There was an episode of the sitcom Scrubs that was a musical, and in it, there was a song called ‘Everything comes down to poo’. Take a moment to watch the clip for a laugh and to get caught up on the importance of stool. When I chose dietetics as a career, I had no idea how much time I’d spend talking and asking about poop. It’s that important. As the song says, our #1 test is your #2! I’ve learned over the years to talk about poop openly, honestly and with a bit of humour.
The problem with the human gastrointestinal system is that once we swallow, it’s hard to know what’s going on. We rely on what comes out to give us tips on what’s happening between points A and B.
Instead of taking stool samples and sending them to your doctor, there are some things you can look for at home to let you know what’s going on. You can gather helpful information to adjust your diet or notify your doctor that something might be going on.
As a disclaimer - this is where things start getting graphic. Make sure you’re not eating anything and get ready, there will be pictures!
Poop factor #1: Frequency
Poop factor #2: Consistency
Poop factor #3: Other indicators
Poop factor #1: Frequency
Bottom line - you don’t need to go every day!
The human bowel is remarkable trainable, generally people go at the same time of day or under the same circumstances each time.
The range of normal for bowel movement (BM) frequency is three times a day to once every three days. Pay attention to what is normal for you, and when your BMs stray from that range, start paying attention. If you’re a once every three days kind of person, you don’t need to worry that you’re not going every day, but if you’re an every day kind of person and it’s going on three days, start paying attention.
Constipation is often considered when you don’t go frequently enough, but the medical definition also includes when stool is hard/dry/lumpy, difficulty to pass, or if you have a feeling that you haven’t passed everything. If you pay attention to your bowel pattern, you’ll know when you’re getting constipated, as you go a day or two longer than your normal pattern.
If you’re a once every four days kind of person (i.e. outside of the normal range), but you don’t have any of the signs or symptoms of constipation and you’re regular, there’s likely no need to worry, that’s just you! But you won’t know this unless you pay attention!
Having frequent bowel movements, and keeping to a regular schedule indicates that you’re eating enough, that you’re hydrated and that the processes that move stool through the body are working (and there’s no blockages!).
Poop factor #2: Consistency
This can also be person-dependent, but there are guidelines. Take a look at the wonderful Bristol Stool Chart below and guess what the range of normal bowel movements are.
If you guessed # 3 - 5, you’re right!! These types of stool will be soft and easy to pass. They also indicate that your small and large intestines are likely healthy, as they are able to form and pass normal stools. All good things!
Types 1 and 2 can mean that you’re not eating enough in general, or not enough fibre, not hydrated enough, or the stool isn’t moving through your body fast enough. Dietary changes can move you from a 1 or 2 to a 3,4 or 5, so speak to a dietitian. If you’re a 6 or 7 on a regular basis, you need more fibre in your diet. There may also be an inflammatory process going on that’s moving the stool through you too fast, which doesn’t give the stool time to form. Again, if this is you, a dietitian can help you make dietary changes to get you back into the normal range.
Poop factor #3: Other indicators
There are a few other things that can indicate something is going on in your body, if you notice any of these, speak to your doctor.
Mucus – this will look like whitish, stringy stuff (like snot), potentially around or mixed through your stool.
Blood – this can be in an around your stool (like clots), can stain the toilet water red, or can appear on the toilet paper after you wipe. These all will mean something different, but you should speak to your doctor about any of these.
Hard to flush – these float and won’t go down the toilet when you flush, even if you try a few times! They also tend to smell particularly bad (worse than normal).
Funky colours – anything that is not a normal medium brown is cause for investigation. Darker brown/black, pale colours, orange/yellow/green tinges are also possible. If you notice anything out of your ordinary, see your doctor.
So, what do I do?
First off, if your poop is such a good indicator of what is going on in your body, you need to know what your normal is, so start paying attention! Take a look before you flush. Learn your normal, then notice when your pattern changes.
From a high level dietary perspective, a lot of issues can be moderated by drinking adequate fluids (anything but alcohol counts but be wary of drinking calories!) and eating lots of fibre (fruit, vegetables, whole grains).
Speaking to a dietitian about what works for you is an easy way to take care of your digestive system – remember, talking about this stuff doesn’t embarrass me – I’m used to it and have heard it all! Let me know if you’d like to talk poop, I’m available.
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