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Poop Is the Most Important Indicator of Your Health

Like it or not, our bowels are the ID cards of our bodies, charting our recent histories with terrifying accuracy. So, how do we ensure a healthy gut?

According to a lawsuit filed this month, Ron and Sarah Bowers bought their son a Subway sandwich in Lombard, Illinois on February 27. After eating it, he had agonizing cramps and diarrhea. According to the suit, what the couple really bought was a shit sandwich.

It had been contaminated with Shigella sonnei, a bacteria transmitted via the fecal-oral route and can cause vomiting, dysentery and death. Over 100 people claim to have been sickened at Lombard's Subway, according to attorney Drew Falkenstein, whose firm has filed suit on behalf of Ron and Sarah Bowers and two other customers.

We don't want to think about excrement. We don't want to see it, smell it or touch it. We definitely don't want to eat it with chicken teriyaki, on toast. Yet intestinal goings-on are in our faces everywhere these days, whether the news is about probiotics and prebiotics appearing in new food products or yet another outbreak of norovirus -- the painful gastroenteritis that is spread via fecally contaminated food, water and surfaces and has sickened thousands of cruise-ship passengers in eight unprecedentedly massive outbreaks so far this year.

And "poopular culture" is upon us: Witness Slumdog Millionaire's outhouse-plunge scene. Witness Oprah's "Everybody Poops" episode, in which Dr. Mehmet Oz avows that excrement should enter the toilet with not a plop but a swoosh "like a diver from Acapulco." In a scene from the forthcoming film Life As We Know It, a young mom portrayed by Katherine Heigl is interrupted by visitors while changing a diaper. "Sweetie," one of the visitors tells her, "you have shit on your face."

In a dirty, crowded world where germs are outsmarting drugs by leaps and bounds and our health care options may or may not be mired in red tape for years, we're being forced to face feces. Which is kind of a good thing. They're the ID cards our bodies issue, charting with terrifying accuracy where we've been and what we've done. The bowel knows.

Good Bugs vs. Bad Bugs

"A gram of feces can contain 10 million viruses, one million bacteria, 1,000 parasite cysts and 100 worm eggs," asserts Rose George, author of The Big Necessity: The Unmentionable World of Human Waste and Why It Matters (Metropolitan, 2008). She despairs over the fact that 2.6 billion people "have no access to any latrine, toilet bucket or box. ... They do it in plastic bags and fling them through the air in narrow slum alleyways." Four out of every 10 human beings, George laments, "live in situations where they are surrounded by human excrement."

In the developed world, our relationship with our bowels mostly entails controlling the flora that live in them. Lactobacillus. Peptococcus. Streptococcus. A hundred trillion microbes belonging to as many as 1,000 different species coexist at any given time in a single gut, which measures over three yards. What are they doing down there? Battling it out, rendering us well or ill.

Over 70 percent of the human body's immune cells are found in the gut's mucosal lining. A healthy gut means more immunity, and a healthy gut is a gut in which good bacteria outnumber bad. And they're all hitchhikers that rushed in from outside, mounting an invasion that began the instant our placentas broke. "We're all bacteria-free until then," says Emory University School of Medicine associate professor Andrew Gewirtz, the senior author of a study released this month on the effects of imbalanced gut flora. Once the placenta breaks, Gewirtz says, "the colonization begins."

Garnering such headlines in the mainstream media as "You can blame bacteria in your stomach for those unwanted pounds" and "Germs are making you fat," his study found that mice whose guts contained too many of the class of bacteria known as Firmicutes ate much more than other mice, experienced metabolic changes and became obese.

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