WEBVTT - Ep 201 Poop Part 2: Flushed away 0:00:00.320 --> 0:00:03.800 Sir, I traversed this day by steamboat the space between 0:00:03.840 --> 0:00:08.000 London and Hungerford Bridges between half past one and two o'clock. 0:00:08.560 --> 0:00:11.200 It was low water, and I think the tide must 0:00:11.200 --> 0:00:14.360 have been near the turn. The appearance and the smell 0:00:14.480 --> 0:00:18.079 of the water forced themselves at once upon my attention. 0:00:18.920 --> 0:00:23.320 The whole of the river was an opaque, pale brown fluid. 0:00:23.880 --> 0:00:26.480 In order to test the degree of opacity, I tore 0:00:26.560 --> 0:00:29.640 up some white card into pieces, moistened them so as 0:00:29.680 --> 0:00:32.559 to make them sink easily below the surface, and then 0:00:32.640 --> 0:00:35.440 dropped some of these pieces into the water at every 0:00:35.520 --> 0:00:39.159 pier the boat came to. Before they had sunk an 0:00:39.320 --> 0:00:43.360 inch below the surface. They were indistinguishable, though the sun 0:00:43.400 --> 0:00:46.880 shone brightly at the time, and when the pieces fell edgeways, 0:00:47.040 --> 0:00:49.880 the lower part was hidden from sight before the upper 0:00:50.080 --> 0:00:54.400 was underwater. Near the bridges, the feculents rolled up in 0:00:54.480 --> 0:00:57.840 clouds so dense that they were visible at the surface 0:00:58.160 --> 0:01:02.920 even in water of this kind. The smell was very 0:01:02.960 --> 0:01:06.200 bad and common to the whole of the water. It 0:01:06.280 --> 0:01:08.640 was the same as that which now comes up from 0:01:08.720 --> 0:01:11.959 the gully holes in the streets. The whole river was, 0:01:12.040 --> 0:01:16.039 for the time a real sewer. Having just returned from 0:01:16.080 --> 0:01:19.080 out of the country air, I was perhaps more affected 0:01:19.080 --> 0:01:21.760 by it than others, But I do not think I 0:01:21.800 --> 0:01:24.280 could have gone on to Lambeth or Chelsea, and I 0:01:24.400 --> 0:01:27.120 was glad to enter the streets for an atmosphere which, 0:01:27.280 --> 0:01:30.520 except near the sinkholes, I found much sweeter than that 0:01:30.680 --> 0:01:33.240 on the river. I have thought it a duty to 0:01:33.319 --> 0:01:35.600 record these facts, that they may be brought to the 0:01:35.640 --> 0:01:39.319 attention of those who exercise power or have responsibility in 0:01:39.360 --> 0:01:43.120 relation to the condition of our river. There is nothing 0:01:43.319 --> 0:01:46.840 figurative in the words I have employed, or any approach 0:01:46.880 --> 0:01:51.440 to exaggeration. They are the simple truth. If there be 0:01:51.520 --> 0:01:55.360 sufficient authority to remove a putrescent pond from the neighborhood 0:01:55.400 --> 0:01:58.960 of a few simple dwellings, surely the river which flows 0:01:59.040 --> 0:02:02.160 so many miles through London ought not to be allowed 0:02:02.200 --> 0:02:06.240 to become a fermenting sewer. The condition in which I 0:02:06.240 --> 0:02:09.960 saw the Thames may perhaps be considered as exceptional, but 0:02:10.080 --> 0:02:13.240 it ought to be an impossible state, instead of which 0:02:13.320 --> 0:02:17.440 I fear it is rapidly becoming the general condition. If 0:02:17.480 --> 0:02:20.920 we neglect this subject, we cannot expect to do so 0:02:20.960 --> 0:02:24.200 with impunity, nor ought we to be surprised if ere 0:02:24.280 --> 0:02:27.320 many years are over, a hot season gives us sad 0:02:27.400 --> 0:02:31.160 proof of the folly of our carelessness. I am, sir, 0:02:31.320 --> 0:02:36.080 your obedient servant. M. Faraday, Royal Institution, July seventh, eighteen 0:02:36.240 --> 0:02:36.840 fifty five. 0:03:25.360 --> 0:03:27.000 There's just so many good parts. 0:03:27.080 --> 0:03:30.559 There's so many good parts, suculents. 0:03:30.880 --> 0:03:32.839 The smell was very bad. 0:03:32.919 --> 0:03:33.920 The smell was very bad. 0:03:34.080 --> 0:03:37.280 Like I have no more synonyms for feculentce and so 0:03:37.320 --> 0:03:40.240 I'm just gonna have to go with the sheer reaction 0:03:40.400 --> 0:03:41.200 of very. 0:03:41.000 --> 0:03:43.119 Bad, very bad, very. 0:03:42.920 --> 0:03:47.920 Bad, I mean. And also this is not an exaggeration. Oh, 0:03:47.960 --> 0:03:49.440 I am not being figurative with it. 0:03:49.520 --> 0:03:53.320 There is no figurative language in this, Sir. 0:03:53.600 --> 0:03:55.640 I love it. I love it so much. 0:03:56.360 --> 0:03:57.119 I love it too. 0:03:57.800 --> 0:03:58.360 I love it. 0:03:58.400 --> 0:04:02.000 I love it. It's ridiculous and it will. 0:04:02.560 --> 0:04:06.240 I will touch more on the specific situation that this 0:04:06.320 --> 0:04:09.320 became the center focus of in this episode. 0:04:09.320 --> 0:04:09.880 I can't wait. 0:04:10.000 --> 0:04:12.520 It's gonna be great. And I already said in the 0:04:12.520 --> 0:04:14.560 first hand where that came from. 0:04:14.800 --> 0:04:16.600 M Fara day There you go. 0:04:16.720 --> 0:04:20.560 Okay, Hi, I'm Aaron Welsh and I'm Aaron Aman update. 0:04:20.360 --> 0:04:22.279 And this is this podcast will kill you. 0:04:22.360 --> 0:04:25.200 Welcome to Poop Part two two. 0:04:25.400 --> 0:04:31.240 Poop number two, number two. We're way too pleased with ourselves. 0:04:31.560 --> 0:04:35.200 But we just think we're so clever we do Okay. 0:04:35.200 --> 0:04:38.159 So, if you have not tuned into the first episode 0:04:38.160 --> 0:04:43.680 in this Poop series, Part two, part series, uh, do it? 0:04:43.320 --> 0:04:45.480 Do it? You know, what are you waiting for? 0:04:45.839 --> 0:04:47.480 Listen to it. You don't have to. 0:04:47.480 --> 0:04:50.240 Listen to it in order, but it will make sense. 0:04:50.279 --> 0:04:52.520 It will still make sense, but you should do it. 0:04:52.520 --> 0:04:54.240 It's a great episode. I'm really proud of it. 0:04:56.000 --> 0:04:58.040 You're going to learn a lot, just like you will 0:04:58.040 --> 0:04:58.640 in this episode. 0:04:58.760 --> 0:05:00.760 So last episode we went over a sort of how 0:05:00.800 --> 0:05:04.760 we make poop and why poop is actually a gold 0:05:04.800 --> 0:05:08.200 mine rather than like the waste that we presently view 0:05:08.240 --> 0:05:11.719 it as. Right, and today we're gonna go over what 0:05:11.839 --> 0:05:15.039 happens when our poop doesn't go to plan right and 0:05:15.800 --> 0:05:22.159 I guess yes, and also why poop is actually gross 0:05:22.160 --> 0:05:22.920 and what we do. 0:05:23.000 --> 0:05:24.600 About it the flip side of the coin. 0:05:24.839 --> 0:05:26.320 You know, poop is many things. 0:05:26.400 --> 0:05:27.400 It is so many things. 0:05:27.520 --> 0:05:28.760 Poop contains multitude. 0:05:29.640 --> 0:05:32.440 It really does it, really truly truly does ed Young 0:05:32.960 --> 0:05:35.560 Thank you. Yeah, it's gonna be a great episode. I'm 0:05:35.560 --> 0:05:39.200 really excited about it. But first at first, it's quarantiny time. 0:05:39.480 --> 0:05:40.640 What are we drinking this week? 0:05:40.720 --> 0:05:43.520 Same thing we drank last week? Drink number two, the 0:05:43.640 --> 0:05:46.520 drink number two. Are actually drinking water, which is also 0:05:46.520 --> 0:05:50.000 important for your poop. But it is you want to 0:05:50.080 --> 0:05:53.040 drink a quarantiny. It's poo number two, it's poop number two, 0:05:53.080 --> 0:05:54.200 it's I drinking number two. 0:05:55.120 --> 0:05:58.200 We keep saying that, Yeah, yeah, yeah, you know, uh 0:05:58.440 --> 0:06:02.039 it's It's basically a chocolate mint. It's great. It's pretty 0:06:02.040 --> 0:06:02.640 easy to make. 0:06:03.120 --> 0:06:08.960 You can do it at home, as you can. 0:06:08.839 --> 0:06:10.240 With all of our quarantines. 0:06:10.320 --> 0:06:13.480 Iway assume we'll post the full recipe for that quarantine 0:06:13.680 --> 0:06:16.360 on our social media channels. Are you following us there? 0:06:16.360 --> 0:06:18.120 Because you should definitely check it out and follow. 0:06:17.960 --> 0:06:21.880 You should You should our website which we may be 0:06:21.960 --> 0:06:25.159 putting quarantini stuff on. Maybe we'll try that out tonight. 0:06:25.360 --> 0:06:28.080 You know, you can find other things though. You can 0:06:28.120 --> 0:06:30.719 find so many things. You can find transcripts, you can 0:06:30.720 --> 0:06:34.160 find links to our bookshop dot org affiliate page, our 0:06:34.200 --> 0:06:38.360 Goodreads list, which needs some updating, links to music by Bloodmobile, 0:06:38.400 --> 0:06:43.240 first hand account form, contact us form sources for each 0:06:43.279 --> 0:06:44.880 and every one of our episodes. It was like I 0:06:44.880 --> 0:06:49.160 know it starts with an S and also YouTube videos. 0:06:49.279 --> 0:06:51.040 You can find links to that. 0:06:51.120 --> 0:06:53.560 Including this one, which we are very excited to be 0:06:53.600 --> 0:06:57.720 bringing you from the Exactly Right Network Studios. Yes, yes, yeah, 0:06:57.800 --> 0:06:58.760 the end, the end. 0:06:59.400 --> 0:07:03.320 Follow us on YouTube, follow us on social media, check 0:07:03.320 --> 0:07:04.000 out our website. 0:07:04.040 --> 0:07:06.360 On the rag, on the rag, what are we? 0:07:06.640 --> 0:07:07.480 Let's just do it. 0:07:07.600 --> 0:07:10.080 Let's just do it. H okay, fantastic. Let's take a 0:07:10.120 --> 0:07:11.360 quick break. 0:07:11.200 --> 0:07:16.000 And then you'll tell us about poop. Sewers, sewers, give 0:07:16.040 --> 0:07:16.400 it to me. 0:07:16.600 --> 0:07:32.800 Okay, poop is gross. 0:07:36.920 --> 0:07:39.280 I love that. That's a sentence that you wrote down upset. 0:07:39.440 --> 0:07:40.880 Yeah. Yeah, I was like, how do I start? 0:07:40.920 --> 0:07:41.840 This is gross? 0:07:41.880 --> 0:07:42.560 Poop is gross. 0:07:42.600 --> 0:07:43.280 It is grody. 0:07:43.600 --> 0:07:45.960 It is it is. There is no getting around it. 0:07:46.480 --> 0:07:48.800 Like, okay, yeah, we can talk about how important it 0:07:48.880 --> 0:07:51.400 is as a resource. We can break it down into 0:07:51.480 --> 0:07:54.400 like what makes up poop? How do we make poop? 0:07:54.440 --> 0:07:57.760 Everyone poops? Pooping is not shameful? Yeah no, I'm behind 0:07:57.800 --> 0:08:00.280 all that. Yeah, the fact remains, poop is. 0:08:00.240 --> 0:08:02.720 Grossss It's gross. After all. 0:08:02.800 --> 0:08:06.200 It can contain pathogens, or it can signal your presence 0:08:06.240 --> 0:08:08.640 to a predator, or it can attract flies that lay 0:08:08.680 --> 0:08:11.920 eggs that hatch maggots. Speaking of which, if you are 0:08:11.960 --> 0:08:14.560 tuning in to the YouTube, we have maggot art. 0:08:14.960 --> 0:08:19.720 We do laid yes, multiple yeah, anyway, yeah, you can 0:08:19.760 --> 0:08:21.440 see it. It's incredible. 0:08:22.680 --> 0:08:25.360 But maggots are also you know, It's just it is what. 0:08:25.280 --> 0:08:26.720 It is, poop. 0:08:27.560 --> 0:08:32.240 The disgust that poop evokes in us is probably evolutionarily 0:08:32.520 --> 0:08:35.240 ingrained because we don't want to be near it, you know. 0:08:35.280 --> 0:08:38.560 It's that it's all again, the pathogens, all that stuff, 0:08:39.160 --> 0:08:42.640 and this aversion that we feel for poop. It's not new, right, 0:08:42.679 --> 0:08:45.480 It's not a product of our modern sanitation system or 0:08:45.520 --> 0:08:50.400 like a remnant of prudish Victorian sensibilities. It's yeah, right, 0:08:50.480 --> 0:08:51.679 it's not just like it is. 0:08:52.000 --> 0:08:53.800 It is normal to feel disgusted by poop. 0:08:53.840 --> 0:08:54.160 Okay. 0:08:54.480 --> 0:08:57.920 Charles Darwin even called disgust one of the six universal 0:08:58.040 --> 0:08:59.119 universal emotions. 0:08:59.200 --> 0:08:59.680 Oh that's so. 0:09:01.640 --> 0:09:04.520 And this disgust for poop it's not specific to humans. 0:09:04.640 --> 0:09:07.319 Many animals go out of their way to avoid poop, 0:09:07.559 --> 0:09:11.200 like having designated latrines far away from their burrows, or 0:09:11.240 --> 0:09:14.640 grazing only in areas uncontaminated by poop. This was a 0:09:14.679 --> 0:09:19.240 real issue in Australia after the poop calcul accounted. Yeah, 0:09:19.280 --> 0:09:21.920 because they were like, I'm not I'm not eating million 0:09:22.000 --> 0:09:24.680 tons right, yes, yes, every year. 0:09:24.880 --> 0:09:25.000 Yea. 0:09:26.000 --> 0:09:29.360 For much of human history, poop didn't pose too much 0:09:29.400 --> 0:09:32.840 of a logistical issue for humans, right. We were living 0:09:32.880 --> 0:09:35.240 in small groups, we were moving around a bunch. It 0:09:35.280 --> 0:09:38.040 was a simple matter to just like, oh, the you know, 0:09:38.080 --> 0:09:40.559 the call of nature, and you just take a little step. 0:09:40.600 --> 0:09:42.559 Away from the grow away you poop. 0:09:42.640 --> 0:09:45.880 Oh actually you didn't go away from the necessarily. Yeah, 0:09:46.120 --> 0:09:47.280 but it wouldn't. 0:09:46.880 --> 0:09:48.640 Have mattered all that much because you were going to 0:09:48.720 --> 0:09:51.040 move on. You were going to move someone else's problems. 0:09:51.200 --> 0:09:51.400 Yep. 0:09:52.880 --> 0:09:58.200 And that is how giardia is everywhere, and now it's 0:09:58.240 --> 0:10:02.240 all of our problem. But yeah, so and also in 0:10:02.280 --> 0:10:04.599 addition to like it not being a huge issue in 0:10:04.679 --> 0:10:07.199 terms of like having to constantly be around your own poop, 0:10:07.240 --> 0:10:09.800 you're moving on, and our poop was an essential part 0:10:09.960 --> 0:10:13.040 of that nutrient cycle and seed dispersal. 0:10:13.200 --> 0:10:15.560 You know, you eat some berries here, you walk for 0:10:15.600 --> 0:10:18.400 a while, you poop over there. Now you got a 0:10:18.440 --> 0:10:20.880 newberry bush. Yeah. 0:10:21.200 --> 0:10:25.040 And then it was also not just seeds for you know, 0:10:25.120 --> 0:10:28.640 berry plants. It was also we're providing material for decomposers 0:10:28.640 --> 0:10:31.520 we're fertilizing the ground. It's the typical circle of poop 0:10:31.600 --> 0:10:34.840 like we talked about. But then, of course humans begin 0:10:34.920 --> 0:10:37.640 to live in larger groups and for longer periods. We 0:10:37.760 --> 0:10:42.360 developed agriculture, we bred livestock, we built permanent settlements, and 0:10:42.400 --> 0:10:44.720 poop became a problem. 0:10:45.200 --> 0:10:46.240 Yeah. 0:10:46.440 --> 0:10:48.640 We used as much as we could to fertilize crops 0:10:48.760 --> 0:10:52.360 aka night soil. We dug poop pits on the fringes 0:10:52.400 --> 0:10:56.160 of our settlements. We designated communal pooping areas. We pooped 0:10:56.160 --> 0:10:58.800 on riverbanks and near stream so that the water would 0:10:58.880 --> 0:11:02.360 wash the pool away and out of sight. But every 0:11:02.400 --> 0:11:06.599 fix proved to be a temporary one. As human populations 0:11:06.679 --> 0:11:11.600 grew and grew, pit toilets filled to the brim, poop 0:11:11.640 --> 0:11:15.360 shoots didn't always extend to the cesspit that collected sewage. 0:11:15.920 --> 0:11:19.800 Sorry, sorry, sorry, A poop shoots a real thing? Is that? 0:11:19.880 --> 0:11:22.920 It technical that I don't know. I was just imagining 0:11:23.000 --> 0:11:25.920 like a tube, you know, what they use for construction exactly. 0:11:25.920 --> 0:11:27.720 I always thought your poop shoot was your butt. 0:11:28.040 --> 0:11:31.320 Well yeah, I think that that's like the idea of 0:11:31.400 --> 0:11:33.200 a multiple meanings shoot. 0:11:33.400 --> 0:11:34.839 Like that was a thing they really had. 0:11:35.320 --> 0:11:38.559 I mean, there were I'll get into it, okay. 0:11:38.600 --> 0:11:43.240 But yes, there were pipes more or less that you know, 0:11:43.400 --> 0:11:47.840 or they would be uncovered essentially gutters gutters, poop gutters, 0:11:47.840 --> 0:11:49.200 but poop shoot just sounds better. 0:11:49.240 --> 0:11:49.599 I love it. 0:11:49.679 --> 0:11:51.120 Yeah. 0:11:51.160 --> 0:11:54.240 And then there were indoor chamber pots that required frequent 0:11:54.320 --> 0:11:57.280 emptying at locations not within a quiet or a quick walk. 0:11:57.320 --> 0:11:57.480 You know. 0:11:57.559 --> 0:11:59.240 This was there were a lot of different ways that 0:11:59.280 --> 0:12:02.160 poop just you can't. You turn your back and suddenly 0:12:02.200 --> 0:12:03.040 there's a massive. 0:12:02.760 --> 0:12:05.040 Pilot's another that you have to do. Of course. Yeah, 0:12:05.080 --> 0:12:06.239 it's just like laundry. 0:12:06.600 --> 0:12:12.240 Okay, So it is. I'm like, dais it is just 0:12:12.320 --> 0:12:13.760 like laundry. Okay. 0:12:13.800 --> 0:12:17.839 So to put the poop overload into perspective, let's consider Canosos, 0:12:17.880 --> 0:12:21.360 which is the largest city of the Minoan civilization, older 0:12:21.400 --> 0:12:25.160 than ancient Greece, located on the island of Crete. Around 0:12:25.160 --> 0:12:29.319 its peak, say seventeen hundred BCE, there were one hundred 0:12:29.360 --> 0:12:30.360 thousand people. 0:12:30.120 --> 0:12:33.239 Living in Canosis, each pooping every. 0:12:33.040 --> 0:12:36.520 Day, of course, well on average, for a total of 0:12:36.600 --> 0:12:38.600 fifty tons of poop per day. 0:12:39.000 --> 0:12:40.440 Wow, that's a lot of poops. 0:12:40.760 --> 0:12:43.560 Even in seventeen hundred BCE, that's a lot of poopy 0:12:44.400 --> 0:12:46.880 and it, of course, pales in comparison to what the 0:12:46.880 --> 0:12:49.200 city of New York makes in a single day today. 0:12:49.360 --> 0:12:52.560 And I singled out New York because that is where 0:12:52.600 --> 0:12:57.600 the data are available. Okay, so poop and pee combined 0:12:57.640 --> 0:13:00.640 to about twelve hundred tons or two point for million 0:13:00.640 --> 0:13:03.360 pounds daily, every day, every. 0:13:03.200 --> 0:13:08.800 Day, two point four million pounds of waste from our bodies. 0:13:08.800 --> 0:13:10.800 Does it waste? Though, Aaron, I thought we learned that 0:13:10.880 --> 0:13:11.320 it wasn't. 0:13:11.400 --> 0:13:16.040 It's a synonym for poop and pea, turds, turds and p. 0:13:16.360 --> 0:13:17.800 We can't forget pee, we can't forget the p. 0:13:18.040 --> 0:13:21.280 Yeah, it's a substantial portion, is yeah, Okay, so it's 0:13:21.360 --> 0:13:24.640 it's it's not New York today, but you could you 0:13:24.640 --> 0:13:26.640 could see why it would quickly become a pressing matter 0:13:26.720 --> 0:13:30.360 immediately an effective solution for the minoans. 0:13:30.440 --> 0:13:32.280 That solution turned out to be water. 0:13:33.160 --> 0:13:37.320 A handful of engineering minded individuals realized the power of 0:13:37.440 --> 0:13:41.240 water as transportation, and they devised water supply systems that 0:13:41.280 --> 0:13:45.080 piped in rain water to flush toilets toilets. 0:13:45.120 --> 0:13:47.880 They had flushing toilets in seventeen hundred BC. 0:13:48.760 --> 0:13:53.199 Yeah, wow, I mean so the toilets were pretty much 0:13:53.400 --> 0:13:57.280 like localized to the Minoan civilization. Okay, And but they 0:13:57.280 --> 0:13:59.480 were not just in palaces, like they started out just 0:13:59.480 --> 0:14:02.280 in palace. But yeah, I mean, and it wasn't like 0:14:02.440 --> 0:14:05.199 continuous supply. You had to you know, dump in you've 0:14:05.200 --> 0:14:06.880 ever been somewhere, you had to dump in waters to 0:14:06.960 --> 0:14:07.280 the top. 0:14:07.440 --> 0:14:08.280 Yeah, it's like that. 0:14:08.920 --> 0:14:11.960 Wow, that's so cool. And then they had pipes, I mean. 0:14:12.040 --> 0:14:15.120 And also the seats were like really wooded and splintery looking. 0:14:15.000 --> 0:14:17.439 For sure, I mean, where did the poop go? 0:14:17.720 --> 0:14:20.040 Okay, So the water flushed the poop out of the 0:14:20.040 --> 0:14:22.440 building and down into the sewers that ran into the 0:14:22.440 --> 0:14:23.920 streams that ran into the sea. 0:14:24.040 --> 0:14:26.520 So it was all just sort of like connect yep. 0:14:27.320 --> 0:14:29.760 And since then the world has never been the same. 0:14:30.840 --> 0:14:31.320 Wow. 0:14:31.480 --> 0:14:35.960 And remarkably, four thousand years later, those drains still function 0:14:36.120 --> 0:14:37.920 perfectly after a large rain shower. 0:14:38.120 --> 0:14:38.840 Are you serious? 0:14:38.880 --> 0:14:41.920 They still wash? They still washed right down like to 0:14:42.000 --> 0:14:44.040 the streams to the sea. Yeah. 0:14:44.080 --> 0:14:46.960 For thousands of years now, though, we have used water 0:14:47.120 --> 0:14:49.960 to do our dirty work, separating us from the poo 0:14:50.040 --> 0:14:51.920 that we produce, so that we don't have to look 0:14:51.960 --> 0:14:54.480 at it or smell it or have it contaminate the 0:14:54.520 --> 0:14:58.600 water that we use the invention of flush toilets and sewers, 0:14:58.800 --> 0:15:01.880 which were all we'll talk about the modern flush toilet, 0:15:01.880 --> 0:15:03.680 because this wasn't one that was like, this. 0:15:03.680 --> 0:15:05.640 Didn't go everywhere. Yeah, exactly. 0:15:06.800 --> 0:15:10.520 They has saved countless lives and it has made our 0:15:10.560 --> 0:15:14.360 day to days much more pleasant. Right, But in allowing 0:15:14.440 --> 0:15:18.480 us to flush and forget, we have become divorced from 0:15:18.520 --> 0:15:20.960 the reality of poop, not as a waste product, but 0:15:21.000 --> 0:15:22.160 again as a resource. 0:15:22.720 --> 0:15:25.080 From those first splintery. 0:15:24.480 --> 0:15:27.920 Wooden Minoan toilets to the seat warming, water spraying high 0:15:27.960 --> 0:15:31.400 tech toilets of today, we've been moving poop from here 0:15:31.640 --> 0:15:35.320 to way over there, radically upsetting the balance of nutrients 0:15:35.320 --> 0:15:39.040 like phosphorus and nitrogen across the landscape. And just as 0:15:39.080 --> 0:15:42.240 the early Minoans confronted the mounting poop problem in their 0:15:42.280 --> 0:15:45.320 city and devised a solution, we finally seem to be 0:15:45.320 --> 0:15:47.680 coming to terms with the fact that it's time for 0:15:47.840 --> 0:15:51.600 a new solution, or a suite of solutions to contend 0:15:51.640 --> 0:15:54.560 with our growing poop issue, our cacatastrophe. 0:15:58.200 --> 0:16:00.960 I can't let that one good it was in the 0:16:00.960 --> 0:16:02.400 moment it was it was. 0:16:03.400 --> 0:16:06.400 We have proof of that. We didn't take a break, 0:16:06.400 --> 0:16:09.640 and then edit that out brain store. Now it sounds 0:16:09.680 --> 0:16:13.760 like we did, but we really didn't. So what I 0:16:13.800 --> 0:16:16.040 want to do now is take us through how we've 0:16:16.080 --> 0:16:19.200 dealt with our poo and pee and other liquid waste 0:16:19.280 --> 0:16:22.400 throughout history, and how a change in how we think 0:16:22.440 --> 0:16:25.480 of and deal with poop is really the only path forward. 0:16:26.920 --> 0:16:29.400 The Minoans were not the first or the only group 0:16:29.440 --> 0:16:31.920 in the ancient world to devise ways to manage the 0:16:31.920 --> 0:16:35.040 sewage that was produced in large cities. Around the same time, 0:16:35.840 --> 0:16:39.120 the harapan civilization in what is now India also had 0:16:39.160 --> 0:16:43.359 a similar drainage system using deep gutters which with removable 0:16:43.400 --> 0:16:46.040 covers so you could like get rid of any yeah, 0:16:46.160 --> 0:16:50.080 exactly connected from house to house, similar to the way 0:16:50.120 --> 0:16:53.440 that many of our modern drainage systems work today. 0:16:53.680 --> 0:16:54.640 Yeah. 0:16:54.680 --> 0:16:57.480 And so for cities that numbered in the tens of thousands, 0:16:57.880 --> 0:17:01.720 these Minoan and Harappan sewage systems they did a decent job, 0:17:02.360 --> 0:17:05.040 no doubt. Things were still stinky, especially if there wasn't 0:17:05.040 --> 0:17:08.280 a lot of rainfall, and like cesspits probably got clogged, 0:17:08.720 --> 0:17:13.560 but it did all right considering Yeah, Unfortunately, they were 0:17:13.640 --> 0:17:16.840 no match for the more than one million occupants of 0:17:16.920 --> 0:17:22.879 ancient Rome. I mean really, the history of sewage systems 0:17:22.960 --> 0:17:26.720 and poop comes down to like, oh no, there's too 0:17:26.760 --> 0:17:29.520 much poop. Oh we fixed it. Oh no, there's too 0:17:29.600 --> 0:17:32.159 much poop again. Oh we fixed it again. Oh no, 0:17:32.440 --> 0:17:36.280 you know, it's just like risky forever forever. Yeah, okay, 0:17:36.280 --> 0:17:40.640 So how did ancient Romans fix it? With something called 0:17:40.680 --> 0:17:43.080 the kloaca maxima cloaka. 0:17:44.160 --> 0:17:44.960 That's a great word. 0:17:45.040 --> 0:17:49.400 It is a great word, Okay, cloaca maxima. 0:17:51.280 --> 0:17:54.960 I know, because like I feel like we should define 0:17:54.960 --> 0:17:55.919 because some people might know. 0:17:56.520 --> 0:17:58.000 Yeah yeah, yeah, no, I mean we could. 0:17:58.080 --> 0:18:02.400 So my first exposure to the word kloaca came from 0:18:02.760 --> 0:18:05.840 what we use it, the biological term meaning the single 0:18:05.920 --> 0:18:09.080 orifice through which many animals do all their business pe 0:18:09.240 --> 0:18:15.040 reproduce kloaca. That usage only came into existence in like 0:18:15.080 --> 0:18:18.960 the eighteen hundreds, So the word kloaca existed before then, 0:18:19.160 --> 0:18:22.680 and it was it translated. It was basically translates into 0:18:22.720 --> 0:18:26.760 the word sewer. So kloaca maxima greatest sewer, greatest sewer 0:18:26.840 --> 0:18:29.360 of meaning like the biggest largest. 0:18:29.400 --> 0:18:31.399 I love imagining ancient. 0:18:33.280 --> 0:18:35.400 It's like very in line with how I think about 0:18:35.400 --> 0:18:37.280 ancient Roman much. 0:18:37.359 --> 0:18:44.680 Yeah, Okay, but Kloaca comes from the Roman goddess Cloacina. 0:18:44.520 --> 0:18:47.560 Based on the word to clean. Oh so it has 0:18:47.880 --> 0:18:53.080 sewer clean yeah, yeah, so yeah, the Kloaca Maxima, it 0:18:53.119 --> 0:18:55.920 really did live up to its name though in terms 0:18:55.920 --> 0:18:59.440 of its size. It was so big that entire wagons 0:18:59.440 --> 0:19:02.199 filled with could travel through it. 0:19:02.200 --> 0:19:06.200 It was mess so it's like storm drain like rivers 0:19:06.240 --> 0:19:08.960 that we have here in southern California today, like like those. 0:19:08.880 --> 0:19:10.400 Like you could take a boat, like a small boat 0:19:10.840 --> 0:19:12.520 throughout it. Wow, isn't that amazing? 0:19:12.560 --> 0:19:13.480 It was just for sewage. 0:19:13.520 --> 0:19:18.000 It was just well no, actually, so every day it 0:19:18.000 --> 0:19:20.560 would handle a lot millions of gallons of water and 0:19:20.600 --> 0:19:23.200 a million pounds of poop probably flowed through the Chloaca 0:19:23.240 --> 0:19:28.920 Maxima every day, something around there. But like our sewer 0:19:29.000 --> 0:19:31.960 systems of today, it was not created necessarily to just 0:19:32.040 --> 0:19:36.919 handle human waste. It was mostly to prevent to remove 0:19:36.960 --> 0:19:39.199 excess water during a rainstorm. And Rome was built on 0:19:39.240 --> 0:19:39.719 a swamp. 0:19:39.800 --> 0:19:46.000 Basically, it's the Houston of the ancient world. 0:19:47.440 --> 0:19:50.320 Thank Houston. Someone's gonna get real mad about that. 0:19:50.480 --> 0:19:51.480 Houston is not a swamp. 0:19:51.560 --> 0:19:57.240 Yes, I know that, Okay, just dating facts here. It's 0:19:57.280 --> 0:20:00.159 true and so you have to drain. You have to 0:20:00.200 --> 0:20:02.760 drain the swamps to prevent flooding, and so that is 0:20:02.800 --> 0:20:05.719 what with the Kloaca Maxima also did. It was mostly 0:20:05.760 --> 0:20:09.960 to just drain the swamp. I don't know why this 0:20:10.040 --> 0:20:13.000 is so funny, but it really is. But the Chloaca Maxima, 0:20:13.080 --> 0:20:14.920 I'm just going to say it as many times as possible, 0:20:15.240 --> 0:20:18.600 was an engineering marvel, and the Romans poured money into 0:20:18.600 --> 0:20:21.800 its construction and its upkeep. It was a real like uh, 0:20:22.080 --> 0:20:24.600 it's a real testament to how much they cared about 0:20:24.640 --> 0:20:27.960 sewage and sewer systems. Is that the Chloaca Maxima, parts 0:20:27.960 --> 0:20:30.360 of it are still standing where many, many, many other 0:20:30.359 --> 0:20:31.280 buildings have fallen. 0:20:31.840 --> 0:20:34.199 But they were like this, this should stand. 0:20:34.760 --> 0:20:37.119 Yes, okay, do you want to hear more about what 0:20:37.160 --> 0:20:39.560 the toilet experience might have been like for someone in an 0:20:39.440 --> 0:20:40.040 ancient room? 0:20:40.080 --> 0:20:40.520 Of course? 0:20:40.520 --> 0:20:43.280 All right, So if you're wealthy, you would have your 0:20:43.320 --> 0:20:46.320 own private latrine in your big house, likely situated over 0:20:46.359 --> 0:20:48.800 a dugout pit. Or you'd be like, no, I'm going 0:20:48.880 --> 0:20:50.960 to get a chamber pot and have someone just get that. 0:20:51.040 --> 0:20:52.000 Get away from more. 0:20:52.040 --> 0:20:54.399 I don't want even this in my pay my house 0:20:54.600 --> 0:20:59.400 to do that okay, pay someone nothing. Many wealthy citizens 0:20:59.400 --> 0:21:00.920 didn't want to care neck to their house to the 0:21:01.000 --> 0:21:04.840 Chloeica maxima because the smell it wasn't Also like there 0:21:04.880 --> 0:21:07.320 wasn't water piping continuously through. 0:21:07.440 --> 0:21:10.240 Okay, and so you kind of it wasn't sunk. 0:21:10.359 --> 0:21:15.359 Things just would have hung out there and then vermin. Yeah, 0:21:16.280 --> 0:21:20.040 you know it's I get it. So but they were 0:21:20.040 --> 0:21:23.520 really the only people to enjoy privacy while pooping were 0:21:23.560 --> 0:21:24.000 the wealthy. 0:21:24.080 --> 0:21:26.240 Everyone else that it was a luxury for them. 0:21:27.200 --> 0:21:30.879 Public toilets were constructed, used almost exclusively by men. It 0:21:30.960 --> 0:21:33.840 was not a safe place for women. They were found 0:21:33.840 --> 0:21:36.880 throughout the city, paid for often by the wealthier citizens 0:21:36.880 --> 0:21:38.760 who wanted to avoid poop in the streets. 0:21:39.600 --> 0:21:42.480 And that happened all the time in the streets. 0:21:42.560 --> 0:21:47.200 Yeah, there are so many inscriptions warning people against pooping 0:21:47.280 --> 0:21:49.879 in this alley or against this building or whatever. So 0:21:49.920 --> 0:21:54.879 there's one found in POMPEII that warned, quote, defecator, watch 0:21:54.880 --> 0:21:56.960 out for what might happen to you. 0:21:58.280 --> 0:22:04.440 In an alley in an alley, stop pooping here, defcator, defecator. 0:22:04.560 --> 0:22:07.160 If you if you poop, you will be by the way. 0:22:07.320 --> 0:22:08.680 Yeah, we should call more people. 0:22:08.840 --> 0:22:10.040 Everyone is a deficator. 0:22:10.080 --> 0:22:13.720 That's true. What we use it as a disc feels intentional. 0:22:13.880 --> 0:22:16.720 It does, it does. Okay. 0:22:16.720 --> 0:22:19.760 So these these public toilets were housed under a low 0:22:19.840 --> 0:22:23.400 ceiling with small windows, so like not a very pleasant, 0:22:24.000 --> 0:22:27.440 you know, place to be. And they were essentially marble 0:22:27.480 --> 0:22:32.400 benches carved with rows of holes, just roll whole after 0:22:32.440 --> 0:22:36.160 hole after hole, no dividers between the holes, so close 0:22:36.200 --> 0:22:37.879 that you could hold hands, you could carry on a 0:22:37.880 --> 0:22:41.760 whispered conversation or make after work plans with your pooping partner. 0:22:42.720 --> 0:22:44.679 People weren't really wearing pants. It was more like a 0:22:44.720 --> 0:22:47.840 toga vibe situation as far as I read, you know, 0:22:48.119 --> 0:22:50.359 I don't know how widespread togas worth. That's just like 0:22:50.440 --> 0:22:53.360 my image of ancient room. But you weren't totally exposed, 0:22:53.400 --> 0:22:55.320 so like you weren't dropping trout. 0:22:55.000 --> 0:22:57.200 The way that you would be today. Yeah, okay. 0:22:57.440 --> 0:23:00.040 And so for wiping your heine, there were which I 0:23:00.040 --> 0:23:04.240 I love wiping heiney is another great word for wiping 0:23:04.280 --> 0:23:08.639 your heney. There were communal communal sea sponges on a 0:23:08.680 --> 0:23:12.920 stick were called tersorium or wiping thing. 0:23:14.680 --> 0:23:14.920 Yeah. 0:23:15.480 --> 0:23:17.879 So they just was like a few of them scattered about. 0:23:18.880 --> 0:23:19.520 I don't know, what. 0:23:19.680 --> 0:23:22.040 I don't know the numeor yeah, I don't know how 0:23:22.040 --> 0:23:22.680 many there were. 0:23:23.000 --> 0:23:25.480 Was there like water, Yes, there was a bucket of water. 0:23:25.560 --> 0:23:28.159 There was a gutter of clean water to clean the 0:23:28.160 --> 0:23:29.400 sponge in between uses. 0:23:30.840 --> 0:23:35.280 Okay, a sea sponge. That's actually genius, it is. Yeah, 0:23:35.359 --> 0:23:36.600 I mean I love it. 0:23:37.600 --> 0:23:39.639 I don't know if I love it. The commune, it's 0:23:39.640 --> 0:23:41.879 the communal part that really gets to me. Yeah, And 0:23:41.920 --> 0:23:45.359 whether there was hand washing, probably not. It doesn't seem 0:23:45.400 --> 0:23:48.400 to be, so who knows. You can, like, let me check, right, yeah, 0:23:48.520 --> 0:23:51.639 let me but know. But okay, So the poop and 0:23:51.680 --> 0:23:55.679 pea would flow from these public toilets away into a 0:23:55.720 --> 0:23:59.719 sewer system where they eventually emptied into the river Tiber, 0:24:00.000 --> 0:24:02.320 which is also where people got their drinking and bathing water. 0:24:04.000 --> 0:24:07.119 The filth might have been out of sight, out of mind, 0:24:07.160 --> 0:24:08.600 but it didn't mean it wasn't an issue. 0:24:08.640 --> 0:24:11.440 There was water borne illness all over the place. 0:24:11.800 --> 0:24:15.080 It was, I mean, based on descriptions, like it seemed 0:24:15.320 --> 0:24:19.520 pretty pretty overrun with poop and pea, and there was 0:24:19.560 --> 0:24:23.359 a lot of like issues related to disease because of that. Yes, okay, 0:24:23.400 --> 0:24:25.920 So moving on from ancient Rome, though throughout the medieval 0:24:25.920 --> 0:24:29.040 period and beyond, sewage construction in most of Europe was 0:24:29.080 --> 0:24:31.359 guided by the get this poop as far away from 0:24:31.359 --> 0:24:35.680 me as possible principle. Livestock manure was spread on fields 0:24:35.720 --> 0:24:39.600 for fertilization, and toilets operated under a similar logic as 0:24:39.640 --> 0:24:44.440 an ancient Rome, not the Minoan civilization, minus the chloaca 0:24:44.520 --> 0:24:48.880 maxima that effectively more or less effectively drained things away, 0:24:49.000 --> 0:24:51.359 so there would be like outdoor latrines for the poor, 0:24:51.600 --> 0:24:54.119 you know, pits or barrels, which could then be like 0:24:54.520 --> 0:24:58.240 buried or taken away, while the rich built private toilet 0:24:58.280 --> 0:25:01.040 rooms in their castles where they like stuck out over 0:25:01.080 --> 0:25:03.159 the moat so that the poop and pea would travel 0:25:03.240 --> 0:25:05.080 down a shoot into the water. 0:25:05.800 --> 0:25:08.879 A poop shoot, poop shoot. This that always makes me 0:25:08.920 --> 0:25:10.960 think of the Game of Thrones, the guy who died 0:25:11.000 --> 0:25:15.199 on the toilet. There was anyways, it doesn't matter, but 0:25:15.200 --> 0:25:17.119 there was a guy who died on the toilet. He 0:25:17.160 --> 0:25:18.960 got shot with like an arrow in the toilet, and 0:25:19.040 --> 0:25:21.879 his toilet room was like way up and off away 0:25:22.160 --> 0:25:25.040 in the castle. Just was like historically accurate. Just might 0:25:25.119 --> 0:25:27.000 it not be an historical show? 0:25:27.359 --> 0:25:29.000 But no, I mean that that I think that is. 0:25:29.080 --> 0:25:31.119 That's what I'm sort of imagining, these little rooms like 0:25:31.440 --> 0:25:35.439 just to sort of cut out and then like boop, yeah, okay, 0:25:35.440 --> 0:25:37.200 cool into the surrounding moat. 0:25:37.320 --> 0:25:40.199 So like it just would just be poop or in 0:25:40.280 --> 0:25:42.360 the moat, just feeding. 0:25:42.040 --> 0:25:44.480 The crocodiles or whatever. 0:25:45.440 --> 0:25:50.119 Feeding something of the carp and catfish, I don't know, uh. 0:25:50.160 --> 0:25:51.960 And so that's where it would stay until like the 0:25:52.040 --> 0:25:54.160 rains grew heavy enough and then the currents could. 0:25:53.960 --> 0:25:54.520 Carry it away. 0:25:54.560 --> 0:25:55.320 Okay, okay. 0:25:55.600 --> 0:25:58.920 So as European cities exploded in population, the situation. 0:25:58.640 --> 0:26:02.680 Grew dire and more diers. It does, poop piled up. 0:26:02.920 --> 0:26:05.639 Multiple laws were passed like this is how bad the 0:26:05.680 --> 0:26:08.720 poop was, right, There were many laws in many countries 0:26:09.119 --> 0:26:12.879 about public pooping. They were trying to regulate how much 0:26:12.960 --> 0:26:15.400 poop there was on the streets. So, for instance, in Berlin, 0:26:15.600 --> 0:26:18.680 a sixteen seventy one law was passed that instructed every 0:26:18.760 --> 0:26:21.640 peasant visiting Saint Peter's Church to. 0:26:21.680 --> 0:26:24.280 Take a pile of poop away. It was a popular 0:26:24.359 --> 0:26:26.919 dumping ground, so many. 0:26:26.800 --> 0:26:29.560 People would poop there. It was like you need to take. 0:26:29.840 --> 0:26:33.159 Take you to take poop away? Yeah, fascinating, I know. 0:26:34.119 --> 0:26:37.959 In fifteen thirty one, a law in Paris required landlords 0:26:37.960 --> 0:26:39.840 to provide a latrine for every house. 0:26:40.680 --> 0:26:42.600 Wow. Not until fifteen thirty. 0:26:42.400 --> 0:26:45.400 One, Yeah, were the laws enforced. 0:26:45.920 --> 0:26:49.840 That Many people did their business in chamber pots in 0:26:49.880 --> 0:26:52.760 their home, which they then emptied out of the window 0:26:52.800 --> 0:26:58.520 after a yelled warning like look out the Yeah. The 0:26:58.560 --> 0:27:01.359 descriptions of people pooping every where in the streets or alleys, 0:27:01.440 --> 0:27:03.880 and waste piled high, like there are many of them, 0:27:04.040 --> 0:27:07.560 but there it's it's too much, okay. For example, quote, 0:27:07.600 --> 0:27:10.679 the louver was a mess. People defecated without restraint or 0:27:10.720 --> 0:27:14.119 attempt at secrecy in the courtyards, on the stairs and balconies, 0:27:14.160 --> 0:27:19.280 and behind doors, without hindrance from palace attendants. On August eighth, 0:27:19.520 --> 0:27:22.680 sixteen oh six, an order was given prohibiting any resident 0:27:22.720 --> 0:27:25.640 of the Palace of Saint Germain from committing a nuisance 0:27:25.680 --> 0:27:29.760 Therein that same day, the King's son urinated against the 0:27:29.800 --> 0:27:30.920 wall of his room. 0:27:31.359 --> 0:27:36.240 End quote. So like people just seem to be pooping everywhere. 0:27:37.480 --> 0:27:39.040 That is so fascinating to me. 0:27:39.800 --> 0:27:44.200 It is to me too, I don't know how. 0:27:44.480 --> 0:27:47.040 Yes, that's like you just I mean, I guess if 0:27:47.080 --> 0:27:50.440 you don't really have an alternative, right, If you don't 0:27:50.480 --> 0:27:52.680 have an alternative, you got to go nature calls. 0:27:52.400 --> 0:27:54.919 In nature calls and so it's like and the laws 0:27:54.920 --> 0:27:58.600 were not effective, and it just kind of of course, 0:27:58.640 --> 0:28:01.920 the problem keeps growing. But keeping in the theme with 0:28:02.040 --> 0:28:05.000 one man's trash is another's treasure, there was an entire 0:28:05.040 --> 0:28:08.800 occupation that sprung out from these soiled streets, the so 0:28:09.000 --> 0:28:13.360 called nightmen oh okay so also known as scavengers. 0:28:13.480 --> 0:28:15.640 These nightmen would walk the streets at night. 0:28:15.920 --> 0:28:18.320 They would empty out chamber pots and public toilets to 0:28:18.359 --> 0:28:21.480 either sell to farmers or just dump in the countryside. 0:28:21.480 --> 0:28:24.800 They would be like, I will handle your waiste. People 0:28:24.840 --> 0:28:27.960 had like signs on like carriages or like wagons that 0:28:28.000 --> 0:28:30.440 were like I am the best at this. I will 0:28:30.440 --> 0:28:31.600 make sure it's love to do this. 0:28:31.800 --> 0:28:33.480 Yeah, yeah. 0:28:33.640 --> 0:28:35.720 And when transport became a challenge, like there was just 0:28:35.760 --> 0:28:38.600 too much to carry or whatever, they dug out big 0:28:38.640 --> 0:28:40.280 pits and they held the waist there. And this is 0:28:40.280 --> 0:28:43.160 when they began to experiment with different chemicals and other 0:28:43.200 --> 0:28:46.600 additives to dissipate the smell, or they would heat the 0:28:46.680 --> 0:28:48.080 night soil to desiccate it. 0:28:49.440 --> 0:28:51.719 But guess what happened, Darren. 0:28:52.120 --> 0:28:53.120 Something bad. 0:28:53.840 --> 0:28:58.479 I mean kind of just populations keep growing and too 0:28:58.520 --> 0:29:01.719 much kept growing, and the nightmen just couldn't keep up, 0:29:02.160 --> 0:29:04.720 and so the situation was again becoming dire. 0:29:05.560 --> 0:29:10.160 Fortunately a hero was about to emerge. Ajax the first 0:29:10.280 --> 0:29:15.480 modern flushing toilet. Oh, it was invented by Sir John Harrington. 0:29:15.520 --> 0:29:16.880 Ajax was the name. He gave it. 0:29:17.000 --> 0:29:20.480 Yeah, yeah, in England fifteen eighty four, after being sent 0:29:20.520 --> 0:29:23.920 away by the Queen, whom he offended with his poetry. 0:29:24.200 --> 0:29:27.800 It's true story. No one knows the exact details, but 0:29:27.920 --> 0:29:29.760 like I can imagine, the gossip. 0:29:29.600 --> 0:29:32.640 Was just what did he say this time? But he 0:29:32.680 --> 0:29:36.160 embarked on some home construction projects and out of this 0:29:36.360 --> 0:29:39.840 creative retreat sprung the toilet. And it wasn't the first, 0:29:39.920 --> 0:29:42.360 like I mentioned, the Manoans and Harrappans hold that title, 0:29:42.440 --> 0:29:45.360 but it did involve a more advanced flushing system with 0:29:45.480 --> 0:29:47.160 valves and a sistern kind of like what we think 0:29:47.200 --> 0:29:47.960 of today where. 0:29:47.800 --> 0:29:50.680 It has that on top. And then yeah, he named 0:29:50.680 --> 0:29:51.840 it Ajax. 0:29:51.360 --> 0:29:55.040 And wrote an ode in its honor, and then the Queen, 0:29:55.160 --> 0:29:58.320 after getting over her irritation towards him, she visited. She 0:29:58.400 --> 0:30:00.240 tried it out and she was like I I need 0:30:00.280 --> 0:30:05.120 one of these, so she had one built in her palace, home, castle, 0:30:05.920 --> 0:30:08.960 whatever it was, whatever it is. Over the next couple 0:30:09.000 --> 0:30:12.320 of centuries, the toilet underwent several technological improvements that made 0:30:12.360 --> 0:30:15.560 it more feasible to be installed in lots of homes, 0:30:15.640 --> 0:30:19.000 and soon everyone it was like, I need this, I 0:30:19.040 --> 0:30:22.479 want a standard part of your home. Its popularity was 0:30:22.640 --> 0:30:27.200 helped along by British plumber Thomas Crapper, who did not 0:30:27.440 --> 0:30:30.240 invent the toilet nor give his name to a slang 0:30:30.240 --> 0:30:37.719 word for poop like his name really yeah, but he 0:30:37.760 --> 0:30:40.080 did a great job at marketing it, and he kind 0:30:40.080 --> 0:30:42.800 of helped to turn the toilet into a status symbol. 0:30:43.480 --> 0:30:44.840 Everyone wanted one for him. 0:30:44.880 --> 0:30:48.280 I want a Crapper, I mean yeah. 0:30:49.120 --> 0:30:50.600 And guess what happened. 0:30:50.680 --> 0:30:54.200 People were so happy to flush and forget and the 0:30:54.240 --> 0:30:57.960 problem of excess poop was solved for a. 0:30:58.120 --> 0:30:59.560 Very brief period of time. 0:31:00.600 --> 0:31:04.200 What the toilet had effectively done was move those individual 0:31:04.280 --> 0:31:07.840 cesspits from the home to the rivers that supplied the 0:31:07.880 --> 0:31:11.600 city with water, making one giant cesspit out of it. 0:31:12.240 --> 0:31:14.960 The situation again grew dire. 0:31:16.200 --> 0:31:19.720 How dire you might ask, Let's go to London eighteen 0:31:19.760 --> 0:31:21.080 fifty eight for the full picture. 0:31:21.160 --> 0:31:23.000 Okay, that summer was. 0:31:23.080 --> 0:31:26.840 Unusually hot and dry, but any enjoyment of sunny weather 0:31:27.440 --> 0:31:31.480 was thwarted by the shocking stench that emanated from the Thames. 0:31:32.560 --> 0:31:35.320 I've mentioned the Great Stink of eighteen fifty eight before 0:31:35.360 --> 0:31:39.000 in our Typhoid Fever episode, and I read a quote 0:31:39.040 --> 0:31:41.959 in that episode that I think is worth dredging up 0:31:42.000 --> 0:31:45.160 for this one. Okay, this is from a newspaper reporting 0:31:45.160 --> 0:31:51.400 on the Great Stink. Quote, for the first time in 0:31:51.480 --> 0:31:55.200 the history of men, the sewage of nearly three million 0:31:55.280 --> 0:31:58.600 people had been brought to seethe and ferment under a 0:31:58.640 --> 0:32:03.600 burning sun in one vast open kloeca, lying in their midst. 0:32:05.200 --> 0:32:07.240 I remember this quote now because we made it into 0:32:07.240 --> 0:32:09.280 a reel. It's like one of our first reels that 0:32:09.320 --> 0:32:10.160 we ever made. 0:32:11.400 --> 0:32:12.840 I don't know why. It just kills me. 0:32:14.640 --> 0:32:17.080 And it's like it is the word kloka, but it's 0:32:17.120 --> 0:32:19.239 also like poetic in a way. 0:32:19.280 --> 0:32:22.440 It is it's beautiful and disgusting. 0:32:21.720 --> 0:32:25.640 Disgusting, it's really effective. It is that is effective language, 0:32:25.800 --> 0:32:30.080 right there. Uh So, Okay, the times had been getting 0:32:30.080 --> 0:32:34.320 more disgusting for years, but the Great Stink really galvanized 0:32:34.360 --> 0:32:38.320 many Londoners. Something had to be done about this, not 0:32:38.400 --> 0:32:41.000 just because of the unpleasantness of having to breathe that 0:32:41.200 --> 0:32:43.320 vile air, but also because that air was thought to 0:32:43.360 --> 0:32:46.959 spread disease. My asthma was sort of the leading idea 0:32:47.040 --> 0:32:50.520 at the time, And it wasn't the air itself, but 0:32:50.600 --> 0:32:53.760 it certainly was the water, as John Snow revealed in 0:32:53.800 --> 0:32:56.800 his investigations of the London caller outbreaks from a few 0:32:56.840 --> 0:33:00.640 years before, which was of course caused by the nasty 0:33:00.680 --> 0:33:04.960 and poorly functioning drainage systems in the city. Those color outbreaks. 0:33:05.800 --> 0:33:07.720 So it took a few decades. I'm skipping over so 0:33:07.840 --> 0:33:10.360 much here in terms of like the history of sewage, 0:33:11.160 --> 0:33:14.600 but eventually a massive and intricate sewer system was built 0:33:14.600 --> 0:33:18.560 to manage London's waste. The project was spearheaded by visionary 0:33:18.600 --> 0:33:24.040 engineer Joseph Basilget, and the completed system, truly a modern marvel, 0:33:24.240 --> 0:33:25.840 still serves the city today. 0:33:26.000 --> 0:33:26.480 Wow. 0:33:27.160 --> 0:33:27.680 And there's a. 0:33:27.600 --> 0:33:30.560 Whole book about its design and basil Get and the 0:33:30.560 --> 0:33:32.760 Great Stink if you'd like to learn more, it's on 0:33:32.760 --> 0:33:36.240 one of these shelves here. The London sewer system, which 0:33:36.240 --> 0:33:39.360 acted as inspiration for many other cities. It operates with 0:33:39.480 --> 0:33:42.640 the goal of using water to wash away the city's 0:33:42.680 --> 0:33:46.640 poop and liquid waste, and in the brainstorming phase of 0:33:46.680 --> 0:33:51.360 this design, several options were presented and dismissed before landing 0:33:51.360 --> 0:33:55.120 on this present layout. One of these ideas involved transporting 0:33:55.120 --> 0:33:58.120 the waste to farms in the surrounding countryside to use 0:33:58.160 --> 0:34:03.280 as fertilizer andn youual value. A four million people's excrement, 0:34:03.880 --> 0:34:06.600 which is in the city of London was estimated to 0:34:06.720 --> 0:34:10.440 be about worth about one point seven million pounds in 0:34:10.480 --> 0:34:12.839 the eighteen eightiesh which is one hundred and seventy eight 0:34:12.840 --> 0:34:13.760 million pounds today. 0:34:13.880 --> 0:34:16.960 Oh wow in terms of fertilizer yep. 0:34:17.440 --> 0:34:21.000 But England, not seeing the tremendous worth of this substance, 0:34:21.200 --> 0:34:24.480 opted to flush it away, a strategy in keeping with 0:34:24.560 --> 0:34:27.160 the sentiment of past centuries that poop was waste and 0:34:27.239 --> 0:34:31.880 nothing more, and this sentiment wasn't universally shared even across Europe. 0:34:32.360 --> 0:34:36.080 In his book Lemiz, Victor Hugo question question to the 0:34:36.120 --> 0:34:39.719 similar approach that Paris took with its sewers, quote, what 0:34:39.840 --> 0:34:42.440 do we do with all this golden dung? It is 0:34:42.480 --> 0:34:46.080 swept into an abyss? All the human and animal manure 0:34:46.120 --> 0:34:49.040 which the world wastes, if returned to the land instead 0:34:49.040 --> 0:34:51.719 of thrown into the sea, would suffice to nourish the 0:34:51.760 --> 0:34:53.160 world end quote. 0:34:53.520 --> 0:34:53.800 Truth. 0:34:53.960 --> 0:34:55.400 Yeah, he's not wrong, truth. 0:34:55.600 --> 0:34:59.400 And he wasn't just discussing a hypothetical strategy. For millennia, 0:34:59.560 --> 0:35:02.480 many cltures had a much different perspective on how best 0:35:02.480 --> 0:35:04.560 to deal with the amount of poop and pea that 0:35:04.640 --> 0:35:10.040 a growing city produced. Where the ancient Romans and modern 0:35:10.080 --> 0:35:13.239 Londoners saw the value of poop in its absence, other 0:35:13.360 --> 0:35:17.319 cultures saw its value as a fertilizer. Why did some 0:35:17.400 --> 0:35:19.720 parts of the world adopt the view of human excrement 0:35:19.760 --> 0:35:21.719 as a valuable thing and others as a thing to 0:35:21.760 --> 0:35:24.520 get as far away from as possible. One aspect was 0:35:24.600 --> 0:35:27.879 need how many livestock you had, or how fertile your 0:35:27.880 --> 0:35:31.200 soil already was, or how much pasture land was even available. 0:35:31.960 --> 0:35:34.680 Maybe you were land limited, right, you couldn't just clear 0:35:34.719 --> 0:35:36.920 more land when all the nutrients were leached out of 0:35:36.960 --> 0:35:39.640 your soil. Or maybe you didn't have and didn't have 0:35:39.680 --> 0:35:42.880 the land to have at these ample amounts of livestock 0:35:42.920 --> 0:35:45.839 that were producing manure that could be used as fertilizer, 0:35:45.960 --> 0:35:47.640 and so you're just like, I'm going to use what's 0:35:47.680 --> 0:35:50.560 right in front of me. This is fertilizer. 0:35:50.920 --> 0:35:51.680 I'm already making it. 0:35:51.880 --> 0:35:52.120 Yeah. 0:35:52.200 --> 0:35:53.319 Yeah. 0:35:53.480 --> 0:35:57.239 Throughout Japan's history, for instance, both poop and urine was 0:35:57.280 --> 0:36:01.000 sold to farmers to fertilize their crops called knights. Japan 0:36:01.040 --> 0:36:03.640 didn't really have acres and acres of pasture land or 0:36:03.719 --> 0:36:07.000 many large livestock, and so night soil was highly valued. 0:36:07.480 --> 0:36:11.239 If you rented an apartment, your landlord technically owned the 0:36:11.360 --> 0:36:14.239 night soil that you produced, and so the rent was 0:36:14.280 --> 0:36:16.879 adjusted based on the number of people living in a room. 0:36:16.920 --> 0:36:18.279 How many people are pooping here? 0:36:18.480 --> 0:36:21.040 Yeah, how much can I get for their poop? So 0:36:21.080 --> 0:36:23.840 if five people lived in one room, rent was free. 0:36:24.239 --> 0:36:27.400 For example, Yeah, that's hilarious. 0:36:27.520 --> 0:36:30.160 Pooping at a friend's house was considered a generous act 0:36:32.200 --> 0:36:33.360 because you're like, thank you for that. 0:36:34.120 --> 0:36:35.319 Oh my god, I love that. 0:36:35.560 --> 0:36:35.920 I know. 0:36:36.680 --> 0:36:39.960 So you might wonder how this practice, which the use 0:36:39.960 --> 0:36:41.879 of night soil is still used in many parts around 0:36:41.920 --> 0:36:44.440 the world today, how it didn't lead to the spread 0:36:44.440 --> 0:36:46.439 of pathogens transmitted by poop. You know, we just talked 0:36:46.440 --> 0:36:48.919 about the Great stink and colera outbreaks. And all of that, 0:36:49.360 --> 0:36:51.320 and a big part of it was how you process 0:36:51.440 --> 0:36:56.440 the poop composting, right, you have to what is the 0:36:56.480 --> 0:37:00.520 word ferment, ferment the poop, I guess, And so this 0:37:00.560 --> 0:37:03.279 what would happen is like in this composting process, it 0:37:03.320 --> 0:37:06.920 would help to reduce the proliferation of pathogenic bacteria in 0:37:06.960 --> 0:37:09.240 the poop and break it down into its raw components, 0:37:09.280 --> 0:37:13.359 which were more readily used by plants. It's a part 0:37:13.400 --> 0:37:17.320 of the decompositions like right, you know. And the second 0:37:17.480 --> 0:37:22.440 was just like standard hygienic practices, washing hands, boiling water, 0:37:22.520 --> 0:37:26.560 cooking vegetables, things like that. Japan wasn't alone in seeing 0:37:26.600 --> 0:37:29.359 the value of night soil. China was also well ahead 0:37:29.400 --> 0:37:31.080 of the curve when it came to seeing poop as 0:37:31.080 --> 0:37:34.719 a resource rather than waste. One strategy that people used 0:37:34.719 --> 0:37:38.320 in China was to let all the refuse from humans, animals, 0:37:38.840 --> 0:37:42.040 other parts of agriculture all mixed together with water in 0:37:42.120 --> 0:37:46.000 covered tubs and pits, and then after the fermentation process 0:37:46.080 --> 0:37:49.120 was complete, they would either pour this liquid maneuver directly 0:37:49.160 --> 0:37:51.520 onto the roots or let it dry in the sun, 0:37:51.760 --> 0:37:54.680 forming cakes which would desiccate, and then they could sell 0:37:55.080 --> 0:37:59.120 yeah mix with water, and there's instant fertilizer. Poop was 0:37:59.200 --> 0:38:02.239 so valued that in seventeen thirty seven in China there 0:38:02.239 --> 0:38:05.839 was an imperial treatise that commanded treasure night soil as 0:38:05.840 --> 0:38:06.640 if it were gold. 0:38:06.920 --> 0:38:08.880 Wow. Yeah, seventeen hundreds. 0:38:08.880 --> 0:38:10.640 You said, seventeen hundreds for that, But it had been 0:38:10.640 --> 0:38:11.840 going on for much longer. 0:38:11.960 --> 0:38:12.720 Yeah. 0:38:12.760 --> 0:38:14.880 And so while most of Europe treated poop as a 0:38:14.920 --> 0:38:17.839 waste product exclusively, there were a few pockets that saw 0:38:17.840 --> 0:38:20.839 it differently, some places that paid for poop rather than 0:38:20.840 --> 0:38:24.480 paying to have it be taken away. In parts of 0:38:24.520 --> 0:38:27.560 Belgium and in the Netherlands, farmers utilized night soil for 0:38:27.640 --> 0:38:31.560 crop fertilization. They constructed specialized casks that could hold over 0:38:31.640 --> 0:38:35.040 one hundred gallons. The casks were loaded onto carts where 0:38:35.080 --> 0:38:38.000 they were dragged around by a horse, the farmer on 0:38:38.080 --> 0:38:40.640 the horse lifting the rope that controlled the lever to 0:38:40.719 --> 0:38:43.200 be like now reallyaseam now really some more. 0:38:44.840 --> 0:38:45.800 It's pretty ingenious. 0:38:46.239 --> 0:38:49.000 And even in the US in the late eighteen hundreds 0:38:49.000 --> 0:38:51.759 there was a very successful night soil company based in 0:38:51.840 --> 0:38:55.440 New Jersey who got paid twice for their labor, first 0:38:55.440 --> 0:38:57.440 to remove the poop in the first place, and then 0:38:57.480 --> 0:39:03.320 the second to sell fertilizer, and so inspired by their success, 0:39:03.440 --> 0:39:06.640 a few sewage farms sprung up around the US, but 0:39:06.760 --> 0:39:08.840 eventually they fell out of favor by the end of 0:39:08.880 --> 0:39:12.600 the nineteenth century, as did night soil almost across the board. 0:39:13.520 --> 0:39:19.120 What changed the invention of commercial fertilizer and the introduction 0:39:19.280 --> 0:39:23.600 of germ theory, whereby poop became the enemy and nothing more. 0:39:24.320 --> 0:39:26.040 And I think it's important to note, and I feel 0:39:26.080 --> 0:39:28.759 like we didn't cover this in an actual episode, like 0:39:28.760 --> 0:39:31.640 a regular episode, but in a there was The Devil's 0:39:31.880 --> 0:39:34.000 The Devil's Element Book club book. 0:39:34.600 --> 0:39:38.120 He talked about fertilizer. 0:39:37.680 --> 0:39:40.800 And like guano, these islands of guano, and then people 0:39:40.840 --> 0:39:46.399 harvesting like bones from battlefields, like old battlefields to use 0:39:46.400 --> 0:39:49.880 his fertilizer. And I just find that so because a 0:39:49.880 --> 0:39:51.600 lot of that was happening in like the eighteen hundreds 0:39:51.719 --> 0:39:53.440 or so, and there was this huge rush prior to 0:39:53.440 --> 0:39:58.000 the introduction of commercial fertilizer, and poop was there all along, right, 0:39:58.800 --> 0:39:59.920 It's just yeah. 0:40:00.000 --> 0:40:02.839 It is really really interesting, right, especially to think about 0:40:02.840 --> 0:40:04.920 that alongside the rise of germ theory, which like we 0:40:05.000 --> 0:40:07.480 talk about so much on this podcast, and it is 0:40:07.520 --> 0:40:10.479 like so important, and your poop can make you quite sick, 0:40:10.960 --> 0:40:13.480 and so it's it is just really interesting to think 0:40:13.520 --> 0:40:15.600 of those things as like side by side and like 0:40:15.719 --> 0:40:17.200 how yeah. 0:40:17.120 --> 0:40:20.440 Wait to see it in one like one one angle right. 0:40:20.520 --> 0:40:23.880 One perspective of poop is just that it is waste 0:40:24.000 --> 0:40:25.800 and nothing more in the enemy, and it's going to 0:40:25.880 --> 0:40:28.560 make you sick, and that's it, and that is true. 0:40:28.640 --> 0:40:32.880 It is true, and two things can be true. 0:40:33.640 --> 0:40:37.080 But what have so that when these when these things change, 0:40:37.120 --> 0:40:41.960 the introduction of commercial fertilizer and then germ theory things, 0:40:42.080 --> 0:40:45.680 even places that had long used night soil, it just 0:40:45.840 --> 0:40:49.719 they kind of stopped, like many places stopped. Commercial fertilizer 0:40:49.760 --> 0:40:52.799 took over in the twentieth century, and that decree of 0:40:52.880 --> 0:40:55.960 treasure night soil, if it were gold, became a relic. 0:40:55.680 --> 0:40:56.280 Of the past. 0:40:56.920 --> 0:40:59.759 Poop was no longer a commodity. It was a thing 0:40:59.840 --> 0:41:03.400 to rid yourself of, a thing to fear, and today 0:41:03.600 --> 0:41:05.880 most of the world is still stuck in that mentality, 0:41:06.120 --> 0:41:09.239 though really we should be following that eighteenth century decree 0:41:09.480 --> 0:41:12.560 because it is wild how much waste we let. 0:41:12.480 --> 0:41:13.360 Go to waste. 0:41:13.920 --> 0:41:17.360 Functioning sewage systems are foundational to public health, and everyone 0:41:17.360 --> 0:41:20.000 should have access to clean water because water borne disease 0:41:20.120 --> 0:41:24.480 kills so many people every year. But it's also clear 0:41:24.520 --> 0:41:28.160 that our massive sewage plants have solved one big problem 0:41:28.560 --> 0:41:33.240 removal of poop from our immediate proximity, while simultaneously creating another, 0:41:33.840 --> 0:41:37.359 too much poop in all the wrong places. We raise 0:41:37.400 --> 0:41:40.560 livestock on large scale farms, where their manure leaches into 0:41:40.560 --> 0:41:43.839 the waterways near the farms. Meat and other food gets 0:41:43.880 --> 0:41:47.319 shipped to our local stores, removing those nutrients from where 0:41:47.360 --> 0:41:50.200 they were grown. Then we eat the food and poop 0:41:50.200 --> 0:41:53.319 it out, and that gets flushed into waterways, again far 0:41:53.400 --> 0:41:55.520 from the original source of these nutrients, and. 0:41:55.520 --> 0:41:56.880 Then it goes into the ocean, goes. 0:41:56.760 --> 0:42:01.360 Into algal blooms, marsh decay, barren farmland, eroding soil's ecosystem 0:42:01.400 --> 0:42:05.720 collapse Like these are the consequences of nutrient redistribution across 0:42:05.719 --> 0:42:06.560 the landscape. 0:42:06.680 --> 0:42:11.840 Oh man, this situation is again becoming dire. What do 0:42:11.880 --> 0:42:13.000 we do about it? This time? 0:42:14.719 --> 0:42:15.480 I have an answer? 0:42:15.640 --> 0:42:17.960 I don't I mean, I don't have an answer personally. 0:42:17.960 --> 0:42:20.480 But there are so many people, so many people who 0:42:20.560 --> 0:42:23.640 are working on this problem from many, many different angles. 0:42:23.640 --> 0:42:28.160 They're designing more efficient toilets, revisiting the idea of sewage farms, 0:42:28.320 --> 0:42:33.160 transforming human waste into fuel or fertilizer, even just rebranding 0:42:33.200 --> 0:42:36.319 poop into something that's like not shameful. Props to the 0:42:36.320 --> 0:42:39.960 poop emoji for that one. It doesn't mean it's like 0:42:40.000 --> 0:42:42.879 it's really funny. It's like a very popular emoji. It's 0:42:42.880 --> 0:42:43.600 a great emoji. 0:42:43.719 --> 0:42:44.560 Yeah. 0:42:44.600 --> 0:42:46.840 And it doesn't mean like there are many people working 0:42:46.840 --> 0:42:48.440 on this, and it doesn't mean that we have everything 0:42:48.520 --> 0:42:52.120 under control right now, but we do have possible paths 0:42:52.160 --> 0:42:55.360 forward and a ton of amazing innovators that are dedicated 0:42:55.400 --> 0:42:56.040 to this work and. 0:42:56.000 --> 0:42:57.120 Really passionate about it. 0:42:57.960 --> 0:43:01.440 Poop is a valuable resource a fertilizer, as a source 0:43:01.440 --> 0:43:05.200 of public health data like wastewater can tell us what pathogens. 0:43:04.719 --> 0:43:05.880 Are currently circulating. 0:43:06.200 --> 0:43:09.759 Huge, huge, And it's also a valuable resource on an 0:43:09.840 --> 0:43:14.080 individual level, Like what does your pooh say about you? 0:43:14.320 --> 0:43:15.240 Such a good question. 0:43:15.520 --> 0:43:18.879 Well, Aaron, this is where I pose that question to you, 0:43:19.239 --> 0:43:21.400 so you can tell me all about what we can 0:43:21.480 --> 0:43:22.320 learn from our poop. 0:43:22.400 --> 0:43:42.440 I cannot wait to do that. So I ended last 0:43:42.440 --> 0:43:46.640 week's episode mostly just talking about what is typical when 0:43:46.680 --> 0:43:51.080 it comes to our poops, right, yeah, yeah, And you 0:43:51.560 --> 0:43:54.040 talked to us through in last week's episode, if anyone 0:43:54.040 --> 0:43:56.440 missed it, all of the different ways that animals use 0:43:56.440 --> 0:44:00.840 our poop as a resource, and poop on a landscape 0:44:00.920 --> 0:44:05.480 level scale tells us so much about how we're dealing 0:44:05.520 --> 0:44:07.919 with Our poop can tell us a lot. But you're right, 0:44:08.000 --> 0:44:10.960 on an individual level, our poop can also tell us 0:44:11.040 --> 0:44:15.040 quite a lot. And I think there's an interesting balance, 0:44:15.160 --> 0:44:19.359 I guess where a lot of us don't think about 0:44:19.400 --> 0:44:22.840 our poop at all. Like we poop and it's done, 0:44:22.880 --> 0:44:25.920 it is out of our mind. We're not worried about it, 0:44:25.960 --> 0:44:27.600 we're not looking at it, we're not thinking about it. 0:44:27.600 --> 0:44:29.319 We're just maybe trying to think about it as little 0:44:29.360 --> 0:44:33.320 as possible. And there are also many people who maybe 0:44:33.320 --> 0:44:36.000 spend a little too much time thinking about their poops 0:44:36.440 --> 0:44:39.280 or worrying about their poops or what is this one poop? 0:44:39.360 --> 0:44:41.360 Did I eat beats? Or is this cooling cancer? 0:44:41.640 --> 0:44:44.760 I mean, that's a reasonable question to ask. 0:44:44.880 --> 0:44:48.120 After a beat, after a beat, poop after a beat, poop, 0:44:48.160 --> 0:44:49.279 unless it's beats. 0:44:50.480 --> 0:44:53.399 But it is true that our poops can tell us 0:44:53.680 --> 0:44:56.360 so much about our health, and a lot of times 0:44:56.520 --> 0:45:01.160 changes in our bowel movements might actually be indicator of 0:45:01.200 --> 0:45:04.200 an underlying disease. Though my point with today is not 0:45:04.280 --> 0:45:07.600 necessarily to make everyone worried about their poops. It's more 0:45:07.719 --> 0:45:11.839 just to kind of understand the spectrum. Okay, And since 0:45:11.880 --> 0:45:15.399 we already covered the range of typical, we can look 0:45:15.480 --> 0:45:21.240 back at our Bristol stool scale to understand the ways 0:45:21.320 --> 0:45:24.799 in which our poop can become a typical. If that 0:45:24.840 --> 0:45:27.400 makes sense. Love this. So if a perfect poop on 0:45:27.440 --> 0:45:29.920 that Bristol scale, which again goes from one to seven, 0:45:30.120 --> 0:45:33.480 where one are these hard, separate lumps kind of like 0:45:33.520 --> 0:45:38.080 a nut of poop, chunk chunk, PLoP, PLoP, and types. 0:45:37.760 --> 0:45:40.320 Are appreciate that extra little little. 0:45:40.120 --> 0:45:44.640 Too much, and a type seven is entirely liquid. Those 0:45:44.680 --> 0:45:49.600 are our two extremes constipation and diarrhea. Yes, and so 0:45:49.640 --> 0:45:50.560 that's what I'm going to kind. 0:45:50.440 --> 0:45:52.040 Of focus on constipation and diarrhea. 0:45:52.040 --> 0:45:55.400 Constipation and diarrheall so, and there's a lot of different 0:45:55.400 --> 0:45:58.440 ways to classify. Those are not the only poop problems 0:45:58.440 --> 0:46:00.399 that you can have, but constipation and diarrhea I think 0:46:00.480 --> 0:46:03.680 give us a lot of insight because that does kind 0:46:03.680 --> 0:46:04.920 of cover that whole spectrum. 0:46:04.960 --> 0:46:05.160 Right. 0:46:05.680 --> 0:46:08.120 So there's a lot of different ways to classify or 0:46:08.160 --> 0:46:10.520 define both of these things. And I'll start with constipation 0:46:10.560 --> 0:46:12.200 because I love talking about constipation. 0:46:13.160 --> 0:46:18.560 So has that word been uttered in the history. 0:46:18.719 --> 0:46:20.960 I'll see it in the office all the time, So 0:46:21.640 --> 0:46:25.640 I love talking about constipation. How we actually define it, 0:46:25.640 --> 0:46:28.120 it's either with this bristol stool scale, but it's never 0:46:28.239 --> 0:46:31.520 just exclusively with the bristol stool, So it's usually hard 0:46:31.600 --> 0:46:36.000 or lumpy stools, or needing to strain during a bowel movement, 0:46:37.400 --> 0:46:41.040 or sometimes feeling like I just can't completely evacuate, like 0:46:41.239 --> 0:46:43.279 you poop and you just feel like there's something still 0:46:43.320 --> 0:46:45.279 there that needs to come out but it cannot come 0:46:45.280 --> 0:46:49.680 out feeling. If those things are happening, usually more than 0:46:49.680 --> 0:46:53.440 twenty five percent of your poops, that's what's considered. 0:46:53.040 --> 0:46:57.480 Constipated, huh okay. 0:46:56.160 --> 0:46:59.160 Or sometimes it can be if you're having fewer than 0:46:59.239 --> 0:47:02.400 three bowl movements per week, that might also be considered 0:47:02.480 --> 0:47:04.000 you constipated. 0:47:03.400 --> 0:47:06.200 Okay, how often? Like okay? 0:47:08.040 --> 0:47:09.560 I love that you're asking questions already. 0:47:09.680 --> 0:47:11.920 I know, I know, well you said fewer that you 0:47:12.000 --> 0:47:14.080 said more than or twenty five. 0:47:14.160 --> 0:47:18.160 Twenty five percent of your poops, So who's watching that. 0:47:18.160 --> 0:47:20.640 That's such a great question, who, like, how many of 0:47:20.680 --> 0:47:22.799 us are paying that much attention to our poop? Right, 0:47:23.120 --> 0:47:25.640 I don't know unless maybe you're dealing with constipation, and 0:47:25.680 --> 0:47:28.080 then you probably are, because a lot of times it's 0:47:28.120 --> 0:47:30.200 maybe more than twenty five percent, Right, it has to 0:47:30.200 --> 0:47:32.480 be at least that for us to call it constipation 0:47:32.560 --> 0:47:35.160 according to the like Rome criteria, which is the criteria 0:47:35.200 --> 0:47:37.399 that we use. But a lot of people who deal 0:47:37.400 --> 0:47:39.279 with constipation have been dealing with it for a really 0:47:39.320 --> 0:47:42.799 long time. It's estimated most of the studies cite that 0:47:42.880 --> 0:47:45.560 in the US something like twelve to fifteen percent are 0:47:45.600 --> 0:47:49.000 dealing with constipation, and a lot of times, unless we 0:47:49.040 --> 0:47:52.640 can identify the cause of constipation, it gets lumped under 0:47:52.680 --> 0:47:55.920 what's called like functional constipation, which really just means that 0:47:55.960 --> 0:47:58.480 we don't necessarily have an idea of what the mechanisms are. 0:47:59.080 --> 0:48:01.720 But it's estimated that up to thirty percent of people 0:48:02.200 --> 0:48:05.560 deal with constipation at least on an occasional basis, so 0:48:05.600 --> 0:48:09.920 they like sometimes have issues pooping, and that is thought 0:48:09.920 --> 0:48:12.359 to be an underestimate because these are data that are 0:48:12.360 --> 0:48:15.160 based on people who seek care. Right of course, right. 0:48:16.719 --> 0:48:18.640 Are you going to talk about the causes of constipation, 0:48:18.680 --> 0:48:20.600 because I want to talk about functional constant. 0:48:20.880 --> 0:48:23.200 Like to me, what's your question, what are the causes 0:48:23.239 --> 0:48:24.000 of constipation? 0:48:24.320 --> 0:48:25.120 That great questions? 0:48:25.239 --> 0:48:28.120 At what point do you go? We don't know, but 0:48:28.200 --> 0:48:29.480 you're clearly constipated. 0:48:29.600 --> 0:48:31.719 Yeah, I mean, it totally depends on the scenario and 0:48:31.760 --> 0:48:34.240 also depends on how well it responds to the various 0:48:34.239 --> 0:48:37.600 treatment options. Right, But there's a lot of things that 0:48:37.640 --> 0:48:40.800 could cause it. It could be that you have slow 0:48:40.880 --> 0:48:44.520 gut transit, right, which we know from last episode, can 0:48:44.560 --> 0:48:46.360 be caused by a number of different things. Some of 0:48:46.400 --> 0:48:48.799 it might be genetics, some of it might be medications 0:48:48.800 --> 0:48:50.920 that you're on. Some of it might be the diet 0:48:50.960 --> 0:48:53.759 that you are eating, is that right, The diet that 0:48:53.800 --> 0:48:56.840 you're eating, diet, the food that your diet or diet. 0:48:58.480 --> 0:49:01.040 Some of it might be diet because fiber, as we know, 0:49:01.239 --> 0:49:05.440 can increase your stool transit time, and so if your 0:49:05.719 --> 0:49:08.080 diet is very low in fiber, then you might have 0:49:08.160 --> 0:49:12.240 prolonged transit times, so you might be more prone to constipation. Also, 0:49:12.320 --> 0:49:16.560 dehydration can put you at risk of harder stools. Physical 0:49:16.600 --> 0:49:20.719 activity increases your motility of your guts, and so we 0:49:20.800 --> 0:49:24.880 all live much more sedentary lifestyles, especially like in the 0:49:25.000 --> 0:49:28.560 US we're quite sedentary, and so that is actually probably 0:49:28.600 --> 0:49:31.919 contributing to constipation. But then there's other things too. There's 0:49:31.960 --> 0:49:35.000 like just actual dysmotility. There's something called Hirsprungs, which is 0:49:35.040 --> 0:49:37.520 like where it's a genetic disorder where some of your 0:49:37.600 --> 0:49:39.719 nerve endings of your colon have not developed all of 0:49:39.760 --> 0:49:42.160 the way and so you cannot get contraction the way 0:49:42.160 --> 0:49:44.600 that you should. So that can make it very hard 0:49:44.600 --> 0:49:46.160 to poop and you can get a huge amount of 0:49:46.160 --> 0:49:49.560 stool build up in things. There's pelvic floor dysfunction, anal 0:49:49.600 --> 0:49:53.000 sphincter issues, like there's a lot of possibilities, A lot. 0:49:52.920 --> 0:49:55.480 Of possibilities, Are there a lot of solutions? 0:49:56.080 --> 0:50:00.319 Is that great question? I mean yes and no. Right, 0:50:00.760 --> 0:50:04.200 the main ways that we go and deal with constipation, 0:50:05.000 --> 0:50:09.000 for like a general rule, are going to be using 0:50:09.040 --> 0:50:13.160 things like laxatives, which are going to hold on to 0:50:13.360 --> 0:50:17.200 water in your stool, so that is going to make 0:50:17.239 --> 0:50:18.120 your stool softer. 0:50:18.400 --> 0:50:19.200 That how they work. 0:50:19.280 --> 0:50:22.400 That's how they work. They just still like okay, mirralax, 0:50:22.440 --> 0:50:24.959 which is polyethylene glycol. There's lots of different brand names 0:50:24.960 --> 0:50:27.600 of it. It's just a very large molecule, and so 0:50:27.680 --> 0:50:30.840 it just attracts water. And so you have this molecule, 0:50:31.040 --> 0:50:33.120 it doesn't get broken down in your digestive tract. So 0:50:33.160 --> 0:50:36.120 it's sitting in your colon holding on to water, and 0:50:36.200 --> 0:50:39.040 therefore you have more water in your poop. Therefore it 0:50:39.080 --> 0:50:43.160 is softer and easier to pass. And other osmotic laxatives 0:50:43.160 --> 0:50:46.400 work the same way. Lactolose, magnesium citrate, all these things. 0:50:46.800 --> 0:50:49.000 There's also some other ones that you can use, like 0:50:49.080 --> 0:50:52.520 stimulant laxatives. Those are things like bisocotal is one or 0:50:52.600 --> 0:50:55.760 senna is another, and these are helping to stimulate paristolsis. 0:50:55.800 --> 0:50:57.799 They're helping to stimulate muscular contractions. 0:50:58.360 --> 0:51:01.400 So it's not like a laxative the water aspect, but 0:51:01.520 --> 0:51:02.800 in the movement it's moving. 0:51:02.880 --> 0:51:05.160 Yeah, it's helping with movement, and so what you might 0:51:05.280 --> 0:51:08.640 use might depend on what you think the underlying issue is, 0:51:09.080 --> 0:51:11.719 so it's going to be kind of person dependent. There's 0:51:11.760 --> 0:51:15.239 also stool softeners. But my favorite thing about stool softeners 0:51:15.280 --> 0:51:17.719 in medicine is that we use them all the time 0:51:17.760 --> 0:51:21.600 and there's like no data that they work. Wait, what, doc, 0:51:21.640 --> 0:51:23.720 you say? It is like one of the most commonly 0:51:23.800 --> 0:51:26.839 used things in hospitals, and like people like to tell 0:51:26.880 --> 0:51:28.359 people to use it all the time, and there's like 0:51:28.880 --> 0:51:31.600 very little if any evidence that it. It's supposed to 0:51:31.680 --> 0:51:35.480 just like help make your stool more slippery, is the idea, 0:51:35.600 --> 0:51:38.600 like mucisi me, I don't know, but it doesn't like 0:51:38.719 --> 0:51:39.640 it doesn't work, okay. 0:51:39.680 --> 0:51:42.000 So so when you say it doesn't work, do you 0:51:42.040 --> 0:51:44.000 mean that there have been studies that have found no effect. 0:51:44.080 --> 0:51:44.920 Yeah, there have been no studies. 0:51:45.000 --> 0:51:48.200 There have been studies that have had no effect. Yeah, 0:51:48.560 --> 0:51:50.560 unlike othmotic laxatives and things which great. 0:51:50.680 --> 0:51:53.359 So why why would you use the stool softener over 0:51:53.400 --> 0:51:54.120 a laxative. 0:51:55.000 --> 0:51:58.440 I don't know. I don't, okay, okay, but lots of 0:51:58.440 --> 0:52:01.600 people do. I don't know. It's thought to be less harsh, okay, right, 0:52:01.640 --> 0:52:03.840 because it's not gonna like grab onto a bunch of 0:52:03.880 --> 0:52:06.920 water and then like have you at risk of diarrhea 0:52:07.080 --> 0:52:09.120 or something quite as much? Right, where you can easily 0:52:09.200 --> 0:52:11.640 overdo it with some laxative. So you could end up 0:52:11.680 --> 0:52:14.560 with electrolyte imbalances if you overdo it on laxatives things 0:52:14.600 --> 0:52:17.359 like that. But realistically I don't know because I don't But. 0:52:17.600 --> 0:52:21.160 What about the like prep for a colonoscope. 0:52:21.280 --> 0:52:24.840 It's basically a huge jug of polyethylene gicoll or. Sometimes 0:52:24.840 --> 0:52:29.160 we use sodium based ones too, so like other electron electrode. Yeah, yeah, yeah, okay, 0:52:29.160 --> 0:52:30.719 but yeah, that's basically what it is, Just like a 0:52:30.800 --> 0:52:34.000 huge jug of it, chug chug, chug with a lot 0:52:34.040 --> 0:52:36.160 of water because you're going to be pooping out a 0:52:36.160 --> 0:52:36.640 lot of water. 0:52:37.320 --> 0:52:37.520 I know. 0:52:37.640 --> 0:52:38.200 Isn't that fun? 0:52:38.360 --> 0:52:42.439 Yeah, it's great. Fun. Yeah, fun, that's exactly the word 0:52:42.440 --> 0:52:43.399 that I would use. Yeah. 0:52:43.680 --> 0:52:45.799 But so that's like, I mean, that's that's most of 0:52:45.800 --> 0:52:48.279 the ways that we try. And there's other newer medicines too, 0:52:48.400 --> 0:52:50.200 Like there's a lot of there's a lot of newer 0:52:50.239 --> 0:52:52.960 medicines that have mechanisms that I'm not going to get 0:52:53.000 --> 0:52:54.680 into because I'm not as familiar with it, but there's 0:52:54.680 --> 0:52:58.200 a lot of Because constipation is such an issue, there 0:52:58.239 --> 0:53:00.799 are a lot of interest in new ways to help 0:53:00.840 --> 0:53:03.560 deal with constipation. When these are not effective, these is 0:53:03.600 --> 0:53:06.040 like go to first line try it out. If it's 0:53:06.080 --> 0:53:08.319 not working, you need to see a specialist kind of 0:53:08.320 --> 0:53:08.600 a thing. 0:53:08.719 --> 0:53:14.399 Okay, question about constipation and treatments the like uh, polyethylene 0:53:14.400 --> 0:53:17.880 gli call et ceteras of the world. Are those for 0:53:18.160 --> 0:53:23.160 acute relief or in is the more like chronic relief? 0:53:23.560 --> 0:53:23.960 Fiber? 0:53:24.239 --> 0:53:27.279 Yes, it's yes, And okay, do you want to talk 0:53:27.280 --> 0:53:28.520 about fiber? I can skip. 0:53:28.920 --> 0:53:31.000 We can know. We keep your notes the way you 0:53:31.040 --> 0:53:31.719 want them to keep. 0:53:32.280 --> 0:53:33.240 Let's talk about fiber. 0:53:33.360 --> 0:53:36.120 Great. Always I'm always down to talk about fiber. 0:53:36.280 --> 0:53:41.239 I know me too, Okay, So yes, laxatives, stool softeners, 0:53:42.120 --> 0:53:44.520 motility agents. These are things that are going to help 0:53:44.760 --> 0:53:50.640 treat constipation. Yes, what if you are constipated? Fiber does 0:53:50.680 --> 0:53:58.280 not necessarily treat constipation, but it can help prevent constipation, right, Okay, 0:53:58.360 --> 0:54:00.920 because like we talked about last episode, it's holding onto 0:54:01.000 --> 0:54:05.480 water in your stool, and so it is hugely beneficial 0:54:05.560 --> 0:54:08.680 in increasing transit time and in making your stool softer, 0:54:08.800 --> 0:54:11.960 and in providing that bulking agent. And there's two major 0:54:12.000 --> 0:54:17.040 divisions of fiber. There's soluble fibers, which is like cilium, husk, oats, pectins, 0:54:17.440 --> 0:54:20.480 and then there's insoluble fibers, which is like wheat brand cellulose. 0:54:20.719 --> 0:54:22.239 Lots of the things that are in our fruits and 0:54:22.280 --> 0:54:22.879 veggies and things. 0:54:23.480 --> 0:54:25.520 I can't believe we're getting to talk about insoluble and 0:54:25.560 --> 0:54:26.480 soluble fibers. 0:54:26.800 --> 0:54:27.360 So excited. 0:54:27.520 --> 0:54:30.800 Yeah, And most of the if you're getting your fiber 0:54:30.880 --> 0:54:33.879 from food sources and not from like a fiber drink 0:54:33.960 --> 0:54:36.920 that you're mixing, then you're getting a combination of soluble 0:54:36.920 --> 0:54:39.320 and insoluble fibers in most of the foods that you're eating. 0:54:39.840 --> 0:54:43.680 And then there's also some of the fibers are like fermentable, 0:54:43.719 --> 0:54:45.920 and I talked a little bit about this last episode, 0:54:46.239 --> 0:54:50.919 Like the bacteria in our guts can break them down 0:54:50.960 --> 0:54:54.960 and ferment them specifically to produce these like short chain 0:54:55.040 --> 0:54:56.640 fatty acids that they can then. 0:54:57.080 --> 0:54:59.000 Use to eat. 0:54:59.080 --> 0:55:02.640 Like the bacteria eat break down this fermentable fiber and 0:55:02.840 --> 0:55:06.560 eat it, and then some of the cells in our 0:55:06.600 --> 0:55:09.080 colon can also use what they break down as an 0:55:09.160 --> 0:55:11.719 energy source, these short chain fatty asss. 0:55:11.880 --> 0:55:15.399 Okay, why choose one fiber over the other, and why 0:55:15.400 --> 0:55:16.240 are they all important? 0:55:16.320 --> 0:55:17.120 They're all important? 0:55:17.320 --> 0:55:19.839 The answer is that they're all important. Some of them 0:55:20.040 --> 0:55:23.000 are increasing bulk in our stool, and some of them 0:55:23.080 --> 0:55:26.640 are helping to feed the gut microbiome, and all of 0:55:26.680 --> 0:55:28.960 them are kind of doing both, like really, if we 0:55:29.000 --> 0:55:32.760 get into it, and so that that is why fiber. 0:55:32.880 --> 0:55:35.319 That's why people get so like stoked about fiber and 0:55:35.360 --> 0:55:37.640 why fiber is such an important part. There's also so 0:55:37.760 --> 0:55:40.920 much interesting data on like fiber because of its effects 0:55:40.960 --> 0:55:43.640 on our gut microbiome in helping to treat or at 0:55:43.719 --> 0:55:47.080 least prevent the worsening of a lot of like inflammatory diseases. 0:55:47.719 --> 0:55:50.960 Colon cancer we think is involved, like our low fiber 0:55:51.000 --> 0:55:53.840 diets we think are maybe involved in the increasing incidents 0:55:53.840 --> 0:55:56.200 of colon cancer that we see, especially in early onset 0:55:56.200 --> 0:55:58.480 colon cancer. It's not one thing, it's many things, but 0:55:58.600 --> 0:56:02.160 fiber is a part of that story. So it's it's huge. 0:56:02.400 --> 0:56:04.239 And part of the reason that this is important to 0:56:04.239 --> 0:56:06.880 you is because constipation, while it's an issue in and 0:56:06.920 --> 0:56:12.560 of itself, it can be very painful. It can, like constipation, 0:56:12.640 --> 0:56:15.399 can cause its own set of problems, constipation can also 0:56:15.480 --> 0:56:19.040 cause other problems. Constipation can put you at risk of 0:56:19.080 --> 0:56:23.120 things like diverticulosis, which are these little out pouchings of 0:56:23.160 --> 0:56:25.960 your gut wall, especially in the stigmoid colon the part 0:56:26.000 --> 0:56:30.560 that sneaks around back before the rectum, and those little 0:56:30.560 --> 0:56:35.080 out pouchings can trap poop and then can get infected 0:56:35.280 --> 0:56:37.840 or can burst or can burst into a blood vessel 0:56:37.880 --> 0:56:40.840 and cause a lot of bleeding. So diverticulosis can be 0:56:40.880 --> 0:56:44.480 a problem, and constipation is a big contributor to diverticulosis 0:56:44.840 --> 0:56:48.319 is not the only thing, but it's one. Also hemorrhoids 0:56:49.360 --> 0:56:53.400 m okay, hemorrhoids are basically everyone actually has hemorrhoids. 0:56:53.520 --> 0:56:56.520 Can I before we go onto hemorrhoids, because I do 0:56:56.600 --> 0:56:58.960 want to talk about hemorrhoids, but I want to I 0:56:59.000 --> 0:56:59.920 want to go back. 0:56:59.760 --> 0:57:01.160 To fiber unless we're done. 0:57:01.200 --> 0:57:03.319 Are you end of fibert Yeah? 0:57:03.360 --> 0:57:06.319 Tell me a good question the relationship between fiber. I'm 0:57:06.320 --> 0:57:09.120 just stuck on these different insoluble soluble. It's fermentable. 0:57:09.200 --> 0:57:11.160 Don't ask me more details, you know, But like. 0:57:11.480 --> 0:57:13.600 We when we talk about a low fiber diet, it 0:57:13.640 --> 0:57:17.520 is of course across the board. But are we getting 0:57:17.720 --> 0:57:21.720 like is the low fiber diet more low in soluble insoluble? 0:57:22.440 --> 0:57:25.000 And are the relationships between these different fiber types and 0:57:25.760 --> 0:57:29.400 colon cancer for instance, or like other outcomes. 0:57:29.560 --> 0:57:31.920 It's a good question. It's beyond I don't know. 0:57:31.960 --> 0:57:36.880 Okay, And then how much? So no one's getting enough fiber? 0:57:37.000 --> 0:57:39.320 How much is enough fiber? What does that look like? 0:57:39.880 --> 0:57:44.400 Our fiber. Uh do do our fiber? 0:57:44.440 --> 0:57:45.080 What do you call them? 0:57:45.120 --> 0:57:48.000 Fiber, fiber, cereals, fiber bars, fiber supplement. 0:57:47.640 --> 0:57:48.520 Fiber powders. 0:57:48.560 --> 0:57:52.760 Ye, yeah, yeah, I love these questions. The recommended amount 0:57:52.960 --> 0:57:55.120 in the US is like twenty eight to thirty five 0:57:55.160 --> 0:57:58.080 grams of fiber a day. Okay, okay, a cup of 0:57:58.200 --> 0:58:00.520 raspberries as an example. I can't believe I know this 0:58:00.680 --> 0:58:01.919 in my head because I didn't write anything. 0:58:01.960 --> 0:58:05.720 We've talked about this, because raspberries especially are very high fibers. 0:58:06.120 --> 0:58:07.840 Of all the fruits, they're one of the best. Because 0:58:07.840 --> 0:58:09.640 a cup of raspberries is like eight grams or so 0:58:09.720 --> 0:58:13.560 of fiber a cup, so it's like pretty dece Kiwis 0:58:13.560 --> 0:58:15.400 also have a lot of fiber. Broccoli has a ton 0:58:15.440 --> 0:58:20.320 of fiber. Beans, especially white beans, so much fiber means 0:58:20.440 --> 0:58:23.920 white interesting, navy beans have more fiber than most other beans. 0:58:23.960 --> 0:58:27.320 Don't ask me why, No clue. Oh, lentils, lentils, lots 0:58:27.320 --> 0:58:29.000 of fiber. Don't know how much. I don't have the 0:58:29.040 --> 0:58:30.919 rest of them memorized because I usually just give people 0:58:30.960 --> 0:58:34.720 a chart. It's one of my that's my standard handout. 0:58:34.720 --> 0:58:36.720 If you come see me for a physical that's literally 0:58:36.800 --> 0:58:37.320 part of my hand. 0:58:37.360 --> 0:58:39.760 Bring bring one next time, yea time we're together. 0:58:39.800 --> 0:58:43.000 Okay, I just got it from the like NIH website 0:58:43.080 --> 0:58:46.720 or whatever. Okay, yeah, still I didn't make it. But no, 0:58:46.800 --> 0:58:48.480 so that that's a recommended amount, and most of us 0:58:48.520 --> 0:58:50.439 are probably getting much less than that. Like if you 0:58:50.960 --> 0:58:53.720 but your question about like fiber supplements and things like 0:58:53.720 --> 0:58:57.080 that can be really helpful, especially some of those soluble 0:58:57.080 --> 0:59:00.400 fibers like sillium husk and things like that tend to 0:59:00.400 --> 0:59:03.200 tolerate really well because they're not going to be as fermentable. 0:59:03.520 --> 0:59:05.800 You're going to get a little bit less bloating potentially 0:59:05.920 --> 0:59:10.360 with those, but you could you could get bloating with anything, 0:59:10.440 --> 0:59:13.080 especially if you're going from like no fiber right to 0:59:13.200 --> 0:59:17.240 some fibert start small, baby steps, baby steps. Always, this 0:59:17.280 --> 0:59:20.560 is not a medical advice podcast. Let me remind you all, 0:59:21.240 --> 0:59:24.360 we're just talking generalities. But yeah, so that's that I 0:59:24.360 --> 0:59:26.880 answer all those questions. Those count. But of course it 0:59:26.960 --> 0:59:29.680 is better if you're getting your fiber from whole foods 0:59:29.680 --> 0:59:32.040 because then you are getting a mix. And I don't 0:59:32.120 --> 0:59:34.280 know the answer as to like what percentage should be 0:59:34.280 --> 0:59:36.880 this or that, and like there's probably people who are 0:59:36.920 --> 0:59:39.960 doing those studies to kind of really look into it. 0:59:40.560 --> 0:59:42.200 But I don't know the answer to that. 0:59:42.280 --> 0:59:44.680 I know, and this like we haven't said this yet, 0:59:44.680 --> 0:59:47.080 which I'm shocked that we haven't said this. But there 0:59:47.080 --> 0:59:51.240 are so many other topics that are related to poop, yes, 0:59:51.360 --> 0:59:52.400 that we will cover. 0:59:52.560 --> 0:59:54.120 There's so many that I'm like, I will say this 0:59:54.200 --> 0:59:56.120 word and then we need to do a whole episode 0:59:56.160 --> 0:59:56.440 on it. 0:59:56.520 --> 0:59:59.480 Colon cancer, cool and cancer, early on set, colon cancer, 0:59:59.600 --> 1:00:03.920 so many things huge, Yeah, diverticulosis. 1:00:02.880 --> 1:00:05.280 Speaking of hemorrhoids. 1:00:04.720 --> 1:00:06.680 Hemorrhoids, so this could be a whole episode. 1:00:06.680 --> 1:00:07.760 Oh my god, it actually would be. 1:00:08.040 --> 1:00:09.680 I want to know about the because I was thinking 1:00:09.680 --> 1:00:12.400 about the development of laxatives. 1:00:12.680 --> 1:00:14.520 Oh interesting, right, okay, so we. 1:00:14.480 --> 1:00:17.760 Should do a and also the development of something hemorrhoid 1:00:17.840 --> 1:00:20.720 cream and whether it is true that you should put 1:00:20.760 --> 1:00:24.520 them under put it under your eye for puffiness. I 1:00:26.120 --> 1:00:29.040 feel like that was something in miscongeniality. 1:00:29.400 --> 1:00:30.640 Really, that's where I learned that. 1:00:30.760 --> 1:00:33.000 I mean, it's just like a low poncy steroid usually. Anyways, 1:00:33.000 --> 1:00:36.840 we're getting off the point Listen, hemorrhois hemorrhoids. Everyone has hemorrhoids. 1:00:37.640 --> 1:00:41.480 They're just collections of blood vessels that are in your 1:00:41.560 --> 1:00:45.840 rectum and your anus, so they function like cushions basically 1:00:46.480 --> 1:00:49.320 that help keep your anal canal closed because we want 1:00:49.360 --> 1:00:51.760 it closed most of the time. They help soften the 1:00:51.800 --> 1:00:54.800 transitive poop, so your poop has like do do think 1:00:54.800 --> 1:00:56.280 of it as like bointing off. 1:00:56.560 --> 1:00:59.120 Like a little pinball machine, like a pinball gently off. 1:01:00.320 --> 1:01:03.600 But they also they are basically collections of blood vessels. 1:01:03.600 --> 1:01:07.960 And because they are venous vessels, like they're veins, not arteries. 1:01:09.000 --> 1:01:13.720 Our veins can get swollen, and as they get swollen, 1:01:14.000 --> 1:01:17.840 they can sometimes burst open and bleed, either in small 1:01:17.840 --> 1:01:21.080 amounts or sometimes in larger amounts, and depending on where 1:01:21.120 --> 1:01:23.840 they form in the anal canal. Your anal canal is 1:01:23.880 --> 1:01:28.440 so interesting because some of it has sensory sensation. The 1:01:28.480 --> 1:01:30.560 external part you can feel it has a lot of 1:01:30.600 --> 1:01:33.440 nerve endings, and the inner part does not. So if 1:01:33.480 --> 1:01:37.840 you have internal hemorrhoids, they generally don't have any pain 1:01:38.000 --> 1:01:42.120 or discomfort or itching, but external hemorrhoids can cause quite 1:01:42.200 --> 1:01:45.600 a lot of itching and pain because especially they don't 1:01:45.640 --> 1:01:49.040 tend to burst open, though they can, but they can 1:01:49.080 --> 1:01:51.920 get very large and very very painful because they're like 1:01:51.960 --> 1:01:55.400 external so you're basically like sitting on them. So those 1:01:55.440 --> 1:01:57.960 can be quite painful, like little water balloons filled with 1:01:57.960 --> 1:02:04.000 blood basically right around your opening. And so those are 1:02:04.240 --> 1:02:07.000 you are at higher risk for those with constipation, like big, big, 1:02:07.040 --> 1:02:10.640 big time, because it is all of that increased pressure 1:02:11.280 --> 1:02:15.240 and the straining straining to poop really puts a lot 1:02:15.280 --> 1:02:17.160 of pressure on that anal canal, and so it really 1:02:17.200 --> 1:02:19.800 increases the pressure in those veins, so then blood pools 1:02:19.840 --> 1:02:20.280 up in there. 1:02:20.880 --> 1:02:24.440 I'm just I'm thinking of as someone who listens to 1:02:24.480 --> 1:02:26.440 a lot of like books on tape and in my 1:02:26.560 --> 1:02:29.400 car and when I'm running and walking the dog and 1:02:29.880 --> 1:02:31.880 when someone gets in the car with me and I 1:02:31.920 --> 1:02:34.600 have like, you know, like a colorful scene in one 1:02:34.640 --> 1:02:38.080 of five books I'm imagining of all of our episodes. 1:02:39.240 --> 1:02:40.360 Someone is playing this and. 1:02:41.840 --> 1:02:45.160 They're they're like, I don't know, brother in law gets 1:02:45.200 --> 1:02:48.560 in the car. It's like, I'm you know what exactly 1:02:48.640 --> 1:02:50.160 they have on the bluetobe speaker. 1:02:50.520 --> 1:02:52.640 Yeah, yeah, this is one to share with your family. 1:02:52.680 --> 1:02:54.760 Please do, because I'll keep going to tell you about 1:02:54.800 --> 1:02:58.520 anal fissures, which are another consequence of constipation. 1:02:58.600 --> 1:03:01.640 Consequence of constipation not related to hemrhoids. 1:03:01.800 --> 1:03:04.600 Not directly related except that they're both like an anal 1:03:04.640 --> 1:03:08.400 disease basically, But anal fissures are also this increased pressure 1:03:08.640 --> 1:03:12.840 sitting constipation issue. They're just teeny tiny, little like paper 1:03:12.840 --> 1:03:15.920 cuts almost in the skin of the anus, and so 1:03:16.000 --> 1:03:19.560 they're super super painful. So treatment for that is really 1:03:19.560 --> 1:03:23.640 to avoid constipation, and sometimes you need surgeries and things 1:03:23.640 --> 1:03:26.280 like that to kind of help treat those. So yeah, 1:03:26.320 --> 1:03:28.480 So constipation is a big deal, right because it can 1:03:28.680 --> 1:03:32.200 be a problem in and of itself, and it can 1:03:32.720 --> 1:03:35.880 cause all of these other problems. There's something called stircurle colitis. 1:03:35.880 --> 1:03:39.360 We won't even get there because it's quite extreme. But 1:03:39.520 --> 1:03:41.280 on the other arm, now I'm like, what, I don't 1:03:41.320 --> 1:03:43.880 google it after that. On the other end of the 1:03:43.920 --> 1:03:48.840 spectrum is diarrhea. Yes, and we've talked a lot about diarrhea. 1:03:48.920 --> 1:03:51.160 I spent more time on constipation because we don't ever 1:03:51.200 --> 1:03:53.240 really cover it on the podcast, but we've talked quite 1:03:53.240 --> 1:03:57.080 a lot about diarrhea. You define acute diarrhea as like 1:03:57.280 --> 1:04:01.040 three loose or watery stools in twenty four them. My 1:04:01.120 --> 1:04:03.080 kid will tell you I only had two, so it's 1:04:03.120 --> 1:04:10.000 not diarrhea. They're well trained. But chronic diarrhea we define 1:04:10.040 --> 1:04:13.120 as loose or watery stools similar to constipation in at 1:04:13.200 --> 1:04:15.600 least twenty five percent of your stools, lasting for at 1:04:15.680 --> 1:04:18.840 least three weeks. Okay, that would call chronic diarrhea. 1:04:18.920 --> 1:04:19.120 Yeah. 1:04:19.640 --> 1:04:22.880 And one of the biggest issues with diarrhea is that 1:04:23.080 --> 1:04:26.800 you're getting a lot of water loss with it, right, 1:04:27.040 --> 1:04:30.480 and diarrheal poops tend to be not only higher in 1:04:30.520 --> 1:04:33.440 water content, they also tend to be higher in protein content. 1:04:34.600 --> 1:04:37.880 And as you're losing all this water, you're also losing 1:04:37.920 --> 1:04:41.560 all those electrolytes that are with that water. So with diarrhea, 1:04:41.600 --> 1:04:45.880 you're at really high risk of dehydration and electrolyte imbalance. Uh. 1:04:46.200 --> 1:04:47.720 Protein, Yeah, because. 1:04:47.440 --> 1:04:49.960 Things are just not getting digested and broken down all 1:04:50.040 --> 1:04:53.240 the way. So fats too. Depending on the type of diarrhea, 1:04:54.280 --> 1:04:56.440 it could be. It just depends on It depends on 1:04:56.480 --> 1:04:58.840 what your GI tract is able to absorb versus not. 1:04:59.200 --> 1:05:03.360 What do you mean by t types of diarrhea. 1:05:02.560 --> 1:05:08.160 I mean what is causing your diarrhea can affect the 1:05:08.320 --> 1:05:13.000 type of diarrhea that you are having. So for example, 1:05:13.840 --> 1:05:18.520 if you have an infection that's just tearing through your 1:05:18.560 --> 1:05:22.040 gi tract so that your say, colon just isn't really 1:05:22.080 --> 1:05:24.400 absorbing any water. Then you're just going to have really 1:05:24.440 --> 1:05:26.520 watery stools. But you're still going to probably be absorbing 1:05:26.520 --> 1:05:29.800 all those nutrients because that happens in your small intestine. Yes, Okay. 1:05:30.440 --> 1:05:33.840 On the other hand, if you have no more gallbladder, 1:05:35.160 --> 1:05:39.280 then you are leaking out by all all the time. Yeah, 1:05:39.440 --> 1:05:44.200 So you might have less ability to digest fats, so 1:05:44.240 --> 1:05:46.120 you have more fat that just made it all the 1:05:46.120 --> 1:05:49.440 way through to your colon and that is providing a 1:05:49.440 --> 1:05:52.920 slippery slide. Then you might have diarrhea that is more 1:05:52.960 --> 1:05:57.480 fatty and is floaty fatty. But there's just I mean, 1:05:57.920 --> 1:06:00.800 there's lots of ranges of diarrhea, and like you were 1:06:00.800 --> 1:06:03.080 talking about, there's lots of ranges of smells of diarrhea. 1:06:03.080 --> 1:06:05.120 There's some people who are like, I can smell a 1:06:05.120 --> 1:06:08.720 sea dip diarrhea versus not. So is it infectious, is 1:06:08.760 --> 1:06:12.400 it chronic diarrhea? Is it more of an acute diarrhea? 1:06:13.400 --> 1:06:14.880 All of them, though, can put you at risk of 1:06:14.880 --> 1:06:17.479 things like collectrolide imbalance and dehydration and all. 1:06:17.400 --> 1:06:21.280 Of that chronic diarrhea. Okay, Yeah, yeah. 1:06:20.800 --> 1:06:23.400 And prevalence rates when it comes to diarrhea, I don't 1:06:23.400 --> 1:06:26.080 have like a one statistic like we do for constipation 1:06:26.160 --> 1:06:29.960 because they range hugely. And we've talked so much on 1:06:30.000 --> 1:06:33.480 this podcast about acute infectious diarrhea, especially in low and 1:06:33.480 --> 1:06:37.160 middle income countries. How many kids die from diarrhea every 1:06:37.240 --> 1:06:40.800 year is in the millions. It's very depressing. But even 1:06:40.800 --> 1:06:43.680 in high income countries, it's estimated that chronic diarrhea, the 1:06:43.720 --> 1:06:46.040 prevalence can range from like three to eight percent, which 1:06:46.120 --> 1:06:50.680 is not a small amount of people. No. So there's 1:06:50.720 --> 1:06:54.480 a lot of different things that can cause both constipation 1:06:55.200 --> 1:06:58.800 and diarrhea, but one that I want to kind of 1:06:58.840 --> 1:07:03.720 talk about because it can actually cause both. Okay is IBS. 1:07:04.000 --> 1:07:05.360 Yeah, okay, okay, okay. 1:07:05.520 --> 1:07:07.560 Yeah, And again this probably deserves its whole lon always 1:07:07.600 --> 1:07:09.760 does we need to do one, Yeah, we do. 1:07:10.000 --> 1:07:12.320 Don't please don't take this as we're just going to 1:07:12.400 --> 1:07:12.960 throw this in. 1:07:13.080 --> 1:07:15.840 No, no, But but I can't do a whole two 1:07:15.880 --> 1:07:19.400 episodes about poop and not talk about IBS, especially about 1:07:19.400 --> 1:07:23.200 problematic poops, because talk about the poster child of problematic pooping. 1:07:23.520 --> 1:07:27.200 Yes it's IBS, So IBS or irritable bowel syndrome, not 1:07:27.320 --> 1:07:30.000 the same thing, by the way, as IBD, or inflammatory 1:07:30.000 --> 1:07:34.120 bowel disease, which very commonly causes diarrhea, especially bloody diarrhea, 1:07:34.200 --> 1:07:37.400 and is an autoimmune disease, an inflammatory and a huge problem. 1:07:38.200 --> 1:07:41.920 IBS is not that it used to be like a 1:07:42.000 --> 1:07:45.880 diagnosis of exclusion, but it's not anymore interesting now. It's 1:07:46.000 --> 1:07:48.960 very much like you should positively diagnose this as IBS. 1:07:49.120 --> 1:07:51.880 What is the criteria, Well, they can they can range 1:07:51.920 --> 1:07:57.000 a little bit, but the core core criteria are recurrent 1:07:57.360 --> 1:08:00.479 cramping abdominal pain. Okay, So you get cramped, being pain, 1:08:00.840 --> 1:08:05.080 and then changes in stool frequency or consistency, and this 1:08:05.240 --> 1:08:08.160 is where it can range. Some people have what's called 1:08:08.240 --> 1:08:12.240 IBS C, which is IBS with constipation, some people have 1:08:12.360 --> 1:08:15.360 IBS D, which is IBS with diarrhea, and some people 1:08:15.400 --> 1:08:19.400 have mixed CD CDM. We call it though, oh, mixed, 1:08:20.400 --> 1:08:23.280 because you have both either constipation or diarrhea, but you're 1:08:23.320 --> 1:08:26.479 having these changes in your stool frequency like I'm having 1:08:26.520 --> 1:08:28.840 a poop all the time all of a sudden, or 1:08:28.920 --> 1:08:31.720 consistency where like i was having like a Bristol three 1:08:31.840 --> 1:08:33.679 or four and now I'm a seven. 1:08:34.280 --> 1:08:38.360 Okay, I'm just so confused about changes in yeah, because 1:08:38.360 --> 1:08:40.040 that implies a time period. 1:08:40.800 --> 1:08:42.479 This has to be for at least three months, and 1:08:42.520 --> 1:08:44.360 it has to be happening at least three I think 1:08:44.400 --> 1:08:46.360 three times a week is the three times a week 1:08:46.520 --> 1:08:49.599 this is the criteria. The d or C is the 1:08:50.120 --> 1:08:53.000 the changes in your stool. Yeah, so, like what is 1:08:53.360 --> 1:08:56.960 your and it's associated with this cramping. So you're having 1:08:56.960 --> 1:08:59.840 this pain and then you have either a constipated poop 1:08:59.920 --> 1:09:01.840 or a diarrheal poop or one or the other. 1:09:02.160 --> 1:09:07.880 And it's happening for three months months Yeah, yeah, Okay. 1:09:08.000 --> 1:09:12.240 And we still do not understand IBS. It's the reserving 1:09:12.280 --> 1:09:15.320 of its whole own episode. But we are pretty sure 1:09:15.479 --> 1:09:18.000 that it is at least in part a disorder of 1:09:18.040 --> 1:09:23.000 the gut brain axis, which is just so interesting and fascinating. 1:09:22.479 --> 1:09:25.320 To me, I know, I mean, the phrase itself is 1:09:25.320 --> 1:09:26.400 is really compelling. 1:09:27.560 --> 1:09:31.759 And what's underneath the surface we don't know. Question. 1:09:33.080 --> 1:09:35.640 But yeah, So it's basically like your guts and your 1:09:35.680 --> 1:09:37.680 brain are not talking to each other the way that 1:09:37.680 --> 1:09:38.160 they should. 1:09:38.320 --> 1:09:38.400 Ye. 1:09:39.280 --> 1:09:42.040 Your neurotransmitters are probably involved. Serotonin. You have more of 1:09:42.080 --> 1:09:43.160 it in your gut than you do in your brain, 1:09:43.160 --> 1:09:48.080 et cetera. But then you also see with this intestinal dismotility. 1:09:48.160 --> 1:09:50.559 So whether that is your guts are going too fast 1:09:50.680 --> 1:09:52.920 and so you're just pooping your brains out because you're 1:09:52.960 --> 1:09:56.439 not absorbing things because they're moving too quickly or you're 1:09:56.560 --> 1:09:59.800 going really slow and there that's why you're constipated. A 1:10:00.080 --> 1:10:03.360 And this is really interesting, visceral hypersensitivity, and that's where 1:10:03.400 --> 1:10:05.599 you get this pain. So viscera is like your your 1:10:05.680 --> 1:10:09.679 guts and hypersensitive, meaning that your nerve endings are feeling 1:10:09.840 --> 1:10:12.240 more pain than they should. 1:10:12.880 --> 1:10:13.360 Interesting. 1:10:13.479 --> 1:10:18.360 So because we've talked about hypersensitivity before when I. 1:10:18.320 --> 1:10:21.760 Don't remember the metriosis maybe maybe, yeah, yeah, And. 1:10:21.680 --> 1:10:23.200 So it's the same sort of thing. It's like those 1:10:23.240 --> 1:10:25.439 pathways have been carved out and so like it's like 1:10:25.479 --> 1:10:26.040 a super. 1:10:25.880 --> 1:10:31.040 Highway yes to pain, Yeah, exactly exactly. But so yeah, 1:10:31.080 --> 1:10:33.639 So there's a lot there's a lot of research being 1:10:33.640 --> 1:10:35.680 done in IBS. There are a lot of new medications, 1:10:35.760 --> 1:10:38.920 especially to treat like IBS with constipation. There's medicines that 1:10:38.960 --> 1:10:41.880 are specific for that same thing with IBS with diarrhea. 1:10:41.920 --> 1:10:44.960 So like there's a lot of research, but there's also 1:10:45.000 --> 1:10:47.599 a lot of people who just like suffer with either 1:10:47.720 --> 1:10:52.040 constipation or diarrhea, and they're looking for ways to manage it, 1:10:52.560 --> 1:10:57.080 and so they turn to things like fiber or prebiotics, 1:10:57.120 --> 1:10:59.880 which are all the rage right now, which is usually 1:10:59.880 --> 1:11:03.280 just fiber. Really, Yeah, they just market it in a 1:11:03.320 --> 1:11:07.320 weird and different way. Prebiotics that's what they're okay, and 1:11:07.360 --> 1:11:10.360 then probiotics is the other one. Ah, So let's talk 1:11:10.400 --> 1:11:12.320 a little bit more about probiotics, because again, we can't 1:11:12.320 --> 1:11:14.720 talk about poop and not talk about probiotics. It's not 1:11:15.040 --> 1:11:16.760 I think the last time we talked about probiotics was 1:11:16.800 --> 1:11:21.000 in our c Diiff episode. Yep, sure, I don't remember 1:11:21.000 --> 1:11:23.919 I honestly though, that was a long time ago, that episode, 1:11:23.960 --> 1:11:25.599 and I'm not sure that we have that much more 1:11:25.680 --> 1:11:29.800 data than we did way back then. People use probiotics, 1:11:29.800 --> 1:11:33.200 and they will recommend that you take probiotics for anything 1:11:33.520 --> 1:11:39.600 from diarrhea to constipation to bloating, whether that's acute infectious 1:11:39.640 --> 1:11:44.559 diarrhea or chronic diarrhea. Right, there's very little data that 1:11:44.720 --> 1:11:48.320 show that there is a benefit to probiotics depending on 1:11:48.360 --> 1:11:51.280 the certain circumstance that you're using them for. 1:11:52.040 --> 1:11:53.360 Tell me about those circumstances. 1:11:53.439 --> 1:11:57.519 Well, most of the data. Most of the data is 1:11:58.560 --> 1:12:03.720 on antibiotics asociated diarrhea or like if you use antibiotics 1:12:03.840 --> 1:12:07.760 or you're using antibotics for something like c DIFF. And 1:12:07.920 --> 1:12:11.400 even then the data is really really mixed. The biggest 1:12:11.479 --> 1:12:16.000 issue is that there's huge heterogeneity in how each of 1:12:16.040 --> 1:12:17.760 these studies are conducted. 1:12:18.040 --> 1:12:19.280 And who's conducting them. 1:12:19.280 --> 1:12:21.479 Who's conducting that Mostly it's like people who are making 1:12:21.600 --> 1:12:24.720 supplements or yogurt or something, So there's that issue, But 1:12:24.720 --> 1:12:27.920 there's also just huge heterogeneity and like which bacterial strains 1:12:27.920 --> 1:12:32.160 are they actually using in this study? How many bacteria 1:12:32.200 --> 1:12:34.479 are you actually getting in that capsule? 1:12:34.640 --> 1:12:36.640 Well, because it's got to go through your stomach. 1:12:36.360 --> 1:12:39.280 Exactly, it has to survive the acidic environment of your stomach, 1:12:39.320 --> 1:12:41.559 it has to make it through your small intestine to 1:12:41.600 --> 1:12:44.000 try and colonize your colon. We know now that that's 1:12:44.040 --> 1:12:48.759 like a twenty plus foot journey, so that's not necessarily easy. 1:12:49.800 --> 1:12:53.920 There's also a huge issue with the fact that in 1:12:53.960 --> 1:12:57.959 the US there's absolutely no regulation on these things because 1:12:58.040 --> 1:13:01.560 probiotics are regulated as supplement and see our supplement. 1:13:01.200 --> 1:13:02.360 Episode for so much more. 1:13:02.640 --> 1:13:06.200 Yeah, we or they're sometimes classified as a food product, 1:13:06.280 --> 1:13:08.200 right if it's like a yogurt or yogurt drink or 1:13:08.240 --> 1:13:11.559 something like that. So we don't have really any data 1:13:11.840 --> 1:13:14.960 on how much live bacteria are even in your gummy 1:13:15.080 --> 1:13:17.280 or your capsule or your juice drink, how much of 1:13:17.320 --> 1:13:21.280 those will survive, or if that particular strain is necessarily 1:13:21.320 --> 1:13:24.320 beneficial for you in your specific clinical scenario. 1:13:24.600 --> 1:13:29.080 I know, I honestly it is. Really it's really frustrating. 1:13:29.120 --> 1:13:32.320 Like the I think in particular, one of my one 1:13:32.360 --> 1:13:37.320 of my irritants is the probiotic soda. Yes, and I'm 1:13:37.439 --> 1:13:42.240 just like it's soda, it's sugar, yeah, what, it's just 1:13:42.479 --> 1:13:44.599 I mean, I'm sure there's more stuff in there, but like. 1:13:44.680 --> 1:13:46.800 Right, some of them are have prebiotics, so again they've 1:13:46.840 --> 1:13:48.960 got like fiber or like non digestible sugar. 1:13:49.080 --> 1:13:49.519 Okay. 1:13:49.560 --> 1:13:53.519 Great. The other issue too, is that we have some 1:13:53.720 --> 1:13:56.280 data on a few species. We've got some decent data 1:13:56.320 --> 1:13:59.360 on Biffitobacterium that at least it's probably not harmful. On 1:13:59.439 --> 1:14:02.360 a few species of Lactobacillus that again, they are good 1:14:02.400 --> 1:14:06.400 colonizers and they're not harmful. And sacrimices, which is actually 1:14:06.400 --> 1:14:10.760 a yeast, right, but that's just like three and like 1:14:10.800 --> 1:14:13.120 a couple species of Lactobacillus. Right, So if we're talking 1:14:13.160 --> 1:14:16.680 a handful of species out of the thousands that colonize 1:14:16.720 --> 1:14:19.479 our guts, like, we don't know what we're doing when 1:14:19.520 --> 1:14:23.479 it comes to probiotics, we don't. So there are people 1:14:23.520 --> 1:14:26.479 who say, well, taking one or two species is never 1:14:26.520 --> 1:14:28.519 going to be enough. It's never going to do the 1:14:28.560 --> 1:14:30.560 thing that you needed to do. What we need is 1:14:30.600 --> 1:14:32.000 a fecal transplant erin. 1:14:32.200 --> 1:14:34.760 Okay, before we talk about fecal transplants, Yeah, I do. 1:14:34.880 --> 1:14:36.559 I feel like every time we end up talking about 1:14:36.560 --> 1:14:38.000 the microbiome, we did it. 1:14:38.000 --> 1:14:39.960 More recently aerin and I don't remember what it was. 1:14:41.040 --> 1:14:44.479 We're always like, the hype is overrated, and it's the 1:14:44.520 --> 1:14:47.080 hype is not overrated for the microbiome it itself, No, 1:14:47.280 --> 1:14:50.880 it is for our understanding of it correct and how 1:14:50.920 --> 1:14:54.680 we are able to manage and optimize it because we 1:14:54.800 --> 1:14:57.760 just aren't there yet, right, maybe we will be, but 1:14:57.800 --> 1:14:58.400 we're not there. 1:14:58.520 --> 1:15:02.360 No, not even closed. And I are are we there 1:15:02.360 --> 1:15:06.160 with fanfre we no or not? But fecal transplants are 1:15:06.240 --> 1:15:08.400 essentially like that. That is one of the answers. Right, 1:15:08.439 --> 1:15:11.400 It's like, well, okay, giving someone just some lacto bacillis 1:15:11.479 --> 1:15:16.400 or lactobacillis and biffittobacteria like two little bacteria. Is that 1:15:16.479 --> 1:15:19.360 going to change the entire architecture of their gut microbiome? 1:15:19.680 --> 1:15:25.040 Probably not right, but hitting them with someone else's entire 1:15:25.120 --> 1:15:29.160 gut microbiome might. And that's the idea behind fecal microbiota 1:15:29.200 --> 1:15:32.479 transplant or FMT. This is a huge field of research. 1:15:32.800 --> 1:15:36.760 I will not do it justice, however. The idea is 1:15:36.800 --> 1:15:40.920 basically that you take a microbial community from a healthy 1:15:40.960 --> 1:15:44.719 person's guts, someone with bristol three or fours all the time. 1:15:44.600 --> 1:15:47.680 Beautiful poop, no blowing east exceptional. 1:15:47.479 --> 1:15:50.760 Love it all the time, and you give it to 1:15:50.840 --> 1:15:53.400 a person with some kind of gut disease. You give 1:15:53.400 --> 1:15:56.560 them some of their poop because in that poop, again, 1:15:56.600 --> 1:15:59.960 fifty percent of the biomass of their poop is bacteria. 1:16:01.240 --> 1:16:03.160 You can do this a few different ways. You can 1:16:03.160 --> 1:16:06.639 instill the poop into somebody via colonoscopy from the bottom 1:16:06.880 --> 1:16:10.000 or an NG tube from the top, because you wouldn't 1:16:10.000 --> 1:16:11.920 want to just eat it because that's gross. But you 1:16:11.960 --> 1:16:14.200 could make it into pellets, and then you could take 1:16:14.200 --> 1:16:16.439 it as a capsule. You can freeze dry them, or 1:16:16.479 --> 1:16:21.680 you can freeze them either way, And there is so 1:16:21.840 --> 1:16:25.519 much research being done on this. It is used clinically already, 1:16:25.760 --> 1:16:28.960 but only in one scenario so far outside of the 1:16:29.000 --> 1:16:33.920 research sphere as of recording. So there is a FDA 1:16:34.000 --> 1:16:37.400 approved treatment here in the US for recurrent se diff 1:16:37.479 --> 1:16:44.360 infection that is an FMT. There's two approved products. One 1:16:44.400 --> 1:16:47.680 of them is given via an enema suspension and the 1:16:47.720 --> 1:16:51.600 other one is oral capsules, which is just really exciting 1:16:51.680 --> 1:16:58.400 because that's so much more palatable to people. Yeah, then 1:16:58.520 --> 1:17:00.479 and also like lower barrier to edge because you don't 1:17:00.479 --> 1:17:02.240 have to go into the office, you don't have to 1:17:02.240 --> 1:17:05.040 do it in clinic, et cetera. You could justo is 1:17:05.080 --> 1:17:07.120 that you just pop it in your mouth, it wallow 1:17:07.120 --> 1:17:10.439 it down. So it's a very exciting area of research. 1:17:11.840 --> 1:17:13.439 But that's all that I really have about it. Because 1:17:13.439 --> 1:17:14.920 there's a lot of people who are wanting to use 1:17:14.960 --> 1:17:17.280 it for a treatment of IBD. There's some really promising 1:17:17.320 --> 1:17:20.080 research in that area. There's some promising research on it 1:17:20.160 --> 1:17:24.960 for IBS even which I think is very exciting. But 1:17:25.000 --> 1:17:26.280 that's all that I really have about that. 1:17:26.560 --> 1:17:28.640 I mean, we could do a whole another whole I 1:17:28.680 --> 1:17:30.880 know that in our CDF episode we did like a 1:17:30.880 --> 1:17:32.120 big segment on. 1:17:32.200 --> 1:17:35.400 We did FMTS shout out to doctor imaj Di Ausmann, 1:17:35.479 --> 1:17:36.479 who we had on the pod. 1:17:36.960 --> 1:17:40.760 Great, But I think that we could do a whole 1:17:40.760 --> 1:17:43.120 like update episode on it because I also want to know, like, Okay, 1:17:43.120 --> 1:17:45.080 people who got a fecal transplant. 1:17:44.600 --> 1:17:46.559 Five years ago, how are they doing now? What are 1:17:46.560 --> 1:17:47.519 their poop like today? 1:17:47.760 --> 1:17:50.120 Do they have the same microbes that they were you know, 1:17:51.040 --> 1:17:53.920 laced with in that first certainly not. 1:17:54.200 --> 1:17:56.200 I would think that there's some turnover. 1:17:56.520 --> 1:17:58.439 So there's turnover, But I mean, like, how much does 1:17:58.479 --> 1:17:59.800 the community community? 1:18:00.080 --> 1:18:02.880 Oh, it's so interesting erin. I know, there's just so 1:18:03.200 --> 1:18:06.439 much I think about our guts and our poop that 1:18:06.600 --> 1:18:08.479 is exciting, I know. 1:18:08.600 --> 1:18:10.920 But it's it's very true, and I feel like it 1:18:10.960 --> 1:18:14.800 has been a field of like taboo to talk about 1:18:14.840 --> 1:18:16.559 or to be excited about her be like it's really 1:18:16.560 --> 1:18:20.479 interesting or anything like that, and so it's discouraged interest 1:18:20.600 --> 1:18:21.560 in this really. 1:18:21.960 --> 1:18:27.280 Is gross, right, but it's also awesome. Yeah, I love it. 1:18:27.400 --> 1:18:28.880 That's pretty much the end of what I got. Aaron. 1:18:28.920 --> 1:18:31.040 Poop is gross. It is awesome. We love it. 1:18:31.120 --> 1:18:33.439 We love it. There's more to it we'll wash our 1:18:33.479 --> 1:18:34.960 hands after we poop, and. 1:18:34.840 --> 1:18:36.280 We we will certainly do that. 1:18:38.000 --> 1:18:39.680 Should we tell the people where they can read more 1:18:39.760 --> 1:18:41.439 shit about fun poop stuff? 1:18:41.439 --> 1:18:42.240 Fun poop stuff. 1:18:42.280 --> 1:18:45.880 There is so much more when it comes to a 1:18:46.240 --> 1:18:49.280 the history of sewers and be what people are doing 1:18:49.400 --> 1:18:53.559 about solving the poop problem. So there's a book by 1:18:53.680 --> 1:18:56.680 Lena Zeldovich, who if I interviewed for a book Club 1:18:56.720 --> 1:19:01.200 episode earlier this year for about phase therapy. But her 1:19:01.240 --> 1:19:04.200 earlier book is called The Other Dark Matter, The Science 1:19:04.240 --> 1:19:07.960 and Business of Turning Waste into Wealth and Health, really fascinating. 1:19:08.680 --> 1:19:12.400 Then by Steven Halliday, The Great Stink of London, Sir 1:19:12.520 --> 1:19:16.160 Joseph Basilgett and the Cleansing of the Victoria Metropolis, and 1:19:16.160 --> 1:19:18.760 then another book by him as well. But it's like 1:19:18.800 --> 1:19:22.080 an illustrated coffee table book for sewers and it's called 1:19:22.160 --> 1:19:25.240 An Underground Guide to Sewers or Down through and Out 1:19:25.280 --> 1:19:28.439 in Paris, London, New York. I love and it's it's here, 1:19:28.560 --> 1:19:32.200 it's it is honestly beautiful and really fun, and I 1:19:32.240 --> 1:19:32.600 loved it. 1:19:32.840 --> 1:19:33.320 It was great. 1:19:34.360 --> 1:19:36.280 I also actually had a book for this one. I 1:19:36.360 --> 1:19:39.400 never have books, but I did enjoy by doctor Pong. 1:19:39.640 --> 1:19:43.120 It's called Constipation Nation, which is such a good type title. 1:19:44.040 --> 1:19:47.400 I really did enjoy that book. I rarely read entire books, 1:19:47.400 --> 1:19:49.360 and I actually read that whole time thing. So that's 1:19:49.400 --> 1:19:51.519 how you know it was good and that there's like 1:19:51.560 --> 1:19:54.400 a lot more detail on constipation. I think there's even 1:19:54.479 --> 1:19:57.200 like treat your constipation smoothies at the end, which is 1:19:57.240 --> 1:19:59.840 hilarious to me. But then I also loved, oh this 1:19:59.880 --> 1:20:01.479 is or I have the citation for the paper. We 1:20:01.479 --> 1:20:04.680 actually mentioned the last episode about how it takes only 1:20:04.680 --> 1:20:06.960 twelve seconds to poop because I didn't get into like 1:20:07.040 --> 1:20:08.720 we spend so much time on the toilet. 1:20:09.120 --> 1:20:11.920 I mean, and that's related to hemorrhoids, and that's related. 1:20:11.640 --> 1:20:13.120 To there was a twenty twenty five paper that was 1:20:13.160 --> 1:20:14.439 like if you spend time on the phone, you're at 1:20:14.479 --> 1:20:16.000 higher risk of hemorrhoids. And I was like, there's so 1:20:16.120 --> 1:20:19.320 much to this, let's keep going right episode Anyways, that 1:20:19.360 --> 1:20:21.920 paper was from twenty seventeen. It was called the Hydrodynamics 1:20:21.960 --> 1:20:26.920 of Defecation, published in Soft Matter Soft Matter, and then 1:20:26.920 --> 1:20:29.439 I've got several papers on like the Global Prevalence of 1:20:29.479 --> 1:20:33.600 Constipation on FMT. I also have some more data on 1:20:34.320 --> 1:20:36.400 because we didn't get deep into this, but on colon 1:20:36.439 --> 1:20:38.280 cancer rates, and we're going to talk more about colon 1:20:38.280 --> 1:20:41.000 cancer later this season, so you can find all of 1:20:41.040 --> 1:20:43.479 it on our website, this podcast with killy dot com 1:20:43.560 --> 1:20:44.840 under the episode stap. 1:20:44.560 --> 1:20:48.559 You can thank you to Bloodmobile for providing the music 1:20:48.560 --> 1:20:50.680 for this episode and all of our episodes. 1:20:50.720 --> 1:20:53.479 Thank you to everyone here at the Exactly Right Studio. 1:20:53.560 --> 1:20:56.160 Thank you and Tom and Leanna and Brent and Pete 1:20:56.240 --> 1:20:58.719 and everyone who's involved in making this podcast possible. 1:20:58.840 --> 1:21:00.080 Pick Yeah. 1:21:00.120 --> 1:21:03.200 A big thank you to our listeners who listen or 1:21:03.240 --> 1:21:07.080 watch or read the transcripts. Even anyone you know who 1:21:07.120 --> 1:21:10.120 somehow enjoys or you know, just partakes in this podcast. 1:21:10.160 --> 1:21:12.479 You don't even have to enjoy it. Thank you. 1:21:12.840 --> 1:21:16.400 Thank you. It helped us out as always. Thank you 1:21:16.479 --> 1:21:18.760 also to our patrons. Your support really really does mean 1:21:18.800 --> 1:21:20.720 the world to us, so we really appreciate it. 1:21:20.840 --> 1:21:24.040 Yes, thank you, Thank you. Well. Until next time, wash 1:21:24.040 --> 1:21:25.880 your hands, filthy animals,