The Poop Episode

0:00 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

0:29 introduce herself my name is Abby Myers and I am a wife and a mother of twin boys who are almost five years old yeah they are the love of my life and after a long about 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

0:59 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'd ask them oh you have an ileostomy they would say oh no no no I don't I don't have that but I know how you feel so I told my mother I don't want I don't want to be teacher

1:22 anymore I want to 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 for sharing that it is so amazing to find a career that is like

1:46 in line with your experience and passion and it's amazing when it's also aligned so there's so many different things we could talk about and I feel like I've had to say the thing we're going to start with but maybe it will just be the thing we talk about for the whole time is is poop my favorite topic Okay so first then like talk to me about poop just you you start you're the expert sure well I am a mom and a physician

2:13 assistant in the area of poop uh 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 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

2:46 before we had children that I was going to come at this potty training thing um 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 Mommy's got that poopy feeling or peepy feeling I gotta go to the potty and so we would say drop every everything and they would crawl and

3:12 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

3:35 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 was shame we've stored in a state of aloneness right and as humans who are oriented by attachment and things that we learned we had to be alone with were almost learned as oh well this is

4:00 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 PP 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

4:28 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 um 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

4:52 Mommy to the bathroom like I have a feeling that's not the way it's gonna go but you've set this foundation for a total absence of Shame absolutely and we saw this actually the other weekend we were 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 right so when we're sitting at the restaurant there are some other people there and all of a

5:14 sudden one of my twins says really loudly of course I need to poop so bad and they said all right let's go and so we just stand up and that's the other thing you know when when our kids say that they have the poopy feeling or have a peepee 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

5:36 like in this new place yes is it disgusting thing when it's important party 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 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

5:58 are in the bathroom that it's okay for me to say 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

6:17 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 it wasn't me nope all right like it it is literally a part of being a healthy human being Everyone Poops everyone

6:43 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

7:09 five dollars you could pay me five dollars 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 the 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

7:30 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 and 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

7:50 there are times that my kids will um even last night one of them came out to me and said you know Mom I had little poop that looks like the 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

8:08 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 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

8:35 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

8:56 that you know we talked 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

9:16 you know 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 um what we want or what we strive for is one to two kind of soft formed stools that's called a Bristol type four 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

9:44 they are taking different medicines or you know maybe they have underlying medical conditions that cause them to be a little bit more constipated 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 um seven is gonna be pure liquid maybe some like Sandy sediment in the bottom

10:10 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 amazing some are just right got it and 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 going to be a looser stool so we

10:37 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 um they look kind of dry so number two on the Bristol stereo scale is like a dry sausage looking they always equate it to food um my kids get that so we do kind of talk about that in our home but um when it's a little bit more dry or a little

11:00 bit harder balls of stool we encourage um 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 I don't know that

11:24 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 it's my kids sick are we able to maintain hydration here you know those

11:50 are going to be the worrisome features are they urinating enough to do their lips look chapped especially in our younger babies um 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 the entire carton of blueberries do they have a bunch of juice so sugar promotes more liquid type stools because um that the water kind of follows with

12:13 the sugar huh okay this is all so helpful a couple other questions color color yeah tell me about that okay so everyone wants to talk about colors or their poop I don't get too excited as a medical professional about the color um 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

12:37 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 bile 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

13:01 depending upon what we're eating and what we're drinking the fat content of the stool and so um 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 the three four days and if so maybe it is something that I should bring up to somebody if it doesn't seem quite right

13:21 so we always talk about our kids you know trusting like intuitive eating and you know you got that poopy peepee 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

13:43 bring in a voicemail I got okay 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 um 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

14:15 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

14:42 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 there so we've told them that he

15:08 if he has to poop when he goes there he needs to go in the body 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

15:32 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 I love that framework okay so let's let's normalize that like yes it's it's really normal to want to poop in a

16:04 way that is most comfortable and known to you and I think as parents we're off and 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 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

16:26 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

16:48 I really worried about putting my own kids into preschool too like there are going to be accents there are going to be things that happen whether it's poop holding or pee 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 it's not the schools you know I understand they can't they can't be doing that for a lot of children of helping them

17:11 through diapers and things like that it's a 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 and her son is not going to be 28 years old and only pooping in a diaper either I just I just want to name that because we all do this as parents so much that I I've called it

17:32 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

17:57 today based on that anxiety based on that fear here as opposed to based on 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 fast forward that oh let me come back and

18:24 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 buddies I'm gonna 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

18:46 know how much P did they have did they really empty their bladder did they really empty their bowels fully in completely I have friends who have this poop holding that we call it and we're not in control of this and our kids are this can be triggering it can be uh 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

19:07 perpetuating the problem so one of the things that I had done and what I had to 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 in the 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

19:29 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

19:52 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 doesn't 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 may be the size of the potty it might be the body positioning it might be that it it hurts

20:14 and so we can we can intervene in different ways based upon what kit 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 of 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

20:37 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 our mind 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

21:06 add control and shame my body literally from a psychological point of view tense is 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

21:34 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 going to follow up with you I have so many other things um I want to say um anything last on on your mind 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 having your repertoire to sing anything we anything that you think

21:57 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 um you've sparked my creativity now I might have to come up with one um 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 hate get this a lot for

22:18 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

22:41 it's working and of course it is because we need to fill up that abdominal abdominal cavity with some pressure to help our our muscles kind of relax and evacuate From Below it's not actually bearing down and pushing it's a 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

23:06 maximum this this is another great way to end it like does so many things it really helps uh the process the evacuation process and it kind of is a signal to your body like I'm safe I will be trying that later today so and I'll be thinking of you you know in that moment I will um this has been so helpful so de-shaming so immediately usable and I want to thank you for not only you know talking

23:34 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 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 but just reminder everybody does it and we're all in the same playing field there's nothing exciting about it everybody does it so let's end today with one simple

24:00 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 do they need to poop or I know you have to go poop but just in the context of D 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

24:29 you to figure that out you should know that I poop too I poop you poop Everyone Poops let's D Shane poop together in these small ways thanks for listening to share a story or ask me a question go to goodinsight.com backslash podcast you could also write me at podcasts good inside.com parenting is the hardest and most important job in the world

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25:31 Kristen Muller I would also like to thank Erica belski 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