The belief that one "must have a bowel movement every day to be healthy" is a common misunderstanding. According to international medical literature and the Rome V criteria—the latest standard for diagnosing functional gastrointestinal disorders—a normal bowel movement frequency of once every two to three days is still within the normal range and not indicative of illness.

Constipation is not solely defined by the frequency of bowel movements. Under the Rome criteria, constipation is considered when at least two of six symptoms are present: straining during defecation, lumpy or hard stools, a sensation of incomplete evacuation, a feeling of anorectal obstruction, manual maneuvers required to facilitate defecation, or fewer than three bowel movements per week. A frequency of "fewer than three times a week" is just one of these six criteria, not the sole mandatory condition.

Stool shape can also indicate digestive health. According to the Bristol stool chart, hard, lumpy stools often suggest constipation, whereas soft, formed, and easily passed stools are typically considered normal. Persistent loose or watery stools may indicate diarrhea.

Illustration created by AI

Therefore, instead of just counting bowel movements, one should pay attention to whether stools are easy to pass, if there is pain, and if there is a feeling of complete evacuation or lingering discomfort. If you have a bowel movement once every two to three days but your stools are soft, easy to pass, and your body feels comfortable, this situation is not a concern.

You should seek medical attention if you experience warning signs such as: blood in stool, unexplained weight loss (more than 5% of body weight within three months), anemia, nocturnal diarrhea that wakes you up, or fecal incontinence. Special attention is needed if symptoms appear after the age of 45 or if there is a family history of colorectal cancer or inflammatory bowel disease.

Dr. Vo Hong Minh Cong

Deputy Director, Nhan Dan Gia Dinh Hospital