This month we are going to discuss poop. Many don’t really pay attention to what is coming out the other end. Shocking, I know. What your stool looks like is an important indicator to what is going on in your digestive system, as well as your overall health.
So what does a healthy stool look like? Typically, a healthy stool is medium brown. This is in large part because of bile. Bile is formed in the liver and secreted by the gallbladder, is incorporated into the food that you have eaten to aid in digestion. Bile is actually dark green in color, but as it travels through the intestines its color changes, most often resulting in the characteristic brown stool. A healthy stool should have the form of a sausage or a snake, and have a smooth texture.
Lets focus on bowel movements that are deviations from normal. Keep in mind that medication and some foods can change the color of your stool and must be considered before thinking that there is something wrong! There is a range of ‘normal’ when we are talking about what your stool should like and most often, an isolated incident of deviation from normal is not cause for alarm. Generally speaking, If it happens multiple times, or there is a significant change in bowel habits it should be investigated. This color guide can help bring some clarity to what deviations from normal can mean.
Tarry/ black: This could indicate a bleed coming from the upper part of the digestive system, namely the esophagus, stomach or the upper part of the small intestine. This is because The blood is reacting to the digestive enzymes in the small intestines.
There are other reasons for very dark brown/black stool that you should be aware of. Iron supplements, supplements/medications containing bismuth (Pepto-bismol), activated charcoal can all turn your stool very dark, which is not an indication of a problem. Discontinuing the culprit should return your stool to a lighter shade of brown.
Red/maroon: If you stools are red or maroon it could indicate bleeding in the lower part of your intestines. There are several conditions that can lead to a red appearance to your stool: Diverticulitis, inflammatory bowel disease, colon polyps, colon cancer, internal or external hemorrhoids (very common), anal fissures (tear) can all lead to various amounts of blood in your stool. But wait! Very often food can influence this to. The most common is beets. Other red vegetables and red food dye can turn your stool a red/maroon color as well
Green: Green stools are generally the result of bile in your stool that is moving through your intestines too quickly and isn’t able to go through chemical changes to darken your stool. Some may experience this if they have diarrhea. You can also have greener stool if you eating a lot of green vegetables.
Yellow: Infection with giardia lamblia (a parasite) produces a characteristic yellow diarrhea. Gallbladder dysfunction leading the the improper handling of bile can also cause yellow stool. Pancreatic disease which can result in too much undigested fat in your stool, may cause your stool to have a yellow appearance. Often it will also have ‘greasy’ appearance and can be quite malodorous.
Clay/Grey: This can happen if there is little or no bile in the stool, or the flow of bile is blocked. Liver disease, gallstones/gallbladder disease, and a pancreatic tumor blockage are all reasons stool could have this appearance. The change of stool color to gray or clay typically occurs gradually as these medical conditions progress relatively slowly and stool becomes pale over time.
Now that we have discussed color, lets move onto the shape and consistency of your stool. A helpful chart is the Bristol Stool Chart. This depicts the continuum of consistency, from hard stool to loose stool:
Hard Bowel Movements
If your stool is difficult to pass, infrequent, and you have straining, or discomfort, your stool is too hard. Often times stool will be smaller in pieces, dry and/or have cracking. This can be a sign of dehydration, not enough fiber, lack of exercise, food sensitivities, stress, structural misalignment, influence from medication, and changes in daily routine are some common reasons for harder stool.
Loose Bowel Movements
If your stool doesn’t hold its shape or is watery (diarrhea) this is considered to be loose. A variety of things can result is loose stool: infection, food poisoning, food sensitivities, stress, drinking too much alcohol, and hormonal fluctuations can all result in stool that is loose.
There are a varying opinions of how often someone should have a bowel movement. Most sources say that moving your bowels daily to 3 times a week is normal. I tend to disagree with this. Generally speaking, I think that a healthy digestive system is reflected in having 1-3 bowel movements a day. If you are eating then you should expel waste by products often. If there is a straining, rabbit pellets, thinly shaped stool or it doesn’t feel like a full evacuation, I consider this a sign of constipation. Also, having undigested food in your stool is an indication that perhaps you aren’t chewing your food well enough, and/or your body isn’t breaking down your food properly. Having a small amount of mucous in your stool is ok, but a lot of mucous in your stool can be an indication of inflammation in your digestive system.
I have been asked many times what the ideal stool looks like, and here is my answer:
It should have a gentle S shape (following the shape of the lower colon), evacuated easily without a lot of straining. It should gently sink to the bottom of the toilet bowel. It is a medium brown. And finally, it is a ‘one wipe wonder’
Nina Paroo, ND