiology.

The process of digestion, besides a remarkable demonstration of biology and physiology, carries a lot of psychological aspects and considerations. It is animal-like in its primal role of being an absolute requirement to stay alive. It is primitive in that we are following the same activity as our prehistoric ancestors. We have to hunt, forage, barter, steal or accept the charity of others for our sustenance. Many of our most basic cultural taboos are intimately involved with the process of digestion, from the spitting of saliva to the abhorrence of vomit and feces. Digestion and bodily sounds, smells, and excretions are often associated with repugnance and revulsion. In spite of the base nature of the process, we recognize its critical importance to health, wellness, satisfaction, and happiness.

Selecting and maintaining a healthy diet is essential to eating, just as staying away from smog and pollution is to breathing. Humans have some interesting, yet very dangerous and self-acquired habits. These include smoking tobacco to assure that we breathe in grossly polluted air with cancer causing particles. It also includes eating junk food with disease inducing contents. As with alcohol and drugs, many of us seem to be pre-wired to be at risk for self-destructive habits that exchange short-term pleasures for long-term harmful effects. As primitive as eating and digestion may seem, especially to those with an eating disorder, it is a natural and healthy requirement of life in general and our species in particular. Humans have the ability to learn from the lessons of others, especially about how the body works and the best way to maintain it for maximal efficiency, longevity, and enjoyment. For many, the anticipation, preparation, and ingestion of food and drink are one of their greatest pleasures in life. Although the wise saying is that we should eat to live, it is apparent that a significant portion of the population embraces its mirror image, in that they live to eat.

The process of diet and digestion from a food source to the elimination of digestive waste is information worth acquiring and understanding. This information allows one to enhance healthful aspects of diet and nutrition, and to reduce the risk of harmful practices that increase being exposed to disease and toxins. The subjects covered in this book range from the traditional and expected to the offbeat, bizarre, and downright unbelievable. The saying that the truth is often stranger than fiction is unquestionably true when it comes to nature, the digestive tract, and humans in particular. The volume is structured as an alphabetical compendium of topics scatological in nature. There is much information and knowledge to share about human health, and subjects historically considered too sensitive for public discussion are especially ripe for attention. The book you are holding, The Scoop on Poop! Flush with Knowledge is one of several volumes that aim to accomplish this goal. There are several companion volumes that may also be of interest, that provide an in-depth discussion of subjects closely related to this book.

To ‘Air’ is Human, Everything You Ever Wanted to Know About Intestinal Gas is a uniquely informative, entertaining, and well-illustrated volume. Useful knowledge about the physiology and science of the fart, burp, and bloat often associated with the digestive process is clearly explained. It covers everything you ever wanted to know about farts and digestion, but were either too afraid or too embarrassed to ask. More for entertainment and historical value is its companion volume, Artsy Fartsy, Cultural History of the Fart. This book provides a fascinating and factual overview of the common fart through human culture and history. The cough, sneeze, hiccup, stomach rumble, burp, belch, and other bodily sounds simply cannot compete with the notoriety of the fart. How Do You Doo? Everybody Pees & Poops! is a delightfully informative, entertaining, and colorfully illustrated volume with valuable practical insights on toilet training. Tasteful color photographs of animals answering the call of nature allows the child to understand that everybody does it! Additional informative relevant content to entertain the adult while the child is ‘on the potty’ is included.

AirVeda: Ancient & New Medical Wisdom, Digestion & Gas covers the remarkable advances in the understanding of digestive health and wellness. New information about the critical role of genomics, epigenetics, the gut microbiome, and the gut-brain-microbiome-diet axis are opening new avenues to optimal whole body health and wellness. Although intestinal gas, basic bodily functions, and feces have been topics culturally suppressed, knowledge and understanding are needed to achieve and maintain optimal health.

"Ayurveda is a 5,000 year old system of natural healing that reminds us that health is the balanced and dynamic integration between our environment, body, mind and spirit. In Dr. Joseph Weiss’ book, AirVeda, he provides an informative and entertaining approach to sharing insights about our digestive system and wellbeing by applying the ancient wisdom of Ayurveda to everyday life." Deepak Chopra, MD

The Quest for Immortality, Advances in Vitality & Longevity provides an informative and enlightening overview of the remarkable advances in science and medicine that are dramatically enhancing human health and lifespan. The volume is written in clear, understandable, and engaging language with striking colorful illustrations. From groundbreaking nanotechnology to genomics and stem cells, the secrets of vitality and longevity are being uncovered along with more traditional advances and practical insights into disease prevention and health enhancement. The website www.smartaskbooks.com has a complete list of books and programs.

Gastrocolic Reflex

The gastrocolic reflex is an increase in colonic motility, often leading to a bowel movement, following distention of the stomach. It predominantly affects the sigmoid colon and is a physiologic response to stretching of the stomach by food or drink. It is commonly seen in infants who may have a bowel movement within moments of feedings. When it is time for toilet training taking advantage of the gastrocolic reflex can be very helpful, encouraging a bowel movement after the first meal in the morning. Irritable bowel syndrome may also be a manifestation of heightened sensitivity to stomach distension triggering the gastrocolic reflex.

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Gastroenteritis (see Diarrhea)

Most transmission of pathogens is via the fecal to oral route is usually accomplished by way of the hands. The average human stool contains three trillion microorganisms. Wiping with toilet paper nearly guarantees that the hands will come into contact with fecal microorganisms. After wiping it is not uncommon to find brown streaks on underwear because of inadequate anal hygiene. The average man’s underwear contains one tenth of a gram of feces at laundering.

Gastroenterology

Gastroenterology is the scientific study of the digestive system and digestive diseases. In the United States it is the field of medicine considered a subspecialty of internal medicine. A physician who specializes in gastrointestinal diseases is referred to as a gastroenterologist. Most of the practicing specialists have completed a three year residency in internal medicine followed by a two or three year fellowship in gastroenterology.

Gastroenterologists frequently perform a variety of endoscopic and colonoscopic examinations that are expanding in therapeutic and diagnostic capabilities with technological advances. Board certification is voluntary, and in a number of the state medical licensing jurisdictions physicians and surgeons may self-designate an area of specialty practice without necessarily completing advance training. Surgical specialist in the field of colon and rectal surgery are often referred to as proctologist or colon and rectal surgeons.. They may also perform endoscopic and colonoscopic examinations.

Gastrointestinal Motility

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Gastrointestinal Pacemaker Cells

Interstitial cells of Cajal are pacemaker cells similar to the pacemaker cells of the heart, which cause the heart to beat regularly. They are present in the wall of the gut and communicate between the nervous system and the smooth muscle of the gut wall. When the signal arrives from the nervous system to the interstitial cells of Cajal that a person has eaten, they begin their pacemaker function.

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This results in a coordinated and rhythmic set of contractions of the gut known as peristalsis, which propels food along the entire length of the digestive tract. The interstitial cells of Cajal were studied in relative obscurity for over one-hundred years until the discovery that gastrointestinal stromal tumors (GIST) arise from interstitial cells of Cajal or an interstitial cell of Cajal-like precursor cell.

The interstitial cells of Cajal are derived from the mesoderm of the gastrointestinal tract and serves as a pacemaker for the peristaltic contractions of the smooth muscle. The interstitial cells of Cajal are named after Santiago Ramón y Cajal (1852 - 1934 ) a Spanish pathologist and Nobel laureate who was considered by many as the father of neuroscience.

The frequency of interstitial cell of Cajal pacemaker activity differs in different regions of the GI tract, three per minute in the stomach, twelve per minute in the duodenum, ten per minute in the ileum, and three per minute again in the colon. The loss of interstitial cells of Cajal may interrupt normal neural control of gastrointestinal contractions and lead to functional gastrointestinal disorders, such as irritable bowel syndrome and chronic intestinal pseudo-obstruction.

Gastrointestinal Transit Time

Gastrointestinal transit time is the time period from ingestion of food or a biomarker until its elimination and exit from the digestive tract. The time period is highly variable and can be influenced by many factors including diet, physical activity, infection, inflammation, pharmaceuticals, etcetera. The gastrointestinal transit time may also be divided into the three subsets of gastric emptying, small intestinal transit, and colonic transit.

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In general it takes about one hour for half of the gastric contents to be processed and advanced into the duodenum. The stomach is usually completely empty two hours after ingestion. Approximately two to four hours is involved in digestion and absorption before the chyme is released into the colon for water absorption and packaging as feces. The material is eliminated as feces approximately twelve to forty-eight hours after ingestion.

The transit time is the general period of time it takes, from the swallow of ingestion to the elimination at defecation, for food to pass through the gastrointestinal track. Normal ranges are from half a day to two days but individuals vary. Certain conditions especially those with diarrhea may have a more rapid transit time, while those with neurologic conditions or diabetes may have a slow transit time.

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Diabetes mellitus is one of the most common causes of delayed gastric emptying, a condition known as gastroparesis diabeticorum. It can also lead to a generalized gastrointestinal motility disorder with delayed total gut transit times. Irritable bowel syndrome is also associated with gastrointestinal motility disorder. Although it is not uncommon to see certain undigested foods passed, like kernels of corn, more undigested foods may be seen with a rapid gut transit time.

Gastroparesis

This disorder of delayed gastric emptying is most often seen as a consequence of neuropathy secondary to diabetes mellitus. The delayed gastric emptying prevents both nutritional intake as well as preventing swallowed gasses from leaving the stomach. Meals that are high in fat cause the release of hormones that slows down gut motility and further delay gastric emptying.

This can lead to increased burping and belching as well as distension. Side effects from medications, especially narcotic analgesics, and antidepressants are well-recognized causes of delayed gastrointestinal peristalsis and bloating. There are a number of pharmacological agents that have prokinetic actions that may be of value in treating delayed gastric emptying.

Gastroparesis is the delayed physiological emptying of the stomach with solids and liquids accumulating leading to discomfort, bloating, and distension and belching. Creative Commons License

Diabetes mellitus is one of the most common causes of delayed gastric emptying known as gastroparesis diabeticorum. It can also lead to generalized gastrointestinal motility disorder with delayed total gut transit times. Irritable bowel syndrome is also associated with gastrointestinal motility disorder.

Mass Movements

The large intestine (colon) does not have peristaltic activity like the small intestine. Feces are propelled through the large intestine by mass movements, which occur one to three times per day. The stool stored in the rectum is expelled via the anus by defecation.

Haustral contractions are slow segmental movements that move the contents of the colon by towards the rectum.. The haustra sequentially contract as they are stimulated by distension. The defecation reflex is triggered by distention of rectal walls by feces. When stimulated the defecation reflex contracts the rectal walls and relaxes the internal anal sphincter. Voluntary signals stimulate relaxation of the external anal sphincter and defecation occurs.

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Motilin

Motilin is a hormone secreted by endocrine M cells in the small intestine, especially in the duodenum and jejunum. It was named motilin because of its ability to stimulate gastric motility. Erythromycin and related antibiotics act as motilin agonists, and are sometimes used for their ability to stimulate gastrointestinal motility. Another hormone ghrelin can also induce motilin like effects.

Motilin triggers the migrating myoelectric complex component of gastrointestinal motility, which induces brief episodes of peristaltic activity several times an hour in between meals. Contractions of the gastric fundus and antrum triggered by motilin can cause stomach rumble or growls, and borborygmi. They are often associated with cramp like discomfort often described as ‘hunger pain’ since they occur during a fasting period. The gastric emptying and peristaltic sweeping action clearing the stomach and small bowel of food residue or chyme has earned motilin the moniker ‘housekeeper of the gut’.

Peristalsis & Segmental Contractions

Peristalsis (Greek peri-, around and stallein, to place) is the propulsive wave of muscular contraction and relaxation, which advances digestive material through the intestinal tract. Earthworms use a similar mechanism in their movement. The process of peristalsis is controlled by the medulla oblongata of the brainstem. Segmental contractions are used to mix the chime with digestive juices and enzymes, and to bring additional nutrient material in contact