The Truth About Poop: Understanding Stool Color, Shape, and Frequency

Posted: Aug 30, 2011 9:45 PM
Source: WebMD

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We have a lot of silly names for it: BMs, caca, doo-doo, turds, and of course, poop.

We don't generally discuss it in our daily conversations.

But asking some important questions about your bowel movements might give you some insight into your gastrointestinal health. Here's the scoop on poop.

ABCs of Poop

Bowel movements are the end result of your body taking the nutrients it needs from the food you eat and eliminating what's left.

"Bowel movements are important for your health because they are the body's natural way of excreting waste from the body," says Eric Esrailian, MD, section head in general gastroenterology at the David Geffen School of Medicine at UCLA.

When it comes to frequency, color, shape, and size, a general rule of thumb is that normal bowel movements are defined as what's comfortable for you. But being knowledgeable about your digestive process can help you identify when normal goes awry.

Frequency: "There is no normal when it comes to frequency of bowel movements, only averages" says Bernard Aserkoff, MD, a physician in the GI Unit at Massachusetts General Hospital in Boston.

It's average to go once or twice a day, he says, but many people go more, and some go less -- maybe every other day, and or as infrequently as once or twice a week. As long as you feel comfortable, you don't need to give your BMs much thought.

Color: "Bowel movements are generally brown in color because of bile, which is produced in the liver and important to the digestion process," Aserkoff tells WebMD.

The food you eat typically takes three days from the time you eat it until it finishes its journey in your toilet, Aserkoff says. If it takes a shorter time, the result may be greener stool because green is one of the first colors in the rainbow of the digestive process.

Color can be a red flag when it's a drastic change, Aserkoff says.

"If stool is black, it can mean that you are bleeding internally, possibly as a result of an ulcer or cancer," he says. Stool that is black due to bleeding is also "sticky" (tarry) and smells bad. However, black stools are common when taking a vitamin that contains iron or medications that contain bismuth subsalicylate.

Stool that is light in color -- like grey clay -- can also mean trouble if it's a change from what you normally see. Although it doesn't happen often, very light-colored stool can indicate a block in the flow of bile or liver disease.

Size and shape: "We used to believe that size was indicative of a problem if the stool was 'pencil-thin,'" Aserkoff says. "But recent research indicates that this is actually not true."

Size and shape are irrelevant, Aserkoff says, if what's coming out is normal for you.

Odor: Bowel movements usually smell. But is it normal if your trips to the bathroom mean that the rest of the family has to avoid that part of the house for an hour or two?

The answer is yes. It's normal, and probably a good sign that your gut is abundant with bacteria that is working hard to keep you healthy.

Your intestines are swarming with trillions upon trillions of bacteria that enhance digestive and metabolic processes. They are also the reason why poop smells -- a direct result of the bacterial activity in your GI tract. So although it's no bed of roses, it is normal for your bowel movements to stink.

Poop Problems

So what happens when your poop process gets out of whack? The first sign that your intestines aren't up to par is a shift from your normal GI routine, and as a result, discomfort below the waist.

Constipation and Diarrhea

Constipation is a concern when you normally have a bowel movement once or twice a day, and that changes -- maybe you haven't gone in three days, or more. However long it's been, you now feel gassy, bloated, and generally uncomfortable. When you try to go, you have to push and strain, and what comes out is a whole lot of nothin'.

Constipation can have many causes. It might be that you've had a shift in your diet, such as a drop in fiber intake, or maybe because you're not drinking enough water each day, or because your physical activity level has decreased, slowing your metabolic processes down, including digestion. Certain medications (such as narcotic pain medicines and iron supplements) can also cause constipation problems.

Although constipation causes one set of problems, diarrhea can also mean digestive disaster. Whether it's caused by a meal that just didn't sit right, or a harmful bacterium or virus, it's categorized by loose stool, and another hallmark of GI trouble -- discomfort.

"Diarrhea can be caused by any number of factors," Aserkoff says. "But the problem with diarrhea, in addition to the obvious, is that it can cause other health problems, like dehydration, if you're living with it for more than two or three days."

Generally, you recoup from a bout of diarrhea or constipation in a day or two, Aserkoff says. If not, it's probably worth a trip to the doctor for further GI troubleshooting.

Blood in the Stool

"One of the most significant warning signs when it comes to bowel movements is blood in the stool," Esrailian says.

Blood in your stool could be a symptom of something as significant as cancer and warrants a call to your doctor right away -- even if you think it could be hemorrhoids, or tiny tears in the anal tissue, as a result of constipation and straining, he says. If you're over 50, or if you have a family history of colorectal cancer, a colonoscopy is probably in order.

Other warning signs to watch for when your bowel movements have taken a turn for the worse are fever, abdominal pain, or dehydration -- any one of which could be tied to GI trouble, such as a virus, appendicitis, or food poisoning.

Good GI Health

Tricks to keeping your poop on track are simple ones: a healthy diet high in fiber, lots of water, and regular exercise.

"Generally, 20-25 grams of dietary fiber per day is recommended, and for many people, you get this much in a healthy diet," Esrailian says. "If you are having infrequent bowel movements and are experiencing discomfort, then the first easy way to correct it is to increase dietary fiber through food, supplement, or both."

High-fiber powerhouse foods are whole-grain cereals and breads, fresh vegetables and fruit, and nuts. Usually, a day or two of a fiber-focused diet will put your trips to the bathroom back on track.

Proper hydration is also key for your colon, ensuring you have enough fluid in your body to move stool through the digestive track and out the other end on a regular basis, Esrailian says.

Exercise is also beneficial for your bowels. It helps improve GI "motility," he says, and can often alleviate constipation by improving your metabolic and digestive processes.

Overall, normal is a pretty easy mark to make when it comes to your bowel movements, both experts say, and aside from the warning signs they offered, what goes in one end usually comes out the other with minimal problems along the way.

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