The signs of IBS used to be too taboo to even mention, but now they're all over TikTok. Here's what's behind the cultural pooping shift and why it matters.
Some people act as if they don't have bowel movements, while others make TikToks about them. For something that was often left behind closed (bathroom) doors, bowel movements and digestive problems seem to be a growing topic of common conversation in line with the public's growing interest and knowledge of digestive health, including the gut microbiome.
Irritable Bowel Syndrome in particular has been enjoying a moment in the spotlight with hashtags and trends on social media, including "Hot girls with IBS" and "All hot girls have stomach problems." Although satirical, the videos prove one thing: More people (or more "hot girls") are willing to talk about their bowel movements, make light of them and even bond with others over them. In addition to normalizing a bodily function that everyone has, the trend is helping people become aware of common digestive issues -- such as diarrhea, constipation and bloating -- and imploring people to take more interest in their own gut health.
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Dr. Niket Sonpal is a gastroenterologist in New York City. He says that people's increased openness about their bathroom habits might be due to cultural changes, media and even the popular use of the poop emoji. When teaching medical students, Sonpal tells them there will be two camps of people.
"One camp is going to be poopers and flushers, and the other camp is going to be poopers and lookers," Sonpal says. "It's good to be a pooper and looker so you know what your stool look like: if there's blood, etc."
IBS and constipation are more common in women than men, but you wouldn't have known it. In 2008, a study by Washington University and Loyola University Chicago found that women who visited a urogynecologist, a specialist who treats the female pelvic floor, greatly underreported bowel issues, such as difficult bowel movements, flatal (gas) incontinence and fecal incontinence. When questioned further, 76% of the women reported a bowel symptom.
The stigma surrounding pooping may have started around the time of the Renaissance, according to a Medium report on Dominique Laporte's book History of Shit, after Parisians were forbidden from emptying their chamber pots (or pooping) in the streets, forcing them to hike away to do their business. As pooping went private, we came to value purity and cleanliness when it comes to what goes on in the bathroom, and that's especially true for women.
"At one level it's an association of women with purity," psychologist Nicholas Haslam told the New York Times. "At another it's a double standard applied to hygiene and civility, where the weight falls disproportionately on women to be clean, odorless and groomed."
In recent years, people have started embracing the joys, or at least the normalcy, of having bowel movements, thanks in part to inventions such as the Squatty Potty, a stool people use to prop up their feet while sitting on the toilet to readjust their colon and relieve constipation. Fun trends exploring the importance of the gut microbiome, such as the "blue poop challenge," have also guided people to be more aware of their digestive systems.
The significance of the women claiming the "hot girls with IBS" trend is a big one in our culture's digestive health journey, as it's been women who've historically felt unique pressure to keep the details of bathroom habits private, or deny them all together. (In a 2013 Huffington Post piece, the author dissects an ad for Poo-Pourri titled "Girls Don't Poop," which claimed to "save your relationships" by removing evidence of your bowel movement.)
The TikTok trend of talking about stomach issues is also connected to other wellness trends, including the body positivity movement and its normalization of bloating. In one video, a TikTok creator describes what happens when her bloated stomach from last night disappears the next morning with the flush of a toilet.
People talking about their IBS also sheds light on the syndrome as a women's health issue. Women in the US are twice as likely to have IBS as men, and younger women are most likely to experience IBS, according to Oregon Health and Science University. It also can be related to pelvic floor health more generally.
Read more: IBD vs. IBS: What's the difference?
Sonpal says he does see more patients presenting with symptoms of IBS, and that it's likely due to the tumultuous year of 2020. By the same token, he thinks that all Americans will experience some symptoms of IBS in their lifetime -- thanks to the connection between mental health and the gut. That's the reason for the phrase "gut instinct," Sonpal says.
"Irritable bowel syndrome has a lot of causes and a lot of factors," Sonpal says. "And that includes things like depression, anxiety, emotional distress, big life changes, life events, exams," he adds, noting that he also likely experienced IBS during the time of his medical licensing exam.
"All of these things can cause stress problems with different neurotransmitters from the mind to affect the gut," he says. Other factors like bacterial growth, fiber intake, binging unhealthy foods and general diet can affect IBS, he says.
Sonpal says that because they're going in to see a gastroenterologist, a specialist who deals with the digestive system and all its woes, most of his patients are comfortable talking about their bowel movements. If someone is a pooper but not a looker, there's a chart for that: A nine-image diagram allows patients to point out where their stool falls.
With more people speaking out about what's going on with their bowels, poop shyness seems to be on a lasting downward trend. People, especially women, are ready to talk about their digestion and its quirks -- even for the world to see on TikTok. As more information becomes available about gut health, we can expect to see even more information about people's guts.