 Ancient Egypt was one of the great civilizations lasting for 3,000 years. Its knowledge of medicine vastly underestimated. They had medical subspecialties, the pharaohs, for example, had access to dedicated physicians to be guardians of the royal bowel movement. A title alternately translated from the hieroglyphics to mean Shepard of the Anus. How's that for a resume builder? Today, the primacy of its importance continues, with some calling for bowel habits to be considered a vital sign on how the body is functioning, along with blood pressure, heart, breathing rate. Although we may not particularly like hearing the details of someone else's bowel movement, it is a function that nurses and doctors need to assess. Surprisingly, the colon remained relatively unexplored territory, one of the body's final frontiers. For example, current concepts of what normal stools are like primarily emanates from the detailed records of 12 consecutive bowel movements and 27 healthy subjects from the United Kingdom, who boldly went where no one had gone before. Those must have been really detailed records. The reason we need to define normal when it comes to bowel movement frequency, for example, is how else can you define concepts like constipation or diarrhea if you don't know what normal is? Standard physiology textbooks may not be helpful in this regard, implying that anything from one bowel movement every few weeks or months to 24 a day can be regarded as normal. Once every few months of all human bodily functions, defecations, perhaps the least understood and least studied. Can't you just ask people? Turns out, people tend to exaggerate. There's a discrepancy between what people report and what researchers find when they actually have them recorded. It wasn't until 2010 when we got the first serious look. Defining normal stool frequency is between 3 per week and 3 per day, based on the fact that that's where 98% of people tend to default. But normal doesn't necessarily mean optimal. Having a normal salt intake can lead to a normal blood pressure, which can help us die from all the normal causes, like heart attacks and strokes. Having a normal cholesterol level in a society where it's normal to drop dead of heart disease are number one killer, not necessarily a good thing. And indeed, significant proportions of people with quote-unquote normal bowel function reported urgency, straining, incomplete defecation, leaving the researchers to conclude that that kind of thing must just be normal. Normal maybe if you're eating a fiber-deficient diet, but not normal for our species. Defication should not be a painful exercise. This is readily demonstrable. For example, the majority of rural Africans eating their traditional fiber-rich plant-based diets can usually pass without straining a stool specimen on demand. See, the rectum may need to accumulate 4 or 5 ounces of fecal matter. Before the defecation reflex is fully initiated. So if you don't even build up that much over the day, you'd have to strain to prime the rectal pump. Hippocrates thought bowel movements should ideally be two or three times a day, which is what you see in populations on traditional plant-based diets, and the kind of fiber intakes you see in our fellow great apes. And what may be more representative of the type of diets we evolved eating for millions of years. It seems somewhat optimistic, though, to expect the average American to adopt a rural African diet. We can, however, eat more plant-based, and bulk up enough to take the Hippocratic Oath to go two to three times a day. No need to obsess about it. In fact, there's actually a bowel obsession syndrome, characterized in part by ideational rambling over bowel habits. But three times a day makes sense. We have what's called a gastrocolic reflex, which consists of a prompt activation of muscular waves in our colon within one to three minutes of the ingestion of the first mouthfuls of food. Even just talking about food can cause your brain to increase colon activity. This suggests the body figure that one meal should be just enough to fill you up down there, so maybe we should eat enough unprocessed plant foods to get up to three a day, a movement for every meal.