Last summer, in one of countless attempts to improve my sluggish digestive system, I bought a tub of Sunsweet prunes from CVS and uploaded a video of the unremarkable purchase to Instagram.
“Ain’t afraid to say I can’t poop.”
I expected nothing in return beyond a satisfactory bowel movement. Having been intermittently constipated for most of my life, even that seemed ambitious. The prunes were a lo-fi addition to a roster of gut health aids that included fiber cubes from France, herbal teas, and various drugstore stimulants. A gastroenterologist once sent me home with a plastic receptacle and asked that I return with a stool sample, but the idea of trafficking feces on the subway was unconscionable. Instead, I ignored him and continued to self-medicate with laxatives, knowing that overuse could result in dependency — or worse. I didn’t care! I wanted the sweet release of an elegant bowel movement, and I wanted it within six to twelve hours, like the labels promised.
Direct messages began to accumulate.
“Dr. Pepper and a couple of prunes will have you in a poop daze.”
Good to know.
“Lying down rub up your stomach (coconut oil is my favorite) in clockwise motion, 90 percent a fart may make its way and you can feel all your poop that’s stuck.”
Thank you for sharing.
“Stand up, hands on hips, as you exhale suck your stomach in, and hold for a count of 20 seconds. Don’t inhale during this hold. Then inhale slowly for 6-8 seconds and let your internal abs relax.”
“Dunkin Donuts corn muffin. Works every time.”
More commonly referred to as breakfast.
Hundreds of people shared their own hyperspecific digestive cocktails. For the sake of better bowel movements, I reposted each one to an Instagram Story, hashtagged pooptalk, and crossed out names to protect the constipated. This dialogue continued for months. I even — full disclosure — did an Instagram ad for probiotic gummy vitamins.
A while later, I got an email about Poop Talk, “a new docu-comedy that gives an open and honest look at a taboo topic in today’s society: poop and how talking about it can help your health.” The film features a roster of actors and comedians like Kumail Nanjiani and Rob Corddry discussing their bowel movements; if that’s your thing, Poop Talk the movie came out last month. Poop Talk (and #pooptalk) speaks to a growing public obsession with gut health and the business of aspirational digestion.
Digestion starts with the gut microbiome — trillions of bacteria, viruses, and fungi that live in your gut, which can affect everything from bowel movements to behavior to skin. Antibiotics, processed foods, even stress, can disrupt the balance of good and bad bacteria. For years, probiotics, beneficial strains of bacteria found in fermented foods like kimchee and kefir, have been used to restore digestive equilibrium, but there’s still uncertainty around their efficacy. A recent study from the University of Copenhagen asserted there’s still not enough evidence to support the effects of probiotic supplements on healthy adults.
The final step of digestion is, of course, elimination. In 2014 on the Dr. Oz show, Cameron Diaz chugged a liter of water in 20 seconds and sportingly talked about the Bristol stool scale — the seven stages of poop, from severe constipation to severe diarrhea — to promote the launch of her beauty manual, The Body Book. In 2016, New York Magazine published a guide called “Everything You Need to Know About Poop.” In early January of this year, Gwyneth Paltrow included Implant-O-Rama’s $135 coffee enema as part of her annual detox. Later that month, the makeup artist and wellness enthusiast Rose-Marie Swift released RMS Beauty Within, a pair of dietary supplements that includes probiotic and digestive enzymes, after fielding complaints on set from constipated models. Celebrity facialist Sonya Dakar now has her own brand of probiotic supplement as well, promising a pathway to better skin through the gut.
“Your face is a crystal ball to what is happening to you internally. I can see by the skin tone, texture, color, and condition if someone is maintaining a poor diet and also their intestinal health,” Dakar tells me over the phone. “You wouldn’t believe the improvements I see in people’s skin when they take probiotics. The live organisms work by dislodging and removing the toxic decay which has accumulated on the walls of your intestines over time. Your body is then able to pass this waste normally.” Sort of, but there’s more to clear skin than de-crusting your intestinal walls.
Dr. Vincent Pedre, the author of Happy Gut, has seen patients at his New York City practice with skin that’s improved with colon hydrotherapy, more commonly known as a colonic, wherein the lower intestine is flushed with gallons of water through a rectal tube. “If you’re backed up and you’re not going to the bathroom regularly, you start to recirculate toxins that were meant to be excreted and eliminated through your stools.” But he cautions against more than one treatment a month, which can wash out the microbiome. Other risks include severe cramping and electrolyte imbalance, according to New York City gastroenterologist Dr. Elana Maser. “A safer way to cleanse the colon would be to take a medically prescribed colonoscopy prep. In general, the people who seek colonic hydrotherapy are often those who suffer from constipation. Unfortunately constipation is rarely a short-lived condition, and colonics are not a long-term solution.”
New York City dermatologist Dr. Joshua Zeichner said that we are just beginning to understand the links between intestinal health and skin. “When the normal collection of bacteria are disrupted and when the gut wall becomes leaky, it sparks a cascade of inflammation with wide-ranging effects on the skin, which can impact a variety of skin diseases ranging from eczema to acne and even skin aging,” he explained. It’s a connection that was first examined in 1930 when dermatologists Dr. John H. Stokes and Dr. Donald M. Pillsbury published their theory on the “emotional linkage” between the brain the gut and the skin. Seventy years later, in their 2011 study examining the gut-brain-skin axis, New York City dermatologists Dr. Whitney Bowe and Dr. Alan Logan speak of Stokes and Pillsbury’s prescience: “They also suggested an acidophilus milk preparation and cod liver oil, long before they would be referred to as probiotics and a rich source of omega-3 fatty acids respectively.” A 2011 study conducted at Korea University found that participants who drank a Lactobacillus-fermented dairy beverage reduced their total acne symptoms and decreased oil production by 40 percent over 12 weeks.
Not all probiotics are created equal. Dr. Bowe, author of new book The Beauty of Dirty Skin, recommends introducing a probiotic that has at least 10 billion CFU (colony forming units) before graduating to a higher dose, up to 100 billion CFU. “If your gut is not starting in a healthy place, you can experience gas and bloating if you start with a very high number of CFUs like 100 billion,” says Dr. Bowe. “Everyone’s gut is unique, which means what works for you may not work effectively for someone else. Your goal is to support diversity in your gut community. The richer the rain forest — the greater the variety of gut bugs — the better for you and your skin.” She encourages patients to experiment with a variety of strains, either by choosing a multi-strain supplement (she likes Genuine Health) or by consuming two or more strains.
As for me, I tried colon hydrotherapy for the first time a few months ago. It was the week between Christmas and New Year’s, an attempt to undo a few days of gluttony. Apart from a temporary hollow sensation in my gut afterward, the treatment didn’t move the Bristol scale significantly and my skin was unchanged. When RMS Beauty Within’s probiotic + prebiotic supplement (25 billion CFUs per serving) arrived in the mail, I began popping the recommended dose every morning. It wasn’t long before my Bristol rating improved. I could drop a smooth type 4 on cue within an hour of waking. I felt like Cameron Diaz.
But did my skin look any glowier as a result? That’s impossible to say. If there was a perceptible difference in texture, it could’ve been because focusing on my gut health instigated more self-improvement and stress-reduction habits. I drank more water. I quit my job. I moved from New York to Los Angeles. I bought a new moisturizer. I got more sleep. All I know is I feel better.