To 3-year-olds, bowel movements are a work of art. To grown-ups, they’re a picture of how our bodies are working. Find out what changes in color, texture and frequency say about our health…
Most of us just flush and forget it. But bowel movements can reveal whether we’re eating right, staying hydrated and maintaining our systems.
“Daily attention can tell you whether you eat enough fiber or have health problems like cancer or inflammatory bowel disease [a group of conditions such as colitis and Crohn’s disease that inflame the colon and small intestine],” says gastroenterologist Anish A. Sheth, M.D., assistant professor of medicine at Yale University School of Medicine in New Haven, Conn., and author of What’s Your Poo Telling You (Chronicle Books).
What you’re looking for are changes in look, color and smell, Sheth says. This simple step can help you identify health issues sooner than you would have otherwise.
It’s normal to have anywhere from three bowel movements a day to three a week. (Any fewer and you’re skirting constipation, according to the National Institute of Digestive Diseases). So you have plenty of chances to keep an eye out for the following issues.
1. Pebble poo
What it means: You’re not getting enough fiber in your diet, so your bowel movements won’t clump in larger lumps.
“The recommended daily amount of fiber is 25-35 grams a day. That will take care of pebble poo,” Sheth says.
Reaching that amount is easier than you think: Eat a cup of raspberries and a half-cup of lentils (8 grams each); a half-cup of cooked greens (4 grams) and a cup of whole-wheat pasta (6 grams).
Small poo clumps could also mean you’re not drinking enough fluids, says Mariam Fayek, M.D., a gastroenterologist at the Center for Women’s Gastrointestinal Services, Women and Infants Hospital in Providence, R.I.
“Women have long colons, so the waste has a longer transit time," she says. "And the longer it’s in the colon, the harder [and drier] it gets.”
Drink at least six 8-ounce glasses of water a day if you suspect that’s the issue.
When to worry: By itself, pebbly poo isn’t worrisome, says Sheth. But if you also feel that you’re not emptying your bowels completely, something could be wrong with your rectum.
For example, pregnant women’s pelvic-floor muscles weaken, which can cause an internally herniated, or protruding, rectum. Waste can get stuck in the pocket the hernia creates, exiting only in pebbles, says Fayek.
Pelvic-floor exercises can help, or this may need to be repaired with surgery.
2. Leaky poo
What it means: Runny stools can signal several issues: infection, virus, intolerance (to lactose-rich dairy foods, for example) or a gastrointestinal condition like colitis (inflammation of the colon) or Crohn’s disease, a chronic inflammatory condition of the intestinal tract.
It’s more common after childbirth or as we get older, says Sheth.
“During childbirth, women may experience small tears in the sphincter muscles that keep stool inside. As these muscles weaken with age, in the 40s and beyond, women may have more [leakage].”
You can strengthen the muscles around the rectum by practicing tightening them. That’s usually done in a biofeedback program, says Sheth, a process during which a machine monitors changes in the body, like muscle tension.
Lack of fiber could also be a factor.
You may need more roughage to bulk up your poo, says Kevin Dolehide, M.D., a gastroenterologist at Advocate South Suburban Hospital in Hazel Crest, Ill., and assistant professor of medicine at Midwestern University in Downer’s Grove, Ill.
When to worry: If you know it’s the flu, stay well hydrated, says Dolehide. If not, and it lasts more than a day, see your doctor to determine the cause.
3. Black or red poo
What it means: Certain medicines – such as Pepto Bismol and iron supplements – can turn poo black.
Red in the stools may be the calling card from beets or tomato sauce.
If blood is causing the color, it could mean hemorrhoids, rectal bleeding or even cancer.
When to worry: Blood is always a concern and requires a doctor’s visit.
If stools are black and you’re not taking iron or Pepto-Bismol, “you need to rule out gastrointestinal bleeding,” Dolehide says.
This would show up as black, tarry and foul-smelling stools, according to Sheth. Read the next entry for more on these warning signs.
4. Unending-Wiping Poo
What it means: Sticky, gel-like stools could be a sign of gastrointestinal bleeding, especially if it’s dark and has been happening for only a short time, says Sheth.
Large hemorrhoids – enlarged blood vessels in the rectal area – can also make it hard to clean after a bowel movement.
When to worry: If the signs point to gastrointestinal bleeding, see a doctor as soon as possible.
If not, you should still see a doctor to confirm whether you have hemorrhoids and to rule out other conditions, such as cancer.
If you’re over age 50, your doctor may schedule a colonoscopy – a visual exam of the colon with a colonscope – to be sure, says Sheth.
5. Loose stools
What it means: Diarrhea can result from too much sugarless gum or soda.
“The artificial sweetener sorbitol and fructose [a sweetener] used in sodas [act as a laxative]," Fayek says. "They pull water into the colon because they can’t be absorbed, which makes bowel movements loose."
Cutting down on those habits and bulking up your stool with fiber supplements such as Benefiber or Citrusol will help.
And watch your diet: If diarrhea always happens after you eat dairy food, you could have lactose intolerance, an inability to digest milk products.
If the cause seems unclear, recurring diarrhea could indicate an infection, inflammatory bowel disease (IBD) or celiac disease (caused by intolerance of gluten, an ingredient in wheat).
When to worry: If you’re losing weight, have a family history of IBD, find blood in your stool or have just returned from a foreign country, make an appointment. These all point to the more serious conditions mentioned above.
6. Painful poo
What it means: If you’re straining like a heavyweight on the toilet, you’re probably constipated – and your efforts may have caused hemorrhoids or tears in your sphincter muscle, says Sheth.
Soothe yourself with over-the-counter remedies like Preparation H or an acetaminophen (Atasol) suppository, says Dolehide. A stool softener like docusate sodium (Colace) or polyethylene glycol (Miralax) will make stools easier to pass.
When to worry: If the over-the-counter treatments above don’t resolve the problem within two weeks, and you have ongoing pain, call the doctor.
Large tears may require surgery to repair.
7. Constipation
What it means: You’re eating too many hamburgers and fries. The typical Western diet doesn’t give us enough fiber, says Fayek.
Constipation can also be caused by medications, like those for high blood pressure.
As with pebble poo, eating 35 grams of fiber a day – lots of beans, fruits, vegetables and whole grains – and drinking enough water can ease constipation, according to Sheth.
Regular exercise aids regularity too.
And go when you have the urge: The longer you wait, the drier the stool becomes, and the tougher it is to pass.
When to worry: If constipation doesn’t get better for several weeks, causes pain or is accompanied by other changes such as bleeding, see your doctor, says Sheth – especially if you’re around 50 and haven’t yet had a colonoscopy.
8. Light-colored poo
What it means: Stools get their color from bile (fluid secreted by the liver), so a light gray or tan poo could mean an obstruction, like a stone, in your bile duct, says Dolehide.
More seriously, it could indicate pancreatic cancer or a liver disorder.
When to worry: One day of light-colored poo isn’t a problem. That could just be a shift in bacteria, says Fayek.
But if it continues, see your doctor to rule out other health conditions.
9. Greenish-yellow poo
What it means: “If you’ve eaten a can of spinach or green Jell-O, that’s probably enough explanation,” Sheth says.
But if it’s happening consistently and you’re going to the bathroom more often, “green-goblin poo is a classic symptom of infection,” Sheth says. “And there’s a particular kind of colitis that causes seaweed-green poo.”
When to worry: Isolated incidents? Stay calm. But if the green continues, see a doctor.
If colitis is the culprit, you’ll probably also have fever, cramping and diarrhea.
10. Pencil-thin poo
What it means: Again, not enough fiber is the likely cause. But if it lasts over weeks or months, it could mean rectal cancer, which narrows the rectal opening, says Sheth.
When to worry: If you’re eating enough fiber and the stool is still thin, see your doctor to rule out cancer.
11. Smelly Poo
What it means: Well, it all smells. That normal odor comes from mercaptans, sulfur-containing compounds. Brussels sprouts, onions and red wine produce more of them, says Sheth.
But if it’s unusually foul – that could signal conditions like gastrointestinal bleeding or trouble digesting fat, possibly from other problems.
“Fat makes its way into the stool and causes a terrible aroma," Sheth says. "People with pancreatic or liver problems can’t digest fat appropriately.”
When to worry : If your poo smells worse than usual and it can’t be traced back to dietary changes, see your doctor.
12. Mucousy Poo
What it means: “Most of time, I see [this sort of stools] in young women with irritable bowel syndrome,” Fayek says.
This gastrointestinal disorder, which can cause pain, diarrhea and/or or constipation, is most common in young women and at least twice as likely in females than in men.
It could also be a sign of inflammatory bowel or celiac diseases.
When to worry: If it happens all the time, and you’re losing weight, have rectal bleeding or abdominal pain, or you have a family history of inflammatory bowel disease or celiac, see your doctor, says Fayek.
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