The down and dirty facts
Health-care professionals weigh in on what your stool could be saying to you
“Red blood is usually coming from the lower part of the intestines, whereas bleeding from higher up in the gut generally causes black tarry stool that has a distinctive, foul odour.” Dr. Michael Stewart Assistant professor, division of digestive care and endoscopy of Dalhousie University
Going to the bathroom is an activity most of us do on autopilot, until, of course, a day when we see extreme colour or texture changes in our bowel movements. We’re talking red, green, blue poop (and, yes, this does happen).
Your gut health, including your poop habits, can tell you a lot about your health — from simple things like, “Are you hydrating enough?” and “Does your diet contain enough fibre?” to more serious things like, “Is Crohn’s or colon cancer causing me to bleed through my rectum?”
Before we jump to health conditions, however, not all colour and texture changes are cause for worry, says Dr. Michael Stewart, shared assistant professor, division of digestive care and endoscopy of Dalhousie University.
“Anyone who has changed the diapers of a newborn baby after solid food is introduced knows that there can be significant changes in the stool when there are major changes in the diet. In adults, we can see these changes, as well, although usually they are less dramatic,” said Stewart.
Consuming beets can turn your stool red, blueberries and plums can cause blue poop and cake frosting and other foods with artificial food colouring can turn your stool “unusual colours,” shared the doctor. Even medications can alter the hue of your bowel movements — examples include Pepto-bismol and iron tablets.
“I frequently hear from people who become concerned when they start to see vegetative material in their stool,” added Stewart. “Most plant-based foods contain starches and cellulose that are not digested well by humans and end up excreted in the stool — think of seeds or the skins of vegetables.”
Diet, activity levels, your water-drinking habits, medications, supplements and even your mental health can cause changes in your poop.
Summerside naturopathic doctor Natalie Hennessey explained that anxiety and depression can result in unusual changes, too, because “much of our feel-good neurotransmitter — serotonin — can be found in the gut.”
WHEN SHOULD CHANGES IN STOOL BE A CAUSE FOR CONCERN?
Typically, while your poop habits could alert you of an underlying health condition, you’d also experience other symptoms, per the experts.
But, to break it down, there are certain health concerns your poop habits and stool texture and colour can tell you about.
Seeing blood in your stool, for example, is an obvious cause for concern.
“Red blood is usually coming from the lower part of the intestines, whereas bleeding from higher up in the gut generally causes black tarry stool that has a distinctive, foul odour,” explained Stewart.
Halifax-based naturopathic doctor Nadia Tymoshenko added that red stools can be indicative of rectal bleeding, haemorrhoids, fissures, polyps, inflammatory bowel disease (IBD) and colorectal cancer.
“Patients who have IBD — Crohn’s or ulcerative colitis — often have changes in stool as the first sign of a flare-up and catching these changes early can go a long way in seeking care before the symptoms become too challenging,” said Hennessey.
As for poop that’s pale beige, accompanied by yellowing skin or eyes, this could mean you’re experiencing trouble with your liver.
“Yellow, pale or greyish stools may be a sign of malabsorption, or liver, gallbladder or pancreas issues,” said Tymoshenko.
Something Hennessey often sees is gut-related changes in women going through perimenopause.
“Many women tend to experience constipation during this stage, but it’s also not uncommon to have women who are struggling with persistent nausea, diarrhea or a mix of constipation and diarrhea,” shared the expert.
Small intestine bacterial overgrowth and large intestine bacterial overgrowth can also be culprits, said Hennessey.
“While this is not always a major concern medically, it does often cause a lot of symptoms that can interfere with quality of life.”
The important thing is to note how long the bowel changes continue and see a physician about them if you’re concerned (and also if you’re experiencing other symptoms). For example, with something like Crohn’s, there could be abdominal cramping, fatigue, mouth sores, fever and weight loss. With collateral cancer, you might experience stomach pain, bloating, gas and constant tiredness.
SHOULD YOU BE LOOKING IN THE TOILET BOWL EVERY TIME YOU GO?
While this is partly a matter of personal preference, all experts agreed that it’s not a bad idea to pay attention to your poop.
But there’s no need to be obsessive about it, added Tymoshenko.
“I don’t believe we need to obsessively track all of our bowel movements or worry about every little variation that we notice, especially if they only last a few days. But if something seems off to you, please pay attention and listen to the warning signals your body may be giving you,” explained the naturopathic doctor.
And see your health-care provider about it.
According to Stewart, Nova Scotians older than 50 receive stool kits in the mail every two years.
“This test looks for microscopic blood in the stool that cannot be seen with the naked eye,” explained the physician, adding that if the test detects blood, a colonoscopy is arranged.
IS THERE SUCH A THING AS HEALTHY POOP?
All three doctors had somewhat different answers to this particular question. “Normal” isn’t a word Stewart would use on bowel movements. He explained that the general goal should be to aim for at least one “soft, easy-to-pass poop daily.”
“The colour, consistency and frequency of bowel movements relate largely to differences in diet, the microbiome, habits and functional variation between individuals,” said Stewart.
A lack of fibre in their diet is a concern with most people and this often leads to harder and less frequent bowel movements, Stewart added.
“I encourage most people I see to increase their intake of fruits and vegetables because of the many health benefits, but this is especially important for people who tend towards constipation,” he explained.
Consuming psyllium husk (which you can buy in bulk or in products like Metamucil) is an easy way to add fibre to your diet, according to Stewart. “Psyllium holds water inside the stool so that it is softer and bulkier.”
Hennessey shared that a healthy poop, while different for everyone, should be “O’henry-like or banana-like” — meaning it should be easy to pass, might have some minor cracks on the surface or just be smooth.
“Healthy stools generally don’t require bathroom fans to be left on for long periods of time (they aren’t overly odorous) and they don’t stain the bowl (a.k.a. they don’t leave “skid marks”). Healthy stools are free of undigested food (with exceptions for indigestible fibres like corn) and contain no blood,” added Hennessey.
Your poop should not be consistently runny or shaped like hard little balls every time you go, said Tymoshenko.
How long you spend on the toilet (it shouldn’t take more than 10 minutes) and whether or not you strain hard (which is not recommended) could also be indicators of how healthy your bowel movements are. Your poop should come out with little effort, not too much straining, and no pain, said Tymoshenko.
“In my clinical experience, I find most people report that they feel best when they have at least one bowel movement per day. One study concluded that normal frequency can vary from three times per week to three times per day. I recommend getting to know what your typical poops are like so that you will be more likely to notice if something is unusual for you.”