Are You Pooping Wrong? with Arielle Kanters, MD

Podcast Transcript

John Horton:

Welcome to another Health Essentials Podcast. I'm John Horton, your host.

It's probably been decades since you were potty-trained, and odds are you don't even think about the whole pooping process anymore. But maybe you should, because despite all of us being seasoned pros when it comes to dropping a deuce, it seems we're not doing it all that well. Where are we going wrong?

To figure that out, we're joined today by colorectal surgeon Arielle Kanters. She is one of the many experts at Cleveland Clinic who drop into our weekly podcast to chat about best health practices. So, with that, let's go back to the training room and learn how to poop correctly. Welcome to the podcast, Dr. Kanters. We always love getting new guests and growing our roster of experts. So, thanks for joining the team.

Dr. Arielle Kanters:

Thank you for having me today.

John Horton:

So, you're here today to talk about pooping, and that's a topic that's not exactly something we routinely chat about in day-to-day life. Just, it's-

Dr. Arielle Kanters:

…depends on the dinner table. It's pretty popular in my house. I don't know.

John Horton:

…kids. Yeah. Kids, it's always a big topic. But I'm guessing, while a lot of us get uncomfortable talking about it, I'm guessing this is something you feel extremely comfortable about.

Dr. Arielle Kanters:

So, I mean, honestly, my kids, they don't even know that I'm a surgeon. They say, "My mom's just a poop doc." So, it's an incredibly stigmatized topic. There's no doubt about it. At least historically speaking, I think this day and age, we're all a lot more transparent about what we consider normal bodily function.

But yeah, talking about pooping, especially talking about dysfunctional pooping, can be a challenging thing to broach with any one of your providers. But I will say, any doctor, no matter who it is, we are all specifically trained to talk about normal bodily functions. I just happened to have decided to spend my career doing it.

John Horton:

Well, I don't think you get to a much more normal bodily function than pooping. I mean, we all do it, and we're going to, I guess, explore it a little more as we start talking about it here.

So, I've been reading this, and it blows my mind that it seems that we're pooping wrong. And this is just … I've been doing this a long time, I didn't realize that I was making a mistake. So, where are we going wrong? It seems like the first thing I see is we're sitting wrong?

Dr. Arielle Kanters:

Yeah. So, you know what? I'm going to steal a line from my husband. My husband's an emergency doc, and so he has to talk about it on the front line of things. And what his line is, "It's not that you're pooping wrong, it's that you could poop better." So, I guess, this isn't about pathologizing what we're all doing. This is just like, there are ways to make your life and your normal daily routines feel a lot more comfortable.

John Horton:

We're going to grow our skills today. Is that what you're talking about?

Dr. Arielle Kanters:

Exactly. That’s it precisely. I want to help you poop better.

So, one of the really common things that I find a lot of patients do is they love tall toilets. Some of that has to do with the fact that I have an older adult patient population. Some of that is just the fact that we believe that sitting up high is better for our body. When in reality, pooping is actually better done in a squatting position.

So, our rectum has a sling muscles, something called a puborectalis. And as we're standing up, it's naturally kinked, so we're not pooping our pants. Something that most of us don't like to do in polite society.

John Horton:

Definitely.

Dr. Arielle Kanters:

As we start to sit down, though, the sling actually starts to relax and start to straighten. As we squat, that sling muscle starts to straighten out even more. So, you get a more natural flow of the gut. So yeah, tall toilets, not a fan of healthy pooping. So, rather than having to replace every toilet in your house, there's a really easy way of modifying the way that you sit on the toilet by putting a little step stool in front. There's a bunch of different names — you can get name-brand or generic — they're all the same. In fact, I tell people, go to the dollar store, pick out a kid's step stool and use that. So, by elevating our feet when we're on the toilet, it'll naturally change the angle of that sling muscle and you'll just have a more natural bowel movement.

John Horton:

That is so wild to think about. So basically, you're saying we just got to straighten out, I mean, I guess the poop shoot.

Dr. Arielle Kanters:

Straighten out the poop shoot by bending the hips, exactly.

John Horton:

Wow. So, all it takes is like you just put your feet up a little bit, you just raise them up a little bit, so that way, your knees are up. Because we're used to sitting there and you have that classic, your knees at that 90-degree angle. So, you want them up a little bit so you're slouched down and angled and-

Dr. Arielle Kanters:

…exactly.

John Horton:

...it goes straight out.

Dr. Arielle Kanters:

Yeah. The further your bottom gets to the same level as your feet, the more natural it is. I mean, same thing as for pregnancy or pregnancy and delivery. We know that our pelvic floor relaxes more naturally, the more squatted down that we are. And so the same rules that apply for getting a poop out.

John Horton:

See, I'm already building my skills here. I can feel-

Dr. Arielle Kanters:

…I'm really excited for you.

John Horton:

Yeah.

Well, another issue that it seems like it comes up is the amount of time that we spend on the toilet.

Dr. Arielle Kanters:

Yes, exactly.

John Horton:

And I got to say, I don't want to get too much information here, but I'm a reader. So, I do tend to linger a little bit. What is too long when you're sitting there on the throne?

Dr. Arielle Kanters:

So, I'll say a couple things about that. First of all, it's not just a matter of too long; it's about what drives you to the bathroom in the first place. Some people were like, "It's 8:00 in the morning. I am supposed to have my bowel movements." So, they go and they sit down until it's time for their body to naturally pass.

Don't sit on the toilet if you do not feel the urge. Our bottom is designed to signal to our brain, "Hey, I'm full. I need empty." It is not necessarily going to be 8:00 a.m. every single day. If you are, amazing, I'm super excited for you; but in reality, don't go in and start to initiate a bowel movement until your body has told you it's ready.

Then, in terms of how long you sit on the toilet, there's no perfect number. I say the shorter, the better. But I generally say you should not be sitting on the toilet for more than five minutes, and that is significantly shorter than what most of my patients do. They like to bring this lovely thing into the bathroom.

And listen, I'm a mom. I get it. It is my escape moment from my kids at times, but the reality is, if that's where you're going to escape, at least stand up, put the seat down, sit on top of it. Your bottom does not need to sit in the hole for you to scroll on your phone.

John Horton:

So, that's the problem. It's that hole, that pressure when you're sitting there and you're just, I guess, just hanging out.

Dr. Arielle Kanters:

Zoning out? Yeah. Exactly. You don't need anything else hanging out of your bottom as a result of this.

John Horton:

Well, and I was going to say, what's the risk if you are sitting there enjoying some quiet time, because that is a room, especially if you have kids, you can lock yourself in there and it's like that inner sanctum. It's the safe moment for you. What kind of risks do you have if you're sitting there too long? What's going to happen?

Dr. Arielle Kanters:

Well, so part of it is people are sitting there, they're still straining. They're like, there's still more to get out, there's still more to get out. And that increase in pressure, that strain is actually causing blood to pool and congest in the area around the bottom.

So, we all have hemorrhoids. I think that's a really important thing to address. Hemorrhoids are not a pathology. Hemorrhoidal prolapse, hemorrhoidal engorgement, hemorrhoidal bleeding, that's a problem. But typically, it's a consequence of another problem. We all have these veins, these blood vessels in our bottom that, at baseline, will fill with blood and then empty and fill up with blood and empty. And in fact, if someone walks into my clinic, they're like, "I just want you to take out all of my hemorrhoids." I say, "You really don't want me to do that." Your hemorrhoids actually provide about a third of the pressure in your bottom-

John Horton:

..oh, wow.

Dr. Arielle Kanters:

...that's keeping your bowels in as you're walking around throughout the day. So, you don't want me to get rid of one-third of your strength.

John Horton:

Yeah, you don't want to lose that.

Dr. Arielle Kanters:

No, you really don't want to lose that pressure down there. But when we sit on this toilet, it's like we're sitting in a funnel, and so all this blood is starting to pool around the anus, and these blood vessels are really good at getting swollen.

And so, the longer we sit there and the longer we let it sit and pool in that area, the more engorged, the more swollen, the more irritated those hemorrhoidal columns, those cushions, start to get, and the more symptomatic people feel about having hemorrhoids down there.

John Horton:

I mean, I take it, gravity is not your friend in that point, too, because they're just hanging out there.

Dr. Arielle Kanters:

Yeah. It's gravity, but gravity in general … yeah, people will talk about how their hemorrhoids feel more engorged after spending long periods of time standing, but this is like gravity on steroids, the way that we are sitting in this circular donut area — which is also why I don't like donut cushions, just as a side note. Those are not helpful either.

John Horton:

All right. A little bonus thing there. So, no donut cushions, just stick with the straight, the lid you got, and get in, do your business, get out.

Dr. Arielle Kanters:

Yes, precisely.

John Horton:

Well, now speaking of doing our business, how often should we be doing that? I mean, is this something you should look to once a day, you got to clear things out, or if it goes a few days, is that normal or natural, too?

Dr. Arielle Kanters:

Sure. Everyone is a bit different. And so, the way I describe it to people is like, if it feels OK to you, if you don't feel constipated, if you don't feel like you're pooping too much, then it's probably fine.

On average, we say that men poop more than women, which is actually probably … most people will agree with. So, we usually quote, "Men will poop one to two times a day. Women will poop every day to every other day." There's a million different reasons why that's true, but that's usually pretty typical across the United States at least.

And so, you don't need to have a bowel movement every single day, but you should not feel like you're backed up. And so, finding that, I feel like I'm emptying well and I'm emptying completely, is what the goal is. Do not force yourself to have a bowel movement.

If you haven't had a bowel movement in more than three days, then yes, we would typically say that you're constipated, but some people might not feel clinically constipated. And so, for them, I'm going to work a lot less hard about getting them on a more regular schedule. I will say, though, that I think we all generally feel more comfortable if we're emptying regularly.

So, there's a lot of really easy things to do that help you empty more regularly. Hydration is key. I usually tell people drink at least two liters of water a day, that's 64 ounces. And then — that sounds like a lot of water — but the reality is that the typical water bottles we carry around are usually about 30 ounces. So you got to drink somehow.

John Horton:

And everybody has them.

Dr. Arielle Kanters:

Correct, exactly. And I say, this is your excuse to go buy whatever fancy new water bottle you want. This is your pooping bottle.

John Horton:

It's for your health.

Dr. Arielle Kanters:

Exactly. So, I say at least two of those a day. So, plenty of water, not a ton of red meat. That's known to be a little bit more constipating. Everyone has slightly different dietary restrictions, so listen to your body. But then, fiber is, I think, the most important thing, and I will argue that anyone who poops should be on a supplemental fiber, and eating greens is great. Eating fruit is fantastic, but it's a little hard to sometimes track how much fiber you take every day.

So, I recommend taking a supplement, something like a psyllium husk-based or a wheat dextrin. There's a million different name brands out there, and I can talk you through which one is better for you based on your normal bowel function, but I do think that fiber is key. So, I call it “the universal normalizer.” If you have soft poops, it'll make them firmer. If you have hard poops, it'll make them softer.

The one rule is that if you don't drink enough water, you are putting yourself at risk of constipation with fiber intake because the fiber is really good at just soaking up wherever the extra water is. So, it can pull it in and make your stool softer or sop up what's making you have diarrhea. But a lot of people will say, "I don't like fiber. I feel gassy. I feel burpy. It does not make me feel good." And that's usually because they're starting with what it says on the back of the bottle.

So, I tell them to start low, go slow, half a teaspoon a day or one teaspoon a day for a week, and one and a half teaspoons a day for a week, and two teaspoons, and very slowly titrate yourself up because the bacteria in our gut is not used to having high fiber for most of us. And so, as soon as it gets hit with this big fiber load, they just start going crazy, and that's where all that gas comes from. If you slowly introduce the fiber, though, they tend to feel a lot better. And before you know it, I tell everyone the goal is to have a ghost poop. You sit down. You pass-

John Horton:

…a ghost? What is a ghost poop?

Dr. Arielle Kanters:

…this is the dream. So, you sit down, you have a bowel movement and you wipe and it's like it was never there. Nothing's left on the toilet paper. It leaves your body easy, and fiber, I think, is the key to getting there.

John Horton:

We've covered so much stuff here. I've never even heard of that. So, the ghost poop is-

Dr. Arielle Kanters:

…the ghost poop, yes.

John Horton:

…it's what we should all be striving for, where it's that clean coming out, huh?

Dr. Arielle Kanters:

Mm-hmm, exactly.

John Horton:

Now, another thing that comes up, I think we've all had this where you go, you sit down, you're there to do your business and it's just not working the way you want to. So, you can push a little bit. Sometimes, they're a little big, sometimes, whatever the reasons are, you got to put a little more oomph into it. Is that something that we should avoid doing?

Dr. Arielle Kanters:

You should avoid doing it regularly. So, there's a couple of funny things. So, our bottoms, we all have sphincter muscles — I hope, for the most part, we all have sphincter — if not, come see me, we can talk about it.

John Horton:

Come see you.

Dr. Arielle Kanters:

Yeah. But for the most part, we all have sphincter muscles, which are designed to hold our stool in. When we sit down on the toilet, when we start to push, that actually induces a relaxation. So, some amount of pushing is good, or I shouldn't say is not necessarily good, but it's appropriate.

John Horton:

You need it.

Dr. Arielle Kanters:

But there's a-

John Horton:

…a little [inaudible 00:13:06].

Dr. Arielle Kanters:

…a little kind of, oomph. But there's such thing as good pushing and bad pushing. So, some people have an irregular reaction to pooping, where the muscles will actually get tighter. And this is something that may land you in my office because of things like anal fissures, worsening hemorrhoids. These are things that we have to figure out together so that we can retrain your muscles.

But if once in a blue moon, you sit down and you're like, "This is not initiating, but I know it's sitting right there," a little bit of a push is totally appropriate. If you're having a hard poop after that push starts, though, that might be a sign, "Hey, I don't think I drank enough water yesterday," or "Hey, I think I got to up whatever it is that's going to soften my bowels for the next day." Consistent straining, that's where the problem arises.

John Horton:

I know you have kids. I had a couple kids. We've all been over there at that time where they're sitting there and they turn into like, their face turns into a tomato-

Dr. Arielle Kanters:

…yes, yes.

John Horton:

...because they're pushing so hard. I take it if you've got to push that much either, maybe you really just don't have to go at that moment.

Dr. Arielle Kanters:

Right. And that's the other thing is, like, don't force it. If it's not ready, it's not going to come out. And then, there's a difference. Sometimes, you can tell, like, "Oh, hey, it's sitting right there. It's waiting to work its way out. It's just a little bit too hard, a little bit bigger than it needs to be today." It's normally not going to feel that good coming out.

John Horton:

No.

Dr. Arielle Kanters:

So, that's very different than just sitting there like, "I will poop now." You might not.

John Horton:

You see, I think we all have that mentality. The whole, "Mama didn't raise no quitters." You know what I mean?

Dr. Arielle Kanters:

Yes.

John Horton:

It's like, it's coming out, man.

Dr. Arielle Kanters:

This is OK. If you're not quitting, you're just pausing. There's a difference.

John Horton:

All right. So, you could-

Dr. Arielle Kanters:

…mostly I tell my son, I'm like, "Miles, breathe. You got to breathe."

John Horton:

So, it's OK to let it sit in there. It's not going anywhere else.

Dr. Arielle Kanters:

No.

John Horton:

You can just relax and maybe later, it'll come out a little bit more naturally.

Dr. Arielle Kanters:

Right. And if it's not, again, these are reasons that you come talk to me, you come talk to your primary, because there may be something we have to look at. Otherwise, I'll just tell you that you have a normal anus and send you on your way.

John Horton:

You just have to have some very interesting days in there. So, with everything that we covered, I'm beginning to feel like I really didn't pay attention during potty training because I don't remember a lot of this stuff coming up.

So, what else do we need to know? I'm just trying to, I mean, the wiping process, is that something where we're not doing it quite right?

Dr. Arielle Kanters:

It depends. Again, it depends. The point is, we don't need to overwipe. So, there's a disease process called pruritus ani, which actually translates to itchy anus. It's just a fancy Greek word, Greek way of saying itchy anus.

John Horton:

The Greek way sounds better, I got to be honest.

Dr. Arielle Kanters:

Doesn't it? Yeah. Pruritus ani sounds a lot more legitimate. So, it is possible to overwipe, and this is something I have to retrain a lot of my patients on. There is such a thing as too much, where you can actually cause essentially small tears and ulcerations around the skin, which burn and hurt and itch. And part of the problem is when we sense that feeling of itch, it tells us we're not clean. So, we go to the bathroom and we wipe again.

Well, it just so happens that when we wipe, it actually stimulates an itch response if we overwipe. The analogy I use for people is, you know during winter? When your hands get so dry that they get those little cracks, they burn, they itch and you have to actually soothe them by getting them with cream on top? The same thing is happening to your bottom. We do not soothe our hands by wiping them even more dry.

So, I don't love astringents, witch hazels. I don't like wipes. Wipes tend to have alcohols or fragrances, which can be very irritating to the skin.

John Horton:

You mean the wet wipes there you're talking about?

Dr. Arielle Kanters:

Yep. Not a fan of wet wipes.

John Horton:

No wet wipes?

Dr. Arielle Kanters:

Nope. I'm sorry. Can't stand them.

John Horton:

Wow. Oh man, no.

Dr. Arielle Kanters:

They're also not good for the toilet. They're not good for the environment. Toilet paper is what it is. It's supposed to be that way. But truly, the gold standard is a bidet. So, a bidet is a water-based cleaning, and people are like, "No, no, I won't be clean.” You're clean in the shower. You can get clean this way. So, using a bidet to actually clean the bottom and then just gently pat dry afterwards, that is the way to have the perfectly clean bottom.

John Horton:

Well, but see, I do think a lot … we are guilty of overwiping because nobody wants a dirty bottom. And I know you mentioned the ghost poops who are also the forever ones that just seem like they just, you don't get it clean. So, what do you, at that point, then, do, just get a little water on something? I mean, kind of?

Dr. Arielle Kanters:

Fiber.

John Horton:

Fiber. OK.

Dr. Arielle Kanters:

You got to up the fiber. Yeah. So, your bowels shouldn't be that loose. Our bottoms aren't designed to hold in liquid stool. They're also not designed to pass liquid stool. Those are how patients have urgency. It's how they have accidents, things that can actually cause irritation. And that residual fecal matter around the bottom can cause skin irritation, which will itch, which then, you go to wipe and it becomes this hyper fixation of, "I am not clean. I must get cleaner."

Don't use soap. I know that is not going to be what a lot of people like to hear, but a lot of soaps are also really drying. So, if you're having the forever poop, it's OK. Again, it's OK once in a blue moon to wipe a little bit more, but you could also just get your toilet paper wet.

That's actually safer than using a wet wipe because it doesn't have all the additives and other things that are drying agents. More importantly, try to get your bowels more regular, and that's where we can help you with that. Trying fiber over-the-counter, best way to start.

John Horton:

All right. So, a little more fiber. All the stuff we were talking about before, a little more fiber in your diet, make sure you're hydrating. If you're having those messy leftover poops, you just see it as a sign that maybe you need to adjust things at the beginning of that process and get some better stuff in your system.

Dr. Arielle Kanters:

Mm-hmm. And truthfully, we all have a regular bowel function. All I have to do is eat a block of cheese at night and the next morning, I'm going to be paying for it. That's just who I am. But I love cheese. I'm going to do it. It's about being aware. It's about not always doing it on repeat, knowing that there are going to be consequences in those circumstances. I'm a little more gentle with myself the next morning.

John Horton:

Now, other things I've seen, as far as just making sure that you're regular and the systems are working, is the importance of exercise. We tie exercise to so many things with our health. I don't think a lot of us tie it to how well we're pooping. So, what is the connection there?

Dr. Arielle Kanters:

Well, sometimes exercising can make you feel like you have to have a bowel movement. The bigger thing I would argue is just don't overstrain, don't overlift. We talk about risks of hernias. We talk about risks of hemorrhoids. That holding that breath, that straining, that's the exact same thing that we see with people on the toilet.

Other than that, just having daily motion, daily mobility, that's important for having regular bowel function. These are all natural, healthy things that I would expect to see of all my patients.

John Horton:

All right. Now, we talked about forcing a poop out and how that's not good. How big of an issue is it where people are just like, "I am not going to go." Maybe you're at the office and you're like, "You know what? I am not pooping at work. I'm going to wait until I get home, and it's going to be 6:00 when this comes out." I take it that's probably not the best approach?

Dr. Arielle Kanters:

Correct. I call that a withholder. So, you know how I talked about sometimes when people push that their bottoms don't relax the way that they're supposed to? Part of that is, unfortunately, a learned behavior. Part of that is subconscious, part of it may be conscious, but holding your bowels in when they're not supposed to can actually cause the muscles to strengthen in a bad way. When our muscles are too tight, it's harder for us to relax appropriately. If we can't relax appropriately, it's harder for our bowel movements to pass through. It's easier to get things like tears, fissures, hemorrhoids again. So, having too strong of a bottom — there are phrases you could choose to use how you describe a person — but if you're a little too high-toned down there, you're actually going to make it harder for you to have bowel movements later on in the day and later on in life. So, it's really important to listen to your body. And if it says, "I got to go now," then go and sit on the toilet and let it pass.

What you might find, though, again, when we talk about dietary changes, fiber supplementation, if you're consistent with the dietary intake, you might become that regular person who just pooped at 6:00 at night or 6:00 in the morning. But that's also part of making sure that we're being aware of what our body is doing and not trying to force it into some … no square peg in a round hole. You don't want to fit something in that doesn't really work.

John Horton:

Yeah. Well, you just mentioned the timing thing. And I got to be honest, I'm a regular guy. I get up, I have my cup of coffee, it is very clockwork. Is that something we should strive for? If it is that way, just accept that it's working, and you can train your body to go at a certain time?

Dr. Arielle Kanters:

That's a hard question. I guess you could train yourself, but it probably has a lot more to do with those cues. Like coffee, for example, will actually stimulate your gut. Eating stimulates your gut. Some people will come in and say, "Doc, every time I eat, I've got to poop right after." I'm like, "That's actually a normal reflex. It's called the gastrocolic reflex." When stuff hits your tongue, your body's going to naturally try to empty things out.

So, though I won't say you need to strive for it, if your body does it, let it happen. That is great. But also, don't force it. You may not be a regular morning pooper. If you poop at 1:00 in the afternoon after lunch, great. If you poop every day at 1:00 in the afternoon, great. That's not a problem if you feel well.

John Horton:

So, just go with the flow, whatever your body's telling you.

Dr. Arielle Kanters:

Yes, yes.

John Horton:

Well, I got to tell you, like I said, I thought I knew what I was doing when I went to the bathroom.

Dr. Arielle Kanters:

It sounds like you do. You sound very regular. If it's not broke, don't fix it. Just add some fiber.

John Horton:

I don't know. I got some things. Apparently, my whole form is wrong. I got to work on how long I'm in there. I've got some issues I need to address, as I always find out when we do these podcasts.

So, sum it, everything up for people, and I know you talk about this all the time — if there's one thing you want to make sure that folks leave this conversation thinking about when it comes to the pooping and their habits, what would it be?

Dr. Arielle Kanters:

I'm going to give you my top little recs, and then I'm going to end with a little bit of a Debbie Downer, but it's my cautionary tale.

So, drink your water, take your fiber, get your knees high when you go to the bowel movement, when you have a bowel movement. Don't sit on the toilet too long and don't strain. So, those are like my five primary tips. But if something feels wrong, if you're passing blood, if you're having a hard time consistently, come see me. Come see one of my partners.

The reality is that colorectal cancer is on a rise across the world, especially in the United States, the young adult population. And you don't want to sit there telling yourself, "I'm fine, I'm fine, I'm fine," or have someone say, "Oh, it's just a hemorrhoid." If something feels wrong, it's worth getting looked at. And nothing makes me happier than someone coming into my clinic and I get to say, "I have amazing news. You have a perfectly normal anus." That's what I want to say.

But the reality is, sometimes, I find something, and I would rather be able to put your mind at ease, or if I have to, find something early so we can treat it.

So, just listen to your body. This is a natural process. If something doesn't feel natural, come talk to us.

John Horton:

You know what? That's a perfect way to end things. And I think, like you said, it's a natural process. Listen to it, watch what's going on, pay attention to it and just, I guess, be the best you can be.

Dr. Arielle Kanters:

Absolutely. Again, it's not that you're a bad pooper; you could be a better pooper. Come meet us.

John Horton:

We all have got those skills we can build now. So, Dr. Kanters, thank you so much for coming in. And like I said, for what I thought was going to be a difficult, awkward conversation, you really made it fun.

Dr. Arielle Kanters:

Thank you. My pleasure. Thanks for having me.

John Horton:

We all poop, but very few of us are doing it all that efficiently, and that can lead to some issues. Consider it a reason to make changes to your No. 2 habits a No. 1 priority.

If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Until next time, be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.