Ep 201 Poop Part 2: Flushed away

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Sir, I traversed this day by steamboat the space between
London and Hungerford Bridges between half past one and two o'clock.
It was low water, and I think the tide must
have been near the turn. The appearance and the smell
of the water forced themselves at once upon my attention.
The whole of the river was an opaque, pale brown fluid.

(00:23):
In order to test the degree of opacity, I tore
up some white card into pieces, moistened them so as
to make them sink easily below the surface, and then
dropped some of these pieces into the water at every
pier the boat came to. Before they had sunk an
inch below the surface. They were indistinguishable, though the sun
shone brightly at the time, and when the pieces fell edgeways,

(00:47):
the lower part was hidden from sight before the upper
was underwater. Near the bridges, the feculents rolled up in
clouds so dense that they were visible at the surface
even in water of this kind. The smell was very
bad and common to the whole of the water. It
was the same as that which now comes up from

(01:08):
the gully holes in the streets. The whole river was,
for the time a real sewer. Having just returned from
out of the country air, I was perhaps more affected
by it than others, But I do not think I
could have gone on to Lambeth or Chelsea, and I
was glad to enter the streets for an atmosphere which,
except near the sinkholes, I found much sweeter than that

(01:30):
on the river. I have thought it a duty to
record these facts, that they may be brought to the
attention of those who exercise power or have responsibility in
relation to the condition of our river. There is nothing
figurative in the words I have employed, or any approach
to exaggeration. They are the simple truth. If there be

(01:51):
sufficient authority to remove a putrescent pond from the neighborhood
of a few simple dwellings, surely the river which flows
so many miles through London ought not to be allowed
to become a fermenting sewer. The condition in which I
saw the Thames may perhaps be considered as exceptional, but
it ought to be an impossible state, instead of which

(02:13):
I fear it is rapidly becoming the general condition. If
we neglect this subject, we cannot expect to do so
with impunity, nor ought we to be surprised if ere
many years are over, a hot season gives us sad
proof of the folly of our carelessness. I am, sir,
your obedient servant. M. Faraday, Royal Institution, July seventh, eighteen

(02:36):
fifty five.

Speaker 2 (03:25):
There's just so many good parts.

Speaker 3 (03:27):
There's so many good parts, suculents.

Speaker 2 (03:30):
The smell was very bad.

Speaker 3 (03:32):
The smell was very bad.

Speaker 1 (03:34):
Like I have no more synonyms for feculentce and so
I'm just gonna have to go with the sheer reaction
of very.

Speaker 3 (03:41):
Bad, very bad, very.

Speaker 2 (03:42):
Bad, I mean. And also this is not an exaggeration. Oh,
I am not being figurative with it.

Speaker 3 (03:49):
There is no figurative language in this, Sir.

Speaker 2 (03:53):
I love it. I love it so much.

Speaker 3 (03:56):
I love it too.

Speaker 2 (03:57):
I love it.

Speaker 3 (03:58):
I love it. It's ridiculous and it will.

Speaker 1 (04:02):
I will touch more on the specific situation that this
became the center focus of in this episode.

Speaker 2 (04:09):
I can't wait.

Speaker 1 (04:10):
It's gonna be great. And I already said in the
first hand where that came from.

Speaker 3 (04:14):
M Fara day There you go.

Speaker 2 (04:16):
Okay, Hi, I'm Aaron Welsh and I'm Aaron Aman update.

Speaker 3 (04:20):
And this is this podcast will kill you.

Speaker 2 (04:22):
Welcome to Poop Part two two.

Speaker 3 (04:25):
Poop number two, number two. We're way too pleased with ourselves.
But we just think we're so clever we do Okay.

Speaker 1 (04:35):
So, if you have not tuned into the first episode
in this Poop series, Part two, part series, uh, do it?

Speaker 3 (04:43):
Do it? You know, what are you waiting for?

Speaker 2 (04:45):
Listen to it. You don't have to.

Speaker 1 (04:47):
Listen to it in order, but it will make sense.
It will still make sense, but you should do it.

Speaker 2 (04:52):
It's a great episode. I'm really proud of it.

Speaker 3 (04:56):
You're going to learn a lot, just like you will
in this episode.

Speaker 1 (04:58):
So last episode we went over a sort of how
we make poop and why poop is actually a gold
mine rather than like the waste that we presently view
it as. Right, and today we're gonna go over what
happens when our poop doesn't go to plan right and
I guess yes, and also why poop is actually gross

(05:22):
and what we do.

Speaker 2 (05:23):
About it the flip side of the coin.

Speaker 3 (05:24):
You know, poop is many things.

Speaker 2 (05:26):
It is so many things.

Speaker 3 (05:27):
Poop contains multitude.

Speaker 2 (05:29):
It really does it, really truly truly does ed Young
Thank you. Yeah, it's gonna be a great episode. I'm
really excited about it. But first at first, it's quarantiny time.

Speaker 3 (05:39):
What are we drinking this week?

Speaker 2 (05:40):
Same thing we drank last week? Drink number two, the
drink number two. Are actually drinking water, which is also
important for your poop. But it is you want to
drink a quarantiny. It's poo number two, it's poop number two,
it's I drinking number two.

Speaker 3 (05:55):
We keep saying that, Yeah, yeah, yeah, you know, uh
it's It's basically a chocolate mint. It's great. It's pretty
easy to make.

Speaker 2 (06:03):
You can do it at home, as you can.

Speaker 3 (06:08):
With all of our quarantines.

Speaker 2 (06:10):
Iway assume we'll post the full recipe for that quarantine
on our social media channels. Are you following us there?
Because you should definitely check it out and follow.

Speaker 1 (06:17):
You should You should our website which we may be
putting quarantini stuff on. Maybe we'll try that out tonight.
You know, you can find other things though. You can
find so many things. You can find transcripts, you can
find links to our bookshop dot org affiliate page, our
Goodreads list, which needs some updating, links to music by Bloodmobile,

(06:38):
first hand account form, contact us form sources for each
and every one of our episodes. It was like I
know it starts with an S and also YouTube videos.

Speaker 3 (06:49):
You can find links to that.

Speaker 2 (06:51):
Including this one, which we are very excited to be
bringing you from the Exactly Right Network Studios. Yes, yes, yeah,
the end, the end.

Speaker 1 (06:59):
Follow us on YouTube, follow us on social media, check
out our website.

Speaker 3 (07:04):
On the rag, on the rag, what are we?

Speaker 2 (07:06):
Let's just do it.

Speaker 3 (07:07):
Let's just do it. H okay, fantastic. Let's take a
quick break.

Speaker 2 (07:11):
And then you'll tell us about poop. Sewers, sewers, give
it to me.

Speaker 3 (07:16):
Okay, poop is gross.

Speaker 2 (07:36):
I love that. That's a sentence that you wrote down upset.

Speaker 3 (07:39):
Yeah. Yeah, I was like, how do I start?

Speaker 2 (07:40):
This is gross?

Speaker 3 (07:41):
Poop is gross.

Speaker 2 (07:42):
It is grody.

Speaker 3 (07:43):
It is it is. There is no getting around it.

Speaker 1 (07:46):
Like, okay, yeah, we can talk about how important it
is as a resource. We can break it down into
like what makes up poop? How do we make poop?
Everyone poops? Pooping is not shameful? Yeah no, I'm behind
all that. Yeah, the fact remains, poop is.

Speaker 3 (08:00):
Grossss It's gross. After all.

Speaker 1 (08:02):
It can contain pathogens, or it can signal your presence
to a predator, or it can attract flies that lay
eggs that hatch maggots. Speaking of which, if you are
tuning in to the YouTube, we have maggot art.

Speaker 3 (08:14):
We do laid yes, multiple yeah, anyway, yeah, you can
see it. It's incredible.

Speaker 1 (08:22):
But maggots are also you know, It's just it is what.

Speaker 3 (08:25):
It is, poop.

Speaker 1 (08:27):
The disgust that poop evokes in us is probably evolutionarily
ingrained because we don't want to be near it, you know.
It's that it's all again, the pathogens, all that stuff,
and this aversion that we feel for poop. It's not new, right,
It's not a product of our modern sanitation system or
like a remnant of prudish Victorian sensibilities. It's yeah, right,

(08:50):
it's not just like it is.

Speaker 3 (08:52):
It is normal to feel disgusted by poop.

Speaker 2 (08:53):
Okay.

Speaker 1 (08:54):
Charles Darwin even called disgust one of the six universal
universal emotions.

Speaker 2 (08:59):
Oh that's so.

Speaker 1 (09:01):
And this disgust for poop it's not specific to humans.
Many animals go out of their way to avoid poop,
like having designated latrines far away from their burrows, or
grazing only in areas uncontaminated by poop. This was a
real issue in Australia after the poop calcul accounted. Yeah,
because they were like, I'm not I'm not eating million

(09:22):
tons right, yes, yes, every year.

Speaker 3 (09:24):
Yea.

Speaker 1 (09:26):
For much of human history, poop didn't pose too much
of a logistical issue for humans, right. We were living
in small groups, we were moving around a bunch. It
was a simple matter to just like, oh, the you know,
the call of nature, and you just take a little step.

Speaker 2 (09:40):
Away from the grow away you poop.

Speaker 1 (09:42):
Oh actually you didn't go away from the necessarily. Yeah,
but it wouldn't.

Speaker 2 (09:46):
Have mattered all that much because you were going to
move on. You were going to move someone else's problems.

Speaker 3 (09:51):
Yep.

Speaker 1 (09:52):
And that is how giardia is everywhere, and now it's
all of our problem. But yeah, so and also in
addition to like it not being a huge issue in
terms of like having to constantly be around your own poop,
you're moving on, and our poop was an essential part
of that nutrient cycle and seed dispersal.

Speaker 3 (10:13):
You know, you eat some berries here, you walk for
a while, you poop over there. Now you got a
newberry bush. Yeah.

Speaker 1 (10:21):
And then it was also not just seeds for you know,
berry plants. It was also we're providing material for decomposers
we're fertilizing the ground. It's the typical circle of poop
like we talked about. But then, of course humans begin
to live in larger groups and for longer periods. We
developed agriculture, we bred livestock, we built permanent settlements, and

(10:42):
poop became a problem.

Speaker 2 (10:45):
Yeah.

Speaker 1 (10:46):
We used as much as we could to fertilize crops
aka night soil. We dug poop pits on the fringes
of our settlements. We designated communal pooping areas. We pooped
on riverbanks and near stream so that the water would
wash the pool away and out of sight. But every
fix proved to be a temporary one. As human populations

(11:06):
grew and grew, pit toilets filled to the brim, poop
shoots didn't always extend to the cesspit that collected sewage.

Speaker 2 (11:15):
Sorry, sorry, sorry, A poop shoots a real thing? Is that?

Speaker 3 (11:19):
It technical that I don't know. I was just imagining
like a tube, you know, what they use for construction exactly.

Speaker 2 (11:25):
I always thought your poop shoot was your butt.

Speaker 3 (11:28):
Well yeah, I think that that's like the idea of
a multiple meanings shoot.

Speaker 2 (11:33):
Like that was a thing they really had.

Speaker 3 (11:35):
I mean, there were I'll get into it, okay.

Speaker 1 (11:38):
But yes, there were pipes more or less that you know,
or they would be uncovered essentially gutters gutters, poop gutters,
but poop shoot just sounds better.

Speaker 2 (11:49):
I love it.

Speaker 3 (11:49):
Yeah.

Speaker 1 (11:51):
And then there were indoor chamber pots that required frequent
emptying at locations not within a quiet or a quick walk.

Speaker 3 (11:57):
You know.

Speaker 1 (11:57):
This was there were a lot of different ways that
poop just you can't. You turn your back and suddenly
there's a massive.

Speaker 2 (12:02):
Pilot's another that you have to do. Of course. Yeah,
it's just like laundry.

Speaker 3 (12:06):
Okay, So it is. I'm like, dais it is just
like laundry. Okay.

Speaker 1 (12:13):
So to put the poop overload into perspective, let's consider Canosos,
which is the largest city of the Minoan civilization, older
than ancient Greece, located on the island of Crete. Around
its peak, say seventeen hundred BCE, there were one hundred
thousand people.

Speaker 3 (12:30):
Living in Canosis, each pooping every.

Speaker 1 (12:33):
Day, of course, well on average, for a total of
fifty tons of poop per day.

Speaker 3 (12:39):
Wow, that's a lot of poops.

Speaker 1 (12:40):
Even in seventeen hundred BCE, that's a lot of poopy
and it, of course, pales in comparison to what the
city of New York makes in a single day today.
And I singled out New York because that is where
the data are available. Okay, so poop and pee combined
to about twelve hundred tons or two point for million
pounds daily, every day, every.

Speaker 2 (13:03):
Day, two point four million pounds of waste from our bodies.

Speaker 3 (13:08):
Does it waste? Though, Aaron, I thought we learned that
it wasn't.

Speaker 2 (13:11):
It's a synonym for poop and pea, turds, turds and p.
We can't forget pee, we can't forget the p.

Speaker 1 (13:18):
Yeah, it's a substantial portion, is yeah, Okay, so it's
it's it's not New York today, but you could you
could see why it would quickly become a pressing matter
immediately an effective solution for the minoans.

Speaker 3 (13:30):
That solution turned out to be water.

Speaker 1 (13:33):
A handful of engineering minded individuals realized the power of
water as transportation, and they devised water supply systems that
piped in rain water to flush toilets toilets.

Speaker 2 (13:45):
They had flushing toilets in seventeen hundred BC.

Speaker 1 (13:48):
Yeah, wow, I mean so the toilets were pretty much
like localized to the Minoan civilization. Okay, And but they
were not just in palaces, like they started out just
in palace. But yeah, I mean, and it wasn't like
continuous supply. You had to you know, dump in you've
ever been somewhere, you had to dump in waters to
the top.

Speaker 3 (14:07):
Yeah, it's like that.

Speaker 2 (14:08):
Wow, that's so cool. And then they had pipes, I mean.

Speaker 1 (14:12):
And also the seats were like really wooded and splintery looking.

Speaker 2 (14:15):
For sure, I mean, where did the poop go?

Speaker 1 (14:17):
Okay, So the water flushed the poop out of the
building and down into the sewers that ran into the
streams that ran into the sea.

Speaker 2 (14:24):
So it was all just sort of like connect yep.

Speaker 1 (14:27):
And since then the world has never been the same.

Speaker 3 (14:30):
Wow.

Speaker 1 (14:31):
And remarkably, four thousand years later, those drains still function
perfectly after a large rain shower.

Speaker 2 (14:38):
Are you serious?

Speaker 3 (14:38):
They still wash? They still washed right down like to
the streams to the sea. Yeah.

Speaker 1 (14:44):
For thousands of years now, though, we have used water
to do our dirty work, separating us from the poo
that we produce, so that we don't have to look
at it or smell it or have it contaminate the
water that we use the invention of flush toilets and sewers,
which were all we'll talk about the modern flush toilet,
because this wasn't one that was like, this.

Speaker 3 (15:03):
Didn't go everywhere. Yeah, exactly.

Speaker 1 (15:06):
They has saved countless lives and it has made our
day to days much more pleasant. Right, But in allowing
us to flush and forget, we have become divorced from
the reality of poop, not as a waste product, but
again as a resource.

Speaker 3 (15:22):
From those first splintery.

Speaker 1 (15:24):
Wooden Minoan toilets to the seat warming, water spraying high
tech toilets of today, we've been moving poop from here
to way over there, radically upsetting the balance of nutrients
like phosphorus and nitrogen across the landscape. And just as
the early Minoans confronted the mounting poop problem in their
city and devised a solution, we finally seem to be

(15:45):
coming to terms with the fact that it's time for
a new solution, or a suite of solutions to contend
with our growing poop issue, our cacatastrophe.

Speaker 2 (15:58):
I can't let that one good it was in the
moment it was it was.

Speaker 1 (16:03):
We have proof of that. We didn't take a break,
and then edit that out brain store. Now it sounds
like we did, but we really didn't. So what I
want to do now is take us through how we've
dealt with our poo and pee and other liquid waste
throughout history, and how a change in how we think
of and deal with poop is really the only path forward.

(16:26):
The Minoans were not the first or the only group
in the ancient world to devise ways to manage the
sewage that was produced in large cities. Around the same time,
the harapan civilization in what is now India also had
a similar drainage system using deep gutters which with removable
covers so you could like get rid of any yeah,
exactly connected from house to house, similar to the way

(16:50):
that many of our modern drainage systems work today.

Speaker 3 (16:53):
Yeah.

Speaker 1 (16:54):
And so for cities that numbered in the tens of thousands,
these Minoan and Harappan sewage systems they did a decent job,
no doubt. Things were still stinky, especially if there wasn't
a lot of rainfall, and like cesspits probably got clogged,
but it did all right considering Yeah, Unfortunately, they were
no match for the more than one million occupants of

(17:16):
ancient Rome. I mean really, the history of sewage systems
and poop comes down to like, oh no, there's too
much poop. Oh we fixed it. Oh no, there's too
much poop again. Oh we fixed it again. Oh no,
you know, it's just like risky forever forever. Yeah, okay,
So how did ancient Romans fix it? With something called

(17:40):
the kloaca maxima cloaka.

Speaker 2 (17:44):
That's a great word.

Speaker 1 (17:45):
It is a great word, Okay, cloaca maxima.

Speaker 2 (17:51):
I know, because like I feel like we should define
because some people might know.

Speaker 3 (17:56):
Yeah yeah, yeah, no, I mean we could.

Speaker 1 (17:58):
So my first exposure to the word kloaca came from
what we use it, the biological term meaning the single
orifice through which many animals do all their business pe
reproduce kloaca. That usage only came into existence in like
the eighteen hundreds, So the word kloaca existed before then,

(18:19):
and it was it translated. It was basically translates into
the word sewer. So kloaca maxima greatest sewer, greatest sewer
of meaning like the biggest largest.

Speaker 2 (18:29):
I love imagining ancient.

Speaker 3 (18:33):
It's like very in line with how I think about
ancient Roman much.

Speaker 1 (18:37):
Yeah, Okay, but Kloaca comes from the Roman goddess Cloacina.

Speaker 3 (18:44):
Based on the word to clean. Oh so it has
sewer clean yeah, yeah, so yeah, the Kloaca Maxima, it
really did live up to its name though in terms
of its size. It was so big that entire wagons
filled with could travel through it.

Speaker 2 (19:02):
It was mess so it's like storm drain like rivers
that we have here in southern California today, like like those.

Speaker 1 (19:08):
Like you could take a boat, like a small boat
throughout it. Wow, isn't that amazing?

Speaker 2 (19:12):
It was just for sewage.

Speaker 1 (19:13):
It was just well no, actually, so every day it
would handle a lot millions of gallons of water and
a million pounds of poop probably flowed through the Chloaca
Maxima every day, something around there. But like our sewer
systems of today, it was not created necessarily to just
handle human waste. It was mostly to prevent to remove

(19:36):
excess water during a rainstorm. And Rome was built on
a swamp.

Speaker 3 (19:39):
Basically, it's the Houston of the ancient world.

Speaker 2 (19:47):
Thank Houston. Someone's gonna get real mad about that.

Speaker 3 (19:50):
Houston is not a swamp.

Speaker 1 (19:51):
Yes, I know that, Okay, just dating facts here. It's
true and so you have to drain. You have to
drain the swamps to prevent flooding, and so that is
what with the Kloaca Maxima also did. It was mostly
to just drain the swamp. I don't know why this
is so funny, but it really is. But the Chloaca Maxima,

(20:13):
I'm just going to say it as many times as possible,
was an engineering marvel, and the Romans poured money into
its construction and its upkeep. It was a real like uh,
it's a real testament to how much they cared about
sewage and sewer systems. Is that the Chloaca Maxima, parts
of it are still standing where many, many, many other
buildings have fallen.

Speaker 2 (20:31):
But they were like this, this should stand.

Speaker 1 (20:34):
Yes, okay, do you want to hear more about what
the toilet experience might have been like for someone in an
ancient room?

Speaker 2 (20:40):
Of course?

Speaker 1 (20:40):
All right, So if you're wealthy, you would have your
own private latrine in your big house, likely situated over
a dugout pit. Or you'd be like, no, I'm going
to get a chamber pot and have someone just get that.

Speaker 2 (20:51):
Get away from more.

Speaker 1 (20:52):
I don't want even this in my pay my house
to do that okay, pay someone nothing. Many wealthy citizens
didn't want to care neck to their house to the
Chloeica maxima because the smell it wasn't Also like there
wasn't water piping continuously through.

Speaker 2 (21:07):
Okay, and so you kind of it wasn't sunk.

Speaker 1 (21:10):
Things just would have hung out there and then vermin. Yeah,
you know it's I get it. So but they were
really the only people to enjoy privacy while pooping were
the wealthy.

Speaker 3 (21:24):
Everyone else that it was a luxury for them.

Speaker 1 (21:27):
Public toilets were constructed, used almost exclusively by men. It
was not a safe place for women. They were found
throughout the city, paid for often by the wealthier citizens
who wanted to avoid poop in the streets.

Speaker 3 (21:39):
And that happened all the time in the streets.

Speaker 1 (21:42):
Yeah, there are so many inscriptions warning people against pooping
in this alley or against this building or whatever. So
there's one found in POMPEII that warned, quote, defecator, watch
out for what might happen to you.

Speaker 3 (21:58):
In an alley in an alley, stop pooping here, defcator, defecator.
If you if you poop, you will be by the way.

Speaker 2 (22:07):
Yeah, we should call more people.

Speaker 3 (22:08):
Everyone is a deficator.

Speaker 2 (22:10):
That's true. What we use it as a disc feels intentional.

Speaker 3 (22:13):
It does, it does. Okay.

Speaker 1 (22:16):
So these these public toilets were housed under a low
ceiling with small windows, so like not a very pleasant,
you know, place to be. And they were essentially marble
benches carved with rows of holes, just roll whole after
hole after hole, no dividers between the holes, so close
that you could hold hands, you could carry on a

(22:37):
whispered conversation or make after work plans with your pooping partner.
People weren't really wearing pants. It was more like a
toga vibe situation as far as I read, you know,
I don't know how widespread togas worth. That's just like
my image of ancient room. But you weren't totally exposed,
so like you weren't dropping trout.

Speaker 2 (22:55):
The way that you would be today. Yeah, okay.

Speaker 1 (22:57):
And so for wiping your heine, there were which I
I love wiping heiney is another great word for wiping
your heney. There were communal communal sea sponges on a
stick were called tersorium or wiping thing.

Speaker 3 (23:14):
Yeah.

Speaker 2 (23:15):
So they just was like a few of them scattered about.
I don't know, what.

Speaker 1 (23:19):
I don't know the numeor yeah, I don't know how
many there were.

Speaker 2 (23:23):
Was there like water, Yes, there was a bucket of water.

Speaker 1 (23:25):
There was a gutter of clean water to clean the
sponge in between uses.

Speaker 2 (23:30):
Okay, a sea sponge. That's actually genius, it is. Yeah,
I mean I love it.

Speaker 1 (23:37):
I don't know if I love it. The commune, it's
the communal part that really gets to me. Yeah, And
whether there was hand washing, probably not. It doesn't seem
to be, so who knows. You can, like, let me check, right, yeah,
let me but know. But okay, So the poop and
pea would flow from these public toilets away into a
sewer system where they eventually emptied into the river Tiber,

(24:00):
which is also where people got their drinking and bathing water.
The filth might have been out of sight, out of mind,
but it didn't mean it wasn't an issue.

Speaker 3 (24:08):
There was water borne illness all over the place.

Speaker 1 (24:11):
It was, I mean, based on descriptions, like it seemed
pretty pretty overrun with poop and pea, and there was
a lot of like issues related to disease because of that. Yes, okay,
So moving on from ancient Rome, though throughout the medieval
period and beyond, sewage construction in most of Europe was
guided by the get this poop as far away from
me as possible principle. Livestock manure was spread on fields

(24:35):
for fertilization, and toilets operated under a similar logic as
an ancient Rome, not the Minoan civilization, minus the chloaca
maxima that effectively more or less effectively drained things away,
so there would be like outdoor latrines for the poor,
you know, pits or barrels, which could then be like
buried or taken away, while the rich built private toilet

(24:58):
rooms in their castles where they like stuck out over
the moat so that the poop and pea would travel
down a shoot into the water.

Speaker 2 (25:05):
A poop shoot, poop shoot. This that always makes me
think of the Game of Thrones, the guy who died
on the toilet. There was anyways, it doesn't matter, but
there was a guy who died on the toilet. He
got shot with like an arrow in the toilet, and
his toilet room was like way up and off away
in the castle. Just was like historically accurate. Just might
it not be an historical show?

Speaker 3 (25:27):
But no, I mean that that I think that is.

Speaker 1 (25:29):
That's what I'm sort of imagining, these little rooms like
just to sort of cut out and then like boop, yeah, okay,
cool into the surrounding moat.

Speaker 3 (25:37):
So like it just would just be poop or in
the moat, just feeding.

Speaker 2 (25:42):
The crocodiles or whatever.

Speaker 1 (25:45):
Feeding something of the carp and catfish, I don't know, uh.
And so that's where it would stay until like the
rains grew heavy enough and then the currents could.

Speaker 3 (25:53):
Carry it away.

Speaker 2 (25:54):
Okay, okay.

Speaker 1 (25:55):
So as European cities exploded in population, the situation.

Speaker 3 (25:58):
Grew dire and more diers. It does, poop piled up.

Speaker 1 (26:02):
Multiple laws were passed like this is how bad the
poop was, right, There were many laws in many countries
about public pooping. They were trying to regulate how much
poop there was on the streets. So, for instance, in Berlin,
a sixteen seventy one law was passed that instructed every
peasant visiting Saint Peter's Church to.

Speaker 3 (26:21):
Take a pile of poop away. It was a popular
dumping ground, so many.

Speaker 2 (26:26):
People would poop there. It was like you need to take.

Speaker 3 (26:29):
Take you to take poop away? Yeah, fascinating, I know.

Speaker 1 (26:34):
In fifteen thirty one, a law in Paris required landlords
to provide a latrine for every house.

Speaker 2 (26:40):
Wow. Not until fifteen thirty.

Speaker 3 (26:42):
One, Yeah, were the laws enforced.

Speaker 1 (26:45):
That Many people did their business in chamber pots in
their home, which they then emptied out of the window
after a yelled warning like look out the Yeah. The
descriptions of people pooping every where in the streets or alleys,
and waste piled high, like there are many of them,
but there it's it's too much, okay. For example, quote,

(27:07):
the louver was a mess. People defecated without restraint or
attempt at secrecy in the courtyards, on the stairs and balconies,
and behind doors, without hindrance from palace attendants. On August eighth,
sixteen oh six, an order was given prohibiting any resident
of the Palace of Saint Germain from committing a nuisance
Therein that same day, the King's son urinated against the

(27:29):
wall of his room.

Speaker 3 (27:31):
End quote. So like people just seem to be pooping everywhere.

Speaker 2 (27:37):
That is so fascinating to me.

Speaker 3 (27:39):
It is to me too, I don't know how.

Speaker 2 (27:44):
Yes, that's like you just I mean, I guess if
you don't really have an alternative, right, If you don't
have an alternative, you got to go nature calls.

Speaker 1 (27:52):
In nature calls and so it's like and the laws
were not effective, and it just kind of of course,
the problem keeps growing. But keeping in the theme with
one man's trash is another's treasure, there was an entire
occupation that sprung out from these soiled streets, the so
called nightmen oh okay so also known as scavengers.

Speaker 3 (28:13):
These nightmen would walk the streets at night.

Speaker 1 (28:15):
They would empty out chamber pots and public toilets to
either sell to farmers or just dump in the countryside.
They would be like, I will handle your waiste. People
had like signs on like carriages or like wagons that
were like I am the best at this. I will
make sure it's love to do this.

Speaker 3 (28:31):
Yeah, yeah.

Speaker 1 (28:33):
And when transport became a challenge, like there was just
too much to carry or whatever, they dug out big
pits and they held the waist there. And this is
when they began to experiment with different chemicals and other
additives to dissipate the smell, or they would heat the
night soil to desiccate it.

Speaker 3 (28:49):
But guess what happened, Darren.

Speaker 2 (28:52):
Something bad.

Speaker 3 (28:53):
I mean kind of just populations keep growing and too
much kept growing, and the nightmen just couldn't keep up,
and so the situation was again becoming dire.

Speaker 1 (29:05):
Fortunately a hero was about to emerge. Ajax the first
modern flushing toilet. Oh, it was invented by Sir John Harrington.

Speaker 3 (29:15):
Ajax was the name. He gave it.

Speaker 1 (29:17):
Yeah, yeah, in England fifteen eighty four, after being sent
away by the Queen, whom he offended with his poetry.

Speaker 3 (29:24):
It's true story. No one knows the exact details, but
like I can imagine, the gossip.

Speaker 1 (29:29):
Was just what did he say this time? But he
embarked on some home construction projects and out of this
creative retreat sprung the toilet. And it wasn't the first,
like I mentioned, the Manoans and Harrappans hold that title,
but it did involve a more advanced flushing system with
valves and a sistern kind of like what we think
of today where.

Speaker 3 (29:47):
It has that on top. And then yeah, he named
it Ajax.

Speaker 1 (29:51):
And wrote an ode in its honor, and then the Queen,
after getting over her irritation towards him, she visited. She
tried it out and she was like I I need
one of these, so she had one built in her palace, home, castle,
whatever it was, whatever it is. Over the next couple
of centuries, the toilet underwent several technological improvements that made

(30:12):
it more feasible to be installed in lots of homes,
and soon everyone it was like, I need this, I
want a standard part of your home. Its popularity was
helped along by British plumber Thomas Crapper, who did not
invent the toilet nor give his name to a slang
word for poop like his name really yeah, but he

(30:37):
did a great job at marketing it, and he kind
of helped to turn the toilet into a status symbol.

Speaker 3 (30:43):
Everyone wanted one for him.

Speaker 2 (30:44):
I want a Crapper, I mean yeah.

Speaker 3 (30:49):
And guess what happened.

Speaker 1 (30:50):
People were so happy to flush and forget and the
problem of excess poop was solved for a.

Speaker 3 (30:58):
Very brief period of time.

Speaker 1 (31:00):
What the toilet had effectively done was move those individual
cesspits from the home to the rivers that supplied the
city with water, making one giant cesspit out of it.

Speaker 3 (31:12):
The situation again grew dire.

Speaker 1 (31:16):
How dire you might ask, Let's go to London eighteen
fifty eight for the full picture.

Speaker 3 (31:21):
Okay, that summer was.

Speaker 1 (31:23):
Unusually hot and dry, but any enjoyment of sunny weather
was thwarted by the shocking stench that emanated from the Thames.
I've mentioned the Great Stink of eighteen fifty eight before
in our Typhoid Fever episode, and I read a quote
in that episode that I think is worth dredging up
for this one. Okay, this is from a newspaper reporting

(31:45):
on the Great Stink. Quote, for the first time in
the history of men, the sewage of nearly three million
people had been brought to seethe and ferment under a
burning sun in one vast open kloeca, lying in their midst.

Speaker 2 (32:05):
I remember this quote now because we made it into
a reel. It's like one of our first reels that
we ever made.

Speaker 3 (32:11):
I don't know why. It just kills me.

Speaker 1 (32:14):
And it's like it is the word kloka, but it's
also like poetic in a way.

Speaker 2 (32:19):
It is it's beautiful and disgusting.

Speaker 1 (32:21):
Disgusting, it's really effective. It is that is effective language,
right there. Uh So, Okay, the times had been getting
more disgusting for years, but the Great Stink really galvanized
many Londoners. Something had to be done about this, not
just because of the unpleasantness of having to breathe that
vile air, but also because that air was thought to

(32:43):
spread disease. My asthma was sort of the leading idea
at the time, And it wasn't the air itself, but
it certainly was the water, as John Snow revealed in
his investigations of the London caller outbreaks from a few
years before, which was of course caused by the nasty
and poorly functioning drainage systems in the city. Those color outbreaks.

(33:05):
So it took a few decades. I'm skipping over so
much here in terms of like the history of sewage,
but eventually a massive and intricate sewer system was built
to manage London's waste. The project was spearheaded by visionary
engineer Joseph Basilget, and the completed system, truly a modern marvel,
still serves the city today.

Speaker 2 (33:26):
Wow.

Speaker 3 (33:27):
And there's a.

Speaker 1 (33:27):
Whole book about its design and basil Get and the
Great Stink if you'd like to learn more, it's on
one of these shelves here. The London sewer system, which
acted as inspiration for many other cities. It operates with
the goal of using water to wash away the city's
poop and liquid waste, and in the brainstorming phase of
this design, several options were presented and dismissed before landing

(33:51):
on this present layout. One of these ideas involved transporting
the waste to farms in the surrounding countryside to use
as fertilizer andn youual value. A four million people's excrement,
which is in the city of London was estimated to
be about worth about one point seven million pounds in
the eighteen eightiesh which is one hundred and seventy eight

(34:12):
million pounds today.

Speaker 3 (34:13):
Oh wow in terms of fertilizer yep.

Speaker 1 (34:17):
But England, not seeing the tremendous worth of this substance,
opted to flush it away, a strategy in keeping with
the sentiment of past centuries that poop was waste and
nothing more, and this sentiment wasn't universally shared even across Europe.
In his book Lemiz, Victor Hugo question question to the
similar approach that Paris took with its sewers, quote, what

(34:39):
do we do with all this golden dung? It is
swept into an abyss? All the human and animal manure
which the world wastes, if returned to the land instead
of thrown into the sea, would suffice to nourish the
world end quote.

Speaker 3 (34:53):
Truth.

Speaker 2 (34:53):
Yeah, he's not wrong, truth.

Speaker 1 (34:55):
And he wasn't just discussing a hypothetical strategy. For millennia,
many cltures had a much different perspective on how best
to deal with the amount of poop and pea that
a growing city produced. Where the ancient Romans and modern
Londoners saw the value of poop in its absence, other
cultures saw its value as a fertilizer. Why did some

(35:17):
parts of the world adopt the view of human excrement
as a valuable thing and others as a thing to
get as far away from as possible. One aspect was
need how many livestock you had, or how fertile your
soil already was, or how much pasture land was even available.
Maybe you were land limited, right, you couldn't just clear
more land when all the nutrients were leached out of
your soil. Or maybe you didn't have and didn't have

(35:39):
the land to have at these ample amounts of livestock
that were producing manure that could be used as fertilizer,
and so you're just like, I'm going to use what's
right in front of me. This is fertilizer.

Speaker 2 (35:50):
I'm already making it.

Speaker 3 (35:51):
Yeah.

Speaker 2 (35:52):
Yeah.

Speaker 1 (35:53):
Throughout Japan's history, for instance, both poop and urine was
sold to farmers to fertilize their crops called knights. Japan
didn't really have acres and acres of pasture land or
many large livestock, and so night soil was highly valued.
If you rented an apartment, your landlord technically owned the
night soil that you produced, and so the rent was

(36:14):
adjusted based on the number of people living in a room.

Speaker 2 (36:16):
How many people are pooping here?

Speaker 1 (36:18):
Yeah, how much can I get for their poop? So
if five people lived in one room, rent was free.

Speaker 3 (36:24):
For example, Yeah, that's hilarious.

Speaker 1 (36:27):
Pooping at a friend's house was considered a generous act
because you're like, thank you for that.

Speaker 2 (36:34):
Oh my god, I love that.

Speaker 3 (36:35):
I know.

Speaker 1 (36:36):
So you might wonder how this practice, which the use
of night soil is still used in many parts around
the world today, how it didn't lead to the spread
of pathogens transmitted by poop. You know, we just talked
about the Great stink and colera outbreaks. And all of that,
and a big part of it was how you process
the poop composting, right, you have to what is the
word ferment, ferment the poop, I guess, And so this

(37:00):
what would happen is like in this composting process, it
would help to reduce the proliferation of pathogenic bacteria in
the poop and break it down into its raw components,
which were more readily used by plants. It's a part
of the decompositions like right, you know. And the second
was just like standard hygienic practices, washing hands, boiling water,

(37:22):
cooking vegetables, things like that. Japan wasn't alone in seeing
the value of night soil. China was also well ahead
of the curve when it came to seeing poop as
a resource rather than waste. One strategy that people used
in China was to let all the refuse from humans, animals,
other parts of agriculture all mixed together with water in
covered tubs and pits, and then after the fermentation process

(37:46):
was complete, they would either pour this liquid maneuver directly
onto the roots or let it dry in the sun,
forming cakes which would desiccate, and then they could sell
yeah mix with water, and there's instant fertilizer. Poop was
so valued that in seventeen thirty seven in China there
was an imperial treatise that commanded treasure night soil as
if it were gold.

Speaker 2 (38:06):
Wow. Yeah, seventeen hundreds.

Speaker 1 (38:08):
You said, seventeen hundreds for that, But it had been
going on for much longer.

Speaker 3 (38:11):
Yeah.

Speaker 1 (38:12):
And so while most of Europe treated poop as a
waste product exclusively, there were a few pockets that saw
it differently, some places that paid for poop rather than
paying to have it be taken away. In parts of
Belgium and in the Netherlands, farmers utilized night soil for
crop fertilization. They constructed specialized casks that could hold over
one hundred gallons. The casks were loaded onto carts where

(38:35):
they were dragged around by a horse, the farmer on
the horse lifting the rope that controlled the lever to
be like now reallyaseam now really some more.

Speaker 3 (38:44):
It's pretty ingenious.

Speaker 1 (38:46):
And even in the US in the late eighteen hundreds
there was a very successful night soil company based in
New Jersey who got paid twice for their labor, first
to remove the poop in the first place, and then
the second to sell fertilizer, and so inspired by their success,
a few sewage farms sprung up around the US, but

(39:06):
eventually they fell out of favor by the end of
the nineteenth century, as did night soil almost across the board.
What changed the invention of commercial fertilizer and the introduction
of germ theory, whereby poop became the enemy and nothing more.
And I think it's important to note, and I feel
like we didn't cover this in an actual episode, like

(39:28):
a regular episode, but in a there was The Devil's
The Devil's Element Book club book.

Speaker 3 (39:34):
He talked about fertilizer.

Speaker 1 (39:37):
And like guano, these islands of guano, and then people
harvesting like bones from battlefields, like old battlefields to use
his fertilizer. And I just find that so because a
lot of that was happening in like the eighteen hundreds
or so, and there was this huge rush prior to
the introduction of commercial fertilizer, and poop was there all along, right,

(39:58):
It's just yeah.

Speaker 2 (40:00):
It is really really interesting, right, especially to think about
that alongside the rise of germ theory, which like we
talk about so much on this podcast, and it is
like so important, and your poop can make you quite sick,
and so it's it is just really interesting to think
of those things as like side by side and like
how yeah.

Speaker 3 (40:17):
Wait to see it in one like one one angle right.

Speaker 1 (40:20):
One perspective of poop is just that it is waste
and nothing more in the enemy, and it's going to
make you sick, and that's it, and that is true.

Speaker 2 (40:28):
It is true, and two things can be true.

Speaker 1 (40:33):
But what have so that when these when these things change,
the introduction of commercial fertilizer and then germ theory things,
even places that had long used night soil, it just
they kind of stopped, like many places stopped. Commercial fertilizer
took over in the twentieth century, and that decree of
treasure night soil, if it were gold, became a relic.

Speaker 3 (40:55):
Of the past.

Speaker 1 (40:56):
Poop was no longer a commodity. It was a thing
to rid yourself of, a thing to fear, and today
most of the world is still stuck in that mentality,
though really we should be following that eighteenth century decree
because it is wild how much waste we let.

Speaker 3 (41:12):
Go to waste.

Speaker 1 (41:13):
Functioning sewage systems are foundational to public health, and everyone
should have access to clean water because water borne disease
kills so many people every year. But it's also clear
that our massive sewage plants have solved one big problem
removal of poop from our immediate proximity, while simultaneously creating another,
too much poop in all the wrong places. We raise

(41:37):
livestock on large scale farms, where their manure leaches into
the waterways near the farms. Meat and other food gets
shipped to our local stores, removing those nutrients from where
they were grown. Then we eat the food and poop
it out, and that gets flushed into waterways, again far
from the original source of these nutrients, and.

Speaker 2 (41:55):
Then it goes into the ocean, goes.

Speaker 1 (41:56):
Into algal blooms, marsh decay, barren farmland, eroding soil's ecosystem
collapse Like these are the consequences of nutrient redistribution across
the landscape.

Speaker 3 (42:06):
Oh man, this situation is again becoming dire. What do
we do about it? This time?

Speaker 2 (42:14):
I have an answer?

Speaker 1 (42:15):
I don't I mean, I don't have an answer personally.
But there are so many people, so many people who
are working on this problem from many, many different angles.
They're designing more efficient toilets, revisiting the idea of sewage farms,
transforming human waste into fuel or fertilizer, even just rebranding
poop into something that's like not shameful. Props to the

(42:36):
poop emoji for that one. It doesn't mean it's like
it's really funny. It's like a very popular emoji. It's
a great emoji.

Speaker 3 (42:43):
Yeah.

Speaker 1 (42:44):
And it doesn't mean like there are many people working
on this, and it doesn't mean that we have everything
under control right now, but we do have possible paths
forward and a ton of amazing innovators that are dedicated
to this work and.

Speaker 3 (42:56):
Really passionate about it.

Speaker 1 (42:57):
Poop is a valuable resource a fertilizer, as a source
of public health data like wastewater can tell us what pathogens.

Speaker 3 (43:04):
Are currently circulating.

Speaker 1 (43:06):
Huge, huge, And it's also a valuable resource on an
individual level, Like what does your pooh say about you?

Speaker 2 (43:14):
Such a good question.

Speaker 3 (43:15):
Well, Aaron, this is where I pose that question to you,
so you can tell me all about what we can
learn from our poop.

Speaker 2 (43:22):
I cannot wait to do that. So I ended last

(43:42):
week's episode mostly just talking about what is typical when
it comes to our poops, right, yeah, yeah, And you
talked to us through in last week's episode, if anyone
missed it, all of the different ways that animals use
our poop as a resource, and poop on a landscape
level scale tells us so much about how we're dealing

(44:05):
with Our poop can tell us a lot. But you're right,
on an individual level, our poop can also tell us
quite a lot. And I think there's an interesting balance,
I guess where a lot of us don't think about
our poop at all. Like we poop and it's done,
it is out of our mind. We're not worried about it,

(44:25):
we're not looking at it, we're not thinking about it.
We're just maybe trying to think about it as little
as possible. And there are also many people who maybe
spend a little too much time thinking about their poops
or worrying about their poops or what is this one poop?
Did I eat beats? Or is this cooling cancer?

Speaker 3 (44:41):
I mean, that's a reasonable question to ask.

Speaker 1 (44:44):
After a beat, after a beat, poop after a beat, poop,
unless it's beats.

Speaker 2 (44:50):
But it is true that our poops can tell us
so much about our health, and a lot of times
changes in our bowel movements might actually be indicator of
an underlying disease. Though my point with today is not
necessarily to make everyone worried about their poops. It's more
just to kind of understand the spectrum. Okay, And since

(45:11):
we already covered the range of typical, we can look
back at our Bristol stool scale to understand the ways
in which our poop can become a typical. If that
makes sense. Love this. So if a perfect poop on
that Bristol scale, which again goes from one to seven,
where one are these hard, separate lumps kind of like

(45:33):
a nut of poop, chunk chunk, PLoP, PLoP, and types.

Speaker 3 (45:37):
Are appreciate that extra little little.

Speaker 2 (45:40):
Too much, and a type seven is entirely liquid. Those
are our two extremes constipation and diarrhea. Yes, and so
that's what I'm going to kind.

Speaker 3 (45:50):
Of focus on constipation and diarrhea.

Speaker 2 (45:52):
Constipation and diarrheall so, and there's a lot of different
ways to classify. Those are not the only poop problems
that you can have, but constipation and diarrhea I think
give us a lot of insight because that does kind
of cover that whole spectrum.

Speaker 3 (46:04):
Right.

Speaker 2 (46:05):
So there's a lot of different ways to classify or
define both of these things. And I'll start with constipation
because I love talking about constipation.

Speaker 3 (46:13):
So has that word been uttered in the history.

Speaker 2 (46:18):
I'll see it in the office all the time, So
I love talking about constipation. How we actually define it,
it's either with this bristol stool scale, but it's never
just exclusively with the bristol stool, So it's usually hard
or lumpy stools, or needing to strain during a bowel movement,
or sometimes feeling like I just can't completely evacuate, like

(46:41):
you poop and you just feel like there's something still
there that needs to come out but it cannot come
out feeling. If those things are happening, usually more than
twenty five percent of your poops, that's what's considered.

Speaker 3 (46:53):
Constipated, huh okay.

Speaker 2 (46:56):
Or sometimes it can be if you're having fewer than
three bowl movements per week, that might also be considered
you constipated.

Speaker 3 (47:03):
Okay, how often? Like okay?

Speaker 2 (47:08):
I love that you're asking questions already.

Speaker 3 (47:09):
I know, I know, well you said fewer that you
said more than or twenty five.

Speaker 2 (47:14):
Twenty five percent of your poops, So who's watching that.
That's such a great question, who, like, how many of
us are paying that much attention to our poop? Right,
I don't know unless maybe you're dealing with constipation, and
then you probably are, because a lot of times it's
maybe more than twenty five percent, Right, it has to
be at least that for us to call it constipation
according to the like Rome criteria, which is the criteria

(47:35):
that we use. But a lot of people who deal
with constipation have been dealing with it for a really
long time. It's estimated most of the studies cite that
in the US something like twelve to fifteen percent are
dealing with constipation, and a lot of times, unless we
can identify the cause of constipation, it gets lumped under
what's called like functional constipation, which really just means that

(47:55):
we don't necessarily have an idea of what the mechanisms are.
But it's estimated that up to thirty percent of people
deal with constipation at least on an occasional basis, so
they like sometimes have issues pooping, and that is thought
to be an underestimate because these are data that are
based on people who seek care. Right of course, right.

Speaker 1 (48:16):
Are you going to talk about the causes of constipation,
because I want to talk about functional constant.

Speaker 3 (48:20):
Like to me, what's your question, what are the causes
of constipation?

Speaker 2 (48:24):
That great questions?

Speaker 1 (48:25):
At what point do you go? We don't know, but
you're clearly constipated.

Speaker 2 (48:29):
Yeah, I mean, it totally depends on the scenario and
also depends on how well it responds to the various
treatment options. Right, But there's a lot of things that
could cause it. It could be that you have slow
gut transit, right, which we know from last episode, can
be caused by a number of different things. Some of
it might be genetics, some of it might be medications
that you're on. Some of it might be the diet

(48:50):
that you are eating, is that right, The diet that
you're eating, diet, the food that your diet or diet.
Some of it might be diet because fiber, as we know,
can increase your stool transit time, and so if your
diet is very low in fiber, then you might have
prolonged transit times, so you might be more prone to constipation. Also,

(49:12):
dehydration can put you at risk of harder stools. Physical
activity increases your motility of your guts, and so we
all live much more sedentary lifestyles, especially like in the
US we're quite sedentary, and so that is actually probably
contributing to constipation. But then there's other things too. There's
like just actual dysmotility. There's something called Hirsprungs, which is

(49:35):
like where it's a genetic disorder where some of your
nerve endings of your colon have not developed all of
the way and so you cannot get contraction the way
that you should. So that can make it very hard
to poop and you can get a huge amount of
stool build up in things. There's pelvic floor dysfunction, anal
sphincter issues, like there's a lot of possibilities, A lot.

Speaker 1 (49:52):
Of possibilities, Are there a lot of solutions?

Speaker 2 (49:56):
Is that great question? I mean yes and no. Right,
the main ways that we go and deal with constipation,
for like a general rule, are going to be using
things like laxatives, which are going to hold on to
water in your stool, so that is going to make

(50:17):
your stool softer.

Speaker 3 (50:18):
That how they work.

Speaker 2 (50:19):
That's how they work. They just still like okay, mirralax,
which is polyethylene glycol. There's lots of different brand names
of it. It's just a very large molecule, and so
it just attracts water. And so you have this molecule,
it doesn't get broken down in your digestive tract. So
it's sitting in your colon holding on to water, and
therefore you have more water in your poop. Therefore it
is softer and easier to pass. And other osmotic laxatives

(50:43):
work the same way. Lactolose, magnesium citrate, all these things.
There's also some other ones that you can use, like
stimulant laxatives. Those are things like bisocotal is one or
senna is another, and these are helping to stimulate paristolsis.
They're helping to stimulate muscular contractions.

Speaker 1 (50:58):
So it's not like a laxative the water aspect, but
in the movement it's moving.

Speaker 2 (51:02):
Yeah, it's helping with movement, and so what you might
use might depend on what you think the underlying issue is,
so it's going to be kind of person dependent. There's
also stool softeners. But my favorite thing about stool softeners
in medicine is that we use them all the time
and there's like no data that they work. Wait, what, doc,
you say? It is like one of the most commonly

(51:23):
used things in hospitals, and like people like to tell
people to use it all the time, and there's like
very little if any evidence that it. It's supposed to
just like help make your stool more slippery, is the idea,
like mucisi me, I don't know, but it doesn't like
it doesn't work, okay.

Speaker 1 (51:39):
So so when you say it doesn't work, do you
mean that there have been studies that have found no effect.

Speaker 3 (51:44):
Yeah, there have been no studies.

Speaker 2 (51:45):
There have been studies that have had no effect. Yeah,
unlike othmotic laxatives and things which great.

Speaker 3 (51:50):
So why why would you use the stool softener over
a laxative.

Speaker 2 (51:55):
I don't know. I don't, okay, okay, but lots of
people do. I don't know. It's thought to be less harsh, okay, right,
because it's not gonna like grab onto a bunch of
water and then like have you at risk of diarrhea
or something quite as much? Right, where you can easily
overdo it with some laxative. So you could end up
with electrolyte imbalances if you overdo it on laxatives things
like that. But realistically I don't know because I don't But.

Speaker 3 (52:17):
What about the like prep for a colonoscope.

Speaker 2 (52:21):
It's basically a huge jug of polyethylene gicoll or. Sometimes
we use sodium based ones too, so like other electron electrode. Yeah, yeah, yeah, okay,
but yeah, that's basically what it is, Just like a
huge jug of it, chug chug, chug with a lot
of water because you're going to be pooping out a
lot of water.

Speaker 3 (52:37):
I know.

Speaker 2 (52:37):
Isn't that fun?

Speaker 3 (52:38):
Yeah, it's great. Fun. Yeah, fun, that's exactly the word
that I would use. Yeah.

Speaker 2 (52:43):
But so that's like, I mean, that's that's most of
the ways that we try. And there's other newer medicines too,
Like there's a lot of there's a lot of newer
medicines that have mechanisms that I'm not going to get
into because I'm not as familiar with it, but there's
a lot of Because constipation is such an issue, there
are a lot of interest in new ways to help
deal with constipation. When these are not effective, these is
like go to first line try it out. If it's

(53:06):
not working, you need to see a specialist kind of
a thing.

Speaker 1 (53:08):
Okay, question about constipation and treatments the like uh, polyethylene
gli call et ceteras of the world. Are those for
acute relief or in is the more like chronic relief?

Speaker 3 (53:23):
Fiber?

Speaker 2 (53:24):
Yes, it's yes, And okay, do you want to talk
about fiber? I can skip.

Speaker 3 (53:28):
We can know. We keep your notes the way you
want them to keep.

Speaker 2 (53:32):
Let's talk about fiber.

Speaker 3 (53:33):
Great. Always I'm always down to talk about fiber.

Speaker 2 (53:36):
I know me too, Okay, So yes, laxatives, stool softeners,
motility agents. These are things that are going to help
treat constipation. Yes, what if you are constipated? Fiber does
not necessarily treat constipation, but it can help prevent constipation, right, Okay,

(53:58):
because like we talked about last episode, it's holding onto
water in your stool, and so it is hugely beneficial
in increasing transit time and in making your stool softer,
and in providing that bulking agent. And there's two major
divisions of fiber. There's soluble fibers, which is like cilium, husk, oats, pectins,
and then there's insoluble fibers, which is like wheat brand cellulose.

(54:20):
Lots of the things that are in our fruits and
veggies and things.

Speaker 1 (54:23):
I can't believe we're getting to talk about insoluble and
soluble fibers.

Speaker 3 (54:26):
So excited.

Speaker 2 (54:27):
Yeah, And most of the if you're getting your fiber
from food sources and not from like a fiber drink
that you're mixing, then you're getting a combination of soluble
and insoluble fibers in most of the foods that you're eating.
And then there's also some of the fibers are like fermentable,
and I talked a little bit about this last episode,
Like the bacteria in our guts can break them down

(54:50):
and ferment them specifically to produce these like short chain
fatty acids that they can then.

Speaker 3 (54:57):
Use to eat.

Speaker 2 (54:59):
Like the bacteria eat break down this fermentable fiber and
eat it, and then some of the cells in our
colon can also use what they break down as an
energy source, these short chain fatty asss.

Speaker 1 (55:11):
Okay, why choose one fiber over the other, and why
are they all important?

Speaker 3 (55:16):
They're all important?

Speaker 2 (55:17):
The answer is that they're all important. Some of them
are increasing bulk in our stool, and some of them
are helping to feed the gut microbiome, and all of
them are kind of doing both, like really, if we
get into it, and so that that is why fiber.
That's why people get so like stoked about fiber and
why fiber is such an important part. There's also so

(55:37):
much interesting data on like fiber because of its effects
on our gut microbiome in helping to treat or at
least prevent the worsening of a lot of like inflammatory diseases.
Colon cancer we think is involved, like our low fiber
diets we think are maybe involved in the increasing incidents
of colon cancer that we see, especially in early onset
colon cancer. It's not one thing, it's many things, but

(55:58):
fiber is a part of that story. So it's it's huge.
And part of the reason that this is important to
you is because constipation, while it's an issue in and
of itself, it can be very painful. It can, like constipation,
can cause its own set of problems, constipation can also
cause other problems. Constipation can put you at risk of

(56:19):
things like diverticulosis, which are these little out pouchings of
your gut wall, especially in the stigmoid colon the part
that sneaks around back before the rectum, and those little
out pouchings can trap poop and then can get infected
or can burst or can burst into a blood vessel
and cause a lot of bleeding. So diverticulosis can be

(56:40):
a problem, and constipation is a big contributor to diverticulosis
is not the only thing, but it's one. Also hemorrhoids
m okay, hemorrhoids are basically everyone actually has hemorrhoids.

Speaker 1 (56:53):
Can I before we go onto hemorrhoids, because I do
want to talk about hemorrhoids, but I want to I
want to go back.

Speaker 3 (56:59):
To fiber unless we're done.

Speaker 2 (57:01):
Are you end of fibert Yeah?

Speaker 1 (57:03):
Tell me a good question the relationship between fiber. I'm
just stuck on these different insoluble soluble. It's fermentable.

Speaker 2 (57:09):
Don't ask me more details, you know, But like.

Speaker 1 (57:11):
We when we talk about a low fiber diet, it
is of course across the board. But are we getting
like is the low fiber diet more low in soluble insoluble?
And are the relationships between these different fiber types and
colon cancer for instance, or like other outcomes.

Speaker 2 (57:29):
It's a good question. It's beyond I don't know.

Speaker 1 (57:31):
Okay, And then how much? So no one's getting enough fiber?
How much is enough fiber? What does that look like?
Our fiber. Uh do do our fiber?

Speaker 3 (57:44):
What do you call them?

Speaker 2 (57:45):
Fiber, fiber, cereals, fiber bars, fiber supplement.

Speaker 3 (57:47):
Fiber powders.

Speaker 2 (57:48):
Ye, yeah, yeah, I love these questions. The recommended amount
in the US is like twenty eight to thirty five
grams of fiber a day. Okay, okay, a cup of
raspberries as an example. I can't believe I know this
in my head because I didn't write anything.

Speaker 3 (58:01):
We've talked about this, because raspberries especially are very high fibers.

Speaker 2 (58:06):
Of all the fruits, they're one of the best. Because
a cup of raspberries is like eight grams or so
of fiber a cup, so it's like pretty dece Kiwis
also have a lot of fiber. Broccoli has a ton
of fiber. Beans, especially white beans, so much fiber means
white interesting, navy beans have more fiber than most other beans.
Don't ask me why, No clue. Oh, lentils, lentils, lots

(58:27):
of fiber. Don't know how much. I don't have the
rest of them memorized because I usually just give people
a chart. It's one of my that's my standard handout.
If you come see me for a physical that's literally
part of my hand.

Speaker 3 (58:37):
Bring bring one next time, yea time we're together.

Speaker 2 (58:39):
Okay, I just got it from the like NIH website
or whatever. Okay, yeah, still I didn't make it. But no,
so that that's a recommended amount, and most of us
are probably getting much less than that. Like if you
but your question about like fiber supplements and things like
that can be really helpful, especially some of those soluble
fibers like sillium husk and things like that tend to

(59:00):
tolerate really well because they're not going to be as fermentable.
You're going to get a little bit less bloating potentially
with those, but you could you could get bloating with anything,
especially if you're going from like no fiber right to
some fibert start small, baby steps, baby steps. Always, this
is not a medical advice podcast. Let me remind you all,

(59:21):
we're just talking generalities. But yeah, so that's that I
answer all those questions. Those count. But of course it
is better if you're getting your fiber from whole foods
because then you are getting a mix. And I don't
know the answer as to like what percentage should be
this or that, and like there's probably people who are
doing those studies to kind of really look into it.
But I don't know the answer to that.

Speaker 1 (59:42):
I know, and this like we haven't said this yet,
which I'm shocked that we haven't said this. But there
are so many other topics that are related to poop, yes,
that we will cover.

Speaker 2 (59:52):
There's so many that I'm like, I will say this
word and then we need to do a whole episode
on it.

Speaker 3 (59:56):
Colon cancer, cool and cancer, early on set, colon cancer,
so many things huge, Yeah, diverticulosis.

Speaker 2 (01:00:02):
Speaking of hemorrhoids.

Speaker 3 (01:00:04):
Hemorrhoids, so this could be a whole episode.

Speaker 2 (01:00:06):
Oh my god, it actually would be.

Speaker 1 (01:00:08):
I want to know about the because I was thinking
about the development of laxatives.

Speaker 2 (01:00:12):
Oh interesting, right, okay, so we.

Speaker 1 (01:00:14):
Should do a and also the development of something hemorrhoid
cream and whether it is true that you should put
them under put it under your eye for puffiness. I
feel like that was something in miscongeniality.

Speaker 3 (01:00:29):
Really, that's where I learned that.

Speaker 2 (01:00:30):
I mean, it's just like a low poncy steroid usually. Anyways,
we're getting off the point Listen, hemorrhois hemorrhoids. Everyone has hemorrhoids.
They're just collections of blood vessels that are in your
rectum and your anus, so they function like cushions basically
that help keep your anal canal closed because we want
it closed most of the time. They help soften the

(01:00:51):
transitive poop, so your poop has like do do think
of it as like bointing off.

Speaker 3 (01:00:56):
Like a little pinball machine, like a pinball gently off.

Speaker 2 (01:01:00):
But they also they are basically collections of blood vessels.
And because they are venous vessels, like they're veins, not arteries.
Our veins can get swollen, and as they get swollen,
they can sometimes burst open and bleed, either in small
amounts or sometimes in larger amounts, and depending on where

(01:01:21):
they form in the anal canal. Your anal canal is
so interesting because some of it has sensory sensation. The
external part you can feel it has a lot of
nerve endings, and the inner part does not. So if
you have internal hemorrhoids, they generally don't have any pain
or discomfort or itching, but external hemorrhoids can cause quite

(01:01:42):
a lot of itching and pain because especially they don't
tend to burst open, though they can, but they can
get very large and very very painful because they're like
external so you're basically like sitting on them. So those
can be quite painful, like little water balloons filled with
blood basically right around your opening. And so those are

(01:02:04):
you are at higher risk for those with constipation, like big, big,
big time, because it is all of that increased pressure
and the straining straining to poop really puts a lot
of pressure on that anal canal, and so it really
increases the pressure in those veins, so then blood pools
up in there.

Speaker 1 (01:02:20):
I'm just I'm thinking of as someone who listens to
a lot of like books on tape and in my
car and when I'm running and walking the dog and
when someone gets in the car with me and I
have like, you know, like a colorful scene in one
of five books I'm imagining of all of our episodes.

Speaker 2 (01:02:39):
Someone is playing this and.

Speaker 1 (01:02:41):
They're they're like, I don't know, brother in law gets
in the car. It's like, I'm you know what exactly
they have on the bluetobe speaker.

Speaker 2 (01:02:50):
Yeah, yeah, this is one to share with your family.
Please do, because I'll keep going to tell you about
anal fissures, which are another consequence of constipation.

Speaker 3 (01:02:58):
Consequence of constipation not related to hemrhoids.

Speaker 2 (01:03:01):
Not directly related except that they're both like an anal
disease basically, But anal fissures are also this increased pressure
sitting constipation issue. They're just teeny tiny, little like paper
cuts almost in the skin of the anus, and so
they're super super painful. So treatment for that is really
to avoid constipation, and sometimes you need surgeries and things

(01:03:23):
like that to kind of help treat those. So yeah,
So constipation is a big deal, right because it can
be a problem in and of itself, and it can
cause all of these other problems. There's something called stircurle colitis.
We won't even get there because it's quite extreme. But
on the other arm, now I'm like, what, I don't
google it after that. On the other end of the

(01:03:43):
spectrum is diarrhea. Yes, and we've talked a lot about diarrhea.
I spent more time on constipation because we don't ever
really cover it on the podcast, but we've talked quite
a lot about diarrhea. You define acute diarrhea as like
three loose or watery stools in twenty four them. My
kid will tell you I only had two, so it's
not diarrhea. They're well trained. But chronic diarrhea we define

(01:04:10):
as loose or watery stools similar to constipation in at
least twenty five percent of your stools, lasting for at
least three weeks. Okay, that would call chronic diarrhea.

Speaker 3 (01:04:18):
Yeah.

Speaker 2 (01:04:19):
And one of the biggest issues with diarrhea is that
you're getting a lot of water loss with it, right,
and diarrheal poops tend to be not only higher in
water content, they also tend to be higher in protein content.
And as you're losing all this water, you're also losing
all those electrolytes that are with that water. So with diarrhea,

(01:04:41):
you're at really high risk of dehydration and electrolyte imbalance. Uh.

Speaker 3 (01:04:46):
Protein, Yeah, because.

Speaker 2 (01:04:47):
Things are just not getting digested and broken down all
the way. So fats too. Depending on the type of diarrhea,
it could be. It just depends on It depends on
what your GI tract is able to absorb versus not.

Speaker 3 (01:04:59):
What do you mean by t types of diarrhea.

Speaker 2 (01:05:02):
I mean what is causing your diarrhea can affect the
type of diarrhea that you are having. So for example,
if you have an infection that's just tearing through your
gi tract so that your say, colon just isn't really
absorbing any water. Then you're just going to have really

(01:05:24):
watery stools. But you're still going to probably be absorbing
all those nutrients because that happens in your small intestine. Yes, Okay.
On the other hand, if you have no more gallbladder,
then you are leaking out by all all the time. Yeah,
So you might have less ability to digest fats, so
you have more fat that just made it all the

(01:05:46):
way through to your colon and that is providing a
slippery slide. Then you might have diarrhea that is more
fatty and is floaty fatty. But there's just I mean,
there's lots of ranges of diarrhea, and like you were
talking about, there's lots of ranges of smells of diarrhea.
There's some people who are like, I can smell a
sea dip diarrhea versus not. So is it infectious, is

(01:06:08):
it chronic diarrhea? Is it more of an acute diarrhea?
All of them, though, can put you at risk of
things like collectrolide imbalance and dehydration and all.

Speaker 3 (01:06:17):
Of that chronic diarrhea. Okay, Yeah, yeah.

Speaker 2 (01:06:20):
And prevalence rates when it comes to diarrhea, I don't
have like a one statistic like we do for constipation
because they range hugely. And we've talked so much on
this podcast about acute infectious diarrhea, especially in low and
middle income countries. How many kids die from diarrhea every
year is in the millions. It's very depressing. But even
in high income countries, it's estimated that chronic diarrhea, the

(01:06:43):
prevalence can range from like three to eight percent, which
is not a small amount of people. No. So there's
a lot of different things that can cause both constipation
and diarrhea, but one that I want to kind of
talk about because it can actually cause both. Okay is IBS.

Speaker 3 (01:07:04):
Yeah, okay, okay, okay.

Speaker 2 (01:07:05):
Yeah, And again this probably deserves its whole lon always
does we need to do one, Yeah, we do.

Speaker 3 (01:07:10):
Don't please don't take this as we're just going to
throw this in.

Speaker 2 (01:07:13):
No, no, But but I can't do a whole two
episodes about poop and not talk about IBS, especially about
problematic poops, because talk about the poster child of problematic pooping.
Yes it's IBS, So IBS or irritable bowel syndrome, not
the same thing, by the way, as IBD, or inflammatory
bowel disease, which very commonly causes diarrhea, especially bloody diarrhea,

(01:07:34):
and is an autoimmune disease, an inflammatory and a huge problem.
IBS is not that it used to be like a
diagnosis of exclusion, but it's not anymore interesting now. It's
very much like you should positively diagnose this as IBS.
What is the criteria, Well, they can they can range
a little bit, but the core core criteria are recurrent

(01:07:57):
cramping abdominal pain. Okay, So you get cramped, being pain,
and then changes in stool frequency or consistency, and this
is where it can range. Some people have what's called
IBS C, which is IBS with constipation, some people have
IBS D, which is IBS with diarrhea, and some people
have mixed CD CDM. We call it though, oh, mixed,

(01:08:20):
because you have both either constipation or diarrhea, but you're
having these changes in your stool frequency like I'm having
a poop all the time all of a sudden, or
consistency where like i was having like a Bristol three
or four and now I'm a seven.

Speaker 3 (01:08:34):
Okay, I'm just so confused about changes in yeah, because
that implies a time period.

Speaker 2 (01:08:40):
This has to be for at least three months, and
it has to be happening at least three I think
three times a week is the three times a week
this is the criteria. The d or C is the
the changes in your stool. Yeah, so, like what is
your and it's associated with this cramping. So you're having
this pain and then you have either a constipated poop
or a diarrheal poop or one or the other.

Speaker 3 (01:09:02):
And it's happening for three months months Yeah, yeah, Okay.

Speaker 2 (01:09:08):
And we still do not understand IBS. It's the reserving
of its whole own episode. But we are pretty sure
that it is at least in part a disorder of
the gut brain axis, which is just so interesting and fascinating.

Speaker 1 (01:09:22):
To me, I know, I mean, the phrase itself is
is really compelling.

Speaker 3 (01:09:27):
And what's underneath the surface we don't know. Question.

Speaker 2 (01:09:33):
But yeah, So it's basically like your guts and your
brain are not talking to each other the way that
they should.

Speaker 3 (01:09:38):
Ye.

Speaker 2 (01:09:39):
Your neurotransmitters are probably involved. Serotonin. You have more of
it in your gut than you do in your brain,
et cetera. But then you also see with this intestinal dismotility.
So whether that is your guts are going too fast
and so you're just pooping your brains out because you're
not absorbing things because they're moving too quickly or you're
going really slow and there that's why you're constipated. A

(01:10:00):
And this is really interesting, visceral hypersensitivity, and that's where
you get this pain. So viscera is like your your
guts and hypersensitive, meaning that your nerve endings are feeling
more pain than they should.

Speaker 3 (01:10:12):
Interesting.

Speaker 1 (01:10:13):
So because we've talked about hypersensitivity before when I.

Speaker 2 (01:10:18):
Don't remember the metriosis maybe maybe, yeah, yeah, And.

Speaker 3 (01:10:21):
So it's the same sort of thing. It's like those
pathways have been carved out and so like it's like
a super.

Speaker 2 (01:10:25):
Highway yes to pain, Yeah, exactly exactly. But so yeah,
So there's a lot there's a lot of research being
done in IBS. There are a lot of new medications,
especially to treat like IBS with constipation. There's medicines that
are specific for that same thing with IBS with diarrhea.
So like there's a lot of research, but there's also
a lot of people who just like suffer with either

(01:10:47):
constipation or diarrhea, and they're looking for ways to manage it,
and so they turn to things like fiber or prebiotics,
which are all the rage right now, which is usually
just fiber. Really, Yeah, they just market it in a
weird and different way. Prebiotics that's what they're okay, and
then probiotics is the other one. Ah, So let's talk

(01:11:10):
a little bit more about probiotics, because again, we can't
talk about poop and not talk about probiotics. It's not
I think the last time we talked about probiotics was
in our c Diiff episode. Yep, sure, I don't remember
I honestly though, that was a long time ago, that episode,
and I'm not sure that we have that much more
data than we did way back then. People use probiotics,
and they will recommend that you take probiotics for anything

(01:11:33):
from diarrhea to constipation to bloating, whether that's acute infectious
diarrhea or chronic diarrhea. Right, there's very little data that
show that there is a benefit to probiotics depending on
the certain circumstance that you're using them for.

Speaker 3 (01:11:52):
Tell me about those circumstances.

Speaker 2 (01:11:53):
Well, most of the data. Most of the data is
on antibiotics asociated diarrhea or like if you use antibiotics
or you're using antibotics for something like c DIFF. And
even then the data is really really mixed. The biggest
issue is that there's huge heterogeneity in how each of

(01:12:16):
these studies are conducted.

Speaker 3 (01:12:18):
And who's conducting them.

Speaker 2 (01:12:19):
Who's conducting that Mostly it's like people who are making
supplements or yogurt or something, So there's that issue, But
there's also just huge heterogeneity and like which bacterial strains
are they actually using in this study? How many bacteria
are you actually getting in that capsule?

Speaker 3 (01:12:34):
Well, because it's got to go through your stomach.

Speaker 2 (01:12:36):
Exactly, it has to survive the acidic environment of your stomach,
it has to make it through your small intestine to
try and colonize your colon. We know now that that's
like a twenty plus foot journey, so that's not necessarily easy.
There's also a huge issue with the fact that in
the US there's absolutely no regulation on these things because

(01:12:58):
probiotics are regulated as supplement and see our supplement.

Speaker 3 (01:13:01):
Episode for so much more.

Speaker 2 (01:13:02):
Yeah, we or they're sometimes classified as a food product,
right if it's like a yogurt or yogurt drink or
something like that. So we don't have really any data
on how much live bacteria are even in your gummy
or your capsule or your juice drink, how much of
those will survive, or if that particular strain is necessarily
beneficial for you in your specific clinical scenario.

Speaker 1 (01:13:24):
I know, I honestly it is. Really it's really frustrating.
Like the I think in particular, one of my one
of my irritants is the probiotic soda. Yes, and I'm
just like it's soda, it's sugar, yeah, what, it's just
I mean, I'm sure there's more stuff in there, but like.

Speaker 2 (01:13:44):
Right, some of them are have prebiotics, so again they've
got like fiber or like non digestible sugar.

Speaker 3 (01:13:49):
Okay.

Speaker 2 (01:13:49):
Great. The other issue too, is that we have some
data on a few species. We've got some decent data
on Biffitobacterium that at least it's probably not harmful. On
a few species of Lactobacillus that again, they are good
colonizers and they're not harmful. And sacrimices, which is actually
a yeast, right, but that's just like three and like

(01:14:10):
a couple species of Lactobacillus. Right, So if we're talking
a handful of species out of the thousands that colonize
our guts, like, we don't know what we're doing when
it comes to probiotics, we don't. So there are people
who say, well, taking one or two species is never
going to be enough. It's never going to do the
thing that you needed to do. What we need is
a fecal transplant erin.

Speaker 1 (01:14:32):
Okay, before we talk about fecal transplants, Yeah, I do.
I feel like every time we end up talking about
the microbiome, we did it.

Speaker 3 (01:14:38):
More recently aerin and I don't remember what it was.
We're always like, the hype is overrated, and it's the
hype is not overrated for the microbiome it itself, No,
it is for our understanding of it correct and how
we are able to manage and optimize it because we
just aren't there yet, right, maybe we will be, but
we're not there.

Speaker 2 (01:14:58):
No, not even closed. And I are are we there
with fanfre we no or not? But fecal transplants are
essentially like that. That is one of the answers. Right,
It's like, well, okay, giving someone just some lacto bacillis
or lactobacillis and biffittobacteria like two little bacteria. Is that
going to change the entire architecture of their gut microbiome?

(01:15:19):
Probably not right, but hitting them with someone else's entire
gut microbiome might. And that's the idea behind fecal microbiota
transplant or FMT. This is a huge field of research.
I will not do it justice, however. The idea is
basically that you take a microbial community from a healthy

(01:15:40):
person's guts, someone with bristol three or fours all the time.

Speaker 3 (01:15:44):
Beautiful poop, no blowing east exceptional.

Speaker 2 (01:15:47):
Love it all the time, and you give it to
a person with some kind of gut disease. You give
them some of their poop because in that poop, again,
fifty percent of the biomass of their poop is bacteria.
You can do this a few different ways. You can
instill the poop into somebody via colonoscopy from the bottom
or an NG tube from the top, because you wouldn't

(01:16:10):
want to just eat it because that's gross. But you
could make it into pellets, and then you could take
it as a capsule. You can freeze dry them, or
you can freeze them either way, And there is so
much research being done on this. It is used clinically already,
but only in one scenario so far outside of the
research sphere as of recording. So there is a FDA

(01:16:34):
approved treatment here in the US for recurrent se diff
infection that is an FMT. There's two approved products. One
of them is given via an enema suspension and the
other one is oral capsules, which is just really exciting
because that's so much more palatable to people. Yeah, then

(01:16:58):
and also like lower barrier to edge because you don't
have to go into the office, you don't have to
do it in clinic, et cetera. You could justo is
that you just pop it in your mouth, it wallow
it down. So it's a very exciting area of research.
But that's all that I really have about it. Because
there's a lot of people who are wanting to use
it for a treatment of IBD. There's some really promising
research in that area. There's some promising research on it

(01:17:20):
for IBS even which I think is very exciting. But
that's all that I really have about that.

Speaker 1 (01:17:26):
I mean, we could do a whole another whole I
know that in our CDF episode we did like a
big segment on.

Speaker 2 (01:17:32):
We did FMTS shout out to doctor imaj Di Ausmann,
who we had on the pod.

Speaker 1 (01:17:36):
Great, But I think that we could do a whole
like update episode on it because I also want to know, like, Okay,
people who got a fecal transplant.

Speaker 3 (01:17:44):
Five years ago, how are they doing now? What are
their poop like today?

Speaker 1 (01:17:47):
Do they have the same microbes that they were you know,
laced with in that first certainly not.

Speaker 2 (01:17:54):
I would think that there's some turnover.

Speaker 3 (01:17:56):
So there's turnover, But I mean, like, how much does
the community community?

Speaker 2 (01:18:00):
Oh, it's so interesting erin. I know, there's just so
much I think about our guts and our poop that
is exciting, I know.

Speaker 3 (01:18:08):
But it's it's very true, and I feel like it
has been a field of like taboo to talk about
or to be excited about her be like it's really
interesting or anything like that, and so it's discouraged interest
in this really.

Speaker 2 (01:18:21):
Is gross, right, but it's also awesome. Yeah, I love it.
That's pretty much the end of what I got. Aaron.

Speaker 3 (01:18:28):
Poop is gross. It is awesome. We love it.

Speaker 2 (01:18:31):
We love it. There's more to it we'll wash our
hands after we poop, and.

Speaker 3 (01:18:34):
We we will certainly do that.

Speaker 1 (01:18:38):
Should we tell the people where they can read more
shit about fun poop stuff?

Speaker 2 (01:18:41):
Fun poop stuff.

Speaker 1 (01:18:42):
There is so much more when it comes to a
the history of sewers and be what people are doing
about solving the poop problem. So there's a book by
Lena Zeldovich, who if I interviewed for a book Club
episode earlier this year for about phase therapy. But her
earlier book is called The Other Dark Matter, The Science

(01:19:04):
and Business of Turning Waste into Wealth and Health, really fascinating.
Then by Steven Halliday, The Great Stink of London, Sir
Joseph Basilgett and the Cleansing of the Victoria Metropolis, and
then another book by him as well. But it's like
an illustrated coffee table book for sewers and it's called
An Underground Guide to Sewers or Down through and Out

(01:19:25):
in Paris, London, New York. I love and it's it's here,
it's it is honestly beautiful and really fun, and I
loved it.

Speaker 3 (01:19:32):
It was great.

Speaker 2 (01:19:34):
I also actually had a book for this one. I
never have books, but I did enjoy by doctor Pong.
It's called Constipation Nation, which is such a good type title.
I really did enjoy that book. I rarely read entire books,
and I actually read that whole time thing. So that's
how you know it was good and that there's like
a lot more detail on constipation. I think there's even

(01:19:54):
like treat your constipation smoothies at the end, which is
hilarious to me. But then I also loved, oh this
is or I have the citation for the paper. We
actually mentioned the last episode about how it takes only
twelve seconds to poop because I didn't get into like
we spend so much time on the toilet.

Speaker 3 (01:20:09):
I mean, and that's related to hemorrhoids, and that's related.

Speaker 2 (01:20:11):
To there was a twenty twenty five paper that was
like if you spend time on the phone, you're at
higher risk of hemorrhoids. And I was like, there's so
much to this, let's keep going right episode Anyways, that
paper was from twenty seventeen. It was called the Hydrodynamics
of Defecation, published in Soft Matter Soft Matter, and then
I've got several papers on like the Global Prevalence of
Constipation on FMT. I also have some more data on

(01:20:34):
because we didn't get deep into this, but on colon
cancer rates, and we're going to talk more about colon
cancer later this season, so you can find all of
it on our website, this podcast with killy dot com
under the episode stap.

Speaker 1 (01:20:44):
You can thank you to Bloodmobile for providing the music
for this episode and all of our episodes.

Speaker 2 (01:20:50):
Thank you to everyone here at the Exactly Right Studio.
Thank you and Tom and Leanna and Brent and Pete
and everyone who's involved in making this podcast possible.

Speaker 3 (01:20:58):
Pick Yeah.

Speaker 1 (01:21:00):
A big thank you to our listeners who listen or
watch or read the transcripts. Even anyone you know who
somehow enjoys or you know, just partakes in this podcast.

Speaker 3 (01:21:10):
You don't even have to enjoy it. Thank you.

Speaker 2 (01:21:12):
Thank you. It helped us out as always. Thank you
also to our patrons. Your support really really does mean
the world to us, so we really appreciate it.

Speaker 3 (01:21:20):
Yes, thank you, Thank you. Well. Until next time, wash
your hands, filthy animals,

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Erin Welsh

Erin Allmann Updyke

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Ep 201 Poop Part 2: Flushed away