Poop. Stool. Feces. BM. Number two. Whatever you call it, when was the last time you took a good look at your loo deposits? Set aside the gross factor and consider this: Your poop can tell you a lot about your health.
“Everything about the stool is diagnostic,” explains Dharam Singh Deutsch, a Doctor of Oriental Medicine, acupuncturist and herbologist at The Center for Energy Medicine in Los Angeles. “The size, the shape, the diameter, the color, the density… all stool diagnosis reflects organ diagnosis.” With everything from information about your diet and hydration level to insight into more serious conditions like gallstones, internal bleeding and celiac disease, your bowel movements are an important barometer of your overall health. So what is your poop telling you?
According to the American Gastroenterological Association, a healthy number of bowel movements can vary from three a day to three a week. Anything within that range is considered normal, but you should investigate if your personal BM schedule switches from one end of the spectrum to the other.
“Many people experience occasional irregularity, but constipation is generally defined as a condition in which a person has fewer than three bowel movements a week, has difficulty having a bowel movement or both,” explains Anish Sheth, MD, a gastroenterologist at the Princeton Medical Group in Princeton, N.J., and co-author of What’s Your Poo Telling You? If constipation symptoms recur regularly, it may indicate a condition such as irritable bowel syndrome.
If you find yourself visiting the lavatory to poop more than three times a day on a regular basis, check your diet. Outside of illness, factors such as lactose intolerance, alcohol, caffeine, and sugars and other sweeteners can all cause persistent diarrhea.
Size, Shape and Consistency
Believe it or not, there’s a scale designed to help you understand your poop. Doctors rate fecal samples based on the seven-point Bristol Stool Form Scale, with #1 being hard pellets associated with constipation and #7 classified as diarrhea. This chart, pictured below, shows you all about what the size, shape and consistency of your stool should look like.
The ideal poop should be made up of about 75 percent water and 25 percent waste and dead bacteria, explains digestive care expert and certified nutrition consultant Brenda Watson in her Poop Chronicles blog series. If waste moves too quickly through your intestines and becomes watery, you’ll end up with diarrhea (a #7 on the scale). Too little water or fiber and you’ll have constipation (#1). “For most people, a healthy bowel movement is soft and smooth, like a sausage or a snake,” explains Sheth. “On the seven-point Bristol Stool Form Scale, that’s somewhere between a #3 and a #5.”
Stool hue is greatly influenced both by your diet and the amount of bile (a yellow-green fluid that digests fat) in your stool. So what can you learn from looking at your poop color? Browns and greens are generally considered normal. A green-ish hue can just mean that your food is moving through your digestive system a bit more quickly, not allowing time for the bile to break down the food, or it may be due to iron supplements or even eating green vegetables. White-ish or clay-colored poop can signal a lack of bile in stool, possibly due to a liver infection or a bile duct obstruction. Certain medications that contain high doses of bismuth subsalicylate, like Pepto-Bismol, can also make stool look pale. Consult a doctor if you’re noticing clay-colored poop and haven’t been on any medications recently.
Two colors you should definitely be concerned about? Black and red, which can indicate gastrointestinal bleeding, warns Sheth, and are worth a call to your doctor. Black poop can be an indication of bleeding in the stomach or other segments of the upper gastrointestinal tract. If you’ve haven’t eaten beets or red food dye recently, bright red stools may also be a sign of bleeding in the lower intestinal tract or the presence of hemorrhoids.
Float or sink: What’s best for your BMs? Ideally, your bowel movements should sink, but slowly—not like you dropped a brick in the bottom of the toilet. According to the National Institutes of Health’s MedlinePlus, “floaters” are most often due to poor absorption of nutrients or an excess of gas in the stool, and are usually accompanied by increased flatulence. While they can also be caused by a gastrointestinal infection, they are usually diet-related and rarely a concern if they last just a day or two. The one exception: foul-smelling, greasy, floating stool. “This is more worrisome,” says Sheth. “It can indicate the presence of fat in the stool. This is never normal and often reflects an underlying problem in the GI tract.”
The Perfect Poop
So what is the “perfect poop”? It’s a delicate balance. “Healthy poop is well formed, not too light, not too dark, not too hard and not too soft, and without blood, pus or food in the stool,” says Sheth. “Bowel movements should be easy, non-urgent, without pain or cramps, and the person should ideally be without gas or bloating. Bowel movements should be complete with a feeling of full evacuation.” In other words, juuuuuust right.
Want to improve your poop? Add more fiber. Experts all agree that additional fiber in the form of whole grains, nuts, seeds, fruits and vegetables will improve your bowel movements and overall gut health. Also, don’t be shy about discussing your bowels with your doctor. “Infrequent bowel movements and constipation (with or without pain) don’t need to be tolerated,” says Sheth. “Candidly discuss your symptoms with a physician to help determine how to best manage your condition.” Finally, consider adding probiotics like kimchi or sauerkraut to your daily diet, or take it in supplement form. According to a study in the American Journal of Clinical Nutrition, taking a daily probiotic supplement improved participants’ poops by increasing the number of weekly bowel movements, helping to soften stools and making them easier to pass.