Since we were little children, and became aware of poop, we’ve all had a tendency to be shy and embarrassed by this most basic bodily function. We do it in private, on our own, as soon as we are able, and like to keep it that way. In days gone by, going to the toilet and sitting alongside others was viewed as perfectly normal, but once sanitation improved we began to feel poop, and everything associated with it, was dirty and best kept private.
Even though it’s become a subject that we don’t like to talk about that much, it is still very important to our overall health. Your faeces are a huge indicator of infections, a sluggish or overactive digestive system and even more serious illnesses.
Most people go to the toilet once or twice a day, nearly always at the same time, without realising that having a routine is quite important. For some people it is normal to pass a stool three times a day, others only feel the need to empty their bowels every other day, or even once every couple of days. However, if you only poop three times a week or less then I recommend you get this checked out. Having an awareness of your normal, routine toilet habits means that if anything becomes different or unusual you have a reference point to start from.
We all need to poop!
For the majority of us we go to the toilet, pass a stool easily (at mostly the same time each day) and that’s it, we don’t think anymore about it. However, for some people, it can take them up to 15 minutes to feel they have emptied their bowels properly. Taking longer than this may mean you are suffering from constipation and the consistency of the waste isn’t good enough to pass easily. You shouldn’t feel that you need to strain.
The healthier your gut in moving the waste products out of your body, the better your overall health will be. Your food works its way through your stomach, into your colon and compresses itself together to give the shape that we’re all familiar with. A healthy sign is poop that is soft to firm in texture (too loose is classed as diarrhoea and too firm as constipation). It should be passed in a long ‘sausage’ like shape or in several smaller pieces as this is indicates healthy bowels. (Interestingly the shape replicates the shape of the intestines).
Your digestive processes can take 24 to 48 hours to deal with the food you’ve eaten, process what the body needs from it and move forward to expel toxins and also waste that isn’t needed any more.
- ABNORMAL POOP
- HEALTHY, NORMAL POOP
Globally The Bristol Stool Chart is used to categorise different types of poop.
Each of these seven types allows doctors to tell how long your poop has been hanging about inside of your bowel. Let’s look at what each type means:
- Separated, hard lumps that are difficult to pass. These generally point towards constipation;
- Sausage-shaped, covered in lumps. This type also means constipation;
- Almost sausage shaped, with surface cracks – this is ideal as it is easy to pass;
- Sausage shape, that is smooth is also ideal;
- Soft lumps but still with proper edges and easily passed, may sometimes indicate diarrhoea;
- Very soft pieces (not lumps) without proper edges, may also mean diarrhoea if passed more than once;
- Watery, liquid poop with little solid matter in it definitely means diarrhoea.
The best, healthy poop to aim for are the third and fourth types on this list. These mean that your digestion is working at its optimum efficiency. The other types on the Bristol Stool Chart may mean that there are some issues and problems that need addressing.
One of the things you need to do when you’ve used the toilet (as well as looking at the consistency of your poop) is to check its colour too.
Your stools can be a variety of colours so don’t be alarmed if it is any colour other than brown. Most changes are due to foods that you’ve eaten, and perhaps as a result of medications you take. These changes are therefore unlikely to cause you problems.
However, you do need to be aware of some of the more serious problems different colours can mean. Different colours can suggest different problems, so you need to understand what you are looking for and at.
Let’s go through each colour individually, so that you are quite clear:
This is the usual colour of our faeces. but the colour range can be from light to dark brown. It is created from a combination of waste products excreted from the liver. A mucus covering (which aids the passage of your stool through your system) is actually a sign that everything is working as it should and your digestion is healthy.
If your poop looks white this is generally an indication of a problem with your bile production – either in the liver or your gastric system.
Alternatively, you may have a blockage in a bile duct which means your bile can’t do its job properly and ultimately turns your poop white. If you’re not taking any medication, and your poop turns white see your GP urgently – this is could be a sign of hepatitis or liver disease.
However, if you are taking new medication and find that your poop has turned white, check on the information leaflet included with the drugs to reassure yourself that it is a recognised side-effect. It should go back to normal when you have finished the prescribed course. Remember to consult your GP if you have any concerns.
Black or almost black
I remember being anaemic a few years ago and having low iron levels that showed up after blood tests. The medication I was prescribed alarmingly turned my stools black!
Too much liquorice can turn your poop black
Luckily my doctor advised me that this would happen. (The medication also made me constipated – but more about constipation later).
It is well known that eating too much liquorice can also cause stools to look black. However, passing black stools can also indicate internal bleeding in your digestive system that may be caused by a bleeding stomach ulcer and needs medical intervention.
The most obvious cause is eating or drinking large amounts of blue coloured products (blueberries for example). But as long as you can identify the cause it is harmless and will pass through your system. (This shade is also described as a blue-green shade).
However, and much more rare, is that a true blue colour that can be as a result of radiation treatments and some types of poison. Your GP can give you more detail and treatment if required.
People who have a problem digesting fats (those who have had their gallbladder removed for example) often find that their poop turns yellow because bile production isn’t working properly and there is too much fat in the stool.
Yellow or light brown stools are very common in cases of diarrhoea but can also point to illnesses such as coeliac disease and pancreas problems. You are likely to have other symptoms, including pain, with these illnesses so see your GP if you have concerns.
Your poop can look green if you follow a diet that includes a lot of healthy green veggies and is generally nothing to worry about.
The green shade can also be a sign of infection however, and generally is accompanied by diarrhoea. You might find that your stools are green looking if bile remains in your poop because your food has transitioned too quickly through your system.
It may be that you have an imbalance in your stomach acid with the green colour indicating low acid levels. Stomach acid helps with protecting our bodies from things that you really don’t want in your system, and by digesting proteins that are found in so many of the foods we eat. Your stomach acid might be depleted due to being low in vitamin B12 and/or zinc as these are both needed to produce it and keep it at healthy levels. You might find that low zinc causes your poop to smell really bad too.
One of the most alarming colours to see, either in the toilet bowl, or on the paper when you wipe, is red. There is no need to worry if you know that you’ve eaten a lot of red foods such as beetroot.
If you know that you haven’t eaten red foods then this might be blood and medical advice is always to see GP so that they can carry out further checks. You may have internal polyps, a problem in your intestines (such as an inflammation) or in the worst case you may have cancer. The sooner you get a diagnosis the better your outcome may be.
Eating too many orange coloured foods like carrots may cause your stools to take on an orange shade. Carrots contain a pigment called beta-carotene which is good for you but as with all foods don’t over-consume them. (Beta-carotene is also in sweet potatoes and many squashes).
If you don’t overdo the orange veggies but still have orange poop, it can be due to antibiotics you are taking. Certain antacids cause stools to take on an orange hue too. A further known cause of orange poop is blocked bile ducts.
Perhaps the most unpleasant things about poop is the smell. That familiar smell often reflects the food we’ve eaten, but is actually made up of bacteria giving off sulphurous compounds.
Let’s look at both bacteria and diet in a little more detail:
We need the bacteria that lives in our colon as its job is to break down the food we eat. However, it often causes the smell. There is a school of thought that states that a healthy diet, (with an exceptionally efficient digestive tract) means that your poop will have little or no smell at all.
Watch out though if your stools change suddenly to having a foul-smelling. This may indicate lactose intolerance, other illnesses such as coeliac disease, pancreatitis or serious infections such as salmonella, food poisoning and e-coli for example.
The food you regularly eat can make your poop smell, particularly if you eat a lot of protein regularly. Protein rich foods take longer to get through your system and they ‘sit’ in your digestive tract for longer, causing gas. Your body is actually an efficient machine in terms of drawing out the nutrients you need quite speedily.
Sugar and carbohydrates actually get through your system quicker than proteins. Eating both protein and carbs at the same time can cause problems for your digestion and make the smell much worse in some people.
A smell that is much worse than normal is indicative of a zinc deficiency as mentioned previously. Zinc is really important for women who suffer from hormonal problems and also helps with the thyroid. You can have your thyroid function checked by your GP if you are worried that you may have symptoms.
What’s normal size? What’s enough? How do you know?
A lot depends on the amount you’ve eaten but a good guide is how empty you feel when you’ve been to the loo. Every day you should be looking to get rid of the waste from what you’ve eaten in the previous 24 hours, as transit time is important to your digestive system and bowels.
Transit time for your food is 24 hours
This could be passed in one long piece or in a few pieces and as well as being as large as possible, it should sink in the toilet bowl. This means that you’re getting the balance of fibre and fats in your diet correct and you’re eating the right amounts.
However, if your poop floats in the water in the toilet bowl, it invariably means that you’ve got a problem with digesting fats. Check your diet as you may be eating too much junk or fatty foods and overloading your system. If floating poop happens occasionally there is probably no need to worry but if it becomes a regular occurrence get it checked out.
I know it seems a little weird to be thinking about inspecting your poop, looking at the colour and consistency of it, thinking about how it smells and its’ size, but it is really important to do this. Illnesses such as Irritable Bowel and Crohn’s can be identified through stool examination.
If you don’t deal with your poop issues then ignoring them can lead to further problems as time progresses:
- Persistent diarrhoea can cause you to leach away vital nutrients, vitamins and minerals before your body can get the benefit from them.
- Ongoing constipation can lead to compaction, obstructions, haemorrhoids, and general feelings of fatigue and lethargy.
- Not opening your bowels regularly can lead to poor sleep and general ill health.
Emptying your bowels less than three days in seven is classed as being constipated. The basic definition of which is difficulty in passing stools. What you pass is solid, hard, and often in small uncomfortable lumps. You’ll suffer pain as you try to open your bowels and this then stops you from even trying, making the matter worse.
Constipation means you just aren’t passing anything!
Under normal circumstances when the stool passes through the gut and colon, water is removed. When you are constipated however, your poop is ‘stuck’ in your large intestine and hangs around trying to continue the water removal process. This makes the stool harder and harder and more and more difficult for it to move down through to the bowel and subsequently find its way out of your body. So the whole process becomes rather more ineffective and ‘lazy’. You may like to try a massage to try to give you some relief.
Because the bowel wall is absorbent it allows vitamins through into your bloodstream. If you are constipated however, waste byproducts from your food gets reabsorbed into your system instead of being evacuated. When this happens you feel tired, out of sorts, headachy and irritable.
With wet and bulky waste your bowel becomes full enough to send a message to your brain (via pressure on the bowel wall), that it needs to empty. Unfortunately, if you have solid, dry poop hanging around for a while the message doesn’t get sent, making conditions worse. Your liver then has to deal with additional pressure by working overtime to naturally detox those waste products that have entered and stayed in our bodies.
I would highly recommend that you increase your fibre intake to help the mobility of poop through your system, as fibre helps with water absorption too. You can increase fibre in your diet by increasing your daily intake of fruit and vegetables.
Some people have difficulty with processed foods and artificial sweeteners, so you may need to look at your diet to see if this is the root of your problem.
To help keep constipation at bay make sure that you drink plenty of water each day as being dehydrated can be a major contributory factor in constipation.
Excessive straining to pass a difficult stool can cause haemorrhoids, anal fissures in extreme cases and at best is extremely uncomfortable, giving you stomach pains so have a word with your pharmacist for help with selecting a laxative for short-term use to help you pass the stool. Check also any prescribed and non-prescription drugs you are currently taking as constipation can be a side effect of these.
Your pharmacist may advise that you take a laxative containing magnesium hydroxide as this is most commonly used as a treatment – being safe for most people. They will take your medical history into account so make sure you disclose any conditions you suffer from and drugs that you already take. Of course you can try over the counter or online natural options too such as Senna as these are easily available.
Foods to avoid if you suffer from constipation:
- Green bananas as these have resistant starch which won’t help your bowels.
- Too little water each day
- White rice is generally highly processed and has little fibre
- Commercially produced white (and often brown) bread is highly processed and there is little or no fibre left in it.
- Alcohol can make you dehydrated if you drink too much.
- Sugar products feed our bad bacteria in the gut. Chocolate I’m afraid has a lot of saturated fat and a minimum amount of fibre. Your digestive system will weaken if you eat these products too often and will become sluggish.
- Meat products take a lot of time to break down and puts pressure on your digestive system. It’s this pressure that gives you that feeling of food hanging around in your stomach after a big meal. Meat based processed fast foods like burgers or fried chicken for example are full of unhealthy fats with little fibre which clogs up the digestive process and slows down the emptying process.
- Dairy products (including milk) have the effect of slowing the transit time of foods through your gut due to their high saturated fat content.
- Caffeine in coffee and many soft, fizzy drinks irritate your digestive tract and could leave you with constipation PLUS diarrhoea.
There are some people who report feeling they suffer from constipation from a variety of other circumstances. They may suffer from problems after surgery (this happened to me after a major surgery); difficult delivery of a baby; diabetes; and from certain prescribed drugs for other unrelated conditions.
How often is is too often?
Having diarrhoea means you daren’t move too far away from your toilet.
It’s classed as being the need to defecate more than 3 times in a day. Regular or unrelenting diarrhoea is often most closely associated with Irritable Bowel and other colon diseases and can drastically affect your social life.
Looking back at the Bristol Stool Chart you can see that there are several ‘shapes’ that relate to diarrhoea and loose stools. But whichever shape it is diarrhoea can be very unpleasant and uncomfortable, leaving you afraid to venture far away from a toilet. Even suffering for a short time can lead to dehydration and losing vital salts and nutrients quickly. But bear in mind that everyone has loose stools and diarrhoea from time to time. If you can manage to eat, try to have some fibre, as it can help to give the stool a firmer consistency. A slice of plain, wholemeal toast is often recommended.
However, with diarrhoea as a result of something that you’ve eaten or from an infection, the advice is to not eat until you are ready – otherwise you will get the feeling of food going straight through you – and it often does!
You need to make sure you stay hydrated when you are suffering from diarrhoea. Dehydration can happen quicker than you think (particularly in children). You will lose vital salts and may need to take rehydration medication to replace these quickly.
Caffeine is a diuretic and can cause dehydration
Caffeine is a diuretic, so avoiding coffee and fizzy soft drinks whilst you have diarrhoea is a good move as these can aggravate the condition. Avoiding milk and sticking to plain water will help you to stay hydrated.
Diarrhoea with Constipation
It’s worth knowing that when you have inflammation in the wall of your bowel due to waste staying there for way too long, you can actually be suffering from diarrhoea and constipation. You resume eating before you’ve got rid of the waste that’s already there and this causes irritation which sets off a bout of diarrhoea. This becomes a real struggle. A natural way that may help you to to try drinking Chai Tea .
When suffering from the uncomfortable problem of diarrhoea and constipation (often die due to IBS) most of us will try to deal with the diarrhoea first as it is the most distressing, with its unusual and unexpected bowel emptying contractions. The diarrhoea however, is secondary to the real issue of constipation. Ensuring compacted stools soften is so important as it means we can pass them easier.
Diarrhoea will eventually settle down in most cases as it is invariably due to a watery ‘overflow’ passing around the hard faeces. However, you should try to deal with both conditions at the same time really – having plenty of fibre allows your bowel to ‘pulse’ the waste through easily. If you need to use laxatives or natural products like senna pods use them only in the short term. But remember that any long term changes in your bowel habits should be checked out.
Crohn’s and Ulcerative Colitis
People who suffer from the inflammatory bowel condition Crohn’s often suffer from chronic, liquid diarrhoea, accompanied by severe pain and often a fever. Health benefits for Crohn’s sufferers have been felt by including chestnuts in the diet.
Ulcerative colitis is similar to Crohn’s but is often identified by blood in the diarrhoea and needs medical diagnosis and treatment.
Irritable Bowel Syndrome (IBS)
This is very common, being a digestive system problem with diarrhoea usually the main symptom – although some people suffer constipation or vary between both – with stomach cramps and bloating. Stress or certain foods can often set off a flare up of IBS.
This is becoming more common, and can cause a range of symptoms. In general, Coeliac’s are unable to properly absorb nutrients from their food as their small intestine is constantly inflamed.
Symptoms are similar to IBS in that sufferers have diarrhoea, bloating and stomach pains.
Coeliacs may need to follow a gluten-free diet to get relief from symptoms
Gluten found in wheat, barley and rye causes problems for coeliac sufferers. There is no cure but switching to a gluten free diet often helps.
Anything that causes stomach pains and bloating after eating can be classified as food intolerance as there is difficulty in digesting and processing some food types. It is often difficult to pinpoint with accuracy a true food intolerance because many conditions present with the same symptoms. A food diary is a good idea so you can pinpoint what causes you problems. You may like to trial eliminating food groups to indicate what becomes an issue for you. However, this is not foolproof as some foods have hidden ingredients.
When you are lactose intolerant you may find you have bloating, stomach pains and diarrhoea a short time after consuming a food or drink that has lactose in it. It is a common condition that means you can’t digest the sugar found in milk and dairy products. You don’t produce enough lactase and It ferments producing gases and diarrhoea.
It’s worth noting at this point that having a milk allergy is not the same as being lactose intolerant.
Blood in your poop
If you’ve had blood in your poop and your stools are softer than normal for a period of 3 weeks, then you need to see your GP for further investigations. BUT, if you have black or dark red poo or diarrhoea that comes on suddenly for no apparent reason, then contact NHS direct for further advice.
It could be something as simple as haemorrhoids, polyps or an anal fissure (simple but still a painful diagnosis). Or you may have a more serious inflammatory bowel condition that requires investigation..
The longer you sit on the toilet trying to poop, means you have a higher chance of developing swollen blood vessels inside your anus and a higher likelihood of developing haemorrhoids. This can lead to bleeding from your bottom and blood streaks in your stools or on the paper when you wipe. Sitting for too long (please don’t take a book or a magazine into the bathroom with you!) restricts the blood flow around your anus. This causes problems due to the pressure and stress you are placing on the area and can cause bleeding.
Anxiety and stress can lead to a ‘nervous stomach’ and bring on a bout or two of diarrhoea. It can lead to a reduction in blood flow to the stomach that brings on cramps, inflammation and problems with your gut bacteria levels. Anxiety leads to very loose stools and that in itself causes stress.
It is known that exercise can help relieve and manage stress and anxiety, but you may not be aware that it also encourages good, normal bowel movements. Regular physical and stretching activity such as yoga can help getting stools moving when suffering from constipation.
Without plenty of water daily you lead yourself open to constipation and compaction of faeces in the bowel. 8 glasses a day is recommended and it is important for you to reach this amount, as without it waste in your bowel quickly dries out. Mucus becomes thicker and stickier making transit difficult instead of the smooth passage that we should all be aiming for.
HEALTHY, NORMAL POOP
There is actually a best position to sit on the toilet to empty your bowels efficiently. To pass a normal healthy poo easily, without straining and certainly without giving you any discomfort, you should aim to have your knees raised higher than your hips.
My 17-month-old granddaughter is just becoming aware of having a poop in her nappy and takes herself off to crouch in a corner – this just goes to show that we have an inbuilt instinct to do the right thing naturally but that we undo this behaviour to conform to social ‘norms’.
Crouching position may help
If you need to make it easier for yourself to get rid of the build up regularly, and have difficulty in raising your knees above your hip level, then take a small, low footstool into the bathroom with you and rest your feet on it.
The bacteria in your gut has a range of health benefits and affects your digestive processes and ultimately your poop. We have a huge amount of bacteria in our digestive system – in fact we have millions! Each one of us has a finely tuned microbiome that is sensitive to the foods we consume.
It is recommended that we have plenty of dietary fibre through green vegetables, seeds, nuts and beans for optimal healthy bowel movements. For our good gut bacteria to thrive, look to consume kefir and fermented foods. Try probiotics and prebiotics to help you achieve a healthy balance if you feel your diet isn’t giving you sufficient.
You need a regular amount of dietary fibre daily to add bulk to your stools so they pass through your system easily without straining. Unfortunately most of us don’t eat enough.
There are two types of fibre – soluble and insoluble. If you are suffering from constipation then try having prunes or prune juice as luckily these have both types. Insoluble fibre in particular will help get your bowels going as it travels through your stomach, on to the small intestine and gets into the large intestine without being absorbed. This then triggers the wave-like pulsating that efficiently moves waste through your digestive system.
To increase your fibre intake eat wheat bran, wholegrains, seeds, and keep the skin on fruit where you can. The British Nutrition Foundation recommends that adults should aim for 30g of fibre daily. For this fibre to transit smoothly increase your liquid intake too.
Remember though that if you suffer from diverticulitis dietary fibre acts as an irritant.
Ever wondered why some foods like sweetcorn are blatantly obvious in your poop and look as if they’ve not been digested? This is down to the cellulose husk that surrounds the starchy kernel. We can’t break down the cellulose molecules so whilst we can digest the inner kernel what you see is the husk coming out in your poop.
Sweetcorn often looks the same coming out as it went in!
If more of us changed our diets to include more unprocessed and fresh foods we would produce much healthier stools.
To avoid picking up any bacteria and bugs after using our own loo (or especially from public toilets) it is so important to wash your hands properly. Even if your hands look clean, washing them after toilet use and before eating is important to avoid diarrhoea and food poisoning.
There are so many studies that show that a lot of people either don’t wash their hands, or don’t wash them properly or for long enough. Evidence of faeces has been found on toilet doors, trolleys in supermarkets and most alarmingly of all on our mobile phones!
Many mobile phones are contaminated with bacteria
It is estimated that one in six mobile phones are contaminated with bacteria that can cause e.coli. At the very least you may end up with a bout of diarrhoea and be left wondering what it was that you had eaten to give you an upset stomach! Make sure you clean your mobile phone regularly to avoid spreading bacteria around via your phone and transferring it into your mouth. And please, please, please do NOT use your mobile phone whilst you are using the toilet.
There’s quite a lot to be aware of when you poop isn’t there? And there’s quite a bit you can do to make sure your digestive tract remains healthy and gets rid of your waste products with the minimum of effort and discomfort. You need your bowels to react swiftly and efficiently to remove toxins out of your body so that you don’t succumb to diarrhoea and constipation.
Healthy bowels are so important – as important as keeping your weight at a healthy level, eating well and exercising regularly – in fact these will definitely all contribute to healthy poop too. For your own well-being it is essential that your digestive tract can carry out its natural functions and that you support this by having a well-balanced diet consisting of unprocessed foods, fibre and keeping hydrated.
Hospital staff are obsessed with your bowels and with good reason
If you’ve ever had a hospital stay you will no doubt have noticed that the staff seem obsessed with asking if you’ve opened your bowels and if you haven’t will give you something to make you ‘go’. Bowel function is so important as an indicator of overall health – that’s why they check.
It’s important not to put it off visits to your GP surgery through shyness or embarrassment. By paying attention to poop you can react to anything out of the ordinary and get it dealt with swiftly by your doctor.
Our bodies are very good in reflecting on the outside what’s happening on the inside – if only we pay attention and watch for subtle changes.