Dr Sean O'Mara, a physician who counts JD Vance and Robert F Kennedy Jr among his clients, has made headlines with his claims about 'perfect' bowel movements. In a recent interview with the New York Times, he said he could 'have a bowel movement behind a sheet at a dinner party in the corner of the room and nobody would know.' He has also posted guides on how to 'poop like a champion,' suggesting the ideal poo takes three to seven seconds, requires 'no wiping,' feels 'near orgasmic,' and produces no noise or smell.
O'Mara's Living Diet plan, which he promotes for 'biological optimisation,' involves eating only grass-fed ruminants (beef, venison, bison or elk meat), wild-caught seafood, and as much fermented food as possible. The plan cuts out entire food groups widely considered part of a healthy, balanced diet, including fibre, which the NHS says is vital for digestion, recommending at least 30g a day for adults.
Experts question the 'perfect poo' benchmark
Dr Alan Desmond, consultant gastroenterologist and author of 'What Your Doctor Isn't Telling You About Food,' told Metro: 'I'm always happy to hear that my patients are having comfortable, satisfying bowel movements — but I'm not sure we need to aim for a three-second, near-orgasmic experience!' He emphasised that what matters more is going regularly for you, having soft and formed stool, passing it comfortably without excessive straining, and feeling properly finished afterwards.
While digestive experts typically put the upper limit for a normal bowel movement around five minutes, NHS literature states 'opening the bowels should take no more than two or three minutes.' However, there are no hard and fast rules in this respect, according to Dr Desmond.
The three Ps and the Bristol Stool Scale
Dr Trisha Pasricha, director of the Institute for Gut-Brain Research, says there are three Ps that make bowel movements easier: propulsion, pliability and pelvic floor. Specialist pelvic health physiotherapist Rosie Cardale told Metro that the position you sit in can make a difference, with squatting being the most optimal choice.
Regarding O'Mara's no-wipe and silent poo claims, Dr Desmond said: 'There is no medically recognised requirement for a bowel movement to be completely silent, or to require absolutely no wiping.' He added that a well-formed stool may leave very little behind, but needing to use toilet paper does not mean your gut is unhealthy. Even if minimal residue remains, a gentle wipe is still sensible hygiene because microscopic traces of faecal matter and bacteria can remain on the skin.
Instead, Dr Desmond recommends the Bristol Stool Scale, a tool used to classify stools by shape and consistency. 'Types 3 and 4 — essentially a smooth, soft, sausage-shaped stool — are generally considered ideal,' he said.
Smell is normal, and 'poo-phoria' explained
Human faeces are supposed to smell, according to Dr Desmond. 'Stool contains bacteria and the products of digestion and fermentation, so it is never going to be completely odourless,' he said. What you eat can also make a difference, particularly foods containing sulphur compounds, while some people simply produce more intestinal gas than others. An unusually foul smell can sometimes signal an issue, especially if accompanied by persistent diarrhoea, bloating, weight loss or blood in the stool. For example, coeliac disease can cause particularly pungent, greasy stools because of problems absorbing fat.
Dr O'Mara isn't the only one who gets a rush from a satisfying bowel movement. 'Poo-phoria' is the sudden wave of deep relaxation, relief, or mild euphoria that can happen after passing a large or satisfying stool. Dr Desmond explains this is due to the 'complex interaction between the bowel, pelvic floor and nervous system' involved with emptying the bowels. A particularly substantial poo may stimulate the vagus nerve, which runs from the brainstem down to the colon, potentially lowering heart rate and blood pressure to trigger an intense wave of physical relief.
While enjoying that feeling is fine, Dr Desmond cautions against judging gut health by how euphoric toilet trips feel. 'And if you're eating plenty of fibre and producing a little more stool as a result, that is generally something to celebrate rather than worry about,' he added.
