It’s time for a poop talk.
I always ask my clients about their bowel movement. I realize it’s not the most comfortable question but poop can be an important marker of health or disease. It can tell you a lot. Is it soft, hard, smelly, yellowish, back, fatty, with mucus, with blood or with undigested foods? Next time you poop, pay attention to what comes out!
We can observe our body, our body fluids (blood) and our body secretions (urine, feces, saliva) for signs of dysfunction. Some parameters can only be measured by a laboratory but you can also be your own detective and learn how to distinguish a healthy bowel movement from an unhealthy one.
What you need to look at in terms of poop?
Color, consistency and smell are the key parameters.
Normal, healthy poop is brown (from light brow to dark brown), well-formed (sausage like) and has no repelling smell.
What’s your poop color like?
Healthy human feces is brown. The color can change after eating some foods (red beets, spinach), after taking certain medications (iron for example) or it can also be an indication of a health issue.
- Black or a very dark color can be related to the use of certain medications, supplements (iron, activated charcoal), foods (black barriers, red wine). It can also indicate a blood loss from stomach or (small) intestine, or can be a sign of inflammation, ulcer, polyps, or cancer. Constipation may promote darker stools. A black stool with a very strong abdominal pain can indicate an internal bleeding.
- Red, eating red beets can color your stool red.
- Green, if you eat a lot of green vegetables your poop can turn green.
- Grey – light color, can indicate that there is no bilirubin (color compound) present in a bile or/and too high fat intake. It can be caused by impaired bile production/storage, intestinal infection, reactivity to foods, pancreas problems, low gastric acid, resulting in impaired digestion. Noteworthy, if you suddenly change your diet by for example following a low carb diet and will be eating more fat, your stool may have lighter color especially in the beginning. It’s related to the fact that if you eat more fat - your body needs more bile and sometimes it needs some time to adjust and to produce more bile.
- Bloody, most of the time caused by rectal/anal bleeding such as hemorrhoids.
- Yellow, often occurs together with a soft stool/diarrhea and intense smell. It can be related to a quick intestinal passage, lack of bile. Bile contains bilirubin which turns your feces brown. Possible causes of yellow stool include gluten intolerance, infection (Salmonella/Clostridium), use of medicines, alcohol consumption, liver and/or bile dysfunction, bile stones. Quick intestinal passage can promote nutrient malabsorption. Babies may have yellow poops.
What’s your poop smell like?
Normal fecal matter can smell as a result of intestinal bacterial fermentation and the presence of dead intestinal microbes. However when the smell of your poop is very intense – it stinks – or it has other than a regular smell it should raise a red flag. It can be a sign of intestinal infection (parasites bacteria), impaired digestion (specially of proteins), intestinal inflammation, food allergy or food intolerance. Sour smell can indicate a low fecal pH, yeast overgrowth and/or overconsumption of starch. If you let stinky gases, of rotten eggs, then think of putrefaction and sulphur release. If your stool stinks and has a “pap-like” consistency – it may indicate a medical condition.
What’s your poop consistency like?
Normal feces has a sausage like shape and the consistency which is not too hard and not too soft – just right. If this description does not fit your poop, please read on. Note, that some people may experience changing stool consistency from too soft to too hard.
*Chronically “Pap-like”, your poop is soft and not well formed. It can stick to the toilet and you need to use a lot of toilet paper to wipe yourself well. The pieces of the feces can float. The most common causes of a “pap-like” stool include parasitic infection (such as Dientoamoeba fragilis), intestinal dysbiosis for example after antibiotic use (candida overgrowth), food intolerance (histamine, lactose, gluten), low gastric acid, pancreatic issues, or medicine use.
*Chronically too hard, a slow bowel movement with a sausage-like but lumpy stool, or separate hard lumps like nuts. For constipation the frequency can be once in 3 days or less. Often there is a feeling of pressure to go to the toilet yet you can’t poop. Hard feces and constipation is more prevalent in women and in overweight individuals. Constipation can be related to a slow intestinal passage which can be a result of holding the stool for too long, for example children and teachers at schools, car drivers may have this tendency. Overweight, intestinal parasites, food allergy, pregnancy, underactive thyroid, gluten intolerance, medicine (codeine, anti-depressives, anti-histamine) use, supplements (iron), genetic predisposition, intestinal physiology, sometimes dehydration and too little dietary fiber (fruits and vegetables) can contribute to constipation and hard stools.
*Chronically too watery, diarrhea. Diarrhea is watery, unformed feces that you can’t keep in. You can have acute or chronic diarrhea. With acute diarrhea complaints should resolve by itself within few days. Chronic diarrhea takes more than 3 weeks. Chronic diarrhea can be accompanied with fecal mucus and blood. Chronic diarrhea can also alternate with the episodes of normally formed stools or constipation and hard stools. Chronic diarrhea increases the risk of dehydration and loss of electrolytes, therefore remember to drink adequate amount of water if you suffer from chronic diarrhea. Chronic diarrhea can be caused by a chronic bacterial infection or a post-infectious syndrome, parasites, food intolerance (gluten, histamine, lactose, fructose), food allergies, intestinal inflammation, auto-immune disease, pancreatic and bile problems, nickel or latex allergy, intestinal dysbiosis (after antibiotic), additives to foods, or cancer.
Normal feces contains fat, about 0-4 gram fat per 100 gram poop. If there is more fat or you can’t digest fat properly, your stool will be fatty, shiny and will stick to the toilet surface. Fatty stool can also stink more or has a lighter color. If your stool is fatty consider following issues: low gastric acid, impaired pancreatic function, bile or liver issues, celiac disease, alcoholism, bacterial or parasitic infection, intestinal inflammation (Crohn disease, Colitis ulcerosa), or over consumption of nuts. Fat malabsorption can cause malabsorption of fat soluble vitamins such as vitamin D, E, A or K.
Fecal mucus comes from intestinal mucosal membranes. Normal and well-formed feces contains no visible mucus. If you do see mucus around your stool or within it, it may indicate inflammation or irritation of the intestinal lining. Bloody mucus will indicate inflammation. With constipation and inflammatory bowel diseases there may be more mucus formation/secretion.
If your feces is off and you can’t identify the reason, do a fecal analysis to begin with.